head and neck anatomy exam 1

anatomic position

• arms are at the sides with the palms and toes directed forward

• eyes looking forward

• position is assumed even when the body may be supine (on the back) or prone (face down)

• the body standing erect

• (erect position, arms at sides, palms and toes directed forward with eyes looking forward)

anterior

• frontal of an area in relation to the entire body

• front of an area

posterior

• back of an area in relation to the rest of the body

• back of an area

anatomic nonmenclature

• system of names for anatomic structures

apex/apices

• pointed end/s of conical structure

contralateral

• structure on the opposite side

deep

• structure located inwards and away from surface

• more internal

• ex: the lungs are deep to the skin

distal

• area farther away from median plane

• farther from the origin of a body part of the point of attachment of a limb to the body trunk

• ex: the knee is distal to the thigh, or the distal surface of the tooth faces away from the median plane

dorsal

• back of area

• “dorsal fin”

• opposite of ventral

external

• outer side of wall of hollow structure

frontal plane/ coronal section

• plane related to imaginary line dividing body at any level into anterior and posterior parts

• splits body into ventral/ dorsal

frontal section

• section through any frontal plane

horizontal plane/ transverse section

• plane related to imaginary line dividing body at any level into superior and inferior parts

• splits body horizontally

• splits body into “hamburger” style

inferior

• area facing away from head and toward feet

internal

• inner side of wall of hollow structure

ipsilateral

• structure located on the same side

lateral

• area farther away from median plane

• to the side

medial

• area closer to median plane

• considered mesial within dentition

median

• structure at median plane

• exact midline

median plane

• plane related to imaginary line dividing body into right and left halves

midsagittal section/ median plane

• section through median plane

• section cuts body vertically into exact left and right halves

• cuts body “hot dog style”

proximal

• area closer to median plane

sagittal plane

• planes of body related to any imaginary plane parallel to medial plane

superficial

• structure located toward surface

superior

• area facing toward head and away from feet

transverse section

• section through any horizontal plane

• splits the body “hamburger style”

ventral

• front of area

• opposite of dorsal

anatomic variation

• there are often variation of head and neck structures

• number of bones and muscles is usually constant but some specific details may vary

• bones may have different sizes, muscles may differ in size and attachment details

frontal region of face

• includes forehead and the area superior to the eyes and is defined by the deeper skull bone

  • frontal eminence

  • supraorbital ridge

  • glabella

frontal eminence

• prominence of the forehead

• is usually more pronounced in children and adult females

supraorbital region

• directly inferior to each eyebrow

• more pronounced in males

glabella

• smooth and elevated area between the eyebrows

• tends to be flat in children and adult females

• forms a rounded prominence in adult males

parietal and occipital region

• both covered by the scalp and defined by the deeper skull bones

• consists of soft layers of tissue overlying the bones of the braincase

• large areas of scalp may additionally be covered by hair

temporal region

• within the temporal region is the temple, the superficial side of the head posterior to each eye, which is defined by the deeper skull bone

  • temple

  • posterior to eye

auricular region

• auricular region of each side of the head has the external ear as a prominent feature

  • external ear

    • auricle

    • helix

    • lobule

    • traugus

    • anti tragus

    • intertragic notch

  • external acoustic meatus

helix

• superior and posterior free margin of the auricle

• ends inferiorly at the lobule, the fleshy protuberance of the earlobe

• upper helix level with eyebrow and glabella

lobule

• the fleshy protuberance of the earlobe

• approximately at the level of the apex of the nose

tragus

• smaller flap of tissue of the auricles anterior to the external acoustic meatus

• flexible when palpated due to cartilage

antitragus

• the other flap of tissue opposite the tragus

intertragic notch

• between the tragus and antitragus

• small groove

the _ _ _ and _are important landmarks when taking certain radiographs and administering certain local anesthesia blocks

• external aucustic meatus

• tragus

external acoustic meatus

• tube through which sound waves are transmitted to the middle ear within the skull

auricle

• collects sound waves

orbital region

• orbit

• eye

• lacrimal glands

• medial canthus

• lateral canthus

orbit

• bony socket that contains the eyeball and its supporting structures

• formed by various skull bones

eye

• eyes usually meet near the midpoint of the vertical height of the head

• width of each eye is usually the same as the distance between the eyes

  • scelera (white)

  • iris (color)

  • pupil (center of iris, appears black and changes size due to light)

  • conjunctiva

lacrimal glands

• produce lacrimal fluid (tears)

conjunctiva

• delicate and thin membrane lining the inside of the eyelids and the front of the eyeball

lateral canthus

• canthi for plural

• the outer corners where the upper and lower eyelids meet

• also known as outer canthus

• important landmark for taking extraoral radiographs

medial canthus

• inner canthus

• inner angles of eye located lateral to root of nose

• important landmark when taking radiographs

nasal region

• contains the external nose

  • root of nose

  • nasion

  • bridge of nose

  • nares

  • nasal septum

  • alae

root of nose

• located between eyes

nasion

• inferior to glabella is a midpoint cephalometric landmark of the nasal region that corresponds with the junction between the underlying bones

