Osteology
|
| Bone |
Structure |
Description |
| frontal |
superior orbital margin (N2, TG7-03, TG7-57) |
contains supraorbital notch or foramen |
|
superciliary arches (TG7-03) |
above orbtial margins |
|
supraorbital notch (foramen occasionally) (N2, TG7-03, TG7-57) |
in superior orbital margin, for supraorbital neurovascular bundle |
| maxilla |
frontal process (N4, TG7-03) |
forms part of medial orbital wall & margin |
|
zygomatic process (N4, TG7-03) |
articulates with zygomatic bone |
|
infraorbital foramen (N2, TG7-03, TG7-57) |
anterior opening of infraorbital canal, for infraorbital neurovascular bundle |
|
alveolar process (N2, TG7-03) |
forms sockets for upper teeth |
| zygomatic |
temporal process (N4, TG7-04A) |
articulates with zygomatic process of temporal bone to form the zygomatic arch (Greek, zygoma = a yoke, this bone yokes or joins several bones together) |
|
frontal process (N4, TG7-04A) |
forms most of lateral orbital margin and anteroinferior part of lateral orbital wall; articulates with frontal bone anteriorly and greater wing of sphenoid bone posteriorly |
|
maxillary process (N4, TG7-04A) |
forms lateral part of inferior orbital margin and anterolateral part of orbital floor; articulates with maxilla |
| mandible |
body (N15,N2, TG7-32B) |
U-shaped, halves fused at symphysis menti |
|
symphysis menti (TG7-32C) |
midline symphysis between the two halves of mandible; fuses during first year (Greek, symphysis = a growing together) |
|
mental protuberance (N15,N2, TG7-32B) |
forms bone of chin anteriorly |
|
mental foramen (N15,N2, TG7-32B) |
on anterior surface of body, inferior to premolar teeth; transmits mental neurovascular bundle |
|
ramus (N15,N2, TG7-32B) |
rises nearly vertically from posterior end of body (Latin, ramus = a branch) |
|
angle (N15,TG7-32B, TG7-32C) |
posteroinferior bend formed by union of body & ramus |
| temporal |
petrous part (TG7-06, TG7-07) |
contains tympanic cavity & bony labyrinth |
|
zygomatic process (N4, TG7-04A) |
articulates with temporal process of zygomatic bone to form the zygomatic arch |
|
mastoid process (N4, TG7-04A) |
projects inferiorly from junction of petrous & squamous parts; contains mastoid air cells that open into tympanic cavity through mastoid antrum |
|
styloid process (N4, TG7-04A, TG7-06) |
projects inferiorly from petrous part; attachment for stylohyoid, styloglossus & stylopharyngeus muscles & stylomandibular & stylohyoid ligaments (Greek, styloid = resembles a pillar or post) |
|
stylomastoid foramen (N8, TG7-06) |
located between the styloid and mastoid processes; exit of the facial nerve from the base of the skull |
|
external acoustic meatus (N4, TG7-04A) |
opening which allows sound to reach tympanic membrane (Latin, meatus = a passage) |
Muscles |
|---|
| Muscle | Origin | Insertion | Action | Innervation | Notes | Image |
|---|
| depressor anguli oris (N26, N54, TG7-29, TG7-30A) |
oblique line of mandible | angle of mouth | pulls the corner of the mouth downward | marginal mandibular & buccal branches of facial nerve (VII) | a "frown" muscle |  |
| levator labii superioris (N26, N54, TG7-29, TG7-30A) |
inferior margin of orbit | skin of upper lip | elevates upper lip | buccal branch of facial nerve (VII) | (Latin, levator = to lift) |  |
| zygomaticus major (N26, N54, TG7-29, TG7-30A) |
zygomatic bone, upper lateral surface | skin of angle of mouth | elevates and draws the corner of mouth laterally | zygomatic and buccal branches of facial nerve (VII) | a "smile" muscle |  |
| orbicularis oris (N26, N54, TG7-29, TG7-30A) |
skin and fascia of lips and area surrounding lips | skin and fascia of lips | purses the lips | buccal branch of facial nerve (VII) | (Latin, orbicularis = a small disk) |  |
| buccinator (N26, N54, TG7-29) |
pterygomandibular raphe, mandible, and maxilla lateral to molar teeth | angle of mouth & lateral portion of upper and lower lips | pulls corner of mouth laterally; pulls cheek against teeth | buccal branches of facial nerve (VII) | although buccinator is important in mastication, it is innervated by the facial nerve, and NOT by the buccal nerve from V3 (a sensory nerve) (Latin, buccinator = trumpeter) |  |
| platysma (N26, TG7-29, TG7-30A) |
fascia overlying the pectoralis major and deltoid muscles | inferior border of mandible and skin of lower face | draws corners of mouth down; aids in depression of the mandible | facial nerve (VII), cervical branch | (Greek, platysma = a flat plate) |  |
Nerves |
|---|
| Nerve | Source | Branches | Motor | Sensory | Notes |
|---|
| facial (N25, TG7-31A, TG7-87C)
|
