ANATOMY OF THE HEAD, FACE AND NECK

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Bones of the Skull
Composition
Sutures unite the separated bones of the skull
sutural ligament - connective tissue between the bones
mandible - exception to this rule; united to the skull by the mobile temporomandibular joint
can be divided into the cranium and those of the face
vault - upper part of the cranium
base - lowest part of the cranium
diploa separates the external and internal tables of compact bones in the skull
internal table - thinner and more brittle than the external table
bones are covered surfaces with
periosteum
cranium consists of the following bones,
two of which are paired:
o Frontal bone: 1
o Parietal bones: 2
o Occipital bone: 1
o Temporal bones: 2
o Sphenoid bone: 1
o Ethmoid bone: 1
facial bones consist of the following,
two of which are single:
o Zygomatic bones: 2
o Maxillae: 2
o Nasal bones: 2
o Lacrimal bones: 2
o Vomer: 1
o Palatine bones: 2
o Inferior conchae: 2
o Mandible: 1

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External Views of the Skull
Anterior View of the Skull
frontal bone (forehead bone) - curves downward to make the upper margins of the orbits
articulates with the frontal processes of the maxillae and with the nasal bones
laterally, the frontal bone articulates with the zygomatic bone
superciliary arches - seen on either side and the supraorbital notch (foramen) can be recognized
orbital margins - bounded by:
o frontal bone superiorly
o zygomatic bone laterally
o maxilla inferiorly
o processes of the maxilla and frontal bone medially
frontal air sinuses w/in the frontal bone; above the orbital margins; two hollow spaces lined
with mucous membrane

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 communicate with the nose and serve as voice resonators
two nasal bones form the bridge of the nose; lower borders, with the maxillae, make the anterior
nasal aperture
nasal cavity - divided into two by the bony nasal septum, which is largely formed by the vomer
superior and middle conchae - project into the nasal cavity from the ethmoid on each side; the
inferior conchae are separate bones
two maxillae form the ff structures:
upper jaw
anterior part of the hard palate
part of the lateral walls of the nasal cavities
part of the floors of the orbital cavities
o meet in the midline at the intermaxillary suture and form the lower margin of the nasal
aperture
below the orbit, maxilla is perforated by the infraorbital foramen
alveolar process projects downward; 2 bones from each side forms the alveolar arch
o carries the upper teeth
maxillary sinus - pyramid-shaped cavity lined with mucous membrane; communicates with the
nasal cavity and serves as a voice resonator
zygomatic bone - forms the prominence of the cheek and part of the lateral wall and floor of the
orbital cavity
o medially, it articulates with the maxilla
o laterally it articulates with the zygomatic process of the temporal bone to form the
zygomatic arch
o perforated by two foramina for the zygomaticofacial and zygomaticotemporal nerves.
The mandible, or lower jaw, consists of a horizontal body and two vertical rami

Lateral View of the Skull

frontal bone - anterior part of the side of the skull; articulates with the parietal bone at the coronal
suture
parietal bones - sides and roof of the cranium; articulate with each other in the midline at the
sagittal suture, with the occipital bone behind at the lambdoid suture
skull is completed at the side by:
o squamous part of the occipital bone
o parts of the temporal bone: squamous, tympanic, mastoid process, styloid process, and
zygomatic process
o greater wing of the sphenoid
pterion - thinnest part of the lateral wall of the skull; where the anteroinferior corner of the
parietal bone articulates with the greater wing of the sphenoid; overlies the anterior division of
the middle meningeal artery and vein
superior and inferior temporal lines - begin as a single line from the posterior margin of the
zygomatic process of the frontal bone and diverge as they arch backward
o temporal fossa lies below the inferior temporal line
infratemporal fossa lies below the infratemporal crest on the greater wing of the sphenoid
pterygomaxillary fissure - vertical fissure that lies within the fossa between the pterygoid process
of the sphenoid bone and back of the maxilla; leads medially into the pterygopalatine fossa
inferior orbital fissure - horizontal fissure between the greater wing of the sphenoid bone and
the maxilla; leads forward into the orbit

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 pterygopalatine fossa - small space behind and below the orbital cavity
o communicates laterally with the infratemporal fossa through the pterygomaxillary fissure
o medially with the nasal cavity through the sphenopalatine foramen
o superiorly with the skull through the foramen rotundum
o anteriorly with the orbit through the inferior orbital fissure

Posterior View of the Skill

Inferiorly - parietal bones articulate with the squamous part of the occipital bone at the lambdoid
suture
occipital bone articulates with the temporal bone on each side
external occipital protuberance - medial to occipital bone; roughened elevation; gives attachment
to muscles and the ligamentum nuchae
o either side - superior nuchal lines extend laterally toward the temporal bone

Superior View of the Skull

frontal bone - articulates with the two parietal bones at the coronal suture anteriorly
midline metopic suture failure of the two frontal bone to fuse
posteriorly - two parietal bones articulate in the midline at the sagittal suture

Inferior View of the Skull

anterior - formed by the hard palate; palatal processes of the maxillae and the horizontal plates
of the palatine bones can be identified
anteromedially - incisive fossa and foramen
posterolaterally - greater and lesser palatine foramina
choanae (posterior nasal apertures ) - above the posterior edge of the hard palate; separated
from each other by the posterior margin of the vomer; bounded laterally by the medial pterygoid
plates of the sphenoid bone
pterygoid hamulus - inferior end of the medial pterygoid plate; prolonged as a curved spike of
bone
o posterolateral to the lateral pterygoid plate, greater wing of the sphenoid pierced by the
large foramen ovale and the small foramen spinosum
posterolateral to the foramen spinosum - spine of the sphenoid
groove for the cartilaginous part of the auditory tube - behind the spine of the sphenoid, interval
between the greater wing of the sphenoid and the petrous part of the temporal bone; opening of
the bony part of the tube can be identified
mandibular fossa of the temporal bone and the articular tubercle - form the upper articular
surfaces for the temporomandibular joint
squamotympanic fissure - separates mandibular fossa and tympanic plate posteriorly; medial end
of which the chorda tympani nerve exits from the tympanic cavity
styloid process of the temporal bone projects downward and forward from its inferior aspect
carotid canal - inferior surface of the petrous part of the temporal bone
foramen lacerum formed by:
o medial end of the petrous part of the temporal bone
o basilar part of the occipital bone
o greater wing of the sphenoid
o closed with fibrous tissue; only a few small vessels pass through this foramen from the
cavity of the skull to the exterior

