Anatomy 1C Joshua Montelibano 1st shift 2015-2016

HEAD AND NECK

THE SCALP AND SKULL

Consists of 5 layers: SCALP
 First 3 layers – intimately bound together, move as 1 unit
 Inner 2 layers – closely adhere to cranial vault

SKIN
 Thin epidermal layers and a thick dermis (thickest a occipital area)
 With hair follicles and sebaceous glands

CONNECTIVE TISSUE (Subcutaneous tissue)

 Fibrofatty – small fat lobules held by shout fibrous septa
Fibrous septa – unites skin to underlying aponeurosis
 Numerous arteries and veins - branches of the external and internal carotid
arteries
 Presence of inelastic fibers – prevents vessels from retracting (contributes to
profuse bleeding during injuries)

APONEUROSIS (Galea aponeurotica)

 Thin, tendinous sheet (glistening structure)
 Unites occipital and frontal bellies of the occipitofrontalis muscle
 Subaponeurotic space – potential space beneath aponeurosis
Muscle of the Scalp
LOOSE AREOLAR TISSUE Occipitofrontalis muscle
 Occupies subaponeurotic space – separates first 3 layers from pericranium
 With few small arteries and important emissary veins Origin Action
 Emissary veins – valveless; connect superficial scalp veins with diploic veins of the Superior nuchal line Move scalp on skull
Occipital belly
skull and intracranial venous sinuses
Skin and superficial Raise eyebrows
Venous Sinus Thrombosis – scalp infection through the emissary veins Frontal belly fascia of eyebrows
PERICRANIUM
 Periosteum covering skull bones Insertion: Aponeurosis (Galea aponeurotica)
Innervation: Facial nerve
 Loosely attached to covered bone except at sutural junction
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

Sensory Nerve Supply

1. Supratrochlear nerve  Branch of the ophthalmic division of the trigeminal nerve
2. Supraorbital nerve  Supplies scalp close to the median plane
3. Zygomaticotemporal  Branch of the maxillary division of the trigeminal nerve
nerve  Supplies scalp over the temple
4. Auriculotemporal  Branch of the mandibular division of the trigeminal nerve
nerve  Ascends over temporal region in front of the auricle
 Branch of the cervical plexus
5. Lesser occipital nerve
 Supplies scalp over lateral part of occipital region

nd
6. Greater occipital Branch of the posterior ramus of 2 cervical nerve
nerve  Supplies skin up to skull vertex

Arterial Supply
1. Supratrochlear artery  Branch of the ophthalmic artery
2. Supraorbital artery  Ascend over forehead in the median plane
 Smaller terminal branch of the external carotid artery
3. Superficial temporal
 Divides into anterior and posterior branches
artery
 Supplies over frontal and temporal regions
4. Posterior auricular  Branches of the external carotid artery
artery  Supplies skin behind the auricle and back of the scalp
5. Occipital artery
*Branches of the ECA – Superficial temporal artery, Posterior auricular artery, occipital artery

Venous Drainage
1. Supratrochlear vein  Unites at medial orbit margin
2. Supraorbital vein  Forms facial vein
 Unites with maxillary vein in parotid gland substance
3. Superficial temporal
– forms retromandibular vein
vein
4. Posterior auricular  Unites with posterior division of the retromandibular vein
*Supratrochlear + Supraorbital – forms facial vein
vein - forms external jugular vein
*Superficial temporal + maxillary vein – forms RMV
5. Occipital vein
 Drains into suboccipital venous plexus into the internal jugular
vein
*Posterior auricular + RMV – forms external jugular
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

