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Head
Lu Xiaoli
Regional Anatomy & Operative Surgery
China Medical University
Boundaries
Inf. Border
of Mandible
 Angle of Mandible
 Mastoid Process
 Sup. Nuchal Line
 Ext. Occipital Protuberance

Divisions
Supraorbital
margin
 Sup. Border of Zygomatic arch
 Sup. Border of external acoustic
meatuses
 Mastoid process

Surface Anatomy
1

Superciliary arch

Supraorbital notch
2
3

Infraorbital foramen

Mental foramen
4
Pterion
1
Zygomatic arch
Mastoid process
2
3
5
Condylar process
Angle of mandible
4
Tragus
Anterosuperiorly:
superficial temporal
a.
Anteriorly:
Temporomandibular
joint
Bregma
1
Lambda
Superior nuchal line
3
2
External occipital protuberance
Cen. sulcus
Sagittal
Mid. meningeal a.
Sup. Horizontal
Lat. sulcus
Inf. Horizontal
Ant. Middle
Pos. Vertical
Face
 Superficial
layers
 Lateral compartment
 parotideomasseteric region
 Deep lateral region
Skin & Superficial Fascia
Thin
 Full of sebaceous gland, sweat gland
& hair follicle – sebaceous cyst &
furuncle (Boil )
 Loose connective tissue in Palpebral
area – edema
 Full of blood vessels – good heal,
anti-infection, but heavy bleeding

furuncle (Boil )
Sebaceous cyst
Facial Muscles




Orbicularis oculi

Nostrils



Rima oculi

Nasalis
Rima oris
Superficial



Middle



Orbicularis oris
Levator labii superioris
Zygomaticus
Risorius
Depressor anguli oris
Levator anguli oris
Depressor labii inferioris
Deep


Buccinator
Mentalis
Orbicularis
oculi
 Nasalis

Orbicularis
oris
 Levator labii
superioris
 Zygomaticus
 Risorius
 Depressor
anguli oris

Levator
anguli oris
 Depressor
labii
inferioris

Buccinator
 Mentalis

Facial a.
Angular a.
 Lateral
nasal a.
 Superior
labial a.
 Inferior
labial a.

External carotid a.
Facial v.
From
Angular v. to
Internal
jugular v.
 Anastomosis
with
cavernous
sinus
 No valves

Innervations

Trigeminal n.
 Supraorbital
n.
 Infraorbital n.
 Mental n.

Facial n.
 Temporal
branches
 Zygomatic branches
 Buccal branches
 Marginal mandibular branch
 Cervical branch
Supraorbital n.
 Infraorbital n.
 Mental n.


Ophthalmic n.

Maxillary n.

Mandibular n.
parotideomasseteric region
Parotid gland
 Masseter
 Blood vessels
 Innervations

Parotid Gland
masseter
Ramus of mandible
Medial pterygoid
Mastoid process
• Zygomatic arch
• Ext. acoustic
meatus
• Temporomandibular
joint
• Angle of mandible
• Mastoid process
• Sternocleidomastoid
superficial temporal
posterior
auricular
maxillary
retromandibular
facial
external
jugular
temporal
Pos. auricular
zygomatic
motor
branch to
pos. belly of
digastric
buccal
mandibular
cervical
transverse facial a.
maxillary a.
superficial
temporal a.
occipital
a.
external carotid a.
Parotid
Bed
styloid process
stylohyoid m.
stylopharyngeus m.
posterior belly of
digastric m.
Parotid Fascia
a derivative of
superficial layer
of deep cervical
fascia
 fixed above to
zygomatic arch
 Superficial layer
is thick, deep
layer is thin

Parotid Duct
Parotid papilla
vestibule of mouth opposite
upper 2nd molar tooth
Sialogram
Muscle of
Mastication
Temporalis
 Masseter
 Lat. Pterygoid
 Medial
pterygoid

Temporomandibular Joint
Temporomandibular Joint
Reduction
Deep lateral region
Roof
Bottom
Greater wing of sphenoid bone
Inferior margin of mandible
Ant. Post. Surface of body of maxilla
Walls
Post. Deep parotid gland
Lat.
Ramus of mandible
Lat. pterygoid plate
Med.
Lat. pharyngeal wall
Greater wing of sphenoid bone
Lat. pterygoid plate
maxilla
Pterygoid
Plexus
Cavernous
sinus
Inf. Ophthalmic v.
Pterygoid Plexus
Pterygoid Plexus
Deep facial v.
mandibular
nerve