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 tympanic plate - forms part of the temporal bone; C shaped on section; forms the bony part of
the external auditory meatus
suprameatal crest on the lateral surface of the squamous part of the temporal bone
identify the suprameatal triangle, and the suprameatal spine
stylomastoid foramen - interval between the styloid and mastoid processes
jugular foramen formed by the notch of the petrous part of temporal bone found medially and
a shallower notch on the occipital bone
behind the posterior apertures of the nose and in front of the foramen magnum are the sphenoid
bone and the basilar part of the occipital bone
pharyngeal tubercle - small prominence on the undersurface of the basilar part of the occipital
bone in the midline
occipital condyles - articulate with the superior aspect of the lateral mass of the first cervical
vertebra (atlas)
hypoglossal canal - superior to the occipital condyle; for transmission of the hypoglossal nerve
external occipital protuberance - posterior to the foramen magnum in the midline; superior
nuchal lines curve laterally on each side

Cranial Cavity
contains the brain and its surrounding meninges, portions of the cranial nerves, arteries, veins,
and venous sinuses

Vault of the Skull

internal surface shows the coronal, sagittal, and lambdoid sutures
midline - shallow sagittal groove that lodges the superior sagittal sinus
granular pits on each side of the groove; small pits lodging the lateral lacunae and arachnoid
granulations
narrow grooves - present for the anterior and posterior divisions of the middle meningeal vessels

Base of the Skull

divided into three cranial fossae: anterior, middle, and posterior
anterior cranial fossa - separated from the middle cranial fossa by the lesser wing of the sphenoid
middle cranial fossa - separated from the posterior cranial fossa by the petrous part of the
temporal bone
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Anterior Cranial Fossa
lodges the frontal lobes of the cerebral hemispheres
bounded anteriorly by the inner surface of the frontal bone; medially is a crest (crista galli) for the
attachment of the falx cerebri
posterior boundary - sharp lesser wing of the sphenoid that articulates laterally with the frontal
bone and meets the anteroinferior angle of the parietal bone, or the pterion
clinoid process formed by the medial end of the lesser wing of the sphenoid anterior on each
side; gives attachment to the tentorium cerebelli
median part of the anterior cranial fossa - limited posteriorly by the groove for the optic chiasma
floor of the fossa - formed by the ridged orbital plates of the frontal bone laterally, cribriform
plate of the ethmoid medially
crista galli - sharp upward projection of the ethmoid bone in the midline; attachment of the falx
cerebri

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 oalongside is a narrow slit in the cribriform plate - passage of the anterior ethmoidal nerve
into the nasal cavity
upper surface of the cribriform plate - supports the olfactory bulbs; small perforations in the
cribriform plate are for the olfactory nerves
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Middle Cranial Fossa
consists of a small median part and expanded lateral parts
median raised part - formed by the body of the sphenoid, and the expanded lateral parts form
concavities on either side, which lodge the temporal lobes of the cerebral hemispheres
bounded anteriorly by the lesser wings of the sphenoid; posteriorly by the superior borders of the
petrous parts of the temporal bones
laterally - squamous parts of the temporal bones, the greater wings of the sphenoid, and the
parietal bones
floor of lateral part - formed by the greater wing of the sphenoid and the squamous and petrous
parts of the temporal bone
sphenoid bone resembles a bat having a centrally placed body with greater and lesser wings that
are outstretched on each side
body of the sphenoid contains the sphenoid air sinuses lined with mucous membrane;
communicate with the nasal cavity; serve as voice resonators
anterior - the optic canal transmits the optic nerve and the ophthalmic artery (branch of the
internal carotid artery) to the orbit
superior orbital fissure - slitlike opening between the lesser and greater wings of the sphenoid;
transmits the lacrimal, frontal, trochlear, oculomotor, nasociliary, and abducent nerves,
together with the superior ophthalmic vein
sphenoparietal venous sinus - medial along the posterior border of the lesser wing of the sphenoid
and drains into the cavernous sinus
foramen rotundum - situated behind the medial end of the superior orbital fissure; perforates
the greater wing of the sphenoid; transmits the maxillary nerve from the trigeminal ganglion to
the pterygopalatine fossa
foramen ovale - posterolateral to the foramen rotundum; perforates the greater wing of the
sphenoid; transmits the large sensory root and small motor root of the mandibular nerve to the
infratemporal fossa; the lesser petrosal nerve also passes through it
foramen spinosum - posterolateral to the foramen ovale; perforates the greater wing of the
sphenoid; transmits the middle meningeal artery from the infratemporal fossa into the cranial
cavity then runs forward and laterally in a groove on the upper surface of the squamous part
of the temporal bone and the greater wing of the sphenoid divides into anterior and posterior
branches
o anterior branch passes forward and upward to the anteroinferior angle of the parietal
bone bone is deeply grooved or tunneled by the artery runs backward and upward
on the parietal bone may be damaged after a blow to the side of the head
o posterior branch passes backward and upward squamous part of the temporal bone
parietal bone
foramen lacerum - between the apex of the petrous part of the temporal bone and the sphenoid
bone
inferior opening filled by cartilage and fibrous tissue, and only small blood vessels pass through
this tissue from the cranial cavity to the neck (repeated twice! Maybe important hehe)
carotid canal - opens into the side of the foramen lacerum above the closed inferior opening

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 o internal carotid artery enters the foramen immediately turns upward to reach the side
of the body of the sphenoid bone turns forward in the cavernous sinus to reach the
region of the anterior clinoid process turns vertically upward, medial to the anterior
clinoid process emerges from the cavernous sinus
Lateral to the foramen lacerum - impression on the apex of the petrous part of the temporal bone
for the trigeminal ganglion
anterior surface of the petrous bone - two grooves for nerves:
largest medial groove - for the greater petrosal nerve (branch of the facial nerve)
o enters the foramen lacerum deep to the trigeminal ganglion joins the deep petrosal
nerve (sympathetic fibers from around the internal carotid artery) form the nerve of
the pterygoid canal
smaller lateral groove - lesser petrosal nerve (branch of the tympanic plexus)
o passes forward to the foramen ovale
abducent nerve - across apex of the petrous bone, medial to the trigeminal ganglion leaves the
posterior cranial fossa enters the cavernous sinus
arcuate eminence - rounded eminence; at anterior surface of the petrous bone; caused by the
underlying superior semicircular canal
tegmen tympani - thin plate of bone; forward extension of the petrous part of the temporal bone;
adjoins the squamous part of the bone; behind forward, forms the roof of the mastoid antrum,
the tympanic cavity, and the auditory tube; only major barrier that separates infection in the
tympanic cavity from the temporal lobe of the cerebral hemisphere
median part of the middle cranial fossa - formed by the body of the sphenoid bone; front - sulcus
chiasmatis: related to the optic chiasma and leads laterally to the optic canal on each side
posterior to the sulcus - tuberculum sellae
sella turcica posterior to tuberculum sellae; a deep depression which lodges the pituitary gland;
bounded posteriorly dorsum sellae (square plate bone)
superior angles of the dorsum sellae have two tubercles: posterior clinoid processes - give
attachment to the fixed margin of the tentorium cerebelli
cavernous sinus - related to the side of the body of the sphenoid; carries in its lateral wall the
third and fourth cranial nerves and ophthalmic and maxillary divisions of the fifth cranial nerve;
internal carotid artery and the sixth cranial nerve pass forward through the sinus
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Posterior Cranial Fossa
deep and lodges the parts of the hindbrain:cerebellum, pons, and medulla oblongata
anteriorly bounded by the superior border of the petrous part of the temporal bone
posteriorly bounded by the internal surface of the squamous part of the occipital bone
floor - formed by the basilar, condylar, and squamous parts of the occipital bone and the mastoid
part of the temporal bone

