Anatomy Final Exam

muscles of facial expression

• in subcutaneous tissue of ant and post scalp, face, and neck

• attach to bone or fascia and produce their effects by pulling the skin

• innervated by CN VII & facial nerve

sensory innervation of facial skin

• CN V

  • ophthalmic (V1) = upper face

    • superior orbital fissure

  • maxillary (V2) = mid face

    • foramen rotundum

  • mandibular (V3) = lower face

    • foramen ovale

blood supply of face

• facial artery = branch of external carotid

  • inferior labial

  • superior labial

  • lateral nasal

  • angular

• superficial temporal = branch of external carotid

  • branches into transverse facial artery

    • feeds parotid gland & medial face

venous drainage of face

• facial vein

  • primary drainage of face

  • starts at angular vein

  • collects from deep facial vein

  • flows into internal jugular vein

parotid gland

• largest of 3 salivary glands

• embedded structures

  • facial nerve

  • external carotid artery

• parotid duct exits gland

• parasympathetic innervation from CN IX via otic ganglion

parotid duct

• exits parotid gland

• pierces buccinator & enters oral cavity

• delivers saliva

osteology of the neck

• cervical vertebrae

• manubrium of sternum

• clavicles

• hyoid bone

hyoid bone

• lies in the ant part of the neck at the level of the C3-C4 vertebrae

• does not directly articulate w/ other bone

  • only bone in body

• attachment for ant neck muscles & and a prop to keep the airway open

superficial cervical fascia

• layer of fatty connective tissue that lies between the dermis of the skin & the investing layer of deep cervical fascia

• contains platysma anteriorly

layers of deep cervical fascia

• superficial → deep

  • investing

  • pretrachael

  • prevertebral

  • carotid sheath

investing layer of deep cervical fascia

• most superfic deep fascia layer

• surrounds entire neck deep to the skin & subcut tissue

• splits into superfic & deeo layers to enclose trapezius & sternocleidomastoid (SCM) muscles

pretrachael layer of deep cervical fascia

• ant part of neck

• muscular part: encloses infrahyoid muscles

• visceral part: encloses thyroid gland, trachea, & esophagus

prevertebral layer of deep cervical fascia

• tubular sheath for the vert column & the muscles associated w/ it

carotid sheath in deep cervical fascia

• common & internal carotid arteries

• internal jugular vein

• vagus nerve (CN X)

• carotid sinus nerve

regions of superficial neck

• sternocleidomastoid region (A)

• post. cervical region (B)

• ant. cervical region (D)

• lateral cervical region (C)

lateral cervical region boundaries

• ant: post. border of SCM

• post: ant. border of trapezius

• inf: middle third of clavicle between trapezius & SCM

• apex: where SCM and trapezius meet on superior nuchal line of occipital bone

• roof: investing layer of deep cervical fascia

• floor: muscles covered by prevert layer of deep cervical fascia

subclavian artery parts

• named w/ respect to anterior scalene muscle

• medial (1)

• posterior (2)

• lateral (3)

arteries of the lateral cervical region

• two branches of thyrocervical trunk (1st part of subclavian)

  • transverse cervical trunk

  • suprascapular artery

• 3rd part of subclavian

• occipital artery

  • branch of external carotid at apex of cervical region

veins of the lateral cervical region

• external jugular

  • transverse cervical (cervicodorsal) vein

  • suprascapular vein

  • anterior jugular vein (not in lateral region)

• external jugular then drains into subclavian vein

nerves of lateral cervical region

• spinal accessory nerve (CN XI)

• roots of the brachial plexus

• suprascapular nerve

• roots of cervical plexus

• phrenic nerves

anterior cervical region boundaries

• ant: median line of neck

• post: ant border of SCM

• sup: inf border of mandible

• apex: jugular notch in manubrium

• roof: subcut tissue containing the platysma

• floor: pharynx, larynx, & thyroid gland

anterior cervical muscles

• suprahyoid

• infrahyoid

anterior cervical region arteries

• common carotid

  • internal & external

• carotid sinus at bifurcation of internal & external

  • baroreceptors in carotid sinus via carotid branch of CN IX to regulate bp

anterior cervical region veins

• internal jugular vein & tributaries

anterior cervical region nerves

CNs IX, X, XII

orbit

• bony cavities shaped like quadrangular pyramids w/ their bases directed anterolaterally & their apices posteromedially

