Deep Head & Neck Spring 2014 Fredit

Structure Type
Grant
15th Drake Notes Landmarks
Temporal Region
mandibular fossa Temporal 230 921 Articulation point for mandible.
A fossa just anterior to the external acoustic
meatus. Also inferior to the zygomatic process of
temporal bone.
articular tubercle (or eminence) Temporal 230 Forms anterior boundary of the mandibular fossa.
mandibular condyle Mandible 230 Also known as condyloid process.
The posterior articulation of the mandible's ramus
to the TMJ.
mandibular notch Mandible 230 922
The divot, or "U," between the mandible's
coronoid process and condylar process.
coronoid process Mandible 230 815 The anterior articulation of the mandible's ramus.
lingula Mandible 230 922
For attachment of sphenomandibular
ligament.
Intenal surface of ramus of mandible, a little
inferior of the mandibular notch and just superior
to the mandibular foramen.
mandibular foramen Mandible 230 922 For inferior alveolar nn's and vessels. Just inferior to the lingula of mandible.
mylohyoid groove Mandible 230 922
For the nn to mylohyoid mm and for the
mylohyoid vessels.
A groove on the internal surface of the mandible's
ramus, just inferior to the mandibular foramen.
inferior orbital fissure Multiple bones 231 885
Holds the Maxillary nn [V2], its zygomatic
branch, the infra-orbital vessels.
Between the greater wing of sphenoid bone and
the maxilla.
pterygoid process Sphenoid 231 941
From the posterior view, the pterygoid processes
are inferior to the great wings of the sphenoid
bone, inferior to the foramen rotundum.
masseter muscle muscle 231 925
Elevates the mandible inmastication.
Innervated by masseteric nn from
anterior trunk of mandibular nn [V3] .
Suppled by masseteric aa from maxillary
aa .
Originates from zygomatic arch an dmaxillary
process of zygomatic bone, inserts to lateral
surface of ramus of mandible.
styloid process Temporal 231 921
A spine-like projection beginning just inferior to
the external acoustic meatus.
temporalis muscle muscle 232 927
Elevates and retracts mandible.
Inneravted by dep temporal nn from
anterior trunk of mandibular nn [V3] .
Supplied by deep temporal aa's, middle
temporal aa. Large, fan-shaped mm filling the temporal fossa.
infratemporal fossa Multiple bones 232 926
Bounded superiorly by zygomatic arch, anteriorly
by infratemporal surface of maxilla, laterally by
ramus of mandible, medially by lateral plate of
pterygoid process.
mandibular canal Mandible 233 Contains inferior alveolar nn and vessels.
Runs obliquely inferiorly and anteriorly along the
ramus of mandible. A side canal communicates
with the mental foramen.
maxillary artery maxillary aa 233
928,
938
Arises near bifurcation of external carotid aa.
Crosses superficial surface or deep surface of
lateral pterygoid mm.
middle meningeal artery maxillary aa 233 938 Supplies dura mater.
Arises medial to neck of mandible, goes superiorly
and deep to lateral pterygoid mm, going through
split in auriculotemporal nn. Enters skull via
Foramen Spinosum.
inferior alveolar artery maxillary aa 233 938
Supplies all lower teeth, buccal gingivae,
chin, lower lip.
Descends from maxillary aa to enter mandibular
foramen and canal, along with the inferior
alveolar nn.
masseteric artery maxillary aa 233 938 Supplies the masseter mm.
May arise from superior border of maxillary aa
and then course laterally through mandibular
notch to enter deep surface of masseter mm.
deep temporal artery (anterior and
posterior) maxillary aa 233 938 Supplies temporalis mm.
Arise from superior border of maxillary aa and
course superiorly across roof of infratemporal
fossa and enters deep surface of temporalis mm.
buccal artery maxillary aa 233 938 Supplies the cheek. Passes anteriorly onto the buccinator mm.
lateral pterygoid muscle muscle 234 931
Protrusion and side-to-side movements
of mandible. Innervated by nn to lateral
pterygoid directly from anterior trunk of
V3 or from buccal branch. Supplied by
pterygoid branches of maxillary aa .
Upper head originates from roof of infratemporal
fossa, lower head from lateral surface of lateral
plate of pterygoid process. Inserts into capsule of
TMJ near articular disc.
medial pterygoid muscle muscle 234 930
Elevation and side to side movements of
mandible. Innervated by nerve to medial
pterygoid from V3 . Supplied by
pterygoid branches of maxillary aa .
Deep head originates from medial surface of
lateral plate of pterygoid process; SF head from
pyramidal process of maxilla. Inserts to medial
surface of mandible near angle.
inferior alveolar nerve V3 - posterior 234 933
Innervates all lower teeth, mucosa and
skin of lower lip, skin of chin. Motor
branch to mylohyoid mm and anterior
belly of digastric mm.
Passes anteriorly within mandibular canal of
lower jaw.
lingual nerve V3 - posterior 234 933
General sensory of anterior 2/3 of
tongue, oral mucosa on floor of oral
cavity, lingual gingivae of lower teeth.
Joined by chorda tympani [VII].
Enters oral cavity between posterior attachment
of mylohyoid mm to the mylohyoid line and
attachment of superior pharynx constrictor. The
lingual nn enters floor of oral cavity in groove on
medial surface of mandible just inferior to the last
molar.
chorda tympani nerve VII 234 933
Carries taste from the anterior 2/3 of
tongue. Does parasymp to all salivary
glands below the oral fissure.
Originates from CN VII within temporal bone, goes
anteriorly through a small canal, goes through
middle ear, enters infratemporal fossa, descends
medial to spine of sphenoid and then to lateral
pterygoid mm, then joins the Lingual nn.
posterior superior alveolar artery maxillary aa 234 946
Supplies molar, pre-molar teeth, and
maxillary sinus.
Originates from maxillary aa as it goes through
pterygo-maxillary fissure. Accompanies posterior
superior alveolar nn through alveolar foramen on
infratemporal surface of maxilla.
superior cavity of the TMJ TMJ 234 923
Articular disc divides joint into upper and lower
part. Upper part allows head of mandible to
translocate forward (protrusion) onto articular
tubercle and back (retraction).
inferior cavity of the TMJ TMJ 234 923
Lower part of TMJ allows depression and
elevation of mandible.
