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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