• apex = optic canal

• base = orbital margin (surrounds orbital opening)

features of the orbit

• optic canal: CN II, ophthalmic artery

• superior orbital fissure: ophthalmic nerve (CN V1), CN III, IV, and VI

• lacrimal fossa: lacrimal gland (frontal bone)

• trochlear spine: for trochlear of sup. oblique (CN IV)

eyelids (conjunctiva)

• eyelids are covered externally by thin skin

  • internally by transparent mucous memb = palpebral conjunctiva

• palpebral conjunctiva is reflected onto the eyeball, where it is continuous w/ bulbar conjunctiva

  • attached to ant. surface (sclera) of the eyeball

eyelids part 2

• lines of reflection of palpebral conjunctiva onto eyeball form recesses of pockets

  • = sup. & inf. conjunctival fornices

• conjunctival sac (sup & inf) = space bound by palpebral & bulbar conjunctivae

• strengthened by dense bands of connective tissue = sup & inf tarsi

• medial palpebral ligament

• lateral palpebral ligament

medial & lateral palpebral ligaments

• medial = connects tarsi to medial margin of orbit

  • between nose & medial angle of eye

• lateral = attaches tarsi to lateral margin of orbit

eyelid glands

• tarsal glands

  • produce lipid secretion that lubricates edges of eyelids & prevent them from sticking tg when closed

• ciliary glands

  • large sebaceous glands associated w/ eyelashes

lacrimal apparatus

• includes:

  • lacrimal gland

  • excretory ducts of lacrimal gland

  • lacrimal canaliculi

  • nasolacrimal duct

lacrimal gland

• secretes lacrimal fluid (tears)

• = watery physiological saline containing bactericidal enzyme lysozyme

excretory ducts of lacrimal gland

• convey lacrimal fluid from lacrimal glands to conjunctival sac

lacrimal canaliculi

• drain lacrimal fluid to lacrimal sac

  • dilated sup part of the nasolacrimal duct

nasolacrimal duct

• conveys lacrimal fluid to inf. nasal meatus of nasal cavity

  • why nose drips when you cry

innervation of the lacrimal apparatus

• parasymp secretomotor fibers are conveyed from the facial nerve

• vasoconstrictive, postsynap symp fibers → brought from sup. cervical ganglion

• branches of V1 and V2 = also autonomic innervation

fascial sheath of eyeball

• connective tissue layer surrounds the eyeball

• post. forms actual socket for eyeball

layers of eyeball

• fibrous layer = outer coat

  • consists of sclera & cornea

• vascular layer = middle coat

  • consists of choroid, ciliary body, & iris

• inner layer = inner coat

  • consists of retina (optic & nonvisual part)

fibrous layer of eyeball

• sclera

  • tough, opaque part

  • covers post. 5/6 of eyeball (white part)

• cornea

  • transparent part

  • covers ant 1/6 of eyeball

• corneal limbus

  • angle formed by intersecting curvatures of sclera & cornea at corneoscleral jxn

sclera

• tough, opaque part of fibrous layer

• covers post. 5/6 of eyeball (white part)

cornea

• transparent part of fibrous layer

• covers ant 1/6 of eyeball

corneal limbus

• angle formed by intersecting curvatures of sclera & cornea at corneoscleral jxn

vascular layer of eyeball

• consists of choroid, ciliary body, and iris

choroid

• dark reddish brown layer between sclera & retina

• forms largest part of vascular layer of eyeball

• lines most of sclera

ciliary body

• ring-like thickening of vascular layer post to corneoscleral jxn

• contraction & relaxation of smooth muscle of ciliary body controls thickness of the lens

ciliary processes

• in vascular layer of eyeball

• secrete aqueous humor

  • clear watery fluid

  • fills ant. segment of eyeball

iris

• lies on ant. surface of lens

• thin contractile diaphragm w/ central aperture (pupil)

stimulation of iris

• parasymp (feeding and breeding) stimulated

  • circularly arranged sphincter pupillae

    • decreases diameter (constricts or contracts pupil)