Interior of the Skull
groove for the superior sagittal
sinus (superior sagittal sulcus) Multiple bones 237 822
Shockingly, this groove holds the
superior sagittal sinus.
Superior point of termination of frontal crest sees
beginning of this groove.
grooves for branches of the middle
meningeal artery Multiple bones 237 832
The middle meningeal aa arises from the
maxillary aa.
Can be seen along the inside of the parietal bone
portion of the skullcap (calvaria).
crista galli Ethmoid 238 1017 Anchors the Falx Cerebri.
A large triangular process on superior surface of
cribiform plate.
cribriform plate Ethmoid 238 1017
Perforations enable CN I to communicate
with the outside world.
A perforated sheet of bone seen anteriorly in the
skull anterior.
anterior clinoid process Sphenoid 238
Point of attachment for tentorium
cerebelli.
Postero-Medially projecting spines on the
sphenoid bone.
posterior clinoid process Sphenoid 238 825
Point of attachment for tentorium
cerebelli.
Rouded projections which can be seen at the
superior margin of the posterior border of the
Turkish saddle.
petrous part Temporal 238 Also known as the "pyramid."
Between sphenoid and occipital bones. Near the
center of the posterior part is the internal acoustic
meatus.
internal acoustic meatus Temporal 238 902
The vestibulocochlear nn passes through
this meatus. Canal in petrous part of temporal bone.
jugular foramen Multiple bones 238 820
The anterior portion carries the inferior
petrosal sinus; intermediate portion
carries CN VII, X, and XI; posterior
transmits sigmoid sinus, ascending
pharyngeal nn's.
Postero-lateral to the carotid canal. Just medial to
the styloid process.
hypoglossal canal Occipital 238 826
Allows CN XII to leave posterior cranial
fossa.
Located very medially, almost right on the margin
of the foramen magnum.
foramen magnum Occipital 238 820 The spinal cord descends.
The absolutely massive hole in the base of the
skull.
groove for the sigmoid sinus
(sigmoid sulcus) Temporal 238 826
Carries the sigmoid sinus for drainage of
the brain.
Grooves inferior to the internal acoustic meatus,
going towards the jugular foramen.
groove for the transverse sinus
(transverse sulcus) Occipital 238 826
Carries the TV sinus for drainage of the
brain.
Transverse grooves on posterior cranial fossa on
the lateral side.
Dural Infoldings & Dural Venous
Sinuses
cerebral falx (or falx cerebri) dura mater 239 831 The "sickle" of dura mater.
Lies between the cerebral hemispheres. Attaches
to crista galli anteriorly, to calvaria on both sides
of groove for superior sagittal sinus, and to
cerebellar tentorium posteriorly.
cerebellar tentorium (or tentorium
cerebelli) dura mater 239 831
A tent of dura mater over the
cerebellum.
Attaches to clinoid processes of sphenoid bone,
superior border of petrous part of temporal bone,
and occipital bone on either side of groove for the
TV sinus. A transverse "tent" atop the cerebellum.
cerebellar falx (or falx cerebelli) dura mater 239 831 A falx for the cerbeellum.
Inferior to the cerebellar tentorium in the midline.
Attaches to inner surface of occipital bone.
superior sagittal sinus dural sinus 239 842 Superior draining vv of brain. Along the superior midline of the brain.
confluence of sinuses dural sinus 239 842
Receives the superior sagittal sinus,
straight sinus, TV sinuses.
Near the posterior margin in the posterior cranial
fossa.
inferior sagittal sinus dural sinus 239 842 Inferior draining vein of the brain. Along the inferior margin of the falx cerebri.
straight sinus dural sinus 239 842
Receives the inferior sagittal sinus and
great cerebral vv. Drains into the
Confluence of Sinuses.
In the line of junction of the cerebral falx and the
cerebellar tentorium.
great cerebral vein vein 239 842 Aka "Vein of Galen." A deep cerebral vv.
transverse sinus (right and left) dural sinus 239 842
Venous drainage away from the
confluence of sinuses.
Run along the groove for TV sinus on the occipital
bone.
sigmoid sinus dural sinus 240 842
Venous drainage away from the TV
sinuses. Run inferiorly from the TV sinuses.
cavernous sinus dural sinus 240
842,
844 Receives cerebral and opthalmic vv's. Along the lateral aspect of the body of sphenoid.
inferior petrosal sinus dural sinus 240 842 Drain into the internal jugular vv.
Begins at posterior end of cavernous sinus, pass in
a groove between petrous part of temporal bone
and basal part of occipital bone.
Cranial Fossae
greater wing Sphenoid 242 941
Holds the foramen rotundum, foramen
ovale, and foramen spinosum, moving
from medially to lateral. Wide, lateral wing of the sphenoid bone.
internal occipital protuberance Occipital 243 826
At the posterior point of the occipital bone, near
the conjunction of the grooves for TV sinuses.
anterior cranial fossa bone 243 823
Contains the foramen cecum, olfactory
foramina in cribiform plate, and optic
canal.
Floor is composed of frontal bone, ethmoid bone
(midline), sphenoid body (midline) and lesser
wings (laterally).
middle cranial fossa bone 243 825
Composed of sphenoid and tem poral
bone. Contains: superior orbital fissure,
foramen rotundum, foramen ovale,
foramen spinosum, hiatuses for greater
and lesser petrosal nn's.
Midway between the anterior and posterior cranial
fossae.
middle meningeal artery maxillary aa 243 832
Supply parts of the meninges which rest
in the middle meningeal fossa. Rest in grooves visible on the calvaria.
foramen spinosum Sphenoid 243 820 Carries the middle meningeal aa.
In the middle cranial fossa, posterolateral from the
foramen ovale.
superior petrosal sinus dural sinus 243 842
Drains cavernous sinus, cerebral, and
cerebellar vv's.