pons & medulla: nucleus solitarius of medulla via nervus intermedius (SVA sensory root) from geniculate ganglion; superior salivatory nucleus (GVE preganglionic parasympathetic) of pons via nervus intermedius, facial motor nucleus of pons via motor root | greater petrosal (preganglionic parasympathetic to pterygopalatine ganglion, postganglionic parasympathetic travels with brs. of maxillary div. of V), chorda tympani (SVA taste from anterior 2/3rds of tongue; preganglionic parasympathetic to submandibular ganglion, postganglionic parasympathetic to submandibular & sublingual glands), n. to stapedius, posterior auricular, intraparotid plexus with temporal, zygomatic, buccal, marginal mandibular & cervical brs. | stapedius, stylohyoid, posterior belly of digastric, muscles of facial expression; secretomotor to lacrimal, submandibular, sublingual, and mucous glands of nasal & oral cavities | taste (SVA) from anterior 2/3rds of tongue; part of skin of external auditory meatus | also known as: CN VII, 7th cranial nerve; passes into internal acoustic meatus, goes through facial canal, exits at stylomastoid foramen |
| supraorbital (N24, N36, N45,N122, TG7-29, TG7-82) |
frontal | medial & lateral brs. | |
skin of forehead, frontal sinus |
| supratrochlear (N24, N36, N45,N122, TG7-29, TG7-82) |
frontal | | | skin of forehead medially & upper eyelid medially & associated conjunctiva |
(Latin, trochlea = a pulley) |
| infratrochlear (N24, N36, N45,N122, TG7-82) |
nasociliary br. of V1 | | | skin & conjunctiva of eyelids medially, skin of nose laterally |
(Latin, trochlea = a pulley) |
| infraorbital (N24,N36, N45,N122, TG7-29, TG7-83) |
maxillary division of trigeminal (V2) | middle & anterior superior alveolar | | maxillary sinus, upper premolar, canine & incisor teeth & gingiva, skin of lateral nose & face below orbit | passes through infraorbital groove, canal & foramen |
| mental (N24,N46,N122, TG7-29, TG7-84) |
inferior alveolar | | | skin of chin & lower lip | passes through mental foramen |
| auriculotemporal (N24,N46,N122, TG7-29, TG7-30, TG7-84) |
mandibular division of trigeminal n. (V3) | parotid brs., articular brs., anterior auricular brs. | secretomotor to parotid gland: postganglionic parasympathetic from communicating br. of otic ganglion; preganglionic parasympathetic from lesser petrosal br. of glossopharyngeal n. (IX) | skin of anterior ear & anterosuperior to ear; part of external auditory meatus; temporomandibular joint | two roots of auriculotemporal encircle the middle meningeal a. |
| buccal nerve (N24, N122, TG7-29) |
mandibular division of trigeminal n. (V3) | | | skin of cheek, oral mucosa | not a motor nerve |
| buccal branches of facial n. (N25, TG7-31A, TG7-87C) |
facial n. (VII); has temporofacial & cervicofacial divisions | | zygomaticus major & minor, buccinator, orbicularis oris, levator anguli oris, levator labii superioris & alaeque nasi, risorius, procerus, nasalis | | not a sensory nerve |
Arteries |
|---|
| Artery | Source | Branches | Supply | Notes |
|---|
| facial (N69,N23, TG7-71) |
external carotid | ascending palatine a., tonsilar br., submental a., sup. & inf. labial as., lat. nasal br., angular a. | lower part of palatine tonsil, submandibular gland, facial muscles & fascia | its angular branch anastomoses with the ophthalmic a. |
| labial, inferior (N69, TG7-71) |
facial | | lower lip - skin, muscles & mucosa | |
| labial, superior (N69, TG7-71) |
facial | septal br. | lower nasal septum; upper lip - skin, muscles & mucosa | |
| nasal, lateral (N69,N23, TG7-71) |
facial | | lateral nose | anastomoses with dorsal nasal |
| angular (N69,N23, TG7-71) |
facial | | orbicularis oculi and lacrimal sac | terminal branch of the facial a. |
| facial, transverse (N69, N23, TG7-71) |
superficial temporal a. | | parotid gland; masseter m.; skin of the face | anastomoses with branches of the buccal, infraorbital and facial arteries |
| supraorbital (N69,N23, TG7-71) |
ophthalmic | | muscles, skin & fascia of forehead | |
| infraorbital (N69,N23, TG7-71) |
maxillary | anterior & middle superior alveolar | maxillary sinus, incisors, canine, premolars, skin of cheek below orbit, mucosa over maxilla and adjacent cheek | a terminal branch of the maxillary a. |
| supratrochlear (N69, N23, TG7-71) |
ophthalmic | | muscles, skin & fascia of forehead medially | |
| carotid, external (N69,N23, TG7-19, TG7-71) |
common carotid | superior thyroid, ascending pharyngeal, lingual, facial, occipital, post. auricular, maxillary & superficial temporal (terminal brs.) | upper neck, face & scalp | primary blood supply to face & superficial head |
| superior thyroid (N69, TG7-19, TG7-71) |
external carotid |
infrahyoid br., sternocleidomastoid br., sup. laryngeal, cricothyroid br., ant., post. & lat. glandular brs. |
thyroid gland, upper larynx, infrahyoid muscles, sternocleidomastoid |
|
| ascending pharyngeal (N69, TG7-71) |
external carotid |
pharyngeal brs., inf. tympanic, post. meningeal |
pharynx |