roof - formed by a fold of dura, the tentorium cerebelli; which intervenes between the cerebellum
below and the occipital lobes of the cerebral hemispheres above
foramen magnum - occupies the central area of the floor; transmits the following:
o medulla oblongata and its surrounding meninges
o ascending spinal parts of the accessory nerves
o two vertebral arteries
hypoglossal canal - above the anterolateral boundary of the foramen magnum; transmits the
hypoglossal nerve

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 jugular foramen - between the lower border of the petrous part of the temporal bone and the
condylar part of the occipital bone; transmits the following structures from before backward:
o inferior petrosal sinus - descends in the groove on the lower border of the petrous part
of the temporal bone to reach the foramen
o 9th, 10th, and 11th cranial nerves
o large sigmoid sinus - turns down through the foramen internal jugular vein
internal acoustic meatus pierces the posterior surface of the petrous part of the temporal bone;
transmits the vestibulocochlear nerve and the motor and sensory roots of the facial nerve
internal occipital crest runs upward in the midline posteriorly from the foramen magnum to the
internal occipital protuberance; to it is attached the small falx cerebelli over the occipital sinus
each side of the internal occipital protuberance is a wide groove for the transverse sinus; sweeps
around on either side, on the internal surface of the occipital bone, to reach the posteroinferior
angle or corner of the parietal bone now passes onto the mastoid part of the temporal bone
transverse sinus becomes the sigmoid sinus
superior petrosal sinus runs backward along the upper border of the petrous bone in a narrow
groove and drains into the sigmoid sinus
sigmoid sinus descends to the jugular foramen, it deeply grooves the back of the petrous bone
and the mastoid part of the temporal bone lies directly posterior to the mastoid antrum

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
Meninges
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Dura Mater
two layers: the endosteal layer and the meningeal layer
closely united except along certain lines, where they separate to form venous sinuses
endosteal layer - ordinary periosteum covering the inner surface of the skull bones
o does not extend through the foramen magnum to become continuous with the dura
mater of the spinal cord
o around the margins of all the foramina in the skull it becomes continuous with the
periosteum on the outside of the skull bones
o at the sutures it is continuous with the sutural ligaments
o strongly adherent to the bones over the base of the skull
meningeal layer (dura mater proper)
o dense, strong, fibrous membrane covering the brain and is continuous through the
foramen magnum with the dura mater of the spinal cord
o provides tubular sheaths for the cranial nerves as the latter pass through the foramina in
the skull
o outside the skull the sheaths fuse with the epineurium of the nerve
o sends inward four septa that divide the cranial cavity into freely communicating spaces
lodging the subdivisions of the brain to restrict the rotatory displacement of the brain
falx cerebri - sickle-shaped fold of dura mater that lies in the midline between the two cerebral
hemispheres
o narrow end in front is attached to the internal frontal crest and the crista galli
o broad posterior part blends in the midline with the upper surface of the tentorium
cerebelli
o superior sagittal sinus runs in its upper fixed margin
o inferior sagittal sinus runs in its lower concave free margin
o straight sinus runs along its attachment to the tentorium cerebelli
tentorium cerebelli - crescent-shaped fold of dura mater that roofs over the posterior cranial
fossa
o covers the upper surface of the cerebellum
o supports the occipital lobes of the cerebral hemispheres
o front is a gap, the tentorial notch, for the passage of the midbrain thus producing an
inner free border and an outer attached or fixed border
o fixed border - attached to the posterior clinoid processes, the superior borders of the
petrous bones, and the margins of the grooves for the transverse sinuses on the occipital
bone
o free border runs forward at its two ends, crosses the attached border, and is affixed to
the anterior clinoid process on each side
o at the point where the two borders cross, the third and fourth cranial nerves pass forward
to enter the lateral wall of the cavernous sinus
at apex of the petrous part of the temporal bone, lower layer of the tentorium pouched forward
beneath the superior petrosal sinus to form a recess for the trigeminal nerve and the trigeminal
ganglion
falx cerebri and the falx cerebelli - attached to the upper and lower surfaces of the tentorium,
respectively
straight sinus runs along its attachment to the falx cerebri

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 superior petrosal sinus along its attachment to the petrous bone, and the transverse sinus along
its attachment to the occipital bone
diaphragma sellae - circular fold of dura mater that forms the roof for the sella turcica; small
opening in its center allows passage of the stalk of the pituitary gland

Dural Nerve Supply

branches of the trigeminal, vagus, and first three cervical nerves and branches from the
sympathetic system pass to the dura
sensitive to stretching, which produces the sensation of headache
stimulation of the sensory endings of the trigeminal nerve above the level of the tentorium
cerebelli referred pain to an area of skin on the same side of the head
dural endings below the level of the tentorium referred pain to the back of the neck and back
of the scalp along the distribution of the greater occipital nerve

Dural Arterial Supply

internal carotid, maxillary, ascending pharyngeal, occipital, and vertebral arteries
middle meningeal artery - most important is the; commonly damaged in head injuries
o arises from the maxillary artery in the infratemporal fossa
o enters the cranial cavity and runs forward and laterally in a groove on the upper surface
of the squamous part of the temporal bone
o passes through the foramen spinosum to lie between the meningeal and endosteal
layers of dura
o anterior (frontal) branch deeply grooves or tunnels the anteroinferior angle of the
parietal bone
o course corresponds roughly to the line of the underlying precentral gyrus of the brain
o posterior (parietal) branch curves backward and supplies the posterior part of the dura
mater

