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Transcript
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)
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Cranial fossa:
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Oral cavity:
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Slide 20:
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Slide 21
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Nasal cavity:
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Slide 24:
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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
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Ethboidal bula
Sphenoethmoidal recess (where the sphenoid sinus empties) –
superior conchae
Everything else drains into the middle meatus
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Sympathetic trunk (found between these 2 muscles)
Longus capitis – lateral
Longus colli – medial
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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
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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)