Along superior margin of petrous part of temporal
bone.
optic nerve (CN II) nerve 243 850, Provides vision.
Courses through the optic canal in the anterior
cranial fossa.
superior orbital fissure Multiple bones 243 885
Carries the superior/inferior branches of
CN III, CN IV, CN VI, the opthalmic nn
[V1] branches (lacrimal, frontal,
nasociliary branches), superior opthalmic
vv. Just lateral to the optic canal.
oculomotor nerve (CN III) nerve 243
850,
894
Superior branch goes to superior rectus
and levator palpebrae superioris mm's.
Inferior divides into 3 branches: 1
(medial rectus); 2 (inferior rectus mm); 3
(inferior oblique mm). Lesion: eye moves
down and out.
Leaves anterior brainstem between midbrain and
pons. Divides into superior/inferior just before
entering orbit and pass through superior orbital
fissure within the common tendinous ring.
trochlear nerve (CN IV) nerve 243
850,
895
Innervates superior oblique mm. Lesion:
eye can't look down when eye is adducted
(down and in). See Drake 855 for more
lesions.
Arise from posterior surface of midbrain, passes
around midbrain to enter edge of tentorium
cerebelli, then passes through cavernous sinus just
below CN III. In the orbit, crosses above levator
palpebrae superioris mm to et to superior oblique
mm.
ophthalmic division of trigeminal
nerve (CN V1) nerve 243
850,
895,
944
Sensory from orbit and some branches of
face and scalp.
Smallest and most superior of the trieminal nn
divisions. Leaves trigeminal ganglion, goes
forward and inferior to trochlear and oculomotor
nn's. Divides into Nasociliary, Lacrimal, Frontal
nn's to enter orbit via Superior Orbital Fissure.
Frontal and Lacrimal nn's are outside common
tendinous ring, nasociliary nn is within.
abducens nerve (CN VI) nerve 243 850,
Innervates the lateral rectus mm, allowing
abduction of the eye. Lesion: inability to
abduct the eye.
Arises from brainstem between pons and medulla,
masses forward, crosses superior edge of petrous
temporal bone, crosses cavernous sinus
inferolateral to internalc arotid aa, enters orbit via
superior orbital fissure.
trigeminal nerve (CN V) nerve 244
850,
866
Major sensory nn of the head, also
innervates mm's that move mandible.
V1 (Opthalmic) goes forward, enters orbit through
superior orbital fissure. V2 (Maxillary) courses
just inferior to opthalmic nn, leaves cranial cavity
via foramen rotundum, enters pterygopalatine
fossa. Mandibular (v3) leaves inferior margin of
trigeminal ganglion, leaves skull via foramen
ovale.
trigeminal ganglion nerve 244 932
Trigeminal ganglion sits in the middle cranial
fossa in the Trigeminal Cave.
maxillary division of the trigeminal
nerve (V2) nerve 244
850,
943
Sensory from middle cranial fossa dura
mater, nasopharynx, palate, nasal cavity,
upper teeth, maxillary sinus, skin of side
of nose, lower eyelid, cheek, upper lip.
Courses forward in dura mater of lateral wall of
cavernous sinus, inferior to V1. Leaves cranial
cavity via foramen rotundum, enters
pterygopalatine fossa.
foramen rotundum Sphenoid 244 941 Carries V2. Antero-medial from the foramen ovale.
mandibular division of the
trigeminal nerve (V3) nerve 245
850,
932,
933,
934
V3 is the only trigeminal nn with motor.
Innervates the four mm's of mastication:
temporalis, masseter, medial/lateral
pterygoids. Also innervates tensor
tympani, tensor veli palatini, anterior
digastric, mylohyoid mm's.
Leaves inferior margin of trigeminal ganglion,
leaves skull via foramen ovale. Motor root of
trigeminal nnalso goes through foramen ovale and
unites with sensory component of V3 outside of
the skull.
foramen ovale Sphenoid 245 820
The mnemonic OVALE: (otic ganglion,
V3, accessory meningeal aa, lesser
petrosal nn, emissary vv's).
Between the foramen rotundum and foramen
spinosum.
internal carotid artery artery 245 941
Enters cranial aa via carotid canal, makes an S-
shaped bend in cavernous sinus, emerges near
optic nn.
carotid canal Temporal 245 820 Carries the internal carotid aa.
When the skull is viewed from inferior, the carotid
canal is almost directly posterior from the foramen
spinosum.
hypophyseal fossa Sphenoid 245 825 Holds the hypophysis. Deep central area in the Turkish Saddle.
posterior cranial fossa bone 245 826
Contains the foramen magnum, internal
acoustic meatus, jugular foramen,
hypoglossal canal, condylar canal. Located in the posterior portion of the skull.
facial nerve (CN VII) nerve 245
850,
868 Innervates mm's of facial expression.
Leaves brainstem between pons and medulla.
Motor and sensory roots leave cranial cavity via
internal acoustic meatus, enter facial canal in
petrous part of temporal bone, forming a
geniculate ganglion.
vestibulocochlear nerve (CN VIII) nerve 245
850,
913 Supplies hearing and balance.
Goes from lateral surface of brainstem between
pons and medulla, emerges from internal acoustic
meatus, crosses posterior cranial fossa and course
within petrous part of temporal bone to inner ear.
glossopharyngeal nerve (CN IX) nerve 245 850
GVA (carotid body, sinus), GSA
(posterior third of tongue, other posterior
regions), SA (taste of opsterior third of
tongue), GVE (parasymp for parotid
gland).
Arises as rootlets on anterolateral surface of upper
medulla. Cross posterior cranial fossa, enter
jugular foramen.
vagus nerve (CN X) nerve 245 850
The major parasymp nn of the body.
Some sensory input from throat, aotic
body and arch, as well as body in general.
Innervates palatoglossus mm, mm's of
soft palate (except tensor veli palatini),
pharynx (except stylopharyngeus), and
larynx.
Arises from anterolateral surface of medulla just
inferior to the rootlets for CN IX. Rootlets cross
posterior cranial fossa, enter jugular foramen.
cervical root of accessory nerve
(CN XI) nerve 245 850
Innervates sternocleidomastoid and
trapezius mm.