Venous drainage
meningeal veins - in the endosteal layer of dura ; follows the branches of the middle meningeal
artery drains into the pterygoid venous plexus or the sphenoparietal sinus
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Arachnoid Mater of the Brain
delicate, impermeable membrane covering the brain; lying between the pia mater internally and
the dura mater externally
separated from the dura by subdural space; from the pia by the subarachnoid space, which is
filled with cerebrospinal fluid
subarachnoid cisternae -formed by arachnoid bridges over the sulci on the surface of the brain,
and in certain situations the arachnoid and pia
o projects into the venous sinuses to form arachnoid villi
o most numerous along the superior sagittal sinus
o serve as sites where the cerebrospinal fluid diffuses into the bloodstream
o arachnoid granulations - aggregations of arachnoid villi
fuses with the epineurium of the nerves at their point of exit from the skull

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 in case of the optic nerve - arachnoid forms a sheath for the nerve that extends into the orbital
cavity through the optic canal and fuses with the sclera of the eyeball the subarachnoid space
extends around the optic nerve as far as the eyeball
cerebrospinal fluid - produced by the choroid plexuses within the lateral, third, and fourth
ventricles of the brain
o escapes from the ventricular system of the brain through the three foramina in the roof
of the fourth ventricle and so enters the subarachnoid space
o circulates both upward over the surfaces of the cerebral hemispheres and downward
around the spinal cord
o subarachnoid space extends down as far as the second sacral vertebra
o fluid enters the bloodstream by passing into the arachnoid villi and diffusing through their
walls
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Pia Mater
vascular membrane that closely invests the brain, covering the gyri and descending into the deepest sulci
extends over the cranial nerves and fuses with their epineurium
arteries entering the substance of the brain carry a sheath of pia with them
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The Venous Blood Sinuses
have no valves
receive tributaries from the brain, diploa of the skull, the orbit, and the internal ear
superior sagittal sinus - upper fixed border of the falx cerebri
o runs backward and becomes continuous with the right transverse sinus
o communicates on each side with the venous lacunae
o numerous arachnoid villi and granulations project into the lacunae
o receives the superior cerebral veins
inferior sagittal sinus - lies in the free lower margin of the falx cerebri
o runs backward and joins the great cerebral vein to form the straight sinus
o receives cerebral veins from the medial surface of the cerebral hemisphere
straight sinus - junction of the falx cerebri with the tentorium cerebelli
o formed by the union of the inferior sagittal sinus with the great cerebral veins
o drains into the left transverse sinus
right transverse sinus - begins as a continuation of the superior sagittal sinus
left transverse sinus - usually a continuation of the straight sinus
o sinus lies in the lateral attached margin of the tentorium cerebelli, and they end on each
side by becoming the sigmoid sinus
sigmoid sinuses - direct continuation of the transverse sinuses
o each sinus turns downward behind the mastoid antrum of the temporal bone and then
leaves the skull through the jugular foramen to become the internal jugular vein
occipital sinus - margin of the falx cerebelli
o communicates with the vertebral veins through the foramen magnum and the transverse
sinuses
cavernous sinus - lateral side of the body of the sphenoid bone
o anteriorly, the sinus receives the inferior ophthalmic vein and the central vein of the
retina
o drains posteriorly into the transverse sinus through the superior petrosal sinus
intercavernous sinuses connect the two cavernous sinuses through the sella turcica

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
Important Structures Associated With the Cavernous Sinuses
internal carotid artery and the sixth cranial nerve
lateral wall - third and fourth cranial nerves, and the ophthalmic and maxillary divisions of the
fifth cranial nerve
pituitary gland - lies medially in the sella turcica
veins of the face - are connected with the cavernous sinus via the facial vein and inferior
ophthalmic vein; important route for the spread of infection from the face
superior and inferior petrosal sinuses - run along the upper and lower borders of the petrous
part of the temporal bone
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The Scalp
Structure
consists of five layers
first three - intimately bound together and move as a unit
Skin - thick and hair bearing; contains numerous sebaceous glands
Connective tissue beneath the skin; fibrofatty, the fibrous septa uniting the skin to the underlying
aponeurosis of the occipitofrontalis muscle
o numerous arteries and veins are found in this layer
o arteries - branches of the external and internal carotid arteries, and anastomoses
between them
Aponeurosis (epicranial); thin, tendinous sheet; unites the occipital and frontal bellies of the
occipitofrontalis muscle
o lateral margins of the aponeurosis are attached to the temporal fascia
o subaponeurotic space is the potential space beneath the epicranial aponeurosis
o limited in front and behind by the origins of the occipitofrontalis muscle
o extends laterally as far as the attachment of the aponeurosis to the temporal fascia
Loose areolar tissue - occupies the subaponeurotic space and loosely connects the epicranial
aponeurosis to the periosteum of the skull (the pericranium)
o has few small arteries, but it also contains some important emissary veins
o valveless and connect the superficial veins of the scalp with the diploic veins of the skull
bones and with the intracranial venous sinuses
Pericranium - periosteum covering the outer surface of the skull bones
o at the sutures between individual skull bones, the periosteum on the outer surface of the
bones becomes continuous with the periosteum on the inner surface of the skull bones

Muscles of the Scalp

Occipitofrontalis
first three layers of the scalp move forward or backward, the loose areolar tissue of the fourth
layer of the scalp allowing the aponeurosis to move on the pericranium
frontal bellies - can raise the eyebrows in expressions of surprise or horror

Sensory Nerve Supply of the Scalp

supratrochlear nerve from ophthalmic division of the trigeminal nerve - around the superior
orbital margin and supplies the scalp; goes backward close to the median plane and reaches
nearly as far as the vertex of the skull
supraorbital nerve - from ophthalmic division of the trigeminal nerve; winds around the superior
orbital margin and ascends over the forehead; supplies the scalp as far backward as the vertex

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 zygomaticotemporal nerve from maxillary division of the trigeminal nerve; supplies the scalp
over the temple
auriculotemporal nerve - mandibular division of the trigeminal nerve; ascends over the side of
the head from in front of the auricle; terminal branches supply the skin over the temporal region
lesser occipital nerve - from cervical plexus (C2); supplies the scalp over the lateral part of the
occipital region and the skin over the medial surface of the auricle
greater occipital nerve from posterior ramus of the second cervical nerve; ascends over the
back of the scalp and supplies the skin as far forward as the vertex of the skull

