ANATOMY OF THE HEAD, FACE AND NECK

Paired

○ Parietal (2)

○ Temporal (2)

What are the paired bones under neurocranium?

Unpaired

○ Frontal (1)

○ Occipital (1)

○ Sphenoid (1)

○ Ethmoid (1)

What are the unpaired bones under neurocranium?

Paired

○ Maxilla (2)

○ Zygomatic (2)

○ Palatine (2)

○ Lacrimal (2)

○ Nasal (2)

○ Inferior concha (2)

Paired bones under viscerocranium?

Unpaired

○ Mandible (1)

○ Vomer (1)

Unpaired bones under viscerocranium?

Pterion

Thinnest/softest part of the lateral aspect of skull?

Unossified membranous intervals

○ Anterior fontanelle - 18 months

○ Posterior fontanelle - 12 months

Unossified membranous intervals

○ Anterior fontanelle - __ months

○ Posterior fontanelle - __ months

• Skin

• Connective tissue

• Aponeurosis

• Loose Areolar Tissue

• Pericranium

Layers of the SCALP?

Blood Supply to the Scalp

Arteries and Veins:

○ Supratrochlear artery and vein

○ Supraorbital artery and vein

○ Superficial temporal artery and vein

○ Posterior auricular artery and vein

○ Occipital artery and vein

Olfactory Nerve

1st cranial nerve?

Nerve Type: Sensory

Function: Smell

What is the nerve type and function of the 1st nerve?

Optic Nerve

2nd cranial nerve?

Nerve type: Sensory

Function: Vision

What is the nerve type and function of the 2nd nerve?

Oculomotor

3rd cranial nerve?

Nerve Type: Motor

Function: Most eye movement

What is the nerve type and function of the 3rd nerve?

Trochlear

4th cranial nerve?

Nerve Type: Motor

Function: Moves eye outer and lower

What is the nerve type and function of the 4th nerve?

Trigeminal

5th cranial nerve?

Nerve Type: Both

Function: Face sensation, mastication

What is the nerve type and function of the 5th nerve?

Abducens

6th cranial nerve?

Nerve Type: Motor

Function: Abducts the eye

What is the nerve type and function of the 6th nerve?

Facial

7th cranial nerve?

Nerve Type: Both

Function: Facial expression, taste

What is the nerve type and function of the 7th nerve?

Vestibulocochlear

8th cranial nerve?

Nerve Type: Sensory

Function: Hearing, Balance

What is the nerve type and function of the 8th nerve?

Glossopharyngeal

9th cranial nerve?

Nerve Type: Both

Function: Taste, gag reflex

What is the nerve type and function of the 9th nerve?

Vagus

10th cranial nerve?

Nerve Type: Both

Function: Gag reflex, parasympathetic innervation

What is the nerve type and function of the 10th nerve?

Accessory

11th cranial nerve?

Nerve Type: Motor

Function: Shoulder shrug

What is the nerve type and function of the 11th nerve?

Hypoglossal

12th cranial nerve?

Nerve Type: Motor

Function: Swallowing, speech

What is the nerve type and function of the 12th nerve?

Eye muscles

Occipitofrontalis (surprise)

Surprise

Levator palpebrae superioris (eye opening)

Eye opening

Orbicularis oculi (eye closing)

Eye closing

Corrugator supercilli (frowning)

Frowning

Procerus (wrinkling the bridge of the nose)

Wrinkling the bridge of the nose

Orbicularis oris (lip closing and kissing)

Lip closing and kissing

Buccinator (cheek compression)

Cheek compression

Levator anguli oris (sneering)

Sneering

Levator labii superioris

Zygomaticus major and minor (smiling)

Smiling

Mentalis (pouting)

Pouting

Depressor anguli oris (sadness)

Sadness

Platysma (egad)

Egad

Risorius (grinning)

Grinning

Depressor labii inferioris (melancholy/irony)

Melancholy or irony

• Facial artery and vein

• Superficial temporal artery

2 blood supply to the face?