Roots arise from motor neurons in upper five
segments of cervical spinal cord, leave lateral
surface of spinal cord, enter cranial cavity via
foramen magnum, exit via jugular foramen.
hypoglossal nerve (CN XII) nerve 245 850
Innergates hyoglossus, styloglossus,
genioglossus mm's and all intrinsic mm's
of tongue.
Arises as rootlets from anterior medulla, passes
laterally across posterior cranial fossa, exits via
hypoglossal canal.
hypoglossal canal Occipital 245 820 Carries the hypoglossal nn. Somewhat anterolateral from the medulla.
Orbit
infraorbital groove Maxilla 246 Carries infraorbital vessels and nn.
A groove coursing medially from the inferior
orbital fissure near the juncture to the superior
orbital fissure.
optic canal Sphenoid 246 885 Carries the optic nn and opthalmic aa. Just medial to the superior orbital fissure.
lesser wing Sphenoid 246 941 Superior to the greater wing.
lacrimal gland gland 248 883 Contains tears.
Supero-lateral to the eyeball, deep to part of the
tendon of levator palpebrae superioris mm.
lacrimal groove Maxilla/Lacrimal 248 878 Assists medial drainage of tears.
Groove on medial aspect of orbit, along lacrimal
and maxilla bones.
nasolacrimal duct soft tissue 248 884
Drains tears from the medial aspect of
the eye and the lacrimal sac into the
nose.
Extends inferiorly from the lacrimal sac and enters
inferior meatus of nasal cavity.
frontal sinus Frontal 249 1019
One frontal sinus on each side, drains
onto the lateral wall of the middle metus
via frontonasal duct. Innervated by
supraorbital nn from opthalmic [V1].
Blood from anterior ethmoidal aa's.
A large hole/sinus in the frontal bone (shocking, I
know) between the two orbits in the forehead.
periorbita CT 249 886 Periosteum of the orbit. Periosteum that lines the orbit.
frontal nerve CN V1, frontal nn 249 895
Also gives off a lacrimal nn and anterior
ethmoidal nn.
Enters the orbit superior to the extraocular mm's.
Courses from apex of orbit towards superior
orbital margin. Divides into Supratrochlear nn and
Supraorbital nn.
supratrochlear nerve CN V1, frontal nn 249 895
Provides skin of eyelid and lower
forehead.
A thin nn that comes off and courses medially
from the frontal nn's division into supraorbital
and supratrochlear nn.
supraorbital nerve CN V1, frontal nn 249 895
Sensory innervation to conjunctiva,
frontal sinus, skin of forehead.
Pterminal branch of V1, passes through
supraorbital foramen and divides into a medial
and lateral branch to supply the scalp.
lacrimal nerve CN V1, frontal nn 249 895 Innervates the lacrimal gland.
Passes through superior orbital fissure lateral to
the frontal nn and innervates the lacrimal gland.
trochlear nerve (CN IV) CN IV 249 895
Innervates the superior rectus mm,
which pulls the eye to look down and
out.
Passes through the superior orbital fissure medial
to the frontal nn to supply the superior oblique
mm by entering its superior surface.
superior oblique muscle (of the
eye) muscle 249 889
Innervated by the trochlear nn (CN IV).
Depression, abduction, medial rotation
of eyeball.
The important note is its wrapping through the
trochlear "sling" before sliding into place. The rule
of the oblique mm's is that both pull the eyeball
outwards (abduction).
levator palprebae superioris
muscle muscle 249 889
Innervated by CN III. Elevates upper
eyelid.
Originates from lesser wing of sphenoid and
inserts to anterior surface of tarsal plate and skin.
superior rectus muscle (of the eye) muscle 249 889
Innervated by CN III. Elevate, adduct,
medial rotation of eyeball.
Originates from common tendinous ring, inserts
to superior aspect of eyeball.
oculomotor nerve (CN III) nerve 249 894
Innervates most intrinsic mm's of the
eye.
Leaves anterior surface of brainstem between
midbrain and pons, divides into superior and
inferior branches, then enter orbit via superior
orbital fissure. Its third branch gives a branch to
ciliary ganglion (parasymp).
lateral rectus muscle (of the eye) muscle 250 889
Innervated by the abducens nn (CN VI).
Abduction of eyeball.
Originates from lateral part of common tendinous
ring, inserts into lateral side of eyeball.
abducens nerve (CN VI) nerve 250 897 Innervates the lateral rectus mm.
Arises from brainstem between pons and
medulla. Enters cavernous sinus, runs lateral to
internal carotid aa. Enters orbit via superior
orbital fissure within common tendinous ring,
then courses laterally to get to lateral rectus mm.
nasociliary nerve
CN V1, nasociliary
nn 250 895
Gives off long ciliary nn, posterior
ethmoidal nn, infratrochlear nn, anterior
ethmoidal nn.
Emerges from V1, often first branch from
opthalmic nn (V1). Enters within common
tendinous ring, enters orbit, crosses superior
surface of optic nn and passes medially, below
superior rectus mm.
long ciliary nerves
CN V1, nasociliary
nn 250 895
Sensory to the eyeball. May contain
sympathetic fibers for pupillary dilation.
Come from the nasociliary nn and head towards
the medial side of the eyeball's posterior midline.
anterior ethmoidal nerve
CN V1, nasociliary
nn 250 895
Supplies anterior cranial fossa, nasal
cavity, skin of lower half of nose.
Courses to the medial aspect of the orbit and
plugs into the ethmoid bone. Exits the orbit
through anterior ethmoidal foramen.
superior division of the oculomotor
nerve CN III 250 894
Innervates superior rectus and levator
palpebrae superioris mm's.
Superiormost nerve in the superior optic fissure
that courses through the common tendinous ring.
Passes up over the lateral side of the optic nn.
inferior division of the oculomotor
nerve CN III 250 894
Branch to the medial rectus; inferior
rectus; and inferior oblique mm.
Inferiormost nn in the superior optic fissure that
courses through the common tendinous ring.