Arterial Supply of the Scalp

From median to lateral side:
o supratrochlear and the supraorbital arteries from ophthalmic artery - ascend over the
forehead in company with the corresponding nerves
o superficial temporal artery - smaller terminal branch of the external carotid artery;
ascends in front of the auricle in company with the auriculotemporal nerve; divides into
anterior and posterior branches, which supply the skin over the frontal and temporal
regions
o posterior auricular artery from external carotid artery; ascends behind the auricle to
supply the scalp above and behind the auricle
o occipital artery - from external carotid artery; ascends from the apex of the posterior
triangle, in company with the greater occipital nerve; supplies the skin over the back of
the scalp and reaches as high as the vertex of the skull

Venous Drainage of the Scalp

supratrochlear and supraorbital veins - unite at the medial margin of the orbit to form the facial
vein
superficial temporal vein unites with the maxillary vein in the substance of the parotid gland to
form the retromandibular vein
posterior auricular vein unites with the posterior division of the retromandibular vein, just below
the parotid gland, to form the external jugular vein
occipital vein drains into the suboccipital venous plexus - beneath the floor of the upper part of
the posterior triangle
suboccipital venous plexus - drains into the vertebral veins or the internal jugular vein

Lymph Drainage of the Scalp

anterior part of the scalp and forehead drain into the submandibular lymph nodes
lateral part of the scalp above the ear - superficial parotid (preauricular) nodes
lymph vessels in the part of the scalp above and behind the ear - mastoid nodes
vessels in the back of the scalp - occipital nodes
_____________________________________________________________________________________
The Face
Skin of the Face
possesses numerous sweat and sebaceous glands
connected to the underlying bones by loose connective tissue; embedded the muscles of facial
expression
no deep fascia is present in the face

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 wrinkle lines - result from the repeated folding of the skin perpendicular to the long axis of the
underlying contracting muscles, coupled with the loss of youthful skin elasticity
surgical scars of the face are less conspicuous if they follow the wrinkle lines

Sensory Nerves of the Face

supplied by branches of the three divisions of the trigeminal nerve
small area over the angle of the mandible and the parotid gland - supplied by the great auricular
nerve (C2 and 3)
ophthalmic nerve - region developed from the frontonasal process
maxillary nerve - region developed from the maxillary process of the first pharyngeal arch
mandibular nerve - region developed from the mandibular process of the first pharyngeal arc.
also supply proprioceptive fibers to the underlying muscles of facial expression
sensory nerve supply to the mouth, teeth, nasal cavities, and paranasal air sinuses

Ophthalmic Nerve
supplies the skin of the forehead, the upper eyelid, the conjunctiva, and the side of the nose down
to and including the tip
5 branches:
o lacrimal nerve - skin and conjunctiva of the lateral part of the upper eyelid
o supraorbital nerve - winds around the upper margin of the orbit at the supraorbital notch;
supply the skin and conjunctiva on the central part of the upper eyelid; supplies the skin
of the forehead.
o supratrochlear nerve - winds around the upper margin of the orbit medial to the
supraorbital nerve; supply the skin and conjunctiva on the medial part of the upper eyelid
and the skin over the lower part of the forehead, close to the median plane
o infratrochlear nerve leaves the orbit below the pulley of the superior oblique muscle;
supplies the skin and conjunctiva on the medial part of the upper eyelid and the adjoining
part of the side of the nose
o external nasal nerve - leaves the nose by emerging between the nasal bone and the upper
nasal cartilages; supplies the skin on the side of the nose down as far as the tip

Maxillary Nerve
supplies the skin on the posterior part of the side of the nose, the lower eyelid, the cheek, the
upper lip, and the lateral side of the orbital opening
Three branches:
o infraorbital nerve - direct continuation; enters the orbit and appears on the face through
the infraorbital foramen; immediately divides into numerous small branches radiate
out from the foramen supply the skin of the lower eyelid and cheek, the side of the
nose, and the upper lip
o zygomaticofacial nerve - passes onto the face through a small foramen on the lateral side
of the zygomatic bone; supplies the skin over the prominence of the cheek
o zygomaticotemporal nerve - emerges in the temporal fossa through a small foramen on
the posterior surface of the zygomatic bone; supplies the skin over the temple

Mandibular Nerve
supplies the skin of the lower lip, the lower part of the face, the temporal region, and part of the
auricle; passes upward to the side of the scalp

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 three branches of the nerve pass to the skin:
o mental nerve - from the mental foramen of the mandible and supplies the skin of the
lower lip and chin
o buccal nerve - from beneath the anterior border of the masseter muscle and supplies the
skin over a small area of the cheek
o auriculotemporal - nerve ascends from the upper border of the parotid gland between
the superficial temporal vessels and the auricle; supplies the skin of the auricle, the
external auditory meatus, the outer surface of the tympanic membrane, and the skin of
the scalp above the auricle

Arterial Supply of the Face

two main vessels: the facial and superficial temporal arteries supplemented by several small
arteries that accompany the sensory nerves of the face
facial artery - from the external carotid artery
o arched upward and over the submandibular salivary gland curves around the inferior
margin of the body of the mandible at the anterior border of the masseter muscle (pulse
can be easily felt) runs upward in a tortuous course toward the angle of the mouth
covered by the platysma and the risorius muscles ascends deep to the zygomaticus
muscles and the levator labii superioris muscle runs along the side of the nose to the
medial angle of the eye anastomoses with the terminal branches of the ophthalmic
artery

Branches
submental artery from the facial artery at the lower border of the body of the mandible; supplies
the skin of the chin and lower lip
inferior labial artery from angle of the mouth; runs medially in the lower lip and anastomoses
with its fellow of the opposite side
superior labial artery from angle of the mouth; runs medially in the upper lip and gives branches
to the septum and ala of the nose
lateral nasal artery - from the facial artery alongside the nose; supplies the skin on the side and
dorsum of the nose
superficial temporal artery - terminal branch of the external carotid artery, commences in the
parotid gland; ascends in front of the auricle to supply the scalp
transverse facial artery (branch of the superficial temporal artery); arises within the parotid
gland; runs forward across the cheek just above the parotid duct
supraorbital and supratrochlear arteries (branches of the ophthalmic artery) -supply the skin of
the forehead

Venous Drainage of the Face

facial - union of the supraorbital and supratrochlear veins
connected to the superior ophthalmic vein directly through the supraorbital vein
via superior ophthalmic vein, the facial vein is connected to the cavernous sinus
o a pathway for the spread of infection from the face to the cavernous sinus
descends behind the facial artery to the lower margin of the body of the mandible
crosses superficial to the submandibular gland and is joined by the anterior division of the
retromandibular vein
ends by draining into the internal jugular vein