SKULL
BASE OF THE SKULL
Cranium components Facial bone components Anterior Cranial Fossa Middle Cranial Fossa Posterior Cranial Fossa
(Neurocranium) (viscerocranium)  Lodges frontal loves of  Lodges temporal lobe of the  Lodges cerebellum, pons,
8 bones: 14 bones: cerebral hemispheres cerebrum, auditory cortex, and medulla oblongata
 Frontal: 1  Vomer: 1 and vestibular pathways
 Occipital: 1  Mandible: 1 Anterior: inner surface of frontal Anterior: petrous part of the
 Sphenoid: 1  Zygomatic bones: 2 bone (with crest in midline for falx Anterior: lesser wing of sphenoid temporal bone
 Ethmoid: 1  Maxillae: 2 cerebri) Posterior: petrous parts of Posterior: squamous part of
 Temporal: 2  Nasal: 2 Posterior: lesser wing of sphenoid temporal bone occipital bone
 Parietal: 2  Lacrimal: 2 Floor: orbital plates of the frontal Lateral: squamous parts of Floor: basilar, condylar, and
 Palatine: 2 bone temporal bone squamous parts of the occipital
 Inferior conchae: 2 Medial: Cribiform plate of the Floor: greater wing of the sphenoid bone; mastoid part of temporal
ethmoid and parietal bones

Cribiform plate perforations – for

olfactory nerves
Important openings in base of the skull and structures that pass
Skull opening Bone of Skull Structures Transmitted
Anterior Cranial Fossa
Perforations in cribriform plate Ethmoid Olfactory Nerves
Middle cranial Fossa
Optic canal Lesser wing of sphenoid Optic nerve, ophthalmic artery
Superior orbital fissure Lacrimal, frontal, trochlear, oculomotor , nasociliary,
Between lesser and greater wings of sphenoid
and abducent nerves; superior ophthalmic vein
Foramen rotundum Maxillary division of trigeminal nerve
Foramen ovale Greater wing of sphenoid Mandibular division of trigeminal nerve
Foramen spinosum Middle meningeal artery
Foramen lacerum Between petrous part of temporal and sphenoid Internal carotid artery
Posterior Cranial Fossa
Foramen magnum Medulla oblongata, spinal part of accessory nerve
Occipital
Hypoglossal canal Hypoglossal nerve
Jugular foramen Between petrous part of temporal and condylar part of occipital Glossopharyngeal, vagus, and accessory nerves
Internal acoustic meatus Petrous part of temporal Vestibulocochlear and facial nerves
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

THE FACE
Skin of the face
Distinguishing features of the skin of the face:
1. Numerous sweat and sebaceous glands
2. Connected to bones by loose connective tissue
3. NO DEEP FASCIA IN THE FACE

Wrinkles
 Due to repeated folding of skin perpendicular to the
long axis of underlying muscles
 Loss of skin elasticity

Sensory Innervation of the Face

 Great auricular nerve – supplies small area over the angle
of the mandible and parotid gland
 Branches of the 3 divisions of the Trigeminal nerve –
supplies skin of the face and proprioceptive fibers to
underlying facial expression muscles

Sensory Nerve Supply

TRIGEMINAL NERVE
OPHTHALMIC NERVE MAXILLARY NERVE MANDIBULAR NERVE
Supplies region from the frontonasal process (around Supplies region from maxillary process of the Supplies region developed from the mandibular
st st
forehead and anterior part of the scalp regions) 1 pharyngeal arch process of the 1 pharyngeal arch

1. Lacrimal nerve – skin and conjunctiva of lateral 1. Infraorbital nerve – direct continuation 1. Mental nerve – skin of lower lip and chin
part of the upper eyelid of maxillary nerve; skin of lower eyelid, 2. Buccal nerve – skin over the small area of the
2. Supraorbital nerve – skin and conjunctiva on cheek, side of the nose, upper lip cheek
central part of upper eyelid, forehead skin (around infraorbital area) 3. Auricotemporal nerve – skin of the auricle,
3. Infratrochlear nerve – skin and conjunctiva on 2. Zygomaticofacial nerve – skin over external auditory meatus, outer surface of the
medial part of the upper eyelid, lower part of prominence of the cheek tympanic membrane, and the scalp above the
forehead 3. Zygomaticotemporal nerve – skin over auricle
4. External nasal nerve – skin on side of the nose to the temple (around the zygomatic arch)
the tip
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

