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‫אוקסיפיטלי‬-‫ המשולש הסאב‬.4
Posterior cervical muscles
(from superficial to deep)
Trapezius
Splenius capitis
Levator scapulae
Longissimus capitis
Semispinalis capitis
innervated by C.N. XI
Innervation is by the spinal nerves near it
innervated by the dorsal scapular nerve
innervated by the dorsal rami of nearby spinal nerves
innervated by dorsal rami of adjacent spinal nerves
The suboccipital triangle
The sides of the triangle are:
Obliquus capitis inferior
Obliquus capitis superior
Rectus capitis posterior major
Rectus capitis posterior minor
These four muscles are all supplied by the
suboccipital nerve
(dorsal ramus of C1)
The greater (C2) and third (C3) occipital nerves
They should come into view on their way to supply the skin
of the posterior scalp, piercing through the muscles.
Vertebral artery
It rises through the foramina transversaria in the cervical vertebrae
Nuchal ligament
Cervical joints and ligaments
Held by
Atlanto-occipital joint
Anterior and posterior antlanto-occipital membranes
Tectorial membrane
Atlantoaxial joint
Alar ligaments
Cruciate ligament (cruciform ligament)
Transverse ligament of atlas
Superior and inferior longitudinal bands
‫ העין‬.5
...‫ להיזכר בחומר של קורס היסטולוגיה‬- ‫רקע היסטולוגי‬
Extraocular muscles
C.N.
IV
Superior oblique
Inferior oblique
C.N.
III
C.N.
VI
Superior rectus
Inferior rectus
Medial rectus
Lateral rectus
They all originate on the
common tendinous ring
surrounding the optic canal
Medial check ligament
Lateral check ligament
Vasculature of the eye
(Internal carotid)
Ophthalmic artery
Central artery of retina
Supraorbital
supratrochlear
Lacrimal
Dorsal nasal
Short/long Post.Ciliaries
Post/Ant Ethmoidal
Anterior ciliary
(maxillary artery) – infraorbital
(cavernous
Veins: Superior/Inferior ophthalmic veins
sinus)
Nerves of the eye
cranial nerves Optic (II) Oculomotor (III) Trochlear (IV) Abducens (VI)
Trigeminal nerve (V)
Ophthalmic branch
Frontal
Nasociliary
lacrimal
Supraorbital
Supratrochlea
Ciliary gan.
Ciliary Short\Long
Post. Ant. Ethmoidal
Infratrochlear
Accessory structures of the eye
Lacrimal gland, Lacrimal ducts, Conjunctival sac, Lacrimal lake, Lacrimal papilla, Lacrimal punctum
Lacrimal canaliculi, Lacrimal sac
Eyelids (palpebrae) Tarsal plates,Ttarsal glands, Medial and lateral palpebral ligaments,
Orbicularis oculi muscle, levator palpebrae superioris muscle
‫טמפורלי והמפרק‬-‫ החלל התת‬,‫ החלל הטמפורלי‬.6
‫הטמפורומנדיבולרי‬
Contents of the temporal fossa
superficial to
the muscle
The superficial temporal arteries
Auriculotemporal nerve a branch
terminal branches of the external carotid artery
of the posterior division of C.N. V3
The temporalis muscle
deep to the
muscle
The anterior and posterior deep
temporal arteries
branches of the maxillary artery
temporal branches of the
mandibular division of the
trigeminal nerve
The infratemporal fossa
Muscles
Medial pterygoid
Lateral pterygoid muscle
Vasculature of the infratemporal fossa
)‫ )שני החלקים הראשונים‬Maxillary
artery
The first part
1. Deep auricular to the external acoustic meatus
2. Anterior tympanic to the tympanic membrane
3. Middle meningeal to the meninges, ascending through the
foramen spinosum.
4. Accessory meningeal to the meninges
5. Inferior alveolar to the lower jaw, traveling with the nerve
The second part
1.
2.
3.
4.
Anterior deep temporal artery
Posterior deep temporal artery
Pterygoid arteries to the muscles
Masseteric artery to deep surface of
the
masseter
5. Buccal artery
to the buccinator muscle
in the mandibular canal
Nerves of the infratemporal fossa
Mandibular nerve (V3)
posterior division
1.
2.
3.
4.
Auriculotemporal nerve "hugs" the middle meningeal artery
Nerve to tensor veli palatini muscle
Nerve to medial pterygoid muscle
Inferior alveolar nerve descends into the mandibular foramen
the nerve to mylohyoid
5. Lingual nerve
anterior division
1. Anterior and posterior deep
temporal nerves
2. Masseteric nerves
3. Nerve to lateral pterygoid muscle
4. Buccal nerve supplies the skin above cheek,
not the buccinators!
More -
1. Two important nervous features: otic ganglion, chorda tympani nerve
2. The TMJ: stylomandibular and sphenomandibular ligaments
3. Middle meningeal artery
‫ הלוע והגרון‬,‫ הסינוסים המקסילריים‬,‫ הפה‬,‫ חללי האף‬.7
Hard/Soft palate
Superficial structures:
Uvula, Palatoglossal arch,
Palatopharyngeal arch.