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
Tributaries
joined to the pterygoid venous plexus by the deep facial vein and to the cavernous sinus by the
superior ophthalmic vein
transverse facial vein joins the superficial temporal vein within the parotid gland

Lymph Drainage of the Face

forehead and the anterior part of the face drains into the submandibular lymph nodes
buccal lymph nodes may be present along the course of these lymph vessel
lateral part of the face, including the lateral parts of the eyelids, is drained by lymph vessels that
end in the parotid lymph nodes
central part of the lower lip and the skin of the chin are drained into the submental lymph nodes

Bones of the Face

superior orbital margins and the area above them are formed by the frontal bone, which contains
the frontal air sinuses
lateral orbital margin is formed by the zygomatic bone
inferior orbital margin is formed by the zygomatic bone and the maxilla
medial orbital margin is formed above the maxillary process of the frontal bone and below by
the frontal process of the maxilla
root of the nose is formed by the nasal bones, which articulate below with the maxilla and above
with the frontal bones
anteriorly, the nose is completed by upper and lower plates of hyaline cartilage and small
cartilages of the ala nasi.
central bone of the middle third of the face is the maxilla, containing its teeth and the maxillary
air sinus

Muscles of the Face (Muscles of Facial Expression)

embedded in the superficial fascia, and most arise from the bones of the skull and are inserted
into the skin
oriifices of the face, namely, the orbit, nose, and mouth, are guarded by the eyelids, nostrils, and
lips, respectively
function of the facial muscles to serve as sphincters or dilators of these structures
secondary function of the facial muscles is to modify the expression of the face
muscles of the face are developed from the second pharyngeal arch and are supplied by the facial
nerve

Muscles of the Eyelids

Sphincyer muscle: orbicularis oculi, and the dilator muscles: levator palpebrae superioris and the
occipitofrontalis

Muscles of the Nostrils

compressor naris and the dilator muscle is the dilator naris

Muscles of the Lips and Cheeks

sphincter muscle the orbicularis oris; dilator muscles consist of a series of small muscles that
radiate out from the lips

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
Sphincter Muscle of the Lips: Orbicularis Oris
Origin and insertion: fibers encircle the oral orifice within the substance of the lips
some of the fibers arise near the midline from the maxilla above and the mandible below
other fibers arise from the deep surface of the skin and pass obliquely to the mucous membrane
lining the inner surface of the lips. Many of the fibers are derived from the buccinator muscle.
Nerve supply: Buccal and mandibular branches of the facial nerve
Action: Compresses the lips together

Dilator Muscles of the Lips

Traced from the side of the nose to the angle of the mouth and then below the oral aperture, the
muscles are named as follows:
o Levator labii superioris alaeque nasi
o Levator labii superioris
o Zygomaticus minor
o Zygomaticus major
o Levator anguli oris (deep to the zygomatic muscles)
o Risorius
o Depressor anguli oris
o Depressor labii inferioris
o Mentalis

Nerve Supply
Buccal and mandibular branches of facial nerve

Muscle of the Cheek

Buccinator
Origin: outer surface of the alveolar margins of the maxilla and mandible opposite the molar teeth
and from the pterygomandibular ligament
Insertion: upper lip and those from above entering the lower lip; the highest and lowest fibers
continue into the upper and lower lips, respectively, without intersecting; blends and forms part
of the orbicularis oris muscle.
Nerve supply: Buccal branch of the facial nerve
Action: Compresses the cheeks and lips against the teeth

Facial Nerve
five terminal branches:
o temporal branch - from the upper border of the gland; supplies the anterior and superior
auricular muscles, the frontal belly of the occipitofrontalis, the orbicularis oculi, and the
corrugator supercilii zygomatic branch - from the anterior border of the gland; supplies
the orbicularis oculi
o buccal branch - from the anterior border of the gland below the parotid duct and supplies
the buccinator muscle and the muscles of the upper lip and nostril
o dilator muscles radiate out from the lips, and their action is to separate the lips; this
movement is usually accompanied by separation of the jaws.
o mandibular branch emerges from the anterior border of the gland; supplies the lower lip

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 o cervical branch from the lower border of the gland and passes forward in the neck below
the mandible to supply the platysma muscle; it may cross the lower margin of the body
of the mandible to supply the depressor anguli oris muscle
nerve of the second pharyngeal; supplies all the muscles of facial expression; does not supply the
skin; its branches communicate with branches of the trigeminal nerve believed that the
proprioceptive nerve fibers of the facial muscles leave the facial nerve in these communicating
branches pass to the central nervous system via the trigeminal nerve

Muscles of the Head

Muscle Origin Insertion Nerve supply Action
Muscle of the Scalp
Occipito
Frontalis Highest nuchal line of Epicranial Facial nerve Moves scalp and
Occipital Belly occipital bone aponeurosis raises eyebrows
Skin and superficial Facial nerve
fascia of eyebrows
Frontal belly
Muscles of Facial expression
Orbicularis Facial nerve
oculi Medial palpebral Lateral palpebral Closes eyelids and
Palpebral part ligament raphe dilates lacrimal
gland
Medial palpebral Loops return to Facial nerve Throws skin around
Orbital part ligament and adjoining origin orbit into folds to
bone protect eyeball
Corrugator Superciliary arch Skin of eyebrow Facial nerve Vertical wrinkles of
supercilii forehead, as in
frowning
Compressor Frontal process of Aponeurosis of Facial nerve Compresses mobile
nasi maxilla bridge of nose nasal cartilage
Dilator naris Maxilla Ala of nose Facial nerve Widens nasal
aperture
Procerus Nasal bone Skin between Facial nerve Wrinkle skin of
eyebrows nose
Orbicularis Maxilla, mandible and Encircles oral Facial nerve Compresses lips
oris skin orifice together
Dilator muscles of lips

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 Levator labii Arise from bones and fascia around oral Facial nerve Separate lips
Superior aperture and insert into substance of lips
alaeque nasi
Levator labii
superioris
Zygomaticus
minor
Zugomaticus
major
Levator anguli
oris
Depressor
labii inferioris
Mentalis
Buccinators Outer surface of alveolar margins of maxilla Facial nerve Compresses cheeks
and mandible and pterygomandibular and lips against the
ligament teeth
Muscles of mastication
Masseter Zygomatic arch Lateral surface Mandibular Elevates mandible
ramus of mandible division of to occlude teeth
trigeminal nerve
Temporalis Floor of temporal Coronoid process Mandibular Anterior and
fossa of mandible division of superior fibers
trigeminal nerve elevate mandible;
posterior fibers
retract mandible
Lateral Greater wing of Neck of mandible Mandibular Pulls neck of
pterygoid sphenoid and lateral and articular disc division of mandible forward
pterygoid plate trigeminal nerve
Medial Tuberosity of maxilla Medial surface of Mandibular Elevates mandible
pterygoid and lateral pterygoid angle of mandible division of
plate trigeminal nerve