Arterial Supply Venous Drainage

2 main blood supply vessels: facial artery & superficial temporal artery Facial Vein
 Formed at medial angle of the eye
Facial Artery  Union of supraorbital vein + supratrochlear vein
 Arises from External Carotid artery  Connected to cavernous sinus by the superior ophthalmic vein -
 Pulsation can be felt around the inferior margin body of the clinically important: pathway for speared of infection in the face
mandible at the anterior border of the masseter muscle
 Covered by platysma and risorius muscles *CAVERNOUS SINUS THROMBOSIS
 Bounded by the nose, eye, and upper lip
Commencement: Level of the hyoid bone  Dangerous zone for an infection
Termination: medial angle of the eye
Angular artery anastomoses with ophthalmic artery Commencement: medial angle of the eye
(Ophthalmic artery is a branch from the internal carotid artery) Drainage: Internal Jugular vein

Course: Tributaries
1. Starts from ECA at the level of the hyoid bone  Opposite with the branches of facial artery
2. Arch upward and over the submandibular salivary glands
3. Curves around inferior margin of the mandible  Deep facial vein - joins it to the pterygoid venous plexus
4. Runs upward toward the angle of the mouth  Superior ophthalmic vein – joins it to the cavernous sinus
5. Ascends into zygomaticus muscles and levator labii superioris muscle  Transverse facial vein – joins the superficial temporal vein with the
6. Runs alongside of the nose terminating at medial angle of the eye parotid gland

Branches Muscles of Facial Expression

1. Submental  Supplies skin of chin and lower lip  Embedded in superficial fascia, arise
artery  At lower border of mandible from skull bones, inserted in the skin
 All muscles are developed from the 2
nd

2. Inferior labial  Near the angle of the mouth pharyngeal arch and supplied by facial
artery  Supplies lower and upper lip nerve
 Inferior: anastomoses with ILA at other side  Orifices of the face: orbit, nose, mouth
3. Superior labial  Superior: gives branches to septum and ala of the – guarded by eyelids, nostrils, lips
artery nose
Function:
4. Lateral nasal 1. Serve as sphincters and dilators
 Supplies skin on the side and dorsum of the nose
artery for the orifices
2. Modify facial expression
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

Muscles of Facial expression

Origin Insertion Action
Muscles of the Eyelids
Orbicularis oculi Palpebral: blinking, closes eyelids and
 Palpebral part Medial palpebral ligament Lateral palpebral raphe dilates lacrimal sac
 Orbital part Orbital: tightly closes eye for protection
Corrugtor Supercilii Superciliary arch Skin of eyebrow Vertical wrinkles of forehead
Anterior surface and upper margin of
Levator palpebrae superioris Back of orbital cavity Raises upper lid (dilation)
superior tarsal plate
Occipital bone, skin and superficial
Occipitofrontalis Epicranial aponeurosis Moves scalp and raises eyebrows
fascia of the eyebrows
Muscles of the Nostrils
Compressor naris Frontal process of maxilla Aponeurosis of nose bridge Compresses mobile nasal cartilages
Dilator naris Maxilla Ala of nose Widens nasal aperture
Procerus Nasal bone Skin between eyebrows Wrinkles skin of the nose
Muscles of the Lips and Cheeks
Orbicularis Oris Maxilla, mandible, and skin Encircles oral orifice Compresses lips together

Levator labii superioris alaeque

nasi Infraorbital margin

Levator labii superioris

Levator anguli oris Canine fossa
Zygomaticus major Skin around the lips Separate lips
Zygomatic bone
Zygomaticus minor
Depressor anguli oris Anterolateral base of the mandible
Depressor labii inferioris Margin of the lower lip
Risorius Parotid fascia
Mentalis Symphysis menti
Outer surface of alveolar margins Angle of the mouth into upper and lower
of the maxilla and mandible lips
Buccinator Compresses cheeks and lips against the
opposite the molar teeth Forms layer of the cheek and orbicularis
(Cheek muscle) teeth
oris muscle
Pterygomandibular ligament Pierced by the parotid duct
*Masseter (Trigeminal nerve) Zygomatic arch Lateral surface ramus of mandible Elevates mandible to occlude teeth
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