• symp (fight or flight) stimulated

  • radially arranged dilator pupillae

    • increases its diameter (dilated pupil)

inner layer of the eyeball

• retina

• optic disc

• macula

retina

• sensory neural layer of eyeball

• consists of two fxnal parts w/ distinct

  • optic part

  • nonvisual retina (retinal tissue not involved in vision)

optic disc

• where sensory fibers & vessels conveyed by optic nerve (CN II) enter eyeball

  • contains no photoreceps

  • optic disc insensitive to light (blind spot)

macula

• small oval area of retina w/ special photoreceps cones that is specialized for acuity of vision

  • at center of macula = depression = fovea centralis

    • = area of most acute vision

chambers of the eye

• anterior

  • space between cornea ant and iris/pupil post

  • aqueous humor

• post

  • between iris/pupil ant and lens & ciliary body post

  • aqueous humor

• vitreous chamber

  • post. 4/5of eyeball post to lens

  • vitreous humor

lens

• post to iris and ant to vitreous humor

• ciliary muscle changes shape of lens

• para sympy stimulation via oculomotor nerve (CN III) → sphincter-like contraction of muscle

  • ring becomes smaller

  • tension on lens = reduced

• thickness of lens increases w/ age

common tendinous ring

• attachment for all four rectus muscle

arteries of the orbit

• blood supply mainly from ophthalmic artery

  • branch of internal carotid artery

• major branches

  • central retinal artery: branches from center of optic disc

  • lacrimal

  • short posterior ciliaries

  • long posterior ciliaries

central retinal artery supplies:

optic retina

lacrimal artery supplies

• lacrimal gland

• conjunctiva

• eyelids

short posterior ciliaries supplies

• choroid

  • in turn supplies cones & rods

long posterior ciliaries supplies

• ciliary body

• ribs

veins of the orbit

• through superior & inferior ophthalmic veins

• pass thru orbital fissure

• also central retinal vein

temporal region fossae

• temporal fossa

• infratemporal fossa

temporal fossa borders

• posterior & superior: by temporal lines

• ant: frontal & zygomatic bones

• lateral: zygomatic arch

temporal fossa contents

upper part of temporalis muscle

infratemporal fossa contents

• inferior to zygomatic arch

• inf part of temporalis muscle

• lat and med pterygoid muscles

• maxillary artery

• pterygoid venous plexus

• nerves:

  • mandibular (V3)

  • inf alveolar

  • lingual

  • buccal

  • chorda tympani nerves (CN VII)

• otic ganglion

maxillary artery

• branch of ext carotid

  • named according to relationship w/ lateral pterygoid

  • supplies lateral-deep face

• 1st part (mandibular): post to lat pterygoid

• 2nd part (pterygoid): adj to lat pterygoid

• 3rd part (pterygopalatine): ant to lat pterygoid

pterygoid plexus

• drains most of region supplied by branches of maxillary artery

• drains post into maxillary vein

• drains ant into facial vein

mandibular nerve (V3)

• inf alveolar = innervation of mandibular teeth

• lingual nerve = sensory to ant 2/3 of tongue

  • not taste

chorda tympani nerve

• branch of CN VII

• carries taste sensation from ant 2/3 of tongue

• joins lingual nerve in infratemporal fossa

bony articular surfaces of tempromandibular joint

• mandibular fossa of temp bone

• articulates w/ head of mandible

ligaments of tempromandibular joint

• lat ligament = thickened part of joint capsule

• 2 extrinsic ligaments = connect mandible to cranium

  • stylomandibular lig = from styloid process to angle of mandible

  • sphenomandibular ligament = from spine of sphenoid to lingula of mandible

oral cavity

• oral vestibule

• oral cavity proper

oral vestibule

• slit-like space between teeth and gingivae (gums) and lips and cheeks

oral cavity proper

• space between upper and lower dental arches of arcades

  • maxillary & mandibular alveolar arches and teeth they bare

gingivae (gums)

• composed of fibrous tissue covered w/ mucous memb

• gingiva proper

  • firmly attached to alveolar part of mandible & alveolar process of maxilla & necks of teeth

• ging proper adj to tongue = sup & inf lingual gingivae

• ging proper adj to lips & cheeks = buccal gingiva

number of teeth

• children = 20 deciduous

• adults = 32 permanent

• on each side of jaw (x4) (from ant → post)

  • 2 incisors (central & lateral)

  • 1 canine

  • 2 premolars (1st and 2nd)

  • 3 molars (1st-3rd)

parts of teeth

• crown = projects from gingiva (gums)