_____________________________________________________________________________________
The Neck
lies between the lower margin of the mandible above and the suprasternal notch and the upper border
of the clavicle below
strengthened by the cervical part of the vertebral column, which is convex forward and supports the skull
structures in the central region: larynx and trachea
behind - the alimentary system, the pharynx and the esophagus
sides - carotid arteries, internal jugular veins, the vagus nerve, and the deep cervical lymph nodes

Skin of the Neck

natural lines of cleavage of the skin - run almost horizontally around the neck; incision along a
cleavage line will heal as a narrow scar, whereas one that crosses the lines will heal as a wide or
heaped-up scar

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
Cutaneous Nerves
posterior rami of cervical nerves 2 to 5 supplies the skin overlying the trapezius muscle on the
nape
o greater occipital nerve (branch of the posterior ramus of the second cervical nerve)
o first cervical nerve has no cutaneous branch
anterior rami of cervical nerves 2 to 4 through branches of the cervical plexus - skin of the front
and sides of the neck
branches emerge from beneath the posterior border of the sternocleidomastoid muscle
lesser occipital nerve (C2) hooks - skin over the lateral part of the occipital region and the medial
surface of the auricle
great auricular nerve (C2 and 3) - divides into branches that supply the skin over the angle of the
mandible, the parotid gland, and on both surfaces of the auricle
transverse cutaneous nerve (C2 and 3) - from behind the middle of the posterior border of the
sternocleidomastoid muscle passes forward across that muscle divides into branches
supply the skin on the anterior and lateral surfaces of the neck, from the body of the mandible to
the sternum
supraclavicular nerves (C3 and 4) - from beneath the posterior border of the sternocleidomastoid
muscle and descend across the side of the neck pass onto the chest wall and shoulder region
down to the level of the second rib
medial supraclavicular nerve - crosses the medial end of the clavicle and supplies the skin as far
as the median plane
intermediate supraclavicular nerve crosses the middle of the clavicle and supplies the skin of
the chest wall
lateral supraclavicular nerve - supplies the skin over the shoulder and the upper half of the deltoid
muscle, the posterior aspect of the shoulder as far down as the spine of the scapula

Superficial Fascia
forms a thin layer that encloses the platysma muscle
embedded in it are the cutaneous nerves referred to in the previous section, the superficial veins,
and the superficial lymph nodes

Platysma
thin but clinically important muscular sheet embedded in the superficial fascia

Superficial Veins
External Jugular Vein
begins just behind the angle of the mandible by the union of the posterior auricular vein with the
posterior division of the retromandibular vein
descends obliquely across the sternocleidomastoid muscle
pierces the deep fascia and drains into the subclavian vein above the clavicle
tributaries:
o Posterior auricular vein
o Posterior division of the retromandibular vein
o Posterior external jugular vein, a small vein that drains the posterior part of the scalp and
neck and joins the external jugular vein about halfway along its course
o Transverse cervical vein
o Suprascapular vein

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 o Anterior jugular vein

Anterior Jugular Vein

begins just below the chin, by the union of several small veins
down the neck close to the midline
veins of the two sides are united by a transverse trunk called the jugular arch
drain into the external jugular vein deep into the sternocleidomastoid muscle

Superficial Lymph Nodes

lie along the external jugular vein superficial to the sternocleidomastoid muscle
receive lymph vessels from the occipital and mastoid lymph nodes
drain into the deep cervical lymph nodes

Bones of the Neck

Cervical Vertebrae
cervical part of the vertebral column

Hyoid Bone
mobile single bone found in the midline of the neck below the mandible and abides the larynx
does not articulate with any other bones
U shaped and consists of a body and two greater and two lesser cornua
attached to the skull by the stylohyoid ligament and to the thyroid cartilage by the thyrohyoid
membrane
forms a base for the tongue and is suspended in position by muscles that connect it to the
mandible, to the styloid process of the temporal bone, to the thyroid cartilage, to the sternum,
and to the scapula

Key Neck Muscles

Sternocleidomastoid Muscle
appears as an oblique band crossing the side of the neck from the sternoclavicular joint to the
mastoid process of the skull
divides the neck into anterior and posterior triangles
nterior border covers the carotid arteries, the internal jugular vein, and the deep cervical lymph
nodes; it also overlaps the thyroid gland
covered superficially by skin, fascia, the platysma muscle, and the external jugular vein
deep surface of the posterior border is related to the cervical plexus of nerves, the phrenic nerve,
and the upper part of the brachial plexus

Scalenus Anterior Muscle

deeply placed and it descends almost vertically from the vertebral column to the first rib
Important Relations
o Anteriorly: carotid arteries, the vagus nerve, the internal jugular vein, and the deep
cervical lymph nodes; transverse cervical and suprascapular arteries and the prevertebral
layer of deep cervical fascia bind the phrenic nerve to the muscle
o Posteriorly: pleura, the origin of the brachial plexus, and the second part of the subclavian
artery; scalenus medius muscle lies behind the scalenus anterior muscle
o Medially: vertebral artery and vein and the sympathetic trunk

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 o left side, the medial border is related to the thoracic duct
o Laterally: emerging branches of the cervical plexus, the roots of the brachial plexus, and
the third part of the subclavian artery