THE NECK
Neck boundaries SUPERFICIAL FASCIA OF THE NECK
1. Cutaneous Nerves
Superior: lower margin of the mandible
Lesser Occipital Nerve Supplies skin over lateral part of occipital region
Inferior : upper border of the clavicle and the suprasternal notch
(C2) and behind
Anterior: Median line of the neck
Great auricular nerve Supplies skin over angle of the mandible, parotid
Posterior: Sternocleidomastoid muscle
(C2,3) gland, and auricle surfaces
Transverse cutaneous Supplies skin on the anterior and lateral surfaces
Skin of the neck
nerve (C2, 3) of the neck – body of the mandible to the sternum
 Natural lines of cleavage – run horizontally around the neck
 Medial – supplies skin as far as the median
*Important clinically – incision along cleavage will heal as a narrow scar
plane
 Skin over trapezius muscles and back on the scalp – supplied by posterior
Supraclavicular nerve  Intermediate – supplies skin of the chest wall
rami of cervical nerves 2-5 (greater occipital nerve)
(C3, 4)  Lateral – supplies skin over the shoulder and
 Skin in front and sides of the neck – supplied by anterior rami of cervical
upper half of the deltoid, posterior aspect of
nerves 2-4 through the cervical plexus
the shoulder up to scapula spine
*Branches emerge from beneath the posterior border of the
sternocleidomastoid muscle 2. Platysma
3. Superficial Veins
Commencement: behind the angle of the
mandible
Union: Posterior auricular vein + posterior division
External Jugular Vein
of the RMV
Termination: behind middle portion of the clavicle
Drainage: Subclavian vein
Commencement: below the chin
Jugular arch: union of 2 anterior jugular veins
Anterior Jugular Vein
above the suprasternal notch; drains into the EJV
(AJVJugular arch EJV)
4. Superficial Lymph Nodes
 Lie along external jugular vein superficial to SCM
 Receive lymph vessels from occipital and mastoid lymph nodes
 Drainage: deep cervical lymph nodes
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

DEEP CERVICAL FASCIA OF THE NECK

 Thick layer, encircles the neck, encloses trapezius and SCM

Superior: Hyoid bone and lower border of mandible

Inferior: Upper border of manubrium, along clavicle to the acromion
and scapula spine
Investing
layer  BURN’S SPACE (Supraclavicular space) – attaches to spinous
processes; located at manubrium with sterna heads and anterior
jugular vein
 PAROTIDEO- MASSETERIC FASCIA – extension; covers side of face
and parotid gland
 Thin layer, attached above laryngeal cartilages
 Dangerous area of the neck – direct continuation with pericardium

Superior: Hyoid bone

Inferior: descends to thoracic cavity blending with adventia of great
vessels and fibrous epricardium
Pretracheal
layer Extensions:
 Prethyroid lamina
 Surrounds thyroid and parathyroid gland
 Encloses infrahyoid muscles
 BERRY’S LIGAMENT (Lateral thyroid ligament) – attaches thyroid
gland to cartilage
 BUCCO-PHARYNGEAL FASCIA – posterior of the esophagus
*Carotid sheath
 Thick layer, forms fascial floor of posterior triangle
 Local condensation of investing, pretracheal, and prevertebral
 Passes behind the pharynx and esophagus in front of prevertebral
layers
muscles and prevertebral column
 Surrounds the CCA, ICA, IJV, Vagus nerve, and deep cervical lymph
Prevertebral nodes
Superior: base of occipital bone
layer Inferior: posterior mediastinum in thoracic cavity
*Axillary sheath
 Extends laterally over 1 rib into the axilla – forms axillary sheath
st  Encloses brachial plexus and subclavian artery
 Blends with bucco-pharyngeal fascia and pharyngo-basilar fascia  Extends to axilla; from between scalenus anterior and medius
 Splits into 2: Alar fascia (anterior), preverterbral fascia (posterior)
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