Divides into three branches.
ciliary ganglion nerve 250
894,
897
Site of synapse for pre- and post-
ganglionic parasymp nn's to eyeball.
The branch of CN III going to inferior oblique mm
gives off branch to ciliary ganglion.
superior ophthalmic vein vein 250 893
Drains the eye and orbit. Only vein in the
superior orbital fissure.
Vein in the superior orbital fissure, just inferior to
branches of V1 and IV.
ophthalmic artery internal carotid aa 251 892
Branches provide blood to the orbit and
eyeball.
Arises from the internal carotid aa just inferior to
the optic chiasm. Enters the orbit, usually superior
to the optic nn and reaches medial wall of orbit.
medial rectus muscle (of the eye) muscle 251 889
Innervated by CN III. Adduction of
eyeball.
Originates from medial part of common tendinous
ring.
inferior rectus muscle (of the eye) muscle 251 889
Innerated by CN III. Depression,
adduction, lateral rotation of eyeball.
Originates from inferior part of common
tendinous ring.
inferior oblique muscle (of the eye) muscle 251 889
Innervated by CN III. Allows you to look
up and out (elevtion, adduction) and
lateral rotation of eyeball.
Originates from medial floor of orbit, inserts to
outer posterior quadrant of eyeball.
occipital condyle Occipital 252 820 Articulates with the Atlas.
Bump just lateral on either side of the foramen
magnum.
Cervical Vertebrae
sympathetic trunk nerve 254 980 Point for synapsing sympathetic nn's.
Rests on the anterior surface of the cervical
vertebral column.
superior cervical sympathetic
ganglion nerve 254 980
Marks superior extent of sympathetic
trunk. Goes to carotid aa's, cervical spinal
nn's C1 to C4, pharynx, and heart
(superior cardiac nn's). Rests near CV I and CV II.
middle cervical sympathetic
ganglion nerve 254 980
Branches to nerves C5 and C6 and to
heart as middle cardiac nn's. About the level of CV VI.
inferior cervical sympathetic
ganglion nerve 254 980
Nerves to C7 - T1, vertebral aa, and
inferior cardiac nn's to heart. About level of CV VII.
longus colli muscle muscle 254 975
Innervated by branches from anterior
rami of C2-6. Flex neck anteriorly and
laterally, slight rotation to opposite side.
Prevertebral mm, originates from cervical and
upper thoracic vertebrae.
longus capitis muscle muscle 254 975
Flex the head. Innervated by branches
from anterior rami C1-3.
Originates from TV processes of upper cervical
vertebrae, insert to inferior surface of basilar part
of occipital bone.
anterior scalene muscle muscle 254 975
Innervated by upper cervical nn's.
Elevate first rib, flex neck to that side.
Originates from lower cervical vertebrae, insert to
first rib.
Pharynx
inferior pharyngeal constrictor
muscle
pharyngeal
constrictor mm 255 988
Innervated by Vagus nn. Constricts
pharynx.
Posterior attachment to pharyngeal raphe.
Anterior attachment to cricoid, oblique line of
thyroid cartilage.
middle pharyngeal constrictor
muscle
pharyngeal
constrictor mm 255 988
Innervated by Vagus nn. Constricts
pharynx.
Posterior attachment to pharyngeal raphe.
Anterior attachment to upper margin of greater
horn of hyoid bone.
superior pharyngeal constrictor
muscle
pharyngeal
constrictor mm 255 988
Innervated by Vagus nn. Constricts
pharynx.
Posterior attachment to pharyngeal raphe.
Anterior attachment to pterygomandibular raphe,
mandible, pterygoid hamulus.
pterygomandibular raphe CT 255 1034 Ligament.
Attaches to hamulus of medial pterygoid plate
and mylohyoid line of mandible.
stylopharyngeus muscle muscle 255 989 Innervated by CN IV. Elevates pharynx.
Originates to medial side of base of styloid
process. Inserts to pharyngeal wall.
glossopharyngeal nerve (CN IX) nerve 256 996
Sensory of the oropharynx and is the
afferent limb of the gag reflex.
Exits skull through jugular foramen, decends on
posterior surface of stylopharyngeus mm, goes
between superior and middle constrictors to
reach the posterior tongue, just inferior to the
palatine tonsil.
superior laryngeal nerve (internal
and external branches) nerve 256 996
External innervates cricothyroid mm,
pharyngeal plexus. Internal provides
sensory to epiglottis, base of tongue.
Branch of the vagus nn, with an internal and
external branch.
pharyngeal branch of the vagus
nerve nerve 256 996 Major motor nn of the pharynx.
Originates from upper part of the vagus nn's
inferior ganglion, above origin of superior
laryngeal nn.
uvula soft tissue 257 1041
Innervated by pharyngeal branch of
vagus nn.
The "punching bag" like thing dangling in the oral
cavity from the roof.
nasopharynx space 258 Posterior to the nose, superior to the soft palate.
oropharynx space 258
Posterior to the oral cavity, bounded superiorly by
soft palate and extends inferiorly to the epiglottis.
laryngopharynx space 258 Posterior to the larynx.
posterior nasal aperture (choana) space 258 1025
Transition region from nasal cavity to
nasopharynx. Separated by nasal septum. Region between nasal cavity and nasopharynx.
opening of the auditory tube space 258 992
Leads to the auditory tube, eustachian
tube.
Lateral wall of the nasopharynx, almost straight
posteriorly from the inferior choncha.
salpingopharyngeus muscle
(and/or fold) muscle 258 989
Raise pharynx and larynx in swallowing.
Can open the pharyngotympanic tube to
equalize pressure with pharynx and
auditory canal. Innervated by CN X.
Extends posteroinferiorly from the torus tubarius,
courses inferiorly and parallel with the
palatopharyngeus for a time.
pharyngeal recess space 258 992
Posterior to the opening to the pharyngotympanic
tube and torus tubarius.
palatoglossus muscle (and/or fold) muscle 258
992,
1041
Innervated by pharyngeal branch of
Vagus nn. Closes oropharyngeal isthmus,
prevents saliva from spilling into
oropharynx, assists swallowing.
