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254 Cards in this Set
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Platysma |
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o Origin: superficial fascia over pectoralis major and deltoid
o Insertion: mandible; muscles around mouth o Innervation: CN VII o Action: depresses mandible, draws lower lip downward, tenses skin of neck |
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Orbicularis Oculi
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• O: medial orbital margin, medial palpebral ligament, lacrimal bone
• I: skin around margin of orbit, tarsal plate • A: close eyelid |
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Temporalis
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o Origin: inferior temporal line, temporal fossa, temporalis fascia
o Insertion: coronoid process; anterior border of mandibular ramus o Innervation: deep temporal branches of V3 o Action: anterior fibers-elevate mandible; posterior fibers-retrude mandible |
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Masseter
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o Origin: zygomatic arch/maxilla
o Insertion: coronoid process/ramus mandible o Innervation: CN V o Action: elevates and retracts the mandible (closes jaw) |
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Masseter
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o Origin: zygomatic arch/maxilla
o Insertion: coronoid process/ramus mandible o Innervation: CN V o Action: elevates and retracts the mandible (closes jaw) |
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Buccinator
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• O: mandible, pterygomandibular raphe, alveolar process of maxilla and mandible
• I: angle of mouth • A: press cheek against molar teeth to keep food between teeth, expel air from oral cavity |
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Parotid (Stenson's) Duct
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found along the edge of the parotid gland; exits from the anterior border of the gland and passing about a finger’s breadth below the zygomatic arch over the superficial fibers of masseter, the duct makes a sharp turn over anterior border of masseter to perforate buccinator and enter the oral cavity (around the max 2nd molar)
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Facial Artery and Vein
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• Facial artery: arises in carotid triangle from ECA, ascends deep to submandibular gland, winds around inferior border of mandible and enters the face (torturous which allows for distention and opening of the jaw); distributes to the muscles of facial expression/face
Facial vein: direct continuation of angular vein past inferior margin of orbit; descends along lateral border of the nose, receiving external nasal and inferior palpebral veins, then obliquely across face to mandible. It receives anterior division of retromandbiular vein, after which it is sometimes called the common facial vein. |
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Facial Nerve - Cervical Branch
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• Cervical:
• Runs forward beneath platysma; one branch descends to join cervical cutaneous nerve from the cervical plexus, which innervates Platysma |
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Facial Nerve - Mandibular Branch |
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• Marginal mandibular:
• Innervates muscles of lower lip & chin; [communicates with mental branch of inferior alveolar branch] |
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Facial Nerve - Buccal Branch
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Runs laterally over the Masseter muscle;• Superficial branches innervate procerus; [join with infratrochlear and nasociliary branches of V1]
• Deep branches innervate zygomaticus and levator labii superioris & nasalis; [form infraorbital plexus with infraorbital branch of V1] • Lower deep branches innervate buccinators & orbicularis oris; [join with fibers of buccinator branch of V3] |
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Facial Nerve - Zygomatic Branch
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• Innervates orbicularis oculi
• [Joins with fibers of lacrimal n. and zygomaticofacial branch of V2] |
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Facial Nerve - Temporal Branch
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• Innervates auriculares anterior & superior, [and join with zygomaticotemporal branch of V2 & auriculotemporal branch of V3]
• Anterior branches innervate frontalis, orbicularis oculi, corrugator supercilii, [and join the supraorbital & lacrimal branches of V1] |
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Opthalmic Nerve (V1) -> Frontal Nerve -> Supraorbital Nerve (through Supraorbital Foramen)
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Maxillary Nerve (V2) - Infraorbital Nerve (through Infraorbital Foramen) NVB
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infraorbital NVB exits here (anterior superior and middle superior alveolar nerve/artery branch off before exit)
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Mandibular Nerve (V3) -> Inferior Alveolar Nerve -> Mental Nerve (through Mental Foramen)
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Long Buccal Nerve (CN V3 - BAIL) |
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Innervates skin and oral mucosa of the cheek; sensory innervation to the vestibule of the oral cavity |
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Facial Artery
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arises in carotid triangle from ECA, ascends deep to submandibular gland, winds around inferior border of mandible and enters the face (torturous which allows for distention and opening of the jaw); distributes to the muscles of facial expression/face |
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Facial Vein
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direct continuation of angular vein past inferior margin of orbit; descends along lateral border of the nose, receiving external nasal and inferior palpebral veins, then obliquely across face to mandible. It receives anterior division of retromandbiular vein, after which it is sometimes called the common facial vein. |
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Angular Artery
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Branch of facial artery (ECA) |
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Platysma
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o Origin: superficial fascia over pectoralis major and deltoid
o Insertion: mandible; muscles around mouth o Innervation: CN VII o Action: depresses mandible, draws lower lip downward, tenses skin of neck |
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Transverse Cervical Nerve (C2 & C3) - Cutaneous branch of cervical plexus