Triangles of the Neck

 Divided into anterior and posterior triangles by the sternocleidomastoid muscle
 Covered by skin, superficial fascia, platysma, and the investing layer of the deep cervical
fascia

ANTERIOR triangle of the neck

Palpable structures within the anterior triangle

1. Hyoid Bone – below the inferior border of the mandible, attaches to tongue
2. Laryngeal prominence (Adam’s apple) – projects superior angular process of thyroid
cartilage; with thyrohyoid membrane
3. Thyroid cartilage
4. Cricoid cartilage – signet ring shape, only complete ring among neck cartilages
Attached with cricothyroid muscles and cricothyroid membrane

Anterior: midline of the neck

Posterior: anterior border of the sternocleidomastoid
Superior: lower border by the body of the mandible

Subdivided into smaller triangles by the anterior and posterior bellies of the digastric and the
superior belly of the omohyoid
1. Digastric triangle (Submandibular triangle)
 With submandibular gland
(opens at the floor of the mouth via Wharton’s duct)
Superior: lower border of the mandible
Inferior: posterior belly of the digastric and stylohyoid
Floor: Mylohyoid
2. Submental triangle
 Bounded by anterior bellies of the digastric, floor: mylohoid
 Contains lymph nodes, fats, and small veins POSTERIOR triangle of the neck
(Commencement of AJV)
3. Carotid triangle Anterior: posterior border of the sternocleidomastoid muscle
 Contains CCA, IJV, and Vagus Nerve Posterior: anterior border of the trapezius
Superior: Bellies of posterior digastric and stylohyoid Inferior: clavicle
Posterior: Anterior border of the SCM
Anterior: Anterior belly of the omohyoid
 Subdivided by the inferior belly of the omohyoid into
4. Muscular triangle
occipital triangle and supraclavicular triangle
 Pretracheal of infrahyoid muscles (Strap muscles) – ensheathed by
pretracheal layer
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

Muscles of the anterior triangle of the neck

Origin Insertion Innervation Action
 Anterior surface of
Sternoclediomastoid 2 muscles acting together
manubrium Mastoid process of temporal Spinal part of accessory nerve
 Sternal head Extend head, flex neck, rotates
 Superior surface of the and occipital bone and C2 and C3
 Clavicular head head
clavicle
Deep fascia over pectoralis Body of mandible Depresses mandible and angle
Platysma Facial Nerve cervical branch
major and deltoid Angle of the mouth of the mouth
Digastric  Body of mandible
Intermediate tendon held by Depresses mandible
 Anterior belly  Mastoid process of  Nerve to mylohyoid
hyoid Elevate hyoid bone
 Posterior belly temporal bone  Facial nerve
Stylohyoid Styloid process Hyoid bone Facial nerve Elevates hyoid bone
Elevates mouth floor and
Mylohyoid line of boy of
Mylohyoid Hyoid bone and fibrous raphe Inferior alveolar nerve hyoid bone
mandible
Depresses mandible
Oblique line on lamina of
Sternothyroid Manubrium sterni Depresses larynx
thyroid cartilage
Omohyoid  Upper margin of scapula Intermediate tendon held to
st
 Inferior belly and subscapular ligament clavicle and 1 rib by fascial Ansa cervicalis (C1,2,3)
 Superior belly  Hyoid bone sling
Manubrium sterni Depresses hyoid bone
Sternohyoid
Clavicle Hyoid bone
Oblique line on lamina of st
Thyrohyoid 1 cervical nerve
thyroid cartilage
Hyoid bone Sternocleidomastoid Muscle
 Found in midline of the neck below the mandible  Oblique band crossing side of the neck
 U shaped; body has 2 greater and 2 lesser cornua  Divides neck into anterior and posterior triangles
 Attached to skull by stylohyoid ligament; to thyroid cartilage by  Anterior border – covers carotid arteries, IJV, and deep cervical lymph
thyrohyoid membrane nodes; overlaps thyroid gland
 Covered superficially by skin, fascia, platysma, and EJV
Ansa Cervicalis Superior root
 Loop of nerves part of the cervical plexus  Branches of the spinal nerves C1 and C2
 Superficial to IJV and carotid sheath  Travel in hypoglossal nerve before separating in carotid triangle forming the superior root
 Innervate 3 of the 4 infrahyoid muscles  Innervates superior belly of omohyoid, upper parts of sternohyroid and sternohyoid
 Roots: Superior root and inferior root Inferior root (Descendens cervicalis)
 Spinal nerves C2 and C3; inferior belly of omohyoid, lower parts of sternothyroid and sternohyoid
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