Muscles of the Neck

Muscle Origin Insertion Nerve supply Action
Platysma Deep fascia over Body of mandible Facial nerve Depresses
pectoralis major and angle of cervical branch mandible and
and deltoid mouth angle of mouth
Sternocleidomastoid Manubrium Mastoid process Spinal part of 2 muscles acting
sterni and medial of temporal bone accessory nerve together extend
third of clavicle and occipital bine and C2 and C3 head and neck;
one muscle
rotates head to
opposite side
Digastric
Posterior belly Mastoid process Intermediate Facial nerve Depresses
of temporal bone tendon is held to mandible or
hyoid by fascial elevates hyoid
sling bone
Anterior belly Body of mandible Nerve to
myolohyoid
Stylohyoid Styloid process Body of hyoid Facial nerve Elevates hyoid
bone bone
Mylohyoid Mylohyoid line of Body of hyoid Inferioir alveolar Elevates floor of
body of mandible bone and fibrous nerve mouth and hyoid
raphe bone or
depresses
mandible
Geniohyoid Inferioir mental Body of hyoid First cervical Elevates hyoid
spine of mandible bone nerve bone or
depresses
mandible
Sternohyoid Manubrium Body of hyoid Ansa cervicalis; Depresses hyoid
sterni and clavicle bone C1-C3 bone
Sternothyroid Manubrium Oblique line on Ansa cervicalis; Depresses larynx
sterniand lamina of thyroid C1-C3
cartilage
Thyrohyoid Oblique line on Lower border of First cervical Depresses hyoid
lamina of thyroid body of hyoid nerve bone or elevates
cartilage bone larynx
Omohyiod
Inferior belly Upper margin of Intermediate Ansa cervicalis; Depresses hyoid
scapula and tendon is held to C1-C3 bone
suprascapular clavicle and first
ligament rib by fascial sling

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
 Superior belly Lower border of
body of hyoid
bone
Scalenus anterior Transverse First rib C4-C6 Elevates first rib;
processes of laterally flexes
third, fourth, and rotates
fifth, and sixth cervical part of
cervical vertebrae vertebral column
Scalenus medius Transverse First rib Anterior rami of Elevates first rib;
processes of cervical nerves laterally flexes
upper six cervical and rotates
vertebrae cervical part of
vertebral column
Scalenus posterior Transverse Second rib Anterior rami of Elevates second
processes of cervical nerves rib; laterally
lower cervical flexes and
vertebrae rotates cervical
part of vertebral
column

Deep Cervical Fascia

Investing Layer - thick layer that encircles the neck; splits to enclose the trapezius and the
sternocleidomastoid muscles
Pretracheal Layer - thin layer that is attached above to the laryngeal cartilages; surrounds the
thyroid and the parathyroid glands, forming a sheath for them, and encloses the infrahyoid
muscles.
Prevertebral Layer - thick layer that passes like a septum across the neck behind the pharynx and
the esophagus and in front of the prevertebral muscles and the vertebral column; forms the fascial
floor of the posterior triangle, and it extends laterally over the first rib into the axilla to form the
important axillary sheath
Carotid Sheath - local condensation of the prevertebral, the pretracheal, and the investing layers
of the deep fascia that surround the common and internal carotid arteries, the internal jugular
vein, the vagus nerve, and the deep cervical lymph nodes
all the anterior rami of the cervical nerves that emerge in the interval between the scalenus
anterior and scalenus medius muscles lie at first deep to the prevertebral fascia
o subclavian artery and the brachial plexus emerge in the interval between the scalenus
anterior and the scalenus medius muscles
o axillary sheath - carry with them a sheath of the fascia, which extends into the axilla

Cervical Ligaments
Stylohyoid ligament: connects the styloid process to the lesser cornu of the hyoid bone
Stylomandibular ligament: Connects the styloid process to the angle of the mandible
Sphenomandibular ligament: Connects the spine of the sphenoid bone to the lingula of the
mandible (Fig. Pterygomandibular ligament: Connects the hamular process of the medial
pterygoid plate to the posterior end of the mylohyoid line of the mandible
o gives attachment to the superior constrictor and the buccinator muscles

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock
Muscular Triangles of the Neck
Anterior Triangle
o bounded above by the body of the mandible, posteriorly by the sternocleidomastoid
muscle
o anteriorly by the midline
o further subdivided into the carotid triangle, the digastric triangle, the submental triangle,
and the muscular triangle
Posterior Triangle
o bounded posteriorly by the trapezius muscle
o anteriorly by the sternocleidomastoid muscle
o inferiorly by the clavicle
o further subdivided by the inferior belly of the omohyoid muscle into a large occipital
triangle above and a small supraclavicular triangle below

Arteries of the Head and Neck

Common Carotid Artery
right common carotid artery - from the brachiocephalic artery behind the right sternoclavicular
joint left artery - from the arch of the aorta in the superior mediastinum
common carotid artery runs upward through the neck under cover of the anterior border of the
sternocleidomastoid muscle, from the sternoclavicular joint to the upper border of the thyroid
cartilage divides into the external and internal carotid arteries

Carotid Sinus
terminal part of the common carotid artery or the beginning of the internal carotid artery shows
a localized dilatation
serves as a reflex pressoreceptor mechanism: rise in blood pressure causes a slowing of the heart
rate and vasodilatation of the arterioles

Carotid Body
small structure that lies posterior to the point of bifurcation of the common carotid artery
innervated by the glossopharyngeal nerve
chemoreceptor, being sensitive to excess carbon dioxide and reduced oxygen tension in the blood
produces a rise in blood pressure and heart rate and an increase in respiratory movements

Relations of the Common Carotid Artery

Anterolaterally: The skin, the fascia, the sternocleidomastoid, the sternohyoid, the sternothyroid,
and the superior belly of the omohyoid)
Posteriorly: The transverse processes of the lower four cervical vertebrae, the prevertebral
muscles, and the sympathetic trunk
o In the lower part of the neck are the vertebral vessels
Medially: The larynx and pharynx and, below these, the trachea and esophagus
o The lobe of the thyroid gland also lies medially
Laterally: The internal jugular vein and, posterolaterally, the vagus nerve

Branches of the Common Carotid Artery

External Carotid Artery
one of the terminal branches of the common carotid artery

Source: Snells, Clinical Anatomy by Regions 8th edition

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 supplies structures in the neck, face, and scalp; it also supplies the tongue and the maxilla
begins at the level of the upper border of the thyroid cartilage and terminates in the substance of
the parotid gland behind the neck of the mandible by dividing into the superficial temporal and
maxillary arteries
emerges from undercover of the sternocleidomastoid muscle, where its pulsations can be felt
lies medial to the internal carotid artery, but as it ascends in the neck, it passes backward and
lateral to it
crossed by the posterior belly of the digastric and the stylohyoid
branches
o Superior thyroid artery cricothyroid muscle
o Ascending pharyngeal artery pharyngeal wall
o Lingual artery - tongue
o Facial artery tonsil, salivary glands, muscles and skin of the face
o Occipital artery back of scalp
o Posterior auricular artery auricle and scalp
o Superficial temporal artery - scalp
o Maxillary artery
Middle meningeal artery
Internal carotid artery
Opthalmic artery
Posterior communicating artery
Anterior cerebral artery
Middle cerebral artery
Circle of Willis
Subclavian Arteries

Source: Snells, Clinical Anatomy by Regions 8th edition

Prepared by: my chemical learns to rock