FITRI HERYANTI FAHMI ATTAUFANNY

BONES
MUSCLES VASCULARIZATION EYE PAROTID GLAND SINUSES INNERVATION TMJ

Os. Os. Os. Os. Os. Os. Os. Os.

Temporal Maxilla Mandibula Zygoma Nasal Sphenoid Ethmoid Lacrimal

Netter Neuroanatomy, 2007

Netter Neuroanatomy, 2007

Canalis opticus (CNII) Fissura orbitalis superior (CN III,IV,VI, V1,V2)

Moore - Clinically Oriented Anatomy, 5th Ed 2006

Moore - Clinically Oriented Anatomy, 5th Ed 2006

BONES

MUSCLES
VASCULARIZATION EYE PAROTID GLAND SINUSES INNERVATION TMJ

Moore - Clinically Oriented Anatomy, 5th Ed 2006

Musclea Occipitofrontalis Frontal belly1

Origin

Insertion

Main Action(s)

Epicranial aponeurosis Skin and subcutaneous Elevates eyebrows and tissue of eyebrows and wrinkles skin of forehead forehead; protracts scalp (indicating surprise or curiosity) Occipital bellya Lateral two thirds of Epicranial aponeurosis Retracts scalp; superior nuchal line increasing effectiveness of frontal belly Orbicularis oculi Medial orbital margin; Skin around margin of Closes eyelids: 1,2 (orbital sphincter) medial palpebral orbit; superior and palpebral part does so ligament; lacrimal bone inferior tarsal plates gently; orbital part tightly (winking) 1 Corrugator supercilii Medial end of Skin superior to middle Draws eyebrow superciliary arch of supraorbital margin medially and inferiorly, and superciliary arch creating vertical wrinkles above nose (demonstrating concern or worry) Procerus plus Fascia aponeurosis Skin of inferior Depresses medial end transverse part of covering nasal bone forehead, between of eyebrow; wrinkles nasalis3 and lateral nasal eyebrows skin over dorsum of cartilage nose (conveying disdain or dislike) Alar part of nasalis plus Frontal process of Major alar cartilage Depresses ala laterally, levator labii superioris maxilla (inferomedial dilating anterior nasal alaeque nasii3 margin of orbit) aperture (i.e., flaring nostrils,

Orbicularis oris (oral sphincter)3

Levator labii superioris3 Zygomaticus minor3 Buccinator (cheek muscle)3

Medial maxilla and mandible; deep surface of perioral skin; angle of mouth (modiolus) Infraorbital margin (maxilla) Anterior aspect, zygomatic bone Mandible, alveolar processes of maxilla and mandible, pterygomandibular raphe Lateral aspect of zygomatic bone Infraorbital maxilla (canine fossa)

Zygomaticus major3 Levator anguli oris3

Risorius3

Parotid fascia and buccal skin (highly variable) 4 Depressor anguli oris Anterolateral base of mandible

Mucous Tonus closes rima oris; membrane of lips phasic contraction compresses and protrudes lips (kissing) or resists distension (when blowing) Skin of upper lip Part of dilators of mouth; retract (elevate) and/or evert upper lip; deepen nasolabial sulcus (showing sadness) Angle of mouth Presses cheek against molar (modiolus); teeth; works with tongue to orbicularis oris keep food between occlusal surfaces and out of oral vestibule; resists distension (when blowing) Angle of mouth Part of dilators of mouth; (modiolus) elevate labial commissurebilaterally to smile (happiness); unilaterally to sneer (disdain) Part of dilators of mouth; widens rima oris, as when grinning or grimacing Part of dilators of mouth; depresses labial commissure bilaterally to

Depressor labii inferioris4

Platysma and anterolateral body of mandible

Skin of lower lip

Part of dilators of mouth; retracts (depresses) and/or everts lower lip (pouting, sadness) Elevates and protrudes lower lip; elevates skin of chin (showing doubt) Depresses mandible (against resistance); tenses skin of inferior face and neck (conveying tension and stress)

Mentalis4

Body of mandible (anterior to roots of inferior incisors)

Skin of chin (mentolabial sulcus)

Platysma5

Subcutaneous tissue of Base of mandible; skin infraclavicular and of cheek and lower lip; supraclavicular regions angle of mouth (modiolus); orbicularis oris

BONES MUSCLES

VASCULARIZATION
EYE PAROTID GLAND SINUSES INNERVATION TMJ

Artery Facial

Origin External carotid artery

Inferior labial Superior labial Lateral nasal Angular Occipital

Facial artery near angle of mouth

Posterior auricular

Facial artery as it ascends alongside nose Terminal branch of Passes to medial facial artery angle (canthus) of eye External carotid Passes medial to artery posterior belly of digastric and mastoid process; Passes posteriorly, deep to parotid gland