Arteries of the Head and neck

Carotid body
-Between ECA and ICA (at bifurcation) Superior thyroid artery
Arch of the aorta
-Innervated by glossopharyngeal nerve
Left Subclavian -Chemoreceptor – sensitive to high O2, Co2, and Ascending pharyngeal artery
artery
H2O
Lingual artery Submental artery

Inferior labial artery

Facial artery
Left Common External Carotid
carotid artery artery Superior labial artery
Right Subclavian Occipital artery
artery Lateral Nasal artery
Posterior auricular artery
Brachiocephalic
artery Superficial temporal artery

Right Common Maxillary artery Middle Meningeal artery

carotid artery
Supratrochlear artery
Opthalmic artery
Supraorbital artery

Internal carotid Posterior Communicating artery

artery
Carotid sinus Anterior Cerebral artery

Carotid sinus – dilatation at commencement of ICA; Middlle cerebral artery

sensitive to high blood pressure (pressoreceptor)

Origin Commencement Termination

Left Common Carotid
Right Common Carotid
Internal carotid artery
(With carotid sinus)
External carotid artery
Arch of the aorta Manubrium Upper border of the thyroid cartilage
Brachiocephalic artery Sternoclavicular joint
Petrous part of temporal bone (divides
Common carotid artery into cerebral arteries)
Upper border of the thyroid cartilage
Substance of the parotid gland behind
the neck into the mandible
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

Veins of the Head and neck

Inferior petrosal sinus
Supratrochlear vein
Pharyngeal veins
Facial vein

Brachiocephalic vein Lingual vein

Supraorbital vein
Internal Jugular
vein
Superior thyroid vein

Middle thyroid vein Superficial temproal vein

Retromandibular vein

Posterior External Maxillary vein

Jugular vein

Posterior auricular vein

Posterior division of the RMV

External Jugular
Subclavian vein vein Transverse cervical vein
Suprascapular vein
Anterior jugular vein

Drainage Commencement Termination

External Jugular vein Subclavian vein Behind the angle of the mandible Posterior part of middle portion of the
clavicle
Anterior jugular vein External Jugular vein Area of submental triangle Above jugular notch
Internal Jugular vein
(Closely related to deep cervical lymph Jugular foramen
Brachiocephalic vein
nodes) Behind medial end of the clavicle
Level of the neck with subclavian
Subclavian vein
artery
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