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(C2, C3) - innervates skin overlying anterior triangle of neck
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Omohyoid (Inferior Belly)
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O: upper border of scapula and suprascapular lig. |
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Omohyoid (Superior Belly) |
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superior belly: central tendon located deep to SCM; here, superior belly unites with inferior belly |
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Transverse Cervical Artery (Superior) and Suprascapular Artery (Inferior)
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branches off of thyrocervical trunk |
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Branches of Facial Nerve
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Two Zebras Bit My Cookies
Temporal, Zygomatic, Buccal, Marginal Mandibular, Cervical (& Posterior Auricular) |
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Angle of Mandible
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attachment of stylomandibular ligament, m pterygoid, masseter
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Coronoid Process
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masseter and temporalis insert here
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Medial Pterygoid Muscle
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• Origin – deep head (medial side of the lateral pterygoid plate); superficial head (pyramidal process of palatine bone and maxillary tuberosity)
• Insertion – medial surface of the ramus and angle of the mandible • Innervation – nerve to medial pterygoid of V3 • Action – elevates mandible; helps lateral pterygoids in lateral movement |
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Medial Pterygoid Muscle
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• Origin – deep head (medial side of the lateral pterygoid plate); superficial head (pyramidal process of palatine bone and maxillary tuberosity) |
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Lateral Pterygoid Muscle
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o Origin: greater wing of sphenoid; lateral pterygoid plate
o Insertion: pterygoid fovea; articular disk/meniscus of TMJ (neck of condyle) o Innervation: lateral pterygoid n of V3 o Action: depress mandible; protrude mandible; lateral excursion |
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Lateral Pterygoid Muscle
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o Origin: greater wing of sphenoid; lateral pterygoid plate
o Insertion: pterygoid fovea; articular disk/meniscus of TMJ (neck of condyle) o Innervation: lateral pterygoid n of V3 o Action: depress mandible; protrude mandible; lateral excursion |
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Lingual Nerve
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Between medial and lateral pterygoids. Courses inferiorly on the superficial aspect of medial pterygoid. Adjacent to inferior alveolar nerve (Superior). Innervates anterior 2/3 of tongue; parasympathetic fibers to submandibular ganglion
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Lingual Nerve
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Between medial and lateral pterygoids. Courses inferiorly on the superficial aspect of medial pterygoid. Adjacent to inferior alveolar nerve (Superior). Innervates anterior 2/3 of tongue; parasympathetic fibers to submandibular ganglion
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Inferior Alveolar Nerve
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Between medial and lateral pterygoids. Adjacent to lingual nerve (Inferior). Enters mandibular foramen.
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Inferior Alveolar Nerve
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Between medial and lateral pterygoids. Adjacent to lingual nerve (Inferior). Enters mandibular foramen. Accompanied by inferior alveolar artery and vein
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Mandibular Nerve (CN V3)
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Branches of Trigeminal nerve; Branches: BAIL (Long Buccal, Auriculotemporal, Inferior Alveolar, Lingual)
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Chorda Tympani
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Emerges from petrotympanic fissure, passes anteriorly and joins the Lingual nerve
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Nerve to Mylohyoid
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Arises from Inferior Alveolar Nerve. Innervates mylohyoid and anterior belly of digastric
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Nerve to Mylohyoid
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Arises from Inferior Alveolar Nerve. Innervates mylohyoid and anterior belly of digastric
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Inferior Alveolar NVB (vein, artery, nerve)
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Passes through mandibular foramen. Course inferiorly on the superficial aspect of medial pterygoid
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Condylar Process of Mandible
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Articular Disc of TMJ
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lateral pterygoid inserts here
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Auriculotemporal Nerve and Middle Meningeal Artery
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two divisions encircling the middle meningeal artery→f. spinosum; conveys sensory fibers from the skin of the temporal region and postganglionic parasympathetic fibers from the otic ganglion to the parotid gland. The otic ganglion is located near the main trunk of the mandibular nerve
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Maxillary Artery
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One of two terminal branches of External Carotid Artery; runs deep to condylar neck; 3 parts: mandibular, pterygoid, pterygopalatine
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Maxillary Artery
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One of two terminal branches of External Carotid Artery; runs deep to condylar neck; 3 parts: mandibular, pterygoid, pterygopalatine
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Anterior Belly of Digastric
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• O: anterior belly: digastric fossa of mandible; posterior belly: mastoid notch of temporal bone
• I: tendinous connection of both bellies through a fascial loop on the hyoid bone • A: depresses mandible/elevates hyoid • I: anterior belly: branch of mylohyoid of V3; posterior belly: branch of CN VII |
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Posterior Belly of Digastric
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• O: anterior belly: digastric fossa of mandible; posterior belly: mastoid notch of temporal bone
