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Head 1. Cranium 1. 2 parts a. Neurocranium (brain box) Encloses the brain and its meninges, proximal parts of the cranial nerves and blood vessels It is formed by eight bones (a frontal bone, paired parietal bones, paired temporal bones, an occipital bone, a sphenoid bone and an ethmoid bone) Has a dome-like roof – the calvaria (skullcap) and a cranial base b. Viscerocranium Contains the orbits (eye sockets) and nasal cavities and includes the maxilla and the mandible Consists of 14 bones: 2 lacrimal bones, 2 nasal bones, 2 maxillae, 2 zygomatic bones, 2 palatine bones, 2 inferior nasal conchae, 2 mandible bones and 1 vomer bone 2. Anterior Aspect a. frontal bone Forms the skeleton of the forehead and articulates inferiorly with the nasal and zygomatic bones 1. supraorbital margin 2. supraorbital foramen 3. superciliary arch b. zygomatic bones Forms the prominences of the cheeks c. orbits Within the orbits are the: 1. superior orbital fissure 2. inferior orbital fissure 3. optic canals d. nasal region 1. nasion the bridge of the nose 2. piriform apertures are inferior to the nasal bones 3. nasal septum can see them through the openings of the piriform apertures 4. nasal conchae are curved bony plates that are located on the lateral wall of each nasal cavity e. maxillae the two maxillae form the whole upper jaw 1. intermaxillary suture suture that unites the two maxillae 2. alveolar process the maxillae contain alveolar processes that contain the dental alveoli (tooth sockets) and constitute the supporting bone for the maxillary teeth 3. infraorbital foramen f. mandible the U-shaped bone forming the lower jaw 1. mandibular teeth located in the alveolar processes of the mandible 2. mental foramina located inferior tot he 2nd premolar teeth 3. mental protuberance forms the prominence of the chin it is a triangular elevation on bone inferior to the mandibular symphysis 4. mandibular symphysis the region where the halves of the fetal bone fused

3. Lateral Aspect a. temporal fossa bounded superiorly and posteriorly by inferior and superior temporal lines, anteriorly by the frontal and zygomatic bones and inferiorly by the zygomatic arch ** the zygomatic arch is formed by the union of the temporal process of the zygomatic bone and the zygomatic process of the temporal bone** in the anterior part of the temporal fossa is the pterion, which is the point at which the frontal, parietal, sphenoid (greater wing) and temporal bones are united by an H-shaped formation of sutures b. external acoustic opening it is the entrance to the external acoustic meatus (the meatus leads to the tympanic membrane) c. mastoid process (part of temporal bone) lies posteroinferior to the external acoustic meatus d. styloid process (part of the temporal bone) located anteromedial to the mastoid process e. mandible 1. body the horizontal curved part of the mandible 2. ramus the vertical part of the mandible 3. angle the junction of the body and ramus 4. Posterior Aspect a. occiput the rounded posterior aspect of the cranium formed by the occipital bone, parts of the parietal bones, and mastoid parts of the temporal bones b. external occipital protuberance an easily palpable elevation in the median plane c. superior nuchal line marks the superior limit of the neck extends laterally on each side of the external occipital protuberance d. inferior nuchal line e. lambda located in the center of the occiput indicates the junction of the sagittal and lambdoid sutures can sometimes be felt as a depression 5. Superior Aspect a. coronal suture separates the frontal and parietal bones b. sagittal suture separates the parietal bones c. lambdoid suture separates the parietal and temporal bones from the occipital bone d. bregma the landmark formed by the intersection of the sagittal and coronal sutures 6. Cranial Base (external aspect) a. alveolar processes surround and support the maxillary teeth b. palatine processes forms part of the hard palate formed from the maxillae bones c. hard palate formed by the palatine processes of the maxillae anteriorly and the horizontal plates of the palatine bones posteriorly


