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Gross I-Head

Tri 2

Occipitofrontalis Epicranial aponeurosis, Occipitalis, Frontalis(blends into procerus)
Orbicularis Oculi 3 parts, Orbital(strongly closes), Palpebral(lightly closes, protects cornea from injury, area affected by Bell's Palsey) Lacrimal (draws lid medially, lacrimal lake)
Orbicularis Oris Vermillion line(border)
Smile Muscle Zygomaticus major
Laugh Muscle Risorius - grin, true laughter, moves lateral commissure laterally
Levator Labii Superioris Alequea Nasi superficial, next to nose, elevates and flares nostril, longest name
Levator Labii Superioris deeper, Elvis muscle
Frown Muscle Depressor angulii Oris
Mentalis pulls chin up or lip down, pouting
Corrugator Supercilli pulls toward midline, forms vertical line, concern muscle
Auricularis Muscles Wiggle ears, Posterior, Superior and Anterior
Outside Muscles of Mastication Masseter and Temporalis
Masseter Origin is inferior and medial zygomatic arch. Insertion Lateral ramus and coronoid process
Temporalis Origin is Temporal fossa and deep fascia, insertion styloid process and anterior ramus
Innervation of Outside Head Facial and Trigeminal Nerve
Facial Nerve (CN VII) Motor to all muscles of facial expression + occipitalis and auricular muscles. Sensory to NONE
Trigeminal Nerve Motor to all muscles of mastication , temporalis and masseter. Sensory to whole face
Facial Nerve Placement exits stylomastoid foramen, pierces parotid gland w/o innervating it, branches to 5 anterior and 1 posterior
Facial Nerve Branches 5 anterior: Temporal, Zygomatic, Buccal, Mandibular, Cervical. 1 Posterior-Posterior auricular
Trigeminal Nerve Placement Exits thru orbit and many foramina, 3 branches, Opthalmic V1, Maxillary V2, Mandibular V3, deep.
Opthalmic V1 forehead, nose, upper eyelid
Maxillary V2 Upper lip, over zygomatic arches
Mandiular V3 Lower lip, lower jaw, anterior to ear, part of ear
Vasculature to face Facial artey(external carotid), Superficial temporal artery(external carotid), branches from internal lcarotid(via opthalmic artery)
Facial Artery 4th branch of external carotid artery(3rd anterior branch), groove in submandibular gland, appears on the face from under mandible and just anterior to masseter muscle
Branches of Facial Artery 3 cervicla branches (ascending palantine, tonsilar, glandular, submental) 3 facial branches ( Inferior and superior labial, angular)
Superficial Temporal Artery Terminal branch of external carotis. between zygomatic arch and parotid. Major branch is transverse facial artery, connects with angular artery
Branches from Internal Carotid via opthalmic artery, exit thru orbit, freely anastomose with facial and superficial temporal
Venous Drainage to Face extensive and varied, connected to deeep veins and plexuses, valveless, blood returns by path of leastt pressure
Dangerous triangle of face infecction can spread to dural venous sinuses
Lymphatics clinically important, swollen and tendor in infection, if swollen but not tendor..cancer?. 10% of blood returns to circulation thru here.
Superficial grp Lymph Nodes-pericervical collar. submental, submandibular (NOT SUBMANDIBULAR GLAND), parotid, superficial cervical, retroauricular, occipital
Deep grp Lymph nodes deep cervical (posterior to SCM)
Parotid Gland largest salivary gland, on face covering ramus of mandible and masseter musccle, Stenson's parotid duct crooses masseter and turns medially to pierce buccinator, then opens into oral cavity lateral to 1 or 2 upper molar
Condylar process TMJ
Coronoid Process insertion of temporalis
Mandibular foramen Lingula(anterior to foramen), mylohyoid groove(for n. and a. )
Alveolar process for teeth
Mental spines genial tubercles
Temporomandibular Joint synovial, diarthrotic-modified hinge joint, articular disc divides joint into 2 synovial compartments, Inferior-hinge motions(depression and elevation), Superior-gliding motions(protrusion and retrusion)
Ligaments of TMJ the capsule is loose to allow motion, Extrensic Ligamnets-stylomandibular lig., sphenomandibular lig., `
Stylomandibular Lig. thickiening of firbrous capsule of parotid gland, No signifigant use
Sphenomandibular Lig. spine of sphenoid to lingula of mandible, primarily passive support.