• I: tendinous connection of both bellies through a fascial loop on the hyoid bone • A: depresses mandible/elevates hyoid • I: anterior belly: branch of mylohyoid of V3; posterior belly: branch of CN VII |
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Neck Region: 1) Internal Jugular Vein, 2) Common Carotid Artery, 3) Thyroid Cartilage, 4) Thyroid Gland, 5) Thyroglossal Duct, 6) Hyoid Bone
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Sternohyoid
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O: posterior manubrium, sternoclavicular lig., and medial end of clavicle
I: medial lower body of hyoid A: depresses hyoid bone I: ansa cervicalis (C1-C3) |
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Orbicularis Oris
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• O: some fibers near medial plane of maxilla superiorly and mandible inferiorly, deep surface of skin
• I: mucous membrane of lips • A: compresses and protrudes lips |
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Frontal Bone
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Parietal Bone
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Occipital Bone
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Temporal Bone
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Sphenoid Bone
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Ethmoid Bone
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Zygomatic Bone
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Maxilla Bone
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Nasal Bone
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Lacrimal Bone
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Vomer Bone
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Palatine Bone
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Inferior Nasal Concha
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Mandible Bone
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Mental Foramen
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Infraorbital Foramen
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Supraorbital Foramen
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Orbital Plate of Frontal Bone
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Coronal Suture
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Superior Orbital Fissure
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Inferior Orbital Fissure
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Hypoglossal Canal
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Middle Concha
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Mental Symphysis
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Anterior Cranial Fossa
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Middle Cranial Fossa
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Posterior Cranial Fossa
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Crista Galli
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Cribriform Plate
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part of ethmoid bone; olfactory bulbs sit here - rootlets pass through perforations in plate to reach nasal epithelium in nasal cavity
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Pituitary/Hypophyseal Fossa (Sella Turcica)
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Groove for Transverse Sinus
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lateral from IOP, Occipital: in tentorium cerebelli; Right: larger, drains superior sagittal; Left: drains straight; drains to internal jugular vein
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Groove for Sigmoid Sinus
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continue from transverse sinuses and end at the jugular f.
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Jugular Foramen
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CN IX, X and XI pass through it
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Foramen Magnum
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Internal Acoustic Meatus
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CN VII and VIII pass through it
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Petrous Part of Temporal Bone
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Squamous Part of Temporal Bone
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Clivus
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Orbital Plate of Frontal Bone
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Middle Cranial Fossa Structures
A. Optic nerve B. Tentorium cerebelli C. Diaphragma sellae D. Cerebral peduncles E. Tectum F. Tegmentum |
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Tentorium cerebelli – horizontal fold across posterior third of skull to separate cerebral hemispheres (occipital lobes) from cerebellum, attaches along transverse sulcus on each side of skull, and attaches along superior petrosal sulcus and ends medially at posterior clinoid process
Diaphragma sellae – dura mater membrane covering sella turcica; stretches from anterior clinoid processes to posterior clinoid processes; pierced by the infundibulum (stalk of pituitary gland) |
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Foramen Lacerum
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Inferior to carotid canal
Greater petrosal nerve-heads to foramen lacerum, enters the pterygoid canal and joins the nerve of the deep petrosal to form the nerve of the pterygoid canal. |
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Foramen Spinosum
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• Middle meningeal artery: passes through foramen spinosum
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Groove for Middle Meningeal Artery
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supplies dura of anterior and middle cranial fossae; 1st branch off of maxillary artery (1 of two terminal branches off ECA); passes through foramen spinosum to enter middle cranial fossa; ascends lateral walls of skull and branches to anterior and posterior
branches |
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Foramen Ovale
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V3 passes through
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Posterior Clinoid Process
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posterior are lateral ends of dorsum sellae |
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Foramen Rotundum
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V2 passes through
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Anterior Clinoid Process
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anterior are medial ends of lesser
wings of sphenoid bone |
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Lesser Wing of Sphenoid
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Optic Canal
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Lamboidal Suture
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Pterion
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Greater Wing of Sphenoid