Tonsillar fossa housing the palatine tonsils.
Palatine glands (mucus). Transverse palatine
folds, Palatine raphe, Incisive papilla.
Muscles: Tensor veli palatine, Levator veli
palatine, Palatoglossus, Palatopharyngeus,
Musculus uvula
descending palatine A
or pterygopalatine gan.
Sphenopalatine A
and nasopalatine N
Incisive
canal
Greater
palatine
Hard palate
Lesser
palatine
Greater and
lesser palatine
foramina
T o ng ue
Superficial structures:
Root, body, apex
median and terminal sulci
lingual septum, foramen cecum,
dorsum, papilla
Lingual tonsils, lingual frenulum,
sublingual caruncle, epiglottis
Muscles of the tongue
Extrinsic muscles: Genioglossus, Hyoglossus, Styloglossus, Palatoglossus
(Intrinsic muscles: Superior longitudinal, Inferior longitudinal, Transverse, Vertical)
Innervation
►All muscles except the palatoglossus (CN X) are innervated by CN XII
►CN IX gives taste and sensation posterior 1/3
►Internal laryngeal (X) - small area in the root of the tongue.
►anterior 2/3 - Chorda Tympani (VII) Lingual (V3)
Vasculature
Lingual artery
►dorsal/deep lingual arteries
►sublingual artery
Pterygopalatine fossa
Nerves
Vessels
enters through the
Maxillary Nerve (CN V2)
foramen rotundum
►Zygomatic nerve
Zygomaticofacial nerve
Zygomaticotemporal nerve*
►Pterygopalatine nerves**
►Infraorbital nerve***
*communicates with the lacrimal n. (CN V1) conveying secremotor fibers
**move downward to the pterygopalatine ganglion where they do not synapse and go
further down to supply the nose, palate, tonsil and gingiva.
***termination of V2. Through the inferior orbital fissure.
The third part of maxillary artery
1.
2.
3.
4.
5.
6.
Posterior superior alveolar artery
Infraorbital artery
Artery of pterygoid canal
Pharyngeal branch
Descending palatine artery
Sphenopalatine artery
Parasympathetic fibers
Sympathetic fibers
(Facial nerve (CN VII))
(Internal carotid plexus)
Great petrosal nerve
Deep petrosal nerve
→ Nerve of the pterygoid canal ←
pterygopalatine ganglion
The Parasympathetic fibers synapse at the pterygopalatine ganglion, while Sympathetic fibers don't.
Nose
External part Root, Apex, Nares, Alae, Septum
Internal parts nasal septum, nasal cavities
Nasal Lamina,
cavities Superior and inferior horns,
Thyroid cartilage
Paranasal sinuses
Superior and
inferior
thyroid notches,
Arterial
supply
Sphenoidal sinus
Laryngeal prominence,
Maxillary a. →Sphenopalatine, Greater palatine
Maxillary sinus
Ophthalmic→ anterior and posterior ethmoidal
Cricoid cartilage
Lamina, Arch
Ethmoidal sinus composed of air cells
Facial
→ superior
lateral nasal
Arytenoids cartilages
anterior vocal
process,
lateral labial,
muscular
Frontal sinus, → Frontonasal duct →
Innervation
process
→ Ethmoidal infundibulum
Olfactory nerve
Epiglottic cartilage
Nasopalatine and greater palatine nerves (V2)
Corniculate
Other structures
(schema): cartilages
Anterior and posterior ethmoidal nerves (V1)
Cuneiform cartilages
Sphenoethmoidal
recess
superior Conchea
˚ ˚ ˚
Posterior ethmoidal air cells
Ethmoidal infundibulum
Superior
meatus
middle Conchea
˚ ˚ ˚
Middle ethmoidal air cells
Semilunar hiatus
Ethmoidal bulla
Middle
meatus
inferior Conchea
Orifice of
Pharynx
Nasolacrimal duct
Nasopharynx: choana
(Tears!)
salpingopharyngeal fold
salpingopharyngeus muscle
torus tubarius, pharyngeal recess, pharyngeal tonsils
Oropharynx: palatoglossal and palatopharyngeal arches,
Palatine tonsils (and their beds)
(Arterial supply of the palatine tonsils)
Laryngopharynx
Adduction
Abduction
Sphyncters
3Tensors
single
cartilages and
3 paired
ones:
Relaxors
Intrinsic muscles
Lateral cricoarytenoids, Larynx
Transverse arytenoids
Posterior cricoarytenoids
Transverse arytenoids, Oblique arytenoids,
Aryepiglottic muscles
Cricothyroids
Thyroarytenoids, Vocalis
Inferior
meatus
Pharyngeal muscles
External layer: superior / Middle / inferior
pharyngeal constrictor
Internal layer: Palatopharyngeus,
Salpingopharyngeus, Stylopharyngeus