Course Distribution Ascends deep to Muscles of facial submandibular expression and face gland; winds around inferior border of mandible and enters face Runs medially in Lower lip lower lip Runs medially in Upper lip and ala upper lip (side) and septum of nose Passes to ala of Skin on ala and nose dorsum of nose Superior part of cheek and inferior eyelid Scalp of back of head, as far as vertex Scalp posterior to auricle and auricle

Superficial temporal Smaller terminal Ascends anterior to Facial muscles and branch of external ear to temporal skin of frontal and carotid artery region and ends in temporal regions scalp Transverse facial Superficial temporalCrosses face Parotid gland and artery within superficial to duct, muscles and parotid gland masseter and inferior skin of face to zygomatic arch Mental Terminal branch of Emerges from mental Facial muscles and inferior alveolar foramen and passes skin of chin artery to chin a Supraorbital Terminal branch of Passes superiorly Muscles and skin of ophthalmic artery, from supraorbital forehead and scalp a branch of internal foramen Supratrochleara carotid artery Passes superiorly Muscles and skin of from supratrochlear scalp notch

Vein

Supratrochlear

Origin

Begins from venous plexus on forehead and scalp, through which it communicates with frontal branch of superficial temporal vein, its contralateral partner, and supraorbital vein

Course

Descends near Angular vein at root Anterior part of midline of forehead of nose scalp and forehead to root of nose, where it joins supraorbital vein

Termination

Area Drained

Supraorbital

Begins in the forehead by anastomosing with frontal tributary of superficial temporal vein

Passes medially superior to orbit; joins supratrochlear vein; a branch passes through supraorbital notch and joins with superior ophthalmic vein Descends obliquely Becomes facial vein Anterior part of along root and side at inferior margin of scalp and forehead; of nose to inferior orbit superior and orbital margin inferior eyelids and conjunctiva; may receive drainage from cavernous sinus

Angular

Begins at root of nose by union of supratrochlear and supraorbital veins

Facial

Continuation of angular vein past inferior margin of orbit

Deep facial

Superficial temporal

Descends along Internal jugular Anterior scalp and lateral border of vein opposite or fore-head; eyelids; nose, receiving inferior to level of external nose; external nasal and hyoid bone anterior cheek; inferior palpebral lips; chin; and veins; passes submandibular obliquely across gland face to cross inferior border of mandible; receives communication from retro mandibular vein Pterygoid venous Runs anteriorly on Enters posterior Infratemporal fossa plexus maxilla superior to aspect of facial (most areas buccinator and vein supplied by deep to masseter, maxillary artery) emerging medial to anterior border of masseter onto face Begins from Frontal and parietal Joins maxillary vein Side of scalp; widespread plexus tributaries unite posterior to neck of superficial aspect of veins on side of anterior to the mandible to form of temporal scalp and along auricle; crosses retromandibular muscle; and zygomatic arch temporal root of vein external ear zygomatic arch to pass from temporal region and enter substance of the parotid gland

Retromandibular

Formed anterior to Runs posterior and Unites with Parotid gland and ear by union of deep to ramus of posterior auricular masseter muscle superficial mandible through vein to form temporal and substance of external jugular maxillary veins parotid gland; vein communicates at inferior end with facial vein

BONES MUSCLES VASCULARIZATION

EYE

PAROTID GLAND SINUSES INNERVATION TMJ

BONES MUSCLES VASCULARIZATION EYE

SINUSES INNERVATION TMJ

PAROTID GLAND

The parotid gland is the largest of three paired salivary glands. Innervation of Parotid Gland The auriculotemporal nerve, a branch of CN V3 The great auricular nerve, a branch of the cervical plexus composed of fibers from C2 and C3 spinal nerves, innervates the parotid sheath Parasympathetic : N IX secretion Sympathetic :cervical ganglion reduce secretion

Vaskularization : V. Retromandibularis A. Temporalis superficialis A. Maxillaris

BONES MUSCLES VASCULARIZATION EYE PAROTID GLAND

SINUSES

INNERVATION TMJ

BONES MUSCLES VASCULARIZATION EYE PAROTID GLAND SINUSES

TMJ

INNERVATION

CN5 Trigeminal Nerves

Biggest cranial nerve Originates in the pons and eventually splits into 3 divisions:

Sensory info (touch, temp., and pain) from face. Motor info to muscles of mastication

Ophthalmic (V1), Maxillary (V2), & Mandibular (V3).