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Zygomaticofacial Foramen
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Pterygomaxillary Fissure
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Pterygopalatine Fossa
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small triangular fossa at the angle of the junction between the pterygomaxillary and inferior orbital fissures. It contains the pterygopalatine ganglion, maxillary nerve (V2), and terminal parts of the internal maxillary artery. Six foramina open into it: foramen rotundum, pterygoid canal, pharyngeal canal, sphenopalatine foramen (which transmits the sphenopalatine artery into the nasal cavity), pterygopalatine foramen, and the inferior orbital fissure
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Sagittal Suture
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Superior Nuchal Line
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External Occipital Protuberance
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Greater Palatine Foramen
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Lesser Palatine Foramen
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Infratemporal Fossa
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Foramen Ovale
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anterior and medial to foramen spinosum
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Foramen Spinosum
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inferior and lateral to foramen ovale
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Carotid Canal
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posterior to foramen spinosum; superior to foramen lacerum
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Stylomastoid Foramen
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facial neve (CN VII) exits here
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Jugular Foramen
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Occipital Condyle
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Palatine Plate of Maxilla
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Maxillary Tuberosity
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Vomer
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Medial Pterygoid Plate and Hamulus
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Lateral Pterygoid Plate
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Mandibular/Glenoid Fossa
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Pterygoid/Vidian Canal
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Spine of Sphenoid Bone
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Petrous Part of Temporal Bone
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Hypoglossal Canal
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Stylomastoid Foramen
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Condylar Process
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Neck of Mandible
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Angle of Mandible
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Body of Mandible
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Ramus of Mandible
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Coronoid Process of Mandible
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Mental Foramen
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Mylohyoid Line
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Mental Spines/Genial Tubercles
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Mandibular Foramen
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Submandibular Fossa
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Pterygoid Fovea
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Vomer
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Perpendicular Plate of Ethmoid Bone
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Crista Galli
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Nasal Septum
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Inferior Concha
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Middle Concha
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Superior Concha
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Sphenopalatine Foramen
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- Near the posterior aspect of the superior conchae and anterior to the sphenoid sinus; sphenopalatine artery passes through (pterygopalatine portion of maxillary artery)
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Pterygoid Hamulus
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tensor veli palatini attaches here
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Ostium of Maxillary Sinus
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Below the bulla ethmoidalis, and partly hidden by the inferior end of the uncinate process
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Ostium of Middle Ethmoid Air Cells
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Pterygoid/Vidian Canal
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Pterygoid Process of Sphenoid Bone
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Semilunar Hiatus
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External Auditory Meatus
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Tympanic Part of Temporal Bone
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Zygomatic Process of Temporal Bone
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Mandibular/Glenoid Fossa
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Parotid Gland
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Sagittal Section of Brain:
Falx Cerebri Falx Cerebelli Tentorium Cerebelli |
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Falx cerebri – separates cerebral hemispheres, attached anteriorly to crista galli, superiorly to lips of superior sagittal sulcus, posteriorly ends at internal occipital protuberance, posterior third of inferior border is attached to tentorium cerebelli, anterior two-thirds of inferior border is free edged
b) Falx cerebelli – smaller fold that also separates cerebral hemispheres but inferior to tentorium cerebelli (from internal occipital crest to foramen magnum) note: impt anastomoses occur btw venous dural sinuses and the internal vertebral venous plexus @f. magnum c) Tentorium cerebelli – horizontal fold across posterior third of skull to separate cerebral hemispheres (occipital lobes) from cerebellum, attaches along transverse sulcus on each side of skull, and attaches along superior petrosal sulcus and ends medially at posterior clinoid process |
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Internal Carotid Artery (next to Optic Nerve)
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enters skull through carotid canal, transverses the petrous portion of the temporal bone, and passes through the cavernous sinus. The two internal carotid arteries join to send communicating branches anteriorly and posteriorly (communicating branches) to join with basilar to form Circle of Willis
