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Posterior triangle: Division is based on the SCM muscle Nerve going in – CN XI No cervical plexus nerves (superficial) External jugular vein crosses over SCM Parotid gland Facial a/v across the mandible (branch of ECA) Superficial muscle Platysma – first thing you see after removing the skin The first few branches of the External Carotid Root of the neck: Transverse cervical artery (above the clavicle) Suprascapular artery – (level of the clavicle) IJV (carotid sheath with CCA and Vagus n.)/EJV Anterior scalene Phrenic nerve lies on anterior surface of anterior scalene Posterior to anterior scalene - vasculature SCM Interscalene triangle (A and M scalene) impinges the brachial plexus and subclavian artery Anterior Triangle: Facial artery Stylohyoid m. (from styloid process to hyoid) o Goes through the tendon of the digastric muscle Anterior belly of the digastric (most superficial) Mylohyoid (right under the digastric) Inferior and superior labial branches come from facial artery Hyoid bone Thyrohyoid m. Sternothyroid m. (under the sternohyoid) Sternohyoid m. (more medial and superficial) SCM (clavicular head and sternal head) Omohyoid (more lateral and superficial) CCA IJV Ansa cervicalis (as a whole) – not deep – on surface of carotid sheath o Nerve loop in the neck that is superficial – embedded in the carotid sheath Carotid sheath and whats inside of it CN XI CN XII – loops over the carotids or can be found on the lingual side btw tongue and mandible Slide 7 Hypoglossal nerve btw mylohyoid and hyoglossus o Anything containing “glossus” will be associated with the external tongue Three branches of External Carotid o Superior thyroid (1) o Lingual (2) o Facial (3) o Ascending pharyngeal? Sinus (dilation in beginning of ICA) and carotid body (at bifurcation) All the muscles from the previous slide too Cranial Osteology KNOW (at least 10 questions) Know all fissures and fossa and what passes through Facial Expression Superficial temporal artery – anterior to ear (from ECA) – accompanied by auriculotemporal nerve (CN V3) Orbicularis oculi Zygomaticus major Parotid duct Buccinator Massater Facial artery Playtsma EJV Parotid gland 5 branches off of the facial nerve (TZBMC) slide 12 cutaneous branches of V1 (supraorbital n. ), V2 (infraorbital n.), V3 (mental foramen) muscles of mastication orbicularis oris zygomaticus major buccinators parotid duct facial artery (a lot of bends = torturous) masseter EJV CN XII Digastric posterior belly Stylohyoid Slide 15: Temporalis Auriculotemporal nerve (runs with the superficial temporal artery) ? Superficial temporal artery (anterior to the ear) Maxillary artery (2nd terminal branch of the ECA) Cranial fossa: Oral cavity: Slide 20: Slide 21 Nasal cavity: Slide 24: KNOW from a model Styloglossus Hyoglossus Genioglossus (bulk of tongue) Geniohyoid (anterior to poasterior) – chin – superior to mylohyoid Mylohyoid (floor) - transverse direction Digastric (anterior to posterior) Mylohyoid Geniohyoid Genioglossus CN XII – medial to lateral nerve Submandibular duct – over and lateral to lingual nerve Submandibular gland Lingual nerve – lateral to CN XII Conchae Sinuses Ethboidal bula Sphenoethmoidal recess (where the sphenoid sinus empties) – superior conchae Everything else drains into the middle meatus Sympathetic trunk (found between these 2 muscles) Longus capitis – lateral Longus colli – medial Superior constrictor – level of the base of skull Middle constrictor – level of hyoid Inferior constrictor – level of thyroid cartilage Stylopharyngeus m. (CN IX) – can see this nerve wrapping around this) CN X CCA CN XI Know what comes in between each constrictor Pharynx: Slide 28: o Runs into the lateral pterygoid (horizontal); more superior ECA Lateral and medial pterygoid (runs vertical)- more inferior?? Lingual nerve Slide 29: Medial to the carotid sheath contents is the sympathetic trunk and ganglion Styloglossus CN XII (btw mylohyoid and hypoglossus) Digastric tendon Stylohyoid Hyoglossus Middle and inferior constrictors Mylohyoid There are 3 muscles coming off of the styloid process Oral cavity (slide 32/33): Levator veli palatine – lift up the soft palate (more POSTERIOR than tensor veli palatine) Tensor veli palatine (tendon associated with this one) – comes around hook of the hamulus (tenses the soft palate) ANTERIOR Palatoglossal arch Palatopharyngeal arch (tonsilar fossa is between these two) Salpingopharyngeal fold Torus (opening of Eustachian tube) Ear mastoid region: Study the ear models Tensor tympani Main parts of middle ear (2 muscles and ossicles) Orbit: 3 nerves (frontal nerve = lateral supraorbital and medial supratrochlear) o frontal nerve – main nerve superiorly in the middle – divides into the nerves above lacrimal nerve goes to lacrimal gland (lateral) CN III, CN IV(trochlear nerve – medial goes to superior oblique), CN VI Levator palpebrae superioris – most superficial on top Rectus muscles and oblique muscles Long ciliary nerves (project from the nasociliary nerve when it crosses CN 2) Nasociliary nerves (gives rise to the long ciliary nerves) – just across top of the optic nerve going toward nose Cranial osteology: (THIS IS NOT A LIST OF DEFINITE THINGS THEY WILL ASK….JUST THINGS THAT DMC POINTED OUT THAT ARE IMPORTANT!!!) Frontal bone Orbital plate Styloid process Mastoid process Stylomastoid foramen Cribiform plate Crista gala Nasal bone Lacrimal bone Palatine bone Concha Vomer Sphenoid bone Lesser and greater wings Hypophyseal fossa Dorsum selae Anterior clinoid process and posterior ROS fossae Pterygoid plates Hamulus Maxilla Infratemporal fossa Spinosum Rotundum Inferior orbital fissure Mandible Mylohyoid line Mental spine Genial tubercle Mental foramen Ramus Coronoid Neck Condyle Notch Mental foramen Supraorbital notch or foramen Optic canal Superior and inferior orbital fissures and what goes through Infraorbital canal Sutures Nasal cavity: Septum Perpendicular plate of ethmoid Conchae and meatus Cochlea Round and oval windows Ossicles (MIS)