Nerves
Facial Nerve Vagus nerve Hypoglossal nerve
Fibers Motor and sensory Motor
Course 1. Emerges on anterior surface of hindbrain between pons 1. Emerges from anterior surface of medulla 1. Emerges from anterior
and medulla oblongata oblongata surface of medulla
2. Pass laterally in posterior cranial fossa 2. Passes laterally through posterior cranial fossa oblongata
3. Enter internal acoustic meatus in petrous part of 3. Leaves skull through jugular foramen 2. Crosses posterior cranial
temporal bone 4. Gives off to superior (meningeal and auricular fossa
4. Enters facial canal (lateral through inner ear) branches) and inferior (Pharyngeal) sensory 3. Leaves skull via hypoglossal
5. Forms geniculate ganglion ganglia canal
6. Nerve descends behind pyramid and emerges from 5. Descends through the neck within the carotid 4. Passes downward and
temporal bone via stylomastoid foramen sheath forward in the neck
7. Passes forward though parotid gland 6. Passes through the mediastinum of the thorax 5. Crosses ICA and ECA
8. Terminates to its distributions for facial expression 7. Passes behind root of lungs 6. Terminates in the tongue
8. Enters abdomen via esophageal opening in
diaphragm
Branches  Greater petrosal nerve - from geniculate ganglion;  Meningeal and auricular branches  Meningeal branch
and contains parasympathetic fibers  Pharyngeal branch – supplies pharynx muscles  Descending branch (C1
Innervatio Secretomotor to lacrimal gland, with taste fibers and soft muscles fibers passes downwards
n  Nerve to stapedius – stapedius muscle in middle ear  Superior laryngeal nerve joining descending cervical
 Chorda tympani – leaves middle ear through  Internal laryngeal nerve – larger branch; nerve (C2 and 3) – forms
petrotympanic fissure; with parasympathetic sensory to mucous membrane of piriform ansa cervicalis
secretomotor fibers to submandibular and sublingual fossa and larynx up to vocal cords  Nerve to thyrohyoid muscle
salivary glands  External laryngeal nerve – motor; supplies (C1)
With taste fibers cricothyroid cartilage  Muscular branches to all
 Posterior auricular – from stylomastoid foramen;  Recurrent laryngeal nerve – supplies larynx tongue muscles (except
posterior belly of digastric and stylohyoid nerves muscles (except cricothyroid), mucous palatoglossus)
membrane below vocal cords and upper part of  Nerve to geniohyoid muscle
Facial expression branches : trachea (C1)
1. Temporal – auricular muscles, occipitofrontalis,  Right recurrent – hooks to subclavian
corrugator supercilii artery; Innervates tongue muscles
2. Zygomatic – orbicularis oris  Left recurrent – hooks to arch of aorta; (controls shape and movement)
3. Buccal- buccinators, upper lip muscles, nostril  Cardiac Branches – arise in the neck, descend
4. Mandibular- lower lip muscles into the thorax, end in cardiac plexus Ansa cervicalis – sternothyroid,
5. Cervical - lower border of gland, platysma, omohyoid, sternohyoid (SOS)
depressor anguli oris Innervates – heart, great vessels in the thorax,
larynx, trachea, bronchi, lungs
Innervates facial expression, salivation, lacrimation
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

Cranial Nerves (Oh Oh Oh To Touch And Feel Virgin Girl’s Vagina And Hymen)
Nerve Components Function Opening in the Skull
1. Olfactory Sensory Smell Opening in cribiform plate
2. Optic Sensory Vision Optic Canal
Lifts upper eyelid, turns eyeball upward, downward and medially; constricts
3. Oculomotor Motor
pupil; accommodates eye
4. Trochlear Motor Assists in turning eyeball downward and laterally
Superior orbital fissure
5. Trigeminal
Cornea, forehead skin, scalp, eyelids, nose; mucous membrane of paranasal
Ophthalmic division Sensory
sinuses and nasal cavity
Face skin over maxilla and upper lip; upper jaw teeth, nsoe mucous
Maxillary division Sensory Foramen rotundum
membrane, maxillary air sinus, palate
Mandibular division Motor Muscles of mastication, mylohyoid, anterior belly of digastric, tensor tympani
Foramen ovale
Sensory Skin of cheek, mandible, lower lip, side of head; teeth of lower jaw
6. Abducent Motor Lateral rectus muscle, turns eyeball laterally Superior orbital fissure
Face muscles, stapedius muscle of middle ear, stylohyoid, posterior belly of
Motor
digastric
Internal acoustic meatus, facial
7. Facial Sensory Taste from anterior 2/3 of the tongue, floor of mouth, palate
canal, stylomastoid foramen
Secretomotor Submandibular and sublingual salivary glands, lacrimal gland, and glands of
parasympathetic nose and palate
8. Vestibulocochlear
Vestibular Sensory Position and head movement
Internal acoustic meatus
Cochlear Sensory Hearing
Motor Stylopharyngeaus muscle; assists in swallowing
Secretomotor Parotid salivary gland
9. Glossopharyngeal
parasympathetic
rd
Sensory General sensation and taste from posterior 3 of tongue, carotid sinus/body
Constrictor muscle of pharynx and intrinsic larynx muscles; involuntary
Motor Jugular foramen
10.Vagus muscle of trachea and bronchii, heart, alimentary tract; liver pancreas
Sensory Taste from epiglottis and vallecular and afferent fibers
11.Accessory
Cranial root Motor Soft palate muscle, pharynx, larynx
Spinal root Motor Sternocleidomastoid and trapezius muscles
12.Hypoglossal Motor Tongue muscles controlling shape and movement Hypoglossus canal
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