TMJ Blood Supply and Innervations Maxillary Artery (one of terminal branches of external carotid), and auriculotemporal nerve (branch of mandibular nerve)
Muscles of mastication Superficial-temporalis, masseter. W?I Infratemporal fossa-medial pterygoid, lateral pterygoid
Lateral Pterygoid Superior head origin is the infratemporal crest and surface of greater wing of sphenoid. The inferior head origin is the lateral surface of the lateral pterygoid plate. Insertion is to the neck of the mandible and the articular disc and capsule of TMJ
Medial Pterygoid Deep Head Origin is medial surface of lateral pterygoid plate and pyrimidal process of palantine bone. Superficial head origin is the tuberosity of maxilla. Insertion to the medial surface of the ramus, inferior to the mandibular foramen
Superficial and Posterior boundaries of temporal fossa superior temporal line, inferior temporal line
Inferior boundary of Temporal Fossa Infratemporal crest
Lateral Boundary of temporal fossa zygomatic arch
Anterior boudary of temporal fossa frontal bone, zygomatic bone
Floor and Contents of fosssa pariental bone, frontal ,temporal , sphenoid, skull is thinnest at the pterion
Boundaries of infratemporal fossa Superior-infratemporal crest, Inferior-medial pterygoid insertion. Anterior-Maxilla. Posterior- mastoid and styloid process. Medial-lateral pterygoid plate of sphenoid. Lateral- ramus of mandible
Contents of Infratemporal Fossa Maxillary Artery, Pterygoud venous plexus, foramina and fisssures for communication
Nerve contents of fossa Mandibular branch of trigeminal nerve, Chorda typani CN7, V3, otic ganglion
Maxillary artery 3 parts delineated by lateral pterygoid. Part 1-proximal to lateral pterygoid. Part 2- either superficial or deep to laterla pterygoid. part 3-distal
Part 1 of maxillary artery from external carotid to inferior border of lateral pterygoid. Branches are inferior alveolar, deep auricular, anterior tympanic, middle meningeal, acessory meningeal
Part 2 of maxillary artery This is the muscular part.,
Part 3 of maxillary artery past the anterior border o flateral pterygoid. There are many branches also
Pterygoid Venous Plexus just superficial to the superficial constrictor muscle, just deep to the lateral pterygoid muscle, communicates with the facial vein and cavernous sinus
Mandibular Nerve Exits thru foramen ovale then branches immediatly. Large branches are the inferior alveolar nerve, and the lingual nerve. Small branches are the buccal nerve and the auriculotemporal nerve
Inferior alveolar nerve Parrt of mandibular nerve, crosses infratemporal space to enter the mandibular foramen, nerves the myliohyoid, sensory to teeth, then becomes mental nerve
Lingual Nerve branched from mandibular nerve, crosses infratemporal space, sensory to tongue and floor of mouth
Buccal nerve branched from mandibular nerve, b/tw two heads o flateral pterygoid, sensory to cheek and gums
Auriculotemporal Nerve branched from Mandibular, splits around middle meningeal artery, sensory to temporal skin, TMJ and skin to the EAM and tympanic membrane. Secretomotor to parotid(parasympathetic) from CN 9
Chorda Tympani deep tp onfratemporal fossa, ONLY travels with ligual nerve to the tongue, sensory to anterior 2/3 of tongue
Otic Ganglion near foramen ovale, exit of mandibular nerve. Meidal to mandibulkar nerve. Autonomic ganglia
Foramen Ovale V3 and accessory meningeal artery
Foramen spinosum middle meningeal artery and vein, meningeal branch of V3
Pterygopalantine fossa maxillary nerve(foramen rorundum) maillary artery, pterygopalantine ganglion
Scalp 5 layers, from the superior nuchal line of the occiput to the supraorbital margins of the temporal bone, laterally over the temporal fascia to the zygomatic arch
S Skin
C connective tissue
A aponeurosis epicranialis
L loose connective tissue
P Pericranium
scalp skin thin except occipital area, contains hair follicles, sweat and sebaceous glands
Scalp connective tissue thick, dense, very vascular, many cutaneous nerves
Aponeurosis epicranialis strong tendinous sheath that connects the frontalis, occipitalis and superior auricularis. These first three layers move as a unit.
Loose connective tissue allows mvmt, spongy( fills with fluid in injury)
Pericranium the periostium of the calveria, firmly attached and is continous with the fibrous tissue of the sutures
Nerves of the scalp all nerves anterior to the auricles are the branches of the trigeminal (V). All posterior to the ears are cervical (C2;C3)
Vascularity of the scalp the vascular system is within between the skin and the connective tissue. It os dense and very extensive to allow cooling.