Muscle arises from anterior surface of soft palate.
Divides oral cavity from oropharynx, just posterior-
inferior from the soft palate and posterior from
the base of tongue.
palatine tonsil soft tissue 258 989 Provides immunological surveillance. Seen in the superior pharyngeal constrictor mm.
palatopharyngeus muscle (and/or
fold) muscle 258 989
Innervated by pharyngeal branch of
Vagus nn. Pulls pharynx and larynx
upward over an incoming bolus of food
to prevent the food from going to the
nasopharynx.
Originates from palatine aponeurosis, inserts to
upper border of thyroid cartilage.
epiglottis larynx 259 999
Lies within larynx in breathing. During
swallowing, is part of anterior of
pharynx.
Leaf-shaped cartilage attached to posterior aspect
of thyroid cartilage.
Nose and Nasal Cavity
middle nasal concha Ethmoid 259 1017 Makes inspired air turbulent. Curved shelf of bone in the nasal cavity.
sphenoidal sinus Sphenoid 259 844
Paired paranasal sinuses inferior to the pituitary
gland.
perpendicular plate of palatine
bone Palatine 259 1022
Superiorly projecting portion of palatine bone just
lateral to the inferior and middle choncae.
sphenopalatine foramen Multiple bones 259 940
Transmits sphenopalatine aa, vv,
nasopalatine nn. Connects nasal cavity to pterygopalatine fossa.
perpendicular plate of the ethmoid Ethmoid 260 1017
Perpendicular flat sheet of ethmoid bone going
straight down from the cribiform plate, crista galli.
vomer bone 260
820,
1020
Bone that projects anterior-inferiorly from the
sphenoidal sinus, ending a little above the hard
palate on the medial wall of the nasal cavity,
connecting to the septal cartilage.
septal cartilage CT 260 1020 Thin cartilage that bisects the nasal cavity.
nasopalatine nerve nerve 260 1028
Supplies oral mucosa covering hard
palate.
Pass diagonally down the nasal septum (henc eon
the medial wall of the nasal septum) from
sphenopalatine foramen to the incisive canal.
sphenopalatine artery artery 260 1026
Supplies oral mucosa covering hard
palate.
Terminal branch of the maxillary aa in the
pterygopalatine fossa, enters nasal cavity by
passing medially through sphenopalatine foramen
and onto the lateral wall of the nasal cavity.
superior nasal concha Ethmoid 261 1017 Assists in making inspired air turbulent. Bony projection which sits high in the nasal cavity.
inferior nasal concha bone 261 1019 Assists in making inspired air turbulent. Bony projection which sits low in the nasal cavity.
nasolacrimal duct space 261 884 Drains the lacrimal sac.
Leads from the lacrimal sac inferiorly into the
bone.
semilunar hiatus space 261 1023
The floor of the hiatus has the opening of
maxillary sinus.
A crescent shaped groove covered by the middle
choncha.
opening of maxillary sinus space 262 1023 Opens to the maxillary sinus. Along the floor of the semilunar hiatus.
maxillary sinus Maxilla 263 1017
Roof is the floor of the orbit, with
mucosa innervated by infraorbital nn.
Floor is the alveolar process of maxilla.
Infero-lateral of the ethmoid bone, in the maxilla
bone, superior-lateral to the teeth.
Hard and Soft Palate
hard palate Multiple bones 263 820 Forms most of the roof of the oral cavity.
Composed of parts from the maxilla and palatine
bone.
incisive fossa (mislabelled as
foramen) Maxilla 263 820
Carries nasopalatine nn's,
sphenopalatine aa to supply the hard
palate mucosa.
A hole in the maxilla part of the hard palate,
located anteriorly and in the midline.
palatine process Maxilla 263 1032 Holds the incisive fossa.
Smooth ridge/plateau on either side of the
midline of the hard palate, along the anterior 2/3
of the hard palate.
horizontal plate of palatine bone Palatine 263 1032
Plate in the posterior third of the hard palate.
Holds the greater and lesser palatine foramina,
and eventually projects back the posterior nasal
spine.
lesser palatine foramen Palatine 263 820 Carries lesser palatine nn.
Posterolateral of the greater palatine foramen,
perforating the pyramidal process of the palatine
bone.
posterior nasal spine Palatine 263 820
Serves as attachment for musculus
uvulae.
A posteriorly projecting bump on the horizontal
plate of palatine bone.
pterygoid canal Sphenoid 263 941
Carries nn, aa, vv of the pterygoid canal.
The nn is formed from combination of
greater petrosal nn (facial nn, parasymp
pregang) and deep petrosal nn (symp
nn's). The parasymp's synapse in the
pterygopalatine ganglion, the symp's do
not.
Bony canal opening onto posterior surface of
pterygoid process, opens into middle cranial fossa
just antero-inferior to the internal carotid aa's
passage through the carotid canal.
medial pterygoid plate Sphenoid 264 820
Has a hamulus for the tensor veli palatini
mm. Comes off of the body of the sphenoid bone.
lateral pterygoid plate Sphenoid 264 921
Gives attachment for lateral pterygoid
mm.
Comes laterally off of the body of the sphenoid.
Do not confuse this with the greater wing of
sphenoid.
soft palate CT 264 810
Can be depressed to close orophayngeal
isthmus or elevated to separate
nasopharynx from oropharynx. Formed
by 5 mm's: tensor veli palatini, levator
veli palatini, palatoglossus,
palatopharyngeus, and musculus uvulae,
which are innervated by Vagus nn via
pharyngeal branch to pharyngeal plexus
(except tensor veli palatini, which is
mandibular nn V3).
Soft tissue that projects posteriorly from the hard
palate.
palatoglossus muscle mm - soft palate 264 1041
Innervated by Vagus nn, pharyngeal
branch to pharyngeal plexus. Depress
palate, moves palatoglossal arch towards
midline, elevates back of tongue.
Originates from inferior surface of palatine
aponeurosis, inserts to lateral margin of tongue.
palatopharyngeus muscle mm - soft palate 264 989
Vagus nn. Depress soft palate, move
palatopharyngeal arch towards midline,
elevates pharynx.