Arteries and veins:

Temporomandibular Joint

• Articulation: Occurs between the articular tubercle and the anterior portion of the mandibular fossa of the temporal bone above and the head (condyloid process) of the mandible below

● Type of joint: Synovial joint

● Movements: Mandibular depression, elevation, protrusion and retrusion and rotation

Mouth/Jaw Closing

MASTICATION MUSCLES

○ Temporalis

○ Internal/Medial pterygoid

○ Masseter

Mouth/Jaw Opening

MASTICATION MUSCLES

○ External/Lateral pterygoid

○ Digastric

○ Mylohyoid

○ Geniohyoid

Mouth/Jaw Retraction

MASTICATION MUSCLES

○ Temporalis

Mouth/Jaw Protrusion

MASTICATION MUSCLES

○ External/Lateral pterygoid

○ Internal/Medial pterygoid

○ Masseter

Lateral excursion/deviation

MASTICATION MUSCLES

○ Ipsilateral

■ Temporalis

■ Masseter

○ Contralateral

■ Medial pterygoid

■ Lateral pterygoid

7 vertebrae

How many vertebrae does cervical region have?

Atlas

Axis

C7

What are the 3 atypical vertebrae?

C1 (Atlas)

• (-) body, pedicle, lamina and spinous process

C2 (Axis)

• (+) odontoid process/dens

C7 (Vertebral prominens)

• Spinous process is not bifid

• Long, slender similar to thoracic vertebra

Anterior atlanto-occipital membrane

● Continuation of the ALL, which runs as a band down the anterior surface of the vertebral column

● The membrane connects the anterior arch of the atlas to the anterior margin of the foramen magnum

● Limits extension

Posterior atlanto-occipital membrane

● Similar to the ligamentum flavum and connects the posterior arch of the atlas to the posterior margin of the foramen magnum

● Limits flexion

Apical Ligament

Alar Ligament

Vertical part

CRUCIATE LIGAMENT

○ runs form the posterior surface of the body to the axis to the anterior margin of the foramen magnum.

Transverse part

CRUCIATE LIGAMENT

○ attached on each side to the inner aspect of the lateral mass of the atlas and bind the odontoid process of the anterior arch of the atlas.

Tectorial Membrane

An upward continuation of the Posterior Longitudinal Ligament (PLL)?

Anterior Longitudinal Ligament (ALL)

• Runs continuous from anterior surface of the vertebral column from skull to sacrum.

• Limits extension

Posterior Longitudinal Ligament (PLL)

• Runs continuous band down the posterior surfaces of the vertebral column form the skull to the sacrum

• Limits flexion

Supraspinous Ligament

Runs between the tips of adjacent spine?

Interspinous Ligament

This connects the adjacent spine?

Ligamentum Flavum

• Connects the laminae of the adjacent vertebrae.

• Continuation of tectorial membrane

Joints of the Neck

• Intervertebral joints

• Zygapophyseal joints

○ Facets are oriented 45 degrees to the transverse plane/ frontal plane

○ Inferior facets face: anteriorly and inferiorly

○ Superior facets face: posteriorly and superiorly

Anterior triangle

• Carotid triangle

• Digastric triangle (Submandibular)

• Submental triangle

• Muscular triangle

Posterior triangle

• Occipital triangle

• Supraclavicular triangle

Carotid triangle

• Contains the carotid arterial system (common carotid artery, IJV and vagus nerve)

• The carotid pulse can be palpated in this are

Digastric triangle

• AKA submandibular triangle

• Contains the submandibular gland and submandibular lymph nodes

Submental triangle

• Contains submental lymph nodes

Muscular triangle

• Anterior border of the SCM

• Floor of the triangle composed of:

○ Sternohyoid

○ Sternothyroid

Occipital triangle

• Superior to the omohyoid muscle

• Contains the spinal accessory nerve (CN XI), cutaneous branches of cervical nerves (C2-C4) and cervical lymph nodes

Supraclavicular triangle

• AKA omoclavicular triangle

• Supraclavicular fossa (subclavian arterial pulse)

• Subclavian artery

Bell’s Palsy

• Injury to the facial nerve (CN VII) or its branches produces paralysis of some or all facial muscles on the affected side

• The affected area sags, and facial expression is distorted, making it appear passive or sad