deep temporal
auriculotemporal
inferior alveolar
Lingual
Buccal
Masseter Space
Skull
Epicranial
Aponeurosis
diploic veins
Emissary vein
venous
sinus of
dura mater
Communications between
intracranial & extracranial veins
Sigmoid sinus
Internal jugular v.
Cavernous sinus
Sup.
ophthalmic v.
Inf.
Ophthalmic v.
Venous Plexus
of foramen ovale
Deep facial v.
Pterygoid plexus
Angular v.
Facial v.
Internal jugular v.
Emissary v.
of foramen lacerum
Superficial
temporal v.
Parietal
emissary v.
Occipital v.
Mastoid
emissary v.
Supoccipital v.
Condylar
emissary v.
Frontal sinus v.
of nasal cavity
Frontal
emissary v.
Sup.
Sagittal simus
Sigmoid sinus
Sup.
Saggittal sinus
Sup. Orbital v.
Frontal
diploic v.
Sup. Sagittal
sinus
Ant. Deep
temporal v.
Ant. Temporal
diploic v.
Sphenoparietal
sinus
Superficial
extracranial v.
Post. Temporal
diploic v.
Transverse
sinus
Occipital v.
Occipital
diploic v.
Transverse
sinus
When trying to locate the parotid duct,
a physician would consider each of the
following relationships EXCEPT:
A.
B.
C.
D.
E.
its opening can be seen in the vestibule of
the mouth opposite the upper 2nd
premolar tooth
it extends from the anterior border of
the parotid gland
it can be palpated as it crosses the face,
superficial to the masseter muscle
it is inferior to the zygomatic arch
it is superior to the zygomatic arch
Which of the following statements best
describes the facial vein? :
A.
B.
C.
D.
E.
it is located within the substance of the
parotid gland
it communicates superiorly with the
ophthalmic vein
it is more tortuous than the facial artery
it lies anterior to the facial artery as it
passes through the face
it usually empties into the external
jugular vein
The coronoid process belongs to
which bone in the head?
A.
B.
C.
D.
E.
maxillary
mandible
sphenoid
occipital
temporal
The muscles of mastication, their
nerves and their vessels are located
primarily in which part of the head?
A.
B.
C.
D.
E.
pterygopalatine fossa
jugular fossa
incisive fossa
infratemporal fossa
temporal fossa
The facial artery gives rise to
branches that supply each of the regions
listed below EXCEPT for the:
A.
B.
C.
D.
E.
medial angle of the orbit
lateral nose
region of the eyebrow
upper lip
lower lip
The superior sagittal sinus:
A.
B.
C.
D.
E.
drains into the straight sinus
is attached to the petrous temporal
bone
receives emissary veins from the scalp
communicates with the cavernous sinus
receives the superior petrosal sinus
Pulsations
felt
just above
the
zygomatic arch and in front of the ear are
from which vessel?
A.
B.
C.
D.
E.
facial
internal jugular vein
superficial temporal artery
retromandibular vein
maxillary artery
The "danger zone" of the scalp is
recognized as which of the following
layers?
A.
B.
C.
D.
E.
Galea aponeurotica
Loose connective tissue
Pericranium
Skin
Subcutaneous connective tissue
An infection in which scalp layer is
likely to spread most readily?
A.
B.
C.
D.
E.
Skin.
Connective tissue layer.
Aponeurotic layer.
Loose areolar tissue.
Pericranium.
An elderly patient developed fever and
worsening headache a few days after sustaining a
scalp laceration and subsequent infection due to a
car accident. At the hospital the case was
diagnosed as meningitis and superior sagittal sinus
thrombosis. The attending physician suggested
that infection to the sinus initially spread through
one of the scalp layers. The scalp layer involved is:
A. Areolar tissue
B. Connective tissue
C. Epicranial aponeurosis
D. Periosteum
E. Skin
What structure lies deepest in the
parotid gland?
A.
B.
C.
D.
E.
External carotid artery
External jugular vein
Facial artery
Facial nerve
Retromandibular vein
A deep laceration of the face in the
middle of the parotid gland could affect
the:
A.
B.
C.
D.
E.
External jugular vein
Facial nerve
Glossopharyngeal nerve
Hypoglossal nerve
Lingual artery
A 38-year-old female patient complained of
parotid pain that increased while eating. Intraoral
examination detected some pus oozing from the
parotid duct opening. What was the most likely
anatomical
reference
that
the
physician
considered to locate the parotid duct opening?
A. Mucosa of the sublingual caruncle behind the
central incisor teeth
B. Mucosa of the cheek across the 2nd upper
(maxillary) molar tooth
C. Mucosa of the floor of the mouth along the
sublingual fold
D. Mucosa of the cheek across the 2nd lower
(mandibular) molar tooth