Originates from superior surface of palatine
aponeurosis, inserts to pharyngeal wall.
salpingopharyngeus muscle muscle 264 989 Vagus nn. Elevates pharynx.
Originates from inferior aspect of pharyngeal end
of pharyngotympanic tube, inserts to pharyngeal
wall.
stylopharyngeus muscle muscle 265 989 CN IX. Elevates pharynx.
Originates from medial side of base of styloid
process. Inserts to pharyngeal wall.
levator veli palatini muscle mm - soft palate 265 989
Vagus nn. Only mm that elevates the soft
palate proper above the neutral position.
Originates from petrous part of temporal bone,
anterior to opening for carotid canal. Inserts to
superior surface of palatine aponeurosis. Runs
parallel to and posterior to the tensor veli palatini
mm.
tensor veli palatini muscle mm - soft palate 265 989
Mandibular nn (V3) via branch to medial
pterygoid mm. Tenses soft palate, opens
pharyngotympanic tube.
Originates from scaphoid fossa of sphenoid bone,
inserts to palatine aponeurosis. Runs parallel to
and anterior to the levator veli palatini mm.
scaphoid fossa Multiple bones 265 820
Origin attachment point for tensor veli
palatini.
A depression between the medial and lateral
pterygoid plates.
hamulus of the medial pterygoid
plate Sphenoid 265 921
Tensor veli palatini mm's tendon slides
along the hamulus.
A small hook on the medial plate of pterygoid
process of sphenoid bone.
greater palatine nerve CN V2 265 1052
Gives general sensory and parasyp
innervation.
Branch of pterygopalatine ganglion, emerges
through greater palatine foramen and continues
onto inferior surface of hard palate.
greater palatine artery maxillary aa 265 1052 Supplies the mucosa of the hard palate.
Originates from maxillary aa in pterygopalatine
fossa, descends into palatine canal (giving rise to
lesser palatine branch), continues through greater
palatine foramen onto inferior surface of hard
palate.
greater palatine foramen Palatine 265 820 Transmits the greater palatine aa and nn.
Foramen on the horizontal plate of the palatine
bone.
lesser palatine nerve CN V2 266 1052
Gives general sensory and parasyp
innervation.
Follows the same course as the greater palatine
nn, though branches go back to the lesser palatine
foramen and project back to cover the soft palate.
descending palatine artery maxillary aa 266 946
Gives rise to greater and lesser palatine
aa's.
The maxillary aa gives off the descending palatine
aa which eventually branches into the greater and
lesser palatine aa's.
lesser palatine artery maxillary aa 267 1052 Supplies soft palate.
Projects posteriorly to the soft palate afte
rbranching off of the descending palatine aa,
going through the lesser palatine foramen.
pterygopalatine ganglion nerve 267 943
The largest parasymp ganglion in the
head, formed by cell bodies of the post-
ganglionic nn's associated with
preganglionic parasymp fibers of facial
nn carried by greater petrosal nn and nn
of pterygoid canal. Post-ganglionic symp
fibers pass through the ganglion, too, to
join the Maxillary nn (V2) on their way
out.
Ganglion that sits in the pterygopalatine fossa,
that divot just posterior to the superior lateral
corner of the maxilla bone.
nerve of the pterygoid canal nerve 267 944
Mainly carries preganglionic parasymp
and post-ganglionic symp fibers.
Formed in middle cranial fossa by greater petrosal
nn (CN VII) and deep petrosal nn (internal carotid
plexus). Passes into pterygopalatine fossa and
joins pterygopalatine ganglion.
infraorbital artery maxillary aa 267 946
Supplies parts of the face below the
orbit.
The maxillary aa continues forward, giving off the
descending palatine aa and posterior superior
alveolar aa's (inferiorly), the aa of pterygoid canal
and sphenopalatine aa's (superiorly), and
continues with the infra-orbital aa through the
inferior orbital fissure and emerges through infra-
orbital foramen.
Oral Region
epiglottic vallecula larynx 269 992
The recess serves as a "spit trap" to hold
saliva and prevent initiation of the
swallow reflex.
A recess/fold below the epiglottis, just behind the
root of the tongue.
geniohyoid muscle muscle 269 1040
Innervated by C1 (carried along with CN
XII). If mandible is fixed, pulls hyoid bone
forward. If hyoid bone is fixed, pulls
mandible down and in.
Deep to the mylohyoid mm. Originates from
inferior mental spine on inner mandible, inserts to
anterior surface of hyoid bone.
genioglossus muscle
mm - extrinsic
tongue 270
1038,
1040
Innervated by CN XII. Protrudes tongue,
depress center of tongue.
Originates from superior mental spine. Inserts to
body of hyoid and entire length of tongue. Deep
to the geniohyoid mm.
sublingual gland gland 270 1045 Mucus salivary gland. Mucosal gland just inferior to the tongue.
submandibular duct gland 270 1043
Drains saliva from the submandibular
and sublingual ducts.
Duct leading from submandibular and sublingual
ducts.
lingual nerve CN V3 270 1045
General sensation from oral part of
tongue, mucosa of floor of oral cavity,
gingiva of lower teeth. Carries parasymp
and taste fibers from oral part of tongue
that are part of facial nn CN VII.
Originates in infratemporal fossa, passes
anteriorly into floor of oral cavity through the gap
between mylohyoid, superior pharyngeal
constrictor, and middle pharyngeal constrictor
mm's. Loops under submandibular duct, ascends
into tongue on external and superior surface of
the hyloglossus mm.
submandibular ganglion nerve 270 1047
One of the four major parasymp ganglia
(along with otic, pterygopalatine, ciliary).
Post-ganglionic fibers leave ganglion and
go directly to the submandibular and
sublingual glands while others hop back
onto Lingual nn to target glands.
Just superior to the deep part of the
submandibular gland (which itself wraps around
the mylohyoid mm). Sits on the hyoglossus mm.
hypoglossal nerve (CN XII) CN XII 270 1043
All mm's of the tongue innervated by CN
XII except for the palatoglossus mm (CN
X).
