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head and neck part II

head and neck part II

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Published by hajajy

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Published by: hajajy on Jan 22, 2008
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09/17/2010

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I.Parotid Region
Boundaries:Posteriorly
mastoid processAnteriorly
ramus of the mandibleSuperiorly
the floor of the external acoustic meatusMedially
the styloid processThe posterior wall of this region extends between the mastoid and styloid processes and this the musclesattached to these processes (sternocleidomastoid, posterior belly of the digastric and the stylohyoid) areclosely related to the glandThe anterior wall of this region is formed by the ramus of the mandible and the two muscles applied to it(masseter and the medial pterygoid)The parotid gland is traversed by branches of the facial nerve, artery and vein
1.Structures of the Parotid Region1.Parotid Duct2.Transverse Facial Artery3.Facial Nervea.stem of the facial nerve
The first part of the facial nerve that emerges from the stylomastoid foramen
b.temporal branches of the facial nerve
Branches that go to the temporal region of the skullMay form two communications with the auriculotemporal nerve (a branch of V3)
4.Parotid Sheath
The parotid gland is enclosed within the parotid sheath
5.Auriculotemporal nerve
A branch of V3Carries secretory fibers to the parotid glandRuns toward the neck of the mandibleRuns medial and deep to the parotid gland
6.Retromandibular Vein7.External Carotid Artery
Runs through the parotid glandIs deeply placed and is sheltered by the ramus of the mandiblePosterior to the neck of the mandible, the external carotid divides into its two terminal branches:the maxillary artery and the superficial temporal artery
8.Maxillary Artery9.Superficial Temporal Artery10.Parotid Bed11.Posterior belly of the digastric12.StylohyoidII.Anterior Aspect of Skull and Face
The muscles of facial expression and the muscles of the scalp originate from the right and left 2
nd
branchialarchesThe nerve associated with the 2
nd
arch is CN VII (facial nerve) and thus innervates all facial muscles of expression, muscles of the scalp and external ear and the platysmaThe nerves associated with the 1
st
branchial arch is CN V (trigeminal nerve) and thus innervates all themuscles of masticationThe main part of the trigeminal nerve is sensory
each of the three divisions of this nerve(V1,V2,V3) supplies an area of skin in the facial regionThe central V shaped region (forehead, eyes and nose) is supplies by V1 (1
st
or ophthalmic division)The intermediate area (cheek) belongs to V2 (2
nd
or maxillary division)The lower part of the face (mandibular region) is supplied by sensory fibers from V3 (3
rd
or mandibular division)
 
A.FrontalisB.Facial Nerve, Vessels and Related Structures1.Platysma
Reaches as far inferiorly as the 2
nd
ribAttaches superiorly to the inferior border of the mandible
2.Masseter Muscle
Extends from the zygomatic arch to the ramus of the mandible
3.Parotid Duct
Crosses the lateral aspect of the masseter muscle (inferior to the zygomatic arch)An empty, collapsed and flattened ductAt the anterior border of the masseter, the duct makes a right angle turn and pierces the buccinator 
4.Transverse Facial Artery
Located superior to the parotid duct, near the buccinator muscle
5.Branches of the Facial Nervea.Temporal Branch
The highest branch of the facial nerveCrosses the zygomatic bone
b.Zygomatic Branch
Has interconnection with the buccal branch
c.Buccal Branch
Has interconnection with the zygomatic branch
d.Cervical Branch
The lowest branch of the facial nerveRuns below the angle of the mandibleSends “twigs” to the platysma
6.Buccal Fat Pad
Is located anterior tot he masseter 
7.Buccinator Muscle
Located under the buccal fat padThe parotid duct pierces this muscleTwo different nerves enter the substance of the buccinator: the buccal branch of the facial nerve
runs lateral to the masseter to supply the buccinator with motor fibers and the buccal branch of thetrigeminal nerve (V3)
runs medial to the masseter and does not supply the buccinator; it sendssensory fibers to the buccal mucosa of the vestibule of the mouth
8.Buccal Branch of the Trigeminal Nerve
V3Runs medial to the masseter and does not supply the buccinator; it sends sensory fibers to the buccal mucosa of the vestibule of the mouth
9.Facial Artery
Crosses the mandible at the anterior border of the masseter Travels to the medial angle of the eye
10.Facial Vein
Lies posterior to the facial arteryTravels to the medial angle of the eye
C.Muscles of the Mouth1.Depressor Anguli Oris
Depresses the corners of the mouthIs aided by the posterior fibers of the platysma
2.Zygomaticus Major
Descends from the zygomatic bone to the corner of the mouthDraws the angle of the mouth superiorly and inferiorly
3.Levator Labii Superioris
Descends from the infraorbital margin to the upper lipIt elevates the upper lip
4.Orbicularis Oris
 
The important sphincter muscle of the mouthIts muscular fibers have a circular arrangmentThe muscle fibers blend in with fibers from other muscles of the mouth
5.Buccinator
Its superior and inferior attachments are to the lateral surfaces of the alveolar process of themaxilla and mandibleBuccinator fibers blend in with the muscle fibers of the orbicularis oris
D.Infraorbital Nerve
Sends branches to the inferior eyelid, side of the nose and upper lip
E.Lower Lip1.Labial Glands
Small glands that are located immediately deep to the mucus membrane
2.Inferior Labial Artery
Located at the red line of the lipA branch of the facial artery
3.Mental Nerve
These nerve branches ascend in the flap of the lower lipTraverses the mental foramen
4.Mental Foramen
The mental nerve traverses this foramen
F.External Nose1.Nasal Cartilages
The nose is held in shape by these hyaline cartilages
2.Lateral Nasal Cartilages
Paired cartilagesLocated adjacent to the inferior borders of the two nasal bonesThey are not independent structures, but are triangular expansions of the large septal cartilage
3.Septal Cartilages
A median, unpaired cartilage
4.Alar Cartilage
Located on each side of the septal cartilageU-shaped cartilages that are responsible for the formation of the nares (nostrils)
G.External Ear1.Auricle
The characteristic shape of the auricle is maintained by a single piece of elastic cartilageThere is no cartilage in the lobule
a.Helix
The prominent rim
b.Antihelix
The curves prominence anterior to the helix
c.conchad.tragus
Usually shows hairs on the medial surface
e.antitragusf.lobule2.External Acoustic Meatus
The external ear canal
H.Inspection of Eye and Eyelids1.Tarsus
Located superior and inferior 
2.Medial Palpebral Ligament
A fibrous band that is located deep to the medial commissure
3.Margins of the Eyelids
Are flat and thick They carry double or triple irregular rows of eyelashes or cilia

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