Arteries of the scalp branches from the external and internal carotid arteries
branches from the external carotid arteries supply the back half of the scalp, superficial temporal, occipital, and posterior auricular
The internal carotid arteries supratrochlear and supraorbital
Veins of the scalp all drain tho the facial vein, external and internal jugular veins, potentially into cranial vault thru emissary veins
Emissary veins connect cranial sinuses with the scalp veins. normally the flow is from cranium to scalp but can go other way in an infection
Lymphatics of scalp drain to the pericervical collar groups of lymph nodes. Eventually all drain to the cervical nodes.
Cranial Fossa forms the base of support for the brain, there are 3. Anterior fossa, Middle fossa, and posterior fossa, each is more inferior than the next
Anterior fossa most shallow, supports frontal poles of cerebrum
Middle fossa supports temporal poles
Posterior fossa largest and deepest, supports cerebellum, pons and medulla
Bones of Anterior fossa orbital plate forms floor, ethmoid, cribiform plate, small part of sphenoid (lesser wings, anterior clinoid process, jugum)
Bones of Middle fossa All of greater wing of sphenoid, body of sphenoid, clivus, most of temporal bone( to the ridge of the petrous portion), parietal bone
Bones of Posterior fossa Temporal bone(posterior and inferior to petrous portion), parietal bone, occipital bone(cerebellar fossa, IOP, vermian fossa for venous drainage)
Foramina of anterior fossa Cribiform(CN 1), foramen cecum (1% of population has an emissary vein from the nasal to superior sagital sinus)
Foramina of the Middle Fossa Optic canal(optic nerve CN2 and opthalmic artery), cresecent of four, foramina lacerum, carotid canal
Cresent of four Superior orbital fissure, foramen rotundum, foramen ovale, foramen spinosum
Superior orbital fissure CN3-Occulomotor, CNIV-Trochlear, CN6-Abducens, CNV1-Opthalmic, and the opthalmic vein
Foramen Rotundum CN V2-Maxillary
Foramen Ovale CN V3-Mandibular
Foramen spinosum middle menengel artery and memingeal branch of V3
Carotid Canal opening into cranial vault, carotid artery goes thru skull here
Foramen lacerum hole covered by fibrous tissue, nothing goes thru, carotid artery goes by
Foramina of posterior fossa Internal acoustic meatus, Foramen magnum, hypoglossal canal, jugular foramen, condylar canal
Internal acoustc meatus CN7 and 8; facial and vestibulocochlear, also the labrinthine artery
Foramen Magnum CN 11-spinal roots and accessory; medulla, SC, meninges, vertebral arteries
Hypoglassal canal CN 12-hypoglossal
Jugular foramen CN 9, 10, 11, posterior meningeal artery and sigmoid sinus
Condylar canal emissary vein from sigmoid sinus to vertebral venous plexus
Dura Mater AKA pachymeningis, external periosteal layer, adheres to internal skull
Arterial supply to the Dura largest artery is the middle meningeal artery which enters calveria thru foramen spoinosum. This artery is between the dura and the bone.
Innervation of the Dura Primarily the trigeminal nerve except inferior to the cerebrum. There are sensory fibers all over
Dural Venous Sinuses form where the septa attch, all blood from brain drains to them then to the interna jugular veins.
Cavernous sinus Dangerous triangle, right and left lateral to sella turcica and upper body of spenoid, contains internal carotid and the abducens nerve
Arachnoid and pia mater from same embryonic layer, leptomeninges, arachnoid layer is avascular and not attached to dura. pia is highly vascularize
Epidurla space potential
Subdurla space potential
Subarachniod spce between leptomeninges(arachnoid and pia). Contains CSF, trebecullar cells, arteries and veins
Central Sulcus of brain starts at lateral fissure and ends at lonf fissure
Precentral gyrus motor
Postcentral gyrus sensory
Insula or island of reil small part underneth(like its own mini brain)
Lateral ventricles Left and right, interventricular foramen communicates with third ventricle
Third ventricle midline, surrounded by thalamus, cerebral aquaduct communicates with 4th ventricle
4th ventricle midline, anterior to cerebellum, communicates with SC thru central canal
CSF flow produced by choroid plexus, thry lateral ventricles, to third ventricle, to fourth ventricle, to subarachnoid space and SC
Created by: hwhite