Nerves of anterior cervical region
Transverse cervical nerve
Hypoglossal nerve
Glossipharyngeal nerve
Vagus nerve - R/L- right recurrent laryngeal nerve / left recurrent laryngeal nerve
Carotid sheath
Superior to thyroid cartilage
Lateral boundary of retro pharyngeal space
Contents: CCA( bifurcates within carotid sheath ) , ICA, IJV, vagus nerve CN X, cervical lymph nodes
Common carotid artery
Branch of brachiocepahlic trunk- arch of aorta
Branches are right common carotid artery
RCC- external and internal carotid artery
External carotid artery branches :
superior thyroid , lingual, facial ( branch as angular artery), occipital , superficial temporal , post auricular , ascending laryngeal artery
Internal carotid artery
Opthalmic artery
Maxillary artery
- branch of ECA
- branches off as :
- inferior alveolar artery, middle meningeal artery
Subclavian Artery
From brachiocephalic trunk Branches are: 1st part- vertebral artery , internal thoracic , thyrocervical trunk 2nd part- costocervical trunk 3rd part- dorsoscapular artery
Brachiocephalic trunk
From arch of aorta
Branches off as :
Right subclavian artery
Right common carotid Artery
Thyrocervical trunk
Supra scapular artery
Inferior thyroid artery
Transverse cervical Artery
Parotid gland
Largest Irregular shape Anteroinferior to external acoustic meatus Apex-Posterior to angle of mandible Base- zygomatic arch
Parotid duct
Anterior edge of parotid gland
Pierces buccinator
Innervation - Glossipharyngeal nerve
Orbit
A base , four walls, and Apex Superior wall/ Roof- frontal bone Medial wall- ethmoid bone Lateral wall- frontal zygomatic bone and greater wing of sphenoid bone Inferior wall/ floor- maxilla Apex - optic canal
Lacrimal gland
Almond shape
Lies in the fossa of lacrimal gland
8-12 secretory ducts
Lacrimal fluid- CN VII
Fluid goes to nasal cavity through nasal lacrimal duct , where fluid goes posteriorly to nasopharnyx and is swallowed
Nerve supply- facial nerve superior cervical ganglion sympathetic
Extra ocular muscles
Levator palpebrae superioris
Superior inferior medial and lateral rectus
Superior and inferior obliques
Fn: moves superior eyelid and eyeballs
Innervation: LR6SO4AO3( lateral rectus- CN 6,superior oblique-CN 4, andAll Others- CN 3
Levator palpebrae superioris
Location: lesser wing of sphenoid
action: elevate superior eyelid
Innervation: oculomotor nerve
Superior rectus
Origin: common tendenious ring
Innervation: oculomotor nerve
Action: abducts elevates and rotates eyeball laterally
Inferior rectus:
O-common tendinous ring
I- oculomotor nerve
A- depresses adducts and rotates eyeball laterally
Medial rectus
O: common tendinous ring
I: oculomotor nerve
A: adducts eyeball
Lateral rectus
O: common tendinous ring
I: abducent nerve
A: abduct eyeball
Superior oblique
O: body of sphenoid bone
I: trochlear nerve
A: abducts depresses and rotates eyeball medially ( in torsion)
Inferior obliques
O: anterior part of the floor of orbit
I: oculomotor nerve
A: abducts elevates and rotates eyeball laterally
Nerves in orbit
Optic nerves
Also oculomotor nerve, trochlear nerve, abducent nerve
3 branches of Opthalmic nerves also supply to orbit ???
Lacrimal nerve- sensory
Frontal nerve- supratrochlear, supraorbital ( sensory)
Nasociliary nerve- sensory - infratrochlear-long ciliary nerves– sympathetic - ethmoidal nerves
Short ciliary nerve- ciliary ganglion -sympathetic
Blood supply to orbit
Opthalmic artery-from internal carotid artery
Infra orbital artery- external carotid artery
Temporal fossa boundaries:
Posterior and superior - superior and inferior temporal lines Anterior- frontal and zygomatic bones Lateral - zygomatic arch Inferior- infratemporal crest Floor: pterion Roof: temporalis fascia
Temporal fossa contents :
Temporalis muscle
Superficial temporal artery
Deep temporal arteries and veins
Infratemporal fossa boundaries:
Inferior to zygomatic arch
Boundaries:
Lateral: mandibular ramus
Medial: lateral pterygoid muscle
Anterior: posterior aspect of maxilla
Posterior: Tympanic plate mastoid and styloid processes
Superior: inferior surface of greater wing of sphenoid bone
Inferior: attachment of medial pterygoid at an angle of mandible
Infratemporal fossa: contents
Inferior temporalis muscle Lateral and medial pterygoid muscle Maxillary artery Pterygoid venous plexus Mandibular, inferior alveolar , lingual, buccla and chordae tympani nerves
Oral cavity
Space posterior and medial upper and lower dental arches
Boundaries: anterior and lateral: maxillary and mandibular alveolar arches
Roof: palate
Posterior: Oropharnyx
Emissary veins
Connect dural venous sinuses with veins of outside the cranium
Pupillary light reflex
Involves CN II and CN III
Is the rapid constriction of pupil in response to light
When the light enters an eye, both pupil constrict because each retina send fibers to to optic tract
Parasympathetic- constrict
Sympathetic - dilation : cervical sympathetic chain- thoracolumbar part
Corneal reflex
Absence of the blink shows lesion of CN V1 and CN V2
Presence of lens abolishes evoke the reflex
TMJ joint temporalmandibular joint
Modified hinge joint
Joint capsule is