arises from the medial side of the external carotid a. close to the birfurcation |
| lingual (N69, TG7-71) |
external carotid |
suprahyoid br., dorsal lingual brs., deep lingual, sublingual |
tongue, suprahyoid muscles, palatine tonsil |
(Latin, lingula = tongue) |
| occipital (N69, N23, TG7-71) |
external carotid |
sternocleidomastoid brs., auricular br., mastoid br., descending br., occipital brs. |
lateral & post. neck, post. scalp |
anastomoses with deep cervical; joins greater occipital nerve posteriorly |
Veins |
| Vein | Tributaries | Drains Into | Region Drained |
Notes |
|---|
| angular (N23,N70, TG7-73) |
union of supraorbital & supratrochlear | continues as facial vein at inferior margin of the orbit | forehead, nose, upper eyelid |
valveless; connects with superior & inferior ophthalmic vv. |
| retromandibular (N70, TG7-11, TG7-73) |
formed by the union of the superficial temporal & maxillary vv. | anterior & posterior divisions of retromandibular; anterior division unites with facial to form common facial, posterior division unites with posterior auricular to form external jugular | side of head & scalp; deep face |
contained within the parotid gland |
| posterior auricular (N70, TG7-11, TG7-73) |
| unites with post. div. of retromandibular to form external jugular | behind ear |
connects with occipital v. behind ear (Latin, auris = ear) |
| common facial (N70, TG7-11, TG7-73) |
union of ant. div. of retromandibular & facial | internal jugular |
face & anterior scalp |
| anterior jugular (N27,N70, TG7-11, TG7-73) |
submental, communicating | external jugular | anterior neck superficially |
(Latin, jugulum = throat) |
| external jugular (N27,N70, TG7-11, TG7-73) |
formed by the union of the retromandibular & posterior auricular vv.; tributaries: posterior external jugular, transverse cervical, suprascapular, anterior jugular | subclavian v. | head & neck, shoulder |
(Latin, jugulum = throat) |
| internal jugular (N27,N70, TG7-11, TG7-73) |
formed by the union of the sigmoid & inferior petrosal sinuses; tributaries: pharyngeal vv.; lingual, common facial, sternocleidomastoid, superior & middle thyroid vv. | brachiocephalic v. | brain & skull, face, viscera of neck | largest vein of the nead and neck (Latin, jugulum = throat) | |
Lymphatics |
|---|
| Structure | Location | Afferents from | Efferents to | Regions drained | Notes |
|---|
| cervical nodes, deep (TG7-74) | in and around carotid sheath | lymphatic vessels from head & neck | jugular trunk | head & neck | superior and inferior subdivisions are delineated by the crossing of the omohyoid m. |
| cervical nodes, superficial (TG7-74) | in superficial fascia and along superficial vessels of the head & neck | lymphatic vessels from superficial structures in head & neck | varies by group; ultimate destination is the jugular trunk | head & neck | several groups are designated by location: occipital, retroauricular, anterior auricular, superficial parotid, facial, submental, submandibular, external jugular, anterior jugular |
Clinical Terms
|
|
Term
|
Definition
|
| Bell's palsy |
a condition that involves the facial nerve (VII cranial nerve) and results in the paralysis of one side of the face. Bell's (facial nerve palsy) can be differentiated from a central (stroke) deficit by the inability to raise the eyebrow on the affected side. |
| trigeminal neuralgia/tic douloureux |
a disorder of trigeminal nerve (cranial nerve V) dysfunction. Synonym: tic douloureux. Characterized by excruciating paroxysms of pain in the lips, gums, cheek or chin, and, very rarely, in the distribution of the eye (ophthalmic division of the trigeminal nerve). |
| Frey's syndrome |
a condition in which the parasympathetic nerves (branches in the auriculotemporal) which normally supply the parotid gland innervate the sweat glands in the area, leading to sweating over the parotid when eating |
| parotid calculus |
a stone in the parotid duct (Latin, calculus = a pebble) |
| sialogram |
an X-ray study of the salivary ducts. A contrast material is injected into the salivary duct
(within the mouth) to highlight the course and caliber of the ducts. This test is used to
detect a stricture or blockage (for example stones, tumor) of the salivary ducts. |
| sialolithiasis |
formation of a stone in a duct of a salivary gland |
| mumps |
an infectious acute viral disease affecting the parotid glands. The gonads, meninges and pancreas can also be affected. The causative agent is a paramyxovirus. Humans are the only natural host for this disease. Common symptoms include weakness, fever, sore throat, malaise and puffiness to the cheeks (due to parotid gland swelling). Patients are contagious 1 day prior to the onset of swelling until the swelling is gone. Recovery is generally in 2 weeks. |
)
)
)
)
)
)