Glands
Characteristics Blood Supply / Venous drainage Nerve supply
 Largest salivary gland Glossopharyngeal nerve
 Composed of serous acini (Secretomotor
Parotid Gland  Deep hollow below external auditory meatus behind ramus parasympathetic supply)
*Parotid duct mandible Transverse Facial artery  Otic ganglion
(Stensen’s duct)  Divided into superficial and deep lobes by the facial nerve (branch of the superficial temporal artery)  Lesser petrosal
 Transverse by the Facial nerve, RMV, and ECA nerve
*Parotid Duct – drains in the vestibule of the mouth (buccal  Auriculo-temporal
nd
mucosa) at the level of the upper 2 molar tooth nerve
 Mixture of serous and mucous acini Facial nerve
 Beneath lower border of body of the mandible (Parasympathetic
Submandibular gland  Divided into superficial and deep part by the mylohyoid secretomotor supply via
 Opens into the mouth on a small papilla at the side of chorda tympani and
tongue frenulum submandibular ganglion)
 With right and left lobes connected by a narrow isthmus Blood Supply: Superior, middle, and
 Surrounded by sheath from pretracheal layer of deep 1. Superior thyroid artery inferior cervical sympathetic
fascia (Ligament of Berry)– attaches glad to larynx and  Branch of ECA ganglia
trachea  Accompanied by external
 Pear/H-/Butterfly shaped gland laryngeal nerve
 Apex directed upward up to oblique line on lamina of 2. Inferior thyroid artery
thyroid cartilage 2,3 and 4th tracheal cartilages  Branch of thyrocervical trunk
 Isthmus – located in front of 3nd tracheal cartilage; base –  Ascends at level of cricoid
th
4 tracheal cartilage cartilage
 Levator glandulae thyroideae – muscular band connecting  Crossed by the recurrent
Lobe laryngeal nerve
pyramidal love to hyoid bone
Thyroid gland Sometimes pyramid lobe is present extending upward from 3. Thyroidea ima – arise from
isthmus usually on left side
Function: for thyroid hormones, thyroxine and brachiocephalic artery or arch of the
triiodothyronine – increases metabolic activity of cells in the aorta
body
Venous drainage
1. Superior thyroid vein – drains into
IJV
2. Middle thyroid vein – drains into IJV
3. Inferior thyroid vein – drain into left
brachiocephalic vein
 Anatomy 1C Joshua Montelibano 1st shift 2015-2016

Blood supply Superior or middle cervical

 Superior and inferior thyroid sympathetic ganglia
 Ovoid bodies; 4 in number arteries
Parathyroid gland  Related closely to posterior border of thyroid gland
 With 2 superior and 2 inferior Venous drainage
Superior at the mid level of thyroid  Superior, middle, and inferior
And inferior at the base of thyroid ,they may be out the thyroid sheath
thyroid veins