CN XII passes between deep part of
submandibular gland and hyoglossus mm. Both
hypoglossal nn and lingual nn pass between
hyoglossus and mylohyoid mm to enter sublingual
region. The hypoglossal nn is inferior to the
lingual nn and goes lateral to the hyoglossus mm.
hyoglossus muscle
mm - extrinsic
tongue 270 1040 Innervated by CN XII. Depress tongue.
Originates from greater horn and body of hyoid
bone. Inserts to lateral surface of tongue.
styloglossus muscle
mm - extrinsic
tongue 270 1040
Innervated by CN XII. Elevate and retract
tongue.
Originates from styloid process. Inserts to lateral
surface of tongue.
Larynx
epiglottic cartilage cartilage 271 999
thyroid cartilage cartilage 271 998
superior cornu (horn) of the
thyroid cartilage thyroid cartilage 271 998
inferior cornu (horn) of the thyroid
cartilage thyroid cartilage 271 998
The inferior horn has a facet to articulate
with the cricoid cartilage.
Horns that are projecting inferiorly from the
thyroid cartilage. They also seem to curve a little
bit anteriorly.
cricoid cartilage cartilage 271 998
Articulates to the inferior horn of the
thyroid cartilage. Its superolateral facet
articulates with the base of arytenoid
cartilages.
A bulgous ring-like cartilage at the top of the
trachaea. Shaped like a signet ring.
arytenoid cartilage cartilage 271 1000
The anterolateral surface has a superior
attachment point for the vetstibular
ligament and an inferior attachment
point for the vocalis mm.
Small triangularly-shaped cartilages which
articulate at the superolateral facets of the cricoid
cartilage.
cricothyroid muscle
mm - intrinsic
larynx 272 1005
Innervated by external branch of
superior laryngeal nn (from Vagus).
Forward and forward rotation of thyroid
cartilage at cricothyroid joint.
Straight and oblique parts run between the
cricoid cartilage and inferior aspect of the thyroid
cartilage.
piriform recess larynx 272 1004
internal branch of the superior
laryngeal nerve nerve 272 1012
inferior laryngeal nerve (recurrent
laryngeal nerve) nerve 272 1012
posterior cricoarytenoid muscle
mm - intrinsic
larynx 272 1006
Recurrent laryngeal branch of Vagus nn.
Abduct and external rotation of
arytenoid cartilage.
Originates from oval depression on oval
depression on posterior surface of lamina of
cricoid cartilage. Inserts to posterior surface of
muscular process of arytenoid crtilage. The two
mm's form a sort of "U" which can be seen on the
posterior aspect of the cricoid cartilage and
arytenoid cartilage.
transverse arytenoid muscle
mm - intrinsic
larynx 272 1006
Recurrent laryngeal branch of Vagus nn.
Adduction of arytenoid cartilage.
Originates from lateral border of posterior surface
of arytenoid cartilage. Inserts to lateral border of
posterior surface of opposite arytenoid cartilage.
Forms a sort of transverse "wrapping" about the
posterior face of the arytenoid cartilages.
oblique arytenoid muscle
mm - intrinsic
larynx 272 1006
Recurrent laryngeal branch of Vagus nn.
Sphincter of laryngeal inlet.
Originates from posterior surface of mm proces of
arytenoid cartilage, inserts to posterior surface of
apex of adjacent arytenoid cartilage. The two
mm's form an "X" when the cricoid cartilage and
arytenoid crtilages are viewed from behind.
lateral cricoarytenoid muscle
mm - intrinsic
larynx 273 1006
Recurrent laryngeal branch of Vagus nn.
Internal rotation of arytenoid cartilage,
adduction of vocal folds.
Originates from superior surface of arch of cricoid
cartilage. Inserts to anterior surface of mm
process of arytenoid cartilage. Somewhat
resemble slender "wings" falling away and
forward along the lateral edge of the cricoid
cartilage.
thyroarytenoid muscle
mm - intrinsic
larynx 273 1007
Recurrent laryngeal branch of Vagus nn.
Sphincter of vestibule and laryngeal inlet.
Originate from thyroid angle and adjacent
cricothyroid ligament. Insert to anterolateral
surface of arytenoid cartilage. Forms a broad
band of mm running parallel to the ground.
rima glottidis larynx 273 1006
Not to be confused by the Rima Vestibuli,
which is defined by the Vestibular Folds
(the "false" vocal cords).
A narrow triangular opening between the vocal
cords.
vestibule of larynx larynx 274 1004
Portion of the laryngeal cavity which is superior to
the vestibular folds.
ventricle of larynx larynx 274 1004
A depression between the vestibular fold and the
vocal fold. Kinda "flaps" or folds out to either side.
Just superior to the Rima Glottis.
infraglottic cavity larynx 274 1004
Space inferior to the vocal folds and continuous
with the trachaea.
vestibular folds larynx 274 1004
The "false" vocal cords, define the ridge
of the Rima Vestibuli and are superior to
the Rima Glottidis/Vocal Folds. Mucosa that overlies the vestibular ligament.
vocal folds larynx 274 1004
The "true" vocal cords, define the Rima
Glottidis. Mucosa that overlies the vocal ligament.
Ear
groove for the greater petrosal
nerve Temporal 275 825 Carries the greater petrosal nn.
A groove a bit posterior to the triad of foramen
rotundum/ovale/spinosum, running somewhat
parallel to it.
internal acoustic meatus Temporal 275 826
Carries CN VII and VIII towards inner and
middle ear.
In the anterior portion of the internal acoustic
meatus, just anterior and a little superior to the
jugular foramen.
stylomastoid foramen Temporal 275 820
Carries CN VII and the stylomastoid aa.
Bell's Palsy may result from inflammation
or impingement of the facial nn here.
When looking at the inferior skull, a foramen on
the temporal bone just posterior to the base of
the styloid process.
jugular fossa Temporal 275 820 Lodges the bulb of the internal jugular vv.
When viewing the inferior skull, just medial to the
base of the styloid process, posterior to the
carotid canal.