Eye mover Originate at the ventral midbrain. Synapse on:

Extraocular muscles

Disorders can result in eye paralysis, diplopia or ptosis.

Iris constrictor muscle Ciliary muscle

Inferior oblique; Inferior, medial, and superior rectus

Controls the superior oblique muscle which depresses the eye via pulling on the superior oblique tendon which loops over a ligamentous pulley known as the trochlea. Originates on the dorsal midbrain and synapses on the superior oblique Trauma can result in double vision.

Runs between inferior pons and lateral rectus.

CN VI Abducens Nerves

Originates at the pons Convey motor impulses to facial skeletal muscles except for chewing muscles. Convey parasympathetic motor impulses to tear, nasal, and some salivary glands. Convey sensory info from taste buds on anterior 2/3 of the tongue. Facial nerve damage may yield Bells palsy, total ipsilateral hemifacial paralysis

BONES MUSCLES VASCULARIZATION EYE PAROTID GLAND SINUSES INNERVATION

TMJ

Cutaneous nerves derived from ophthalmic nerve (CN V1) Supraorbital Largest branch from Continues anteriorly Mucosa of frontal bifurcation of frontal along roof of orbit, sinus; skin and nerve, approximately in emerging via conjunctiva of middle middle of orbital roof supraorbital notch or of superior eyelid; skin foramen; ascends and pericranium of forehead, breaking into anterolateral forehead branches and scalp to vertex (interauricular line) Smaller branch from Continues Skin and conjunctive of bifurcation of frontal anteromedially along medial aspect of nerve, approximately in roof of orbit, passing superior eyelid; skin middle of orbital roof lateral to trochlea and and pericranium of ascending forehead anteromedial forehead Smallest branch from Runs superolaterally Lacrimal gland trifurcation of CN V1 through orbit, receiving (secretomotor fibers); proximal to superior secretomotor fibers via small area of skin and orbital fissure a communicating conjunctiva of lateral branch from the part of superior eyelid zygomaticotemporal nerve Terminal branch (with Follows medial wall of Skin lateral to root of anterior ethmoidal orbit, passing inferior nose; skin and nerve) of nasociliary to trochlea conjunctiva of eyelids

Supratrochlear

Lacrimal

Infratrochlear

nerve
External nasal

Terminal branch of

anterior ethmoidal nerve

Emerges from nasal cavity by passing between nasal bone and lateral nasal

adjacent to medial canthus, lacrimal sac, and lacrimal caruncle Skin of nasal ala, vestibule, and dorsum of nose, including apex

Cutaneous nerves derived from maxillary nerve (CN V2) Infraorbital Continuation of CN V2 distal to its entrance into the orbit via the inferior orbital fissure Traverses infraorbital Mucosa of maxillary groove and canal in sinus; premolar, orbital floor, giving rise canine, and incisor to superior alveolar maxillary teeth; skin branches; then and conjunctiva of emerges via infraorbitalinferior eyelid; skin of foramen, immediately cheek, lateral nose, and dividing into inferior anteroinferior nasal palpebral, internal and septum; skin and oral external nasal, and mucosa of superior lip superior labial branches Smaller terminal branchTraverses Skin on prominence of (with zygomaticofacial canal cheek zygomaticotemporal in zygomatic bone at nerve) of zygomatic inferolateral angle of nerve orbit Larger terminal branch Sends communicating Hairless skin anterior (with zygomaticofacial branch to lacrimal part of temporal fossa nerve) of zygomatic nerve in orbit; then nerve passes to temporal fossa via zygomaticotemporal canal in zygomatic bone

Zygomaticofacial

Zygomaticotemporal

Cutaneous nerves derived from mandibular nerve (CN V3) Auriculotemporal In infratemporal fossa Passes posteriorly deep Skin anterior to auricle via two roots from to ramus of mandible and posterior two posterior trunk of CN and superior deep part thirds of temporal V3 that encircle middle of parotid gland, region; skin of tragus meningeal artery emerging posterior to and adjacent helix of temporomandibular auricle; skin of roof of joint external acoustic meatus; and skin of superior tympanic In infratemporal fossa Passes between two as sensory branch of parts of lateral anterior trunk of CN V3 pterygoid muscle, emerging anteriorly from cover of ramus of mandible and masseter, uniting with buccal branches of facial nerve Terminal branch of Emerges from inferior alveolar nerve mandibular canal via (CN V3) mental foramen in anterolateral aspect of body of mandible

Buccal

membrane

Skin and oral mucosa of cheek (overlying and deep to anterior part of buccinator); buccal gingivae (gums) adjacent to second and third molars Skin of chin and skin; oral mucosa of inferior

Mental

lip