• landmark for external radiograph

bridge of nose

• inferior to nasion is the bony structure of the skull that forms the __ of the nose

apex of nose

• formed by cartilage

• is flexible when palpated

nares

• nostrils

• inferior to the apex on each side of the nose

• the opening

• separated by the midline nasal septum

nasal septum

• formed by various skull bones and the adjoining nasal septal cartilage

• separates nares

• midline of nose

ala

• tissue surrounding nostrils

• winglike cartilaginous structures

• the width between the ale should be approximately the same width as one eye or the space between eyes

• landmark for external radiograph

infraorbital region

• located inferior to orbital region and lateral to nasal region

zygomatic region

• overlies cheekbone, the zygomatic arch

• extends from just inferior to the lateral margin of eye toward middle part of ear

• zygomatic arch is formed from various skull bones

temporomandibular joint (TMJ)

• inferior to zygomatic arch and anterior to middle ear

• upper skull forms joint with lower jaw

buccal region

• soft tissue of cheek

• includes the masseter muscle

  • felt when patient clenches teeth

oral region!

• includes

  • lips

  • oral cavity

  • palate

  • tongue

  • floor of mouth

  • part of throat

  • pharynx

vermillion zone

• has a darker appearance than the surrounding skin

• darker shade of lips

• width of lips should be approximately the same distance as between the irises of the eyes

mucocutaneous junction

• outline of lips at vermillion border

vermillion border

• the lips are outlined from the surrounding skin by the transition of the mucocutaneous junction at the __ __

philtrum

• superior to the midline of upper lip, extending downward from the nasal septum

• vertical groove of upper lip

tubercle

• inferior to philtrum

• midline of upper lip

• the midline of the upper lip terminates in a thicker area, or __ of the upper lip

labial commissures

• corners of mouth where upper and lower lips meet

nasolabial sulcus

• the groove running upward between each labial commissure and each ala of the nose

labiomental groove

• lower lip extends to the horizontally placed __

• separates the lower lip from the chin in the mental region

facial

• structure located closest to face

labial

• structure located closest to lips

buccal

• structures closest to inner cheek

lingual

• structures located closest to tongue

palatal

• structures that are closest to palate

vertical dimensions of face

• division of face into thirds

• when we age, or even lose teeth, there can be a loss of “vertical dimension” resulting in a sinking appearance

• used to compare portions of face for functional and esthetic purposes

golden proportions

• used in vertical dimension as a set of guidelines

• used to compare portions of face for functional and esthetic purposes

oral cavity is lined by __ mucosa

• the oral cavity is lined by oral mucosa

lips are lined with __ mucosa

• the inner parts of the lips are lined by a pink and thick labial mucosa

• is continuous with the equally pink and thick buccal mucosa

• can vary in color and pigmentation while still being healthy

cheeks are lined with __ mucosa

• buccal mucosa

• covers the buccal fat bad which is a dense pad of inner tissue

• can vary in color and pigmentation while still being healthy

parotid papilla

• located opposite to maxillary second molar

• a small elevation of tissue that protects the ductal opening of parotid salivary gland

• this is why buccal maxillary molars always should be checked for calculus

maxillary tuberosity

• tissue covered elevation on the posterior aspects of the maxilla just posterior to the most distal maxillary molar

retromolar pad

• dense pad of tissue just posterior to most distal mandibular molar

gingiva

• surrounds maxillary and mandibular teeth

• composed of a firm pink oral mucosa

attached gingiva

• the gingiva that tightly adheres to the bone around the roots of the teeth

• may also have localized areas of pigmentation

alveolar mucosa

• moveable, red mucosa that makes up the oral vestibules

mucogingival junction

• the line of demarcation between the firmer and pinker attached gingiva and the moveable and redder alveolar mucosa

• scallop-shaped

vestibules

• upper and lower horseshoe shaped spaced between lips and cheek anteriorly and laterally as well as the teeth and their soft tissues medially and posteriorly

vestibular fornix

• where the pink and thick labial or buccal musoca meets the redder and thinner alveolar mucosa at the mucobuccal fold

labial frenum

• fold of tissue located as the midline between the labial mucosa and the alveolar mucosa on both the maxilla and mandible

boundaries of oral cavity

• anteriorly - lips

• laterally - cheeks

• posteriorly and medially - teeth and gums

soft palate

• yellower and looser posterior part of the palate

• only compromises 15% of palate

  • uvula

  • median palatine raphe

uvula

• midline muscular structure

• hands from the posterior margin of soft palate

median palate raphe

• midline ridge of tissue on the palate

• runs from incisive papilla to the uvula

pterygomandibular fold

• extends from junction of hard and soft palates down to the mandible on each side just posterior to most distal mandibular molar

• stretches when patient opens mouth wider

pharyngeal part of tongue

• also known as the base of the tongue

• the posterior 1/3

• attaches to the floor of the mouth

• does not lie withing the oral cavity but within the oral part of the throat or pharynx

body of tongue

• anterior 2/3rds of the tongue

• lies within the oral cavity

• covered in lingual papillae on dorsal surface

  • filliform

  • fungiform

apex of tongue

• tip of the tongue

filliform tastebuds

• slender, threadlike papillae making tongue velvety