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Ophthalmic Artery
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First branch from ICA, through optic canal; distal to cavernous sinus; supply all the structures in the orbit as well as some structures in the nose, face and meninges
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CN III - Oculomotor Nerve
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pierces dura and enters cavernous sinus, travels along lateral wall; enters orbit by passing through superior orbital fissure
-Controls eye movement and pupil constriction (superior: levator palpebrae superioris, superior rectus; inferior: medial rectus, inferior rectus, inferior oblique; ciliary muscle |
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CN IV - Trochlear Nerve
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passes through cavernous sinus; exits cranial cavity through superior orbital fissure; innervates superior oblique
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CN V - Trigeminal Nerve
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pierces dura just antero-inferior to the trochlear nerve
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Olfactory Bulb
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olfactory bulbs sit on cribriform plates of ethmoid bone; rootlets pass through perforation in the cribriform plates to reach the nasal epithelium in the nasal cavity
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CN VII - Facial Nerve
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pierces dura and exits through internal auditory meatus, entering the petrous temporal bone; goes through the facial canal; exits base of skull through stylomastoid foramen; innervates muscles of facial expression (motor trunk divides in parotid gland to temporal, zygomatic, buccal, marginal mandibular, cervical branches); chorda tympani branch of VII eventually joins lingual branch of V3 to hitchhike along it (innervates anterior 2/3 of tongue: taste); Greater petrosal nerve – branches from VII at geniculate ganglion and exits via hiatus of facial nerve, crosses foramen lacerum, and joins deep petrosal nerve to form nerve of the pterygoid canal (Vidian nerve); nerve to the stapedius; PS innervation of submandibular, sublingual, and lacrimal glands
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Straight Sinus
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base of falx tentorium cerebelli; drainage: inferior sagittal and great cerebral vein to confluence of sinuses
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Cavernous Sinus
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paired, 1cm wide, R and L of sphenoid bone; transversed by network of fibrous filaments (unusual): serve to slow flow of venous blood through these structures; allows pathogens to colonize within these regions
- extends 2cm from superior orbital fissure anteriorly to apex of petrous temporal bone posteriorly; anterior and posterior intercavernous sinuses (forms circular sinus) connects both L and R cavernous sinus; receives blood from: Pterygoid plexus via inferior ophthalmic vein, emissary veins, and deep facial vein drain into cavernous thru sphenoid foramen |
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Confluence of Sinuses
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sinus junction at internal occipital protuberance; drainage from: Superior Sagittal, Straight, and Occipital Sinuses; drainage to: transverse sinuses
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Inferior Sagittal Sinus
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inferior to falx cerebri; anterior: crista galli; posterior: joins Great Cerebral Vein; drainage: small cerebral veins
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Superior Sagittal Sinus
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largest dural sinus; cranial falx cerebri; anterior: foramen cecum; posterior: internal occipital protuberance; drains: cerebral veins, emissary veins, diploic veins
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Frontal Nerve (CN V1)
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supraorbital nerve, supratrochlear nerve; provides sensory info for forehead skin, frontal sinus mucosa, and upper eyelid; above levator palpebrae superioris
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Lacrimal Nerve (CN V1)
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innervates lacrimal gland (smallest of three branches)
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Supraorbital Nerve
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branch of Frontal Nerve (CN V1)
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Supratrochlear Nerve
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branch of Frontal Nerve (CN V1)
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Lateral Rectus
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abducts; innervated by CN VI
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Medial Rectus
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adducts; inferior division of CN III
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Superior Rectus
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elevates, adducts, intorts; innervated by CN III
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Inferior Rectus
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depresses, adducts, extorts; innervated by CN III
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Levator Palpebrae Superioris
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elevates upper eyelid; innervated by CN III
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Superior Oblique
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depresses, abducts, extorts; arises from superomedial margin of the optic foramen, runs forward forming a tendon passing though the trochlea; innervated by CN IV
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Inferior Oblique
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o action: depresses, adducts, extorts (3 axes movement)
o course: arise from annular tendon to attach to anterior sclera o innervation: inferior division of CN 3 |
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Trochlea
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Lacrimal Gland
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• located in the lacrimal fossa of the frontal bone
• sensory innervation from lacrimal nerve (V1) • secretomotor nerves piggyback on zygomatic nerve (V2) o parasympathetic innervation from greater petrosal nerve of CN 7 o sympathetic innervation from deep petrosal nerve from internal carotid plexus o greater petrosal and deep petrosal → Vidian nerve → pterygopalatine ganglion → infraorbital nerve (V2) → zygomatic branch of infraorbital → lacrimal gland • arterial supply from lacrimal artery (branch of ophthalmic artery) |
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Lacrimal Sac & Nasolacrimal Duct