d. incisive fossa located posterior to the central incisor teeth e. palatine foramina located in the palatine bones there are a greater and lesser foramina f. vomer a thin, flat bone that makes a contribution to the bony nasal septum g. sphenoid located centrally between the frontal, temporal and occipital bone consists of a body from which 3 pairs of processes arise: the greater and lesser wings and the pterygoid processes 1. pterygoid processes consists of medial and lateral pterygoid plates that extends inferiorly on each side from the junction of the body and greater wings h. mandibular fossae depressions in the temporal bone that accommodate the condyles of the mandible when the mouth is closed i. foramen magnum j. occipital condyles located on the lateral parts of the occipital bone are two large protuberances k. jugular foramen the large opening between the occipital bone and the petrous part of the temporal bone l. carotid canal the entrance is located anterior to the jugular foramen Cranial Base (internal aspect) a. anterior cranial fossa formed by the frontal bone anteriorly and laterally, the ethmoid bone centrally and the body and lesser wings of the sphenoid bone posteriorly 1. orbital plates of the frontal bone (frontal bone) 2. frontal crest (frontal bone) 3. crista galli (cock’s comb  ethmoid bone) 4. cribiform plate (ethmoid bone) b. middle cranial fossa the bones forming the larger, lateral parts of the fossa are the greater wings of the sphenoid, squamous parts of the temporal bones laterally and the petrous parts of the temporal bones posteriorly the boundary between the middle and posterior cranial fossae is formed by the petrous crests of the temporal bones laterally and the dorsum sellae of the sphenoid medially composed of deep depressions on each side of the sella turcica (turkish saddle), which is located on the upper surface of the body of the sphenoid 1. sella turcica surrounded by the anterior and posterior clinoid processes composed of three parts: a. tuberculum sellae the slight elevation anteriorly on the body of the sphenoid b. hypophysial fossa a saddle-like depression for the pituitary gland in the middle c. dosum sellae posteriorly, a square plate of bone on the body of the sphenoid form the posterior part of the sella turcica 2. foramen lacerum lies posterolateral to the hypophysial fossa 3. hypophysial fossa 4. optic canal lies between the root of the lesser wing


superior orbital fissure an opening between the greater and lesser wings 6. foramen rotundum 7. foramen ovale 8. foramen spinousum posterior cranial fossa formed largely by the occipital bone (parts of the sphenoid and temporal bones make smaller contributions to it) the broad grooves in this fossa are formed by the transverse and sigmoid sinuses 1. foramen magnum located at the center of the posterior cranial fossa 2. internal occipital crest located posterior to the foramen magnum is a landmark that divides the posterior part of the fossae into two cerebellar fossae the crest ends superiorly in the internal occipital protuberance 3. cerebellar fossae 4. internal occipital protuberance 5. jugular foramina located at the bases of the petrous crests (ridges) of the temporal bones 6. hypoglossal canals contains the hypoglossal nerves lies between the anterolateral margin of the foramen magnum and the jugular foramina



Face A. Muscles The muscles of the face are in the subcutaneous tissue They move the skin and change facial expressions to convey mood The muscles of facial expression also surround the orifices of the mouth, eyes and nose and act as sphincters and dilators that open and close the orifices The orbicularis oris is the sphincter of the mouth and is the first in a series of sphincters associated with the digestive tract The buccinator, active in smiling also keeps the cheek taut, thereby preventing it from folding and being injured during chewing. It is also active during sucking, whistling and blowing B. Nerves Cutaneous branches of the cervical nerves from the cervical plexus extend over the ear, the posterior aspect of the neck, and much of the parotid region (area overlying the angle of the mandible) The trigeminal nerve (CN V) is the sensory nerve for the face and the motor nerve for the muscles of mastication Three large groups of peripheral processes from nerve cell bodies comprising the trigeminal ganglion – the large sensory ganglion of CN V form the opthalmic nerve (V1), the maxillary nerve (V2) and the sensory component of the mandibular nerve (V3) [ the nerves are named according to their main regions of termination V1 and V2 are wholly sensory and V3 is largely sensory but also conveys fibers of the motor root of CN V The major cutaneous branches of V1 (ophthalmic nerve) are: Lacrimal nerve Supraorbital nerve Supratrochlear nerve Infratrochlear nerve External Nasal nerve The major cutaneous branches of V2 (maxillary nerve ) are: Infraorbital nerve Zygomaticotemporal nerve Zygomaticofacial nerve