• neck = between crown and root

• root = fixed in tooth socket by periodontium

  • connective tissue surrounding roots

• dental alveolus = tooth socket

• most of tooth = composed of dentine

  • covered by enamel over crown & cement over the root

teeth pulp cavity

• contains connective tissue, blood vessels, & nerves

teeth root canal

• aka pulp canal

• transmits nerves & vessels to and from pulp cavity thru apical foramen

innervation of teeth

• branches of sup (CN V2) and inf (CN V3) alveolar nerves

• give rise to dental plexuses that supply maxillary & mandibular teeth

blood supply of teeth

• sup alveolar artery = supplies maxillary teeth

• inf alveolar artery = supplies mandibular teeth

• branches of maxillary artery

palate

• sep oral cavity from nasal cavities and nasopharnyx

  • hard palate ant

  • soft palate post

hard palate

• ant 2/3 of palate

• bony skeleton formed by

  • maxillae bones ant

  • palatine bones post

hard palate features

• incisive fossa

• intermaxillary suture

• greater palatine foramina

• lesser palatine foramina

soft palate

• movable post 1/3 of palate & is suspended from post border of hard palate

• palatine aponeurosis

  • attaches to post edge of hard palate

  • blends w/ post muscular part of soft

  • structural support

• uvula

  • conical process hanging from free margin of post soft palate

blood supply of oral cavity

• from maxillary artery

• greater and lesser palatine arteries

• enter thru corresponding greater and lesser palatine foramina

innervation of oral cavity

• from maxillary nerve (V2)

• greater and lesser palatine nerves

• enter thru corresponding greater and lesser palatine foramina

parts of the tongue

• root = attached post portion

  • extends between mandible, hyoid, and nearly vertical post surface of tongue

• body = ant 2/3 of tongue (between root and apex)

• apex = ant end of body

features of the tongue

• terminal sulcus = V shaped groove on post dorsum of tongue

• foramen cecum = depression at vertex of terminal sulcus

• midline groove = divides ant part of tongue into L and R

• lingual papillae = bumps on dorsum of tongue

  • some house taste buds

• frenulum = connects underside of tongue from floor of mouth posteriorly

tongue innervation

• motor

  • all intrinsic and extrinsic muscles of tongue (except 1) = supplied by CN XII

• sensory

  • ant 2/3

    • general sensory = lingual nerve of CN V3

    • taste = CN VII (chorda tympani)

  • post 1/3

    • general sensory and taste = CN IX

blood supply of tongue

• derived from lingual artery

• arise from external carotid artery

pretrachael layer of deep cervical fascia

• ant part of neck

• muscular part: encloses the infrahyoid muscles

• visceral part: encloses thyroid gland, trachea, & esophagus

visceral part of pretracheal fascia (layers)

1. endocrine layer = thyroid & parathyroid glands

2. respiratory layer = larynx & trachea

3. alimentary layer = pharynx & esophagus

thyroid gland

• part of endocrine layer of visceral pretrach fascia

• produces

  • thyroid hormone = controls rate of metabolism

  • calcitonin = hormone that controls calcium metabolism

• lies deep to sternothyroid & sternohyoid muscles

• consists of R and L lobes

  • anterolateral to larynx and trachea

  • relatively thin isthmus unites lobes over trachea

blood supply of thyroid gland

• sup thyroid arteries

  • 1st branches of external carotid arteries

  • supply anterosuperior aspect of gland

• inf thyroid arteries

  • largest branch of thyrocervical trunks

    • arise from subclavian arteries

  • supply posteroinf aspect of thyroid

parathyroid glands

• part of endocrine layer of visceral pretrach fascia

• produces parathyroid hormone = controls metabolism of phosphorous & calcium

• usually 4 → lie on medial half of post surface of each lobe of thyroid gland

blood supply of parathyroid glands

• inf thyroid arteries

• provide primary blood supply to post aspect of thyroid land were parathyroid glands are located

• branches of these arteries usually supply these glands

larynx

• part of resp layer of visceral part of pretrach fascia

• organ or voice production (the “voice box”)

• guards the air passages → especially during swallowing when it serves as the “sphincter” or “valve” of the lower resp tract

• connects inf part of pharynx (oropharynx) w trachea

laryngeal skeleton

• consists of 9 cartilages

• 3 single

  • thyroid

  • cricoid

  • epiglottic

• 3 paired

  • arytenoid

  • corniculate

  • cuneiform