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• tears are secreted by the lacrimal gland (at superolateral part of eye) to lubricate the eyes
• tears pool in the lacrimal caruncle/lake (at medial part of eye) • tears drain into the puncta lacrimalis and then through the lacrimal canaliculi to the lacrimal sac • lacrimal sac (above medial palpebral ligament) drains into the nasolacrimal duct which opens at the inferior nasal meatus (of the same side) • remember tears are disseminated by actions of the orbicularis oculi and related papebral musculature |
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Zygomaticus Major
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Innervated by buccal and zygomatic branches of facial nerve; extends from zygomatic arch to corner of the mouth; supplied by facial artery
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Phrenic Nerve (C3-C5) - muscular branch of cervical plexus
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important nerve that lies on the anterior surface of the anterior scalene; descends from its origins in the cervical plexus along the anterior surface of the anterior scalene; deep nerve of cervical plexus
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Hypoglossal Nerve
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courses between the mylohyoid and hyoglossus muscles
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Superior Thyroid Artery (ECA)
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• Infrahyoid: GT
• Sternocleidomastoid: GT • Superior Laryngeal: GT (upper larynx) • Cricothyroid: cricothyroid ligament |
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Ascending Pharyngeal Artery (ECA)
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• Pharyngeal: middle constrictors
• Palatine: soft palate & tonsil • Prevertebral: longus capitis & colli • Inferior tympanic: tympanic cavity • Posterior meningeal: dura mater |
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Lingual Artery (ECA)
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• Suprahyoid: GT
• Dorsal lingual: post. part of dorsum of tongue, tonsil, soft palate & epiglottis • Sublingual: sublingual gland & mylohyoid m. • Deep lingual: underside of tongue, genioglossus |
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Facial Artery (ECA)
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• Cervical branches: ATGS
• Ascending palatine: soft palate, palatine glands • Tonsilar: tonsil & tongue • Glandular: submandibular gland • Submental: chin & lip • Facial branches: ISLAM • Inferior labial: GT • Superior labial: GT • Lateral nasal: GT • Angular (terminal branch): lacrimal sac; anastomoses with V1 • Muscular: neck, face |
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Occipital Artery (ECA)
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supplies scalp, mastoid process, SCM & Trapezius
• Muscular: digastric, stylohyoid • SCM: GT • Auricular: mastoid air cells • Meningeal: dura of PC fossa • Terminal: occipital bone Hypoglossal Nerve passes over it |
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Transverse Facial Artery
Labial Arteries Angular Arteries Superficial Temporal Arteries |
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Levator Labii Superioris
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• O: frontal process of maxilla and infraorbital region |
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Deep Facial Vein
Angular Vein Posterior Auricular Vein |
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Mylohyoid
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• O: mylohyoid line of mandible
• I: median raphe from chin to hyoid bone and onto hyoid (mylohyoid raphe) • A: elevates floor of mouth & hyoid bone/depresses mandible (raises tongue in early stage of swallowing) • I: mylohyoid branch of inferior alveolar branch of V3 |
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Geniohyoid
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• O: inferior genial tubercle
• I: anterior border of hyoid • A: elevates the hyoid and draws it forward/depresses mandible • I: C1 through the hypoglossal n. |
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Genioglossus
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Origin – superior genial tubercle/superior part of mental spine of mandible
Insertion – dorsum of tongue and body of hyoid Innervation – CN XII Action – depresses tongue, posterior part pulls tongue anteriorly for protrusion |
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Stylohyoid
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• O: posterior border of styloid process of temporal bone
• I: hyoid bone, at junction of the body and greater cornu • A: elevates hyoid & draws it posteriorly • I: stylohyoid branch of VII |
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Stylopharyngeus
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o Only muscle derived from pharyngeal arch 3
o Origin: styloid process o Insertion: thyroid cartilage (pharynx) o Innervation: only muscle innervated by CN 9; CN 9 accompanies stylopharyngeus thru the gap between the superior and middle constrictors o Action: elevates the pharynx and larynx |
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Hyoglossus
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Origin – body and greater horn of hyoid
- Insertion – side and inferior aspect of tongue - Innervation – CN XII - Action – depresses and retracts tongue |
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Sternothyroid
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deep to sternohyoid; is raised and stretched by the mass of the underlying thyroid gland;
O: posterior manubrium, deep to sternohyoid; 1st costal cartilage I: oblique line on lamina of thyroid cartilage A: depresses larynx I: ansa cervicalis (C1-C3) |
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Thyrohyoid
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(deep to the sternohyoid)
O: oblique line on thyroid cartilage I: lower border of body and greater cornu of hyoid A: depresses hyoid bone/elevates larynx I: thyrohyoid branch of C1 through the hypoglossal |
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Levator Anguli Oris
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immediately below the infraorbital foramen; innervated by buccal branches of the facial nerve
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Vagus Nerve (in neck)
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internal jugular vein courses with the nerve laterally, common carotid medially
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Carotid Sinus
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dilation of the ICA near the bifurcation of the common carotid a. containing baroreceptors
• Convey info abt changes in BP; innervated by IX to medulla |
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Common Carotid Artery
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Part of the carotid sheath (with internal jugular vein and vagus nerve); bifurcates into internal and external branches