The major cutaneous branches of V3 (mandibular nerve) are: Auriculotemporal nerve Buccal nerve Mental nerve The motor nerves of the face are the facial nerve (CN VII) to the muscles of facial expression and the mandibular nerve (V3) to the muscles of mastication (masseter, temporal, medial and lateral pterygoids) and to the mylohyoid, anterior belly of the digastric, tensor veli palatini and the tensor tympani The facial nerve exits the cranium through the stylomastoid foramen and has 6 main branches around the face (temporal, zygomatic, buccal, mandibular, cervical and posterior auricular nerves) C. Vasculature of the Face Most arteries supplying the face are branches of the external carotid artery The facial artery provides the major arterial supply to the face (terminates to the medial angle of the eye) It sends branches to the upper and lower lips (superior and inferior labial arteries) , to the side of the nose (lateral nasal artery) and then terminates as the angular artery, which supplies the medial angle of the eye The external carotid artery terminates into two branches – the superficial temporal artery and the maxillary The superficial temporal emerges on the face between the temporomandibular joint (TMJ) and the ear and ends in the scalp by dividing into the frontal and parietal branches The transverse facial artery arises from the superficial temporal artery within the parotid gland  it divides into numerous branches that supply the parotid gland and duct, masseter and skin of face The facial vein provides the major venous drainage of the face It begins as the angular vein (at medial angle of eye) which it formed by the union of the supraorbital and supratrochlear veins As the facial vein runs, it receives the deep facial vein (drains the pterygoid venous plexus of the infratemporal fossa) Inferior to the mandible, the facial vein is joined by the anterior branch of the retromandibular vein The facial vein drains directly into the internal jugular vein The superficial temporal vein drains the forehead and scalp It receives tributaries from the veins of the temple and face Near the auricle this vein enters the parotid gland The retromandibular vein is formed by the union of the superficial temporal and maxillary veins It divides into an anterior branch (that unites with the facial vein) and a posterior branch that joins the posterior auricular vein to form the external jugular vein The external jugular vein drains into the subclavian vein D. Lymphatics of the Face The lymphatic vessels accompany other vessels of the face Those from the lateral part of the face (including the eyelids) drain inferiorly to the parotid lymph nodes Lymph from the deep parotid nodes drains into the deep cervical lymph nodes Lymphatic vessels in the upper lip and lateral parts of the lower lip drain into the submandibular Lymphatic vessels in the chin and the central part of the lower lip drain into the submental lymph nodes E. Parotid Gland The largest of the salivary glands and is enclosed within a capsule called the parotid sheath (continuation of the investing layer of deep cervical fascia) Located anteroinferior to the external acoustic meatus where it is wedged between the ramus of the mandible and the mastoid process The parotid duct passes anteriorly and horizontally from the anterior edge of the gland  at the anterior border of the masseter, the duct turns medially, pierces the buccinator and enters the oral cavity opposite to the 2nd maxilllary molar tooth


Structures within the parotid gland (from superficial to deep): facial nerve and its branches, the retromandibular vein and the external carotid artery On the parotid sheath and within the gland are the parotid lymph nodes (receives lymph from the forehead, lateral parts of the eyelids, temporal region, lateral surface of the auricle, anterior wall of the external acoustic meatus and the middle ear) Lymph from the parotid nodes drains into the upper deep cervical lymph nodes The great auricular nerve (C2 and C3  branch of cervical plexus) innervates the parotid sheath and overlying skin The auriculotemporal nerve (branch of V3) passes superior to the parotid gland with the superficial temporal vessels The parasympathetic component of the glossopharyngeal nerve (CN IX) supplies secretory fibers to the parotid gland (fibers are conveyed from the otic ganglion by the auriculotemporal nerve)  stimulation causes secretion of saliva Sympathetic fibers are derived from the cervical ganglia through the external carotid nerve plexus on the external carotid artery Sensory fibers pass through the gland through the great auricular and auriculotemporal nerves Scalp Consists of skin and subcutaneous tissue that covers the neurocranium from the superior nuchal lines on the occipital bone to the supraorbital margins of the frontal bone Consists of 5 layers: Skin contains sweat and sebaceous glands and hair follicles; has good arterial supply and venous and lymph drainage Connective Tissue  forms the thick, dense, vascularized subcutaneous layer that is supplied with cutaneous nerves Aponeurosis  epicranial aponeurosis – a strong tendinous sheet that covers the calvaria b/w the frontal and occipital bellies of the occipitofrontal muscle Loose Connective Tissue has potential space that may distend with fluid resulting from injury or infection; allows free movement of the scalp proper over the underlying calvaria Pericranium  a dense layer of CT that forms the external periosteum of the calvaria; it is firmly attached by can be stripped easily, except where the pericranium is continuous with the fibrous tissue in the cranial structures The innervation of the scalp anterior to the auricles is by branches of all three divisions of the trigeminal nerve (CN V) The innervation posterior to the auricles is by spinal cutaneous nerves (C2 and C3) The arteries of the scalp run in layer 2 The arteries derive from the external carotid arteries through the occipital, posterior auricular and superficial temporal and from the internal carotid arteries by way of the supratrochlear and supraorbital Venous drainage of superficial parts of the scalp is through the supraorbital and supratrochlear veins, which begin in the forehead and descend to unite at the medial angle of the eye to form the angular vein that becomes the facial vein at the inferior margin of the orbit The superficial temporal veins and posterior auricular vein drain the scalp anterior and posterior to the auricles, respectively. The occipital veins drain the occipital region of the scalp Venous drainage of the deep parts of the scalp occurs via emissary veins that communicate with the dural sinuses In the temporal region, venous drainage occurs through the deep temporal veins, which are tributaries of the pterygoid venous plexus Lymphatic drainage of the scalp is into the superficial ring of lymph nodes (submental, submandibular, parotid, mastoid, and occipital. **there are no lymph nodes in the scalp Lymph from the superficial ring of nodes drains into the deep cervical lymph nodes along the IJV