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External Carotid Artery
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More superficial branch of the common carotid artery; branches into SALFOPSM
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Internal Carotid Artery
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More deep branch of the common carotid artery; supplies the brain
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Thyroid Gland (Isthmus)
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covered by a pretracheal layer of deep cervical fascia; two lobes and an isthmus); look for pyramidal lobe or partially obliterated thyroglossal duct; supplied by superior and inferior thyroid arteries; drains to superior, middle and inferior thyroid veins
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Cricothyroid Muscle
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• O: lateral surface of cricoid cartilage
• I: (lower fibers) anterior margin of inferior horn of thyroid C; (upper fibers) lower border of lamina of thyroid C • I: external laryngeal nerve (from superior laryngeal branch of X) • A: tenses vocal folds (raise pitch of speech) Cricothyroid joint: Movement at this joint changes length and tension of the vocal ligaments, determining pitch of speech |
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Thyroid Cartilage
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contains the larynx; laryngeal prominence in front is palpable, superior and inferior thyroid notches; posteriorly, superior horns of the thyroid come close to greater horns of hyoid; many muscles originate and insert here; sternothyroid inserts, thyrohyoid originates, inferior pharyngeal constrictor inserts, stylopharyngeus inserts, palatopharyngeus inserts
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Cricoid Cartilage (Signet Ring)
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only complete ring around the trachea; disparity in anterior arch thickness (band) and posterior lamina thickness (slightly broader)… like a signet ring; opposite the sixth cervical vertebra
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Hyoid Bone
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floating bone just below the mandible with lesser and greater horns
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Greater Petrosal Nerve
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branches from VII at geniculate ganglion and exits via hiatus of facial nerve, crosses foramen lacerum, and joins deep petrosal nerve to form nerve of the pterygoid canal
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Depressor Anguli Oris
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frowning; from mandible to angle of the mouth; innervated by mandibular branch of facial nerve
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Inferior Alveolar Artery (Mandibular Portion of Maxillary Artery)
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#29
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Runs with inferior alveolar nerve
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Middle Meningeal Artery (Mandibular Portion of Maxillary Artery) w/ Auriculotemporal Nerve
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#41
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Mandibular portion of Maxillary Artery; passes through foramen spinosum; surrounded by two branches of auriculotemporal nerve
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23: Inferior Thyroid Artery
21: Ascending Cervical Artery 19: Superior Thyroid Artery |
#23 + #21 + #19
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inferior thyroid artery (supplies trachea, esophagus, larynx, thyroid gland) is a branch off the thyrocervical trunk, ascending cervical artery (supplies vertebrae and neck muscles) branches off inferior thyroid; superior thyroid is a branch off ECA; both thyroid arteries supply the thyroid gland
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Vertebral Artery
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#47
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branch off Subclavian artery; ascends and courses posteriorly toward the cervical spine where it normally ascends thru the transverse foramina of the upper six vertebrae
• Supplies blood to the posterior part of circle of Willis and anastomoses with blood supplied to the anterior part of the circle of Willis from the carotid |
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Submandibular Gland
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mixed gland found below the mandible and superior to the digastric muscles; located inferior to mylohyoid muscle and close to medial surface of the body of the mandible
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Nasopharynx
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#13
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o Communicates anteriorly with nasal cavity
o Nasal cavity is split into left and right by the nasal septum o Continuous with nasal cavity at the choanae or posterior nasal aperture o Nasopharynx and oropharynx separated by soft palate musculature |
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Oropharynx
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#15
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o Communicates anteriorly with oral cavity
o Separated from oral cavity by the fauces or pillars o Nasopharynx and oropharynx separated by soft palate musculature |
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Laryngopharynx
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#17
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Below the oropharynx to the esophagus
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Submandibular/Wharton's Duct
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runs with the lingual nerve in the floor of the mouth; crosses superior to the lingual nerve as the duct courses toward its opening on the sublingual caruncle
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Hard Palate
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#2
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Oral and nasal cavity separated by hard palate
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Soft Palate & Uvula
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#14
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soft palate divides nasopharynx from oropharynx; o Soft palate muscles attach to a fibrous aponeurosis
o Soft palate is elevated and tensed to limit reflux of fluid into nasopharynx during swallowing and to enable certain plosive speech sounds o Musculus uvulae, levator veli palatini, tensor veli palatini |
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Styloid Process
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Its proximal part (tympanohyal) is ensheathed by the vaginal process of the tympanic portion.
Its distal part (stylohyal) gives attachment to the following: stylohyoid ligament stylomandibular ligament styloglossus muscle (innervated by the hypoglossal nerve) stylohyoid muscle (innervated by the facial nerve) stylopharyngeus muscle (innervated by the glossopharyngeal nerve) |
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Auditory/Eustachian/Pharyngotympanic Tube
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#27
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extends from middle ear to lateral wall of nasopharynx at inferior nasal concha level; opening of the auditory tube is found below the broad cartilaginous end of the tube know as the torus tubarius
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Levator Veli Palatini
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soft palate muscle;
o Origin: petrous temporal + cartilaginous auditory tube (torus tubarius) o Insertion: contralateral muscle in the velum palatinum (soft palate) • Review: torus tubarius is ridge in the nasopharyngeal wall posterior to the opening of the auditory tube, caused by the projection of the cartilaginous portion of this tube. The salpingopharyngeal fold also descends from this torus tubarius. o Action: elevates the soft palate, pulling posteriorly and narrowing the walls of the nasopharynx (drawing medially) o Innervation: pharyngeal plexus of CNX. |
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Tensor Veli Palatini
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soft palate muscle;
o Origin: scaphoid fossa, spina angularis, and cartilaginous part of the auditory tube o Insertion: velum palatinum after being redirected by the tendinous portion of the pterygoid hamulus. o Action: tenses the soft palate and opens the cartilaginous auditory tube. In other words, it elevates the lateral edges, providing a good seal of the soft palate from the nasopharynx. o Innervation: tensor veli palatini branch of CNV3 |
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Lingual Tonsil (& Root of Tongue)
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#16
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lymph tissue covering the base of the tongue
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Palatoglossus
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Origin – palatine aponeurosis of soft palate
- Insertion – side of tongue - Inneration – cranial root of CN XI vial pharyngeal branch of CN X and pharyngeal plexus - Action – elevates posterior part of tongue |
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Palatopharyngeus
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(covered by a mucosal fold)
o Origin: palatine aponeurosis and hard palate o Insertion: thyroid cartilage o Innervation: vagus and cranial accessory nerve o Action: pulls pharynx and larynx upward |
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Oropharyngeal Isthmus/Oropharynx
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#5
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• Boundaries of oropharynx: laryngopharynx inferior, oral cavity anterior (by the oropharyngeal isthmus or the isthmus of the fauces= bounded superiorly by soft palate, inferiorly by root of tongue (where lingual tonsils lie), laterally by palatoglossal and paaltopharyngeal arches/folds), nasopharynx superior (by the soft palate muscles), pharyngeal wall posteriorly (sup constrictor)
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Palatine Tonsils/Tonsilar Fossa
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palatoglossal fold and palatopharyngeal fold (aka anterior and posterior pillars of the fauces); palatine tonsils lie btw the pillars of the fauces on the loose connective tissue covering the superior pharyngeal constrictor
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Epiglottis
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o Lid-like flap of cartilage guarding the entrance of the laryngeal inlet
o During swallowing, elevation of the hyoid draws the epiglottis down to direct food to esophagus o Upper epiglottis: CN 9 fibers contribute to afferent gag reflex o Lower epiglottis: CN 10 fibers contribute to afferent cough reflex |
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Epiglottis
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o Lid-like flap of cartilage guarding the entrance of the laryngeal inlet
o During swallowing, elevation of the hyoid draws the epiglottis down to direct food to esophagus o Upper epiglottis: CN 9 fibers contribute to afferent gag reflex o Lower epiglottis: CN 10 fibers contribute to afferent cough reflex |
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Vestibular/False Vocal Fold
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• Contain no muscle and are found superior to the true vocal folds; Vestibule: portion of the larynx above the vocal folds
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True Vocal Fold
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contain: vocal ligament, vocalis muscle, thyroarytenoid muscle; Ventricle: fossa between the vocal folds; inferior to false vocal folds
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Arytenoid Cartilage
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#14
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triangular cartilages articulating inferiorly with cricoid lamina
o Vocal process: attaches vocalis muscle and vocal ligament o Muscular process: attached thyroarytenoid muscles |
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Superior Nasal Concha
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#13
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protect olfactory bulb, part of ethmoid bone
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Middle Nasal Concha
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#14
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protect sinuses from coming into direct contact with nasal airflow, part of ethmoid bone
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Inferior Nasal Concha
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#15
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responsible for airflow, humidification, filtering; are separate bones (superior and middle conchae are parts of other bones)
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Superior Nasal Meatus
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#2
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sphenopalatine foramen opens into it posteriorly, posterior ethmoidal cells anteriorly (drain here)
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Middle Nasal Meatus
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#3
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bulla ethmoidalis(=elevation containing the middle ethmoidal cells (drain here)), hiatus semilunaris (anterior ethmoidal cells (drain here), frontonasal duct, ostium of maxillary sinus…. Sooooo frontal, middle ethmoid, and maxillary drain here!!!), uncinate process
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Inferior Nasal Meatus
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#17
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ostium of nasolacrimal duct anteriorly (draining tears form the lacrimal sac into the inferior meatus
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Nasolacrimal Duct Opening
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#19
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ostium of nasolacrimal duct anteriorly (draining tears form the lacrimal sac into the inferior meatus
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Semilunar Hiatus
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#16
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hiatus semilunaris (anterior ethmoidal cells (drain here); on lateral wall of middle nasal meatus
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Lingual Branch of Glossopharyngeal Nerve
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posterior to palatoglossal fold, runs medially and on posterior border of stylopharyngeus muscle for a short distance before it passes deep to hyoglossus muscle to enter the deep portion of the tongue
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Sublingual gland
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primarily mucous-secreting salivary gland
- Located in floor of mouth, nestles laterally in sublingual fossa of mandible and medially against base of tongue - It is elongated – L and R meet anteriorly →horseshoe shape of sublingual folds - Covered by a thin lining of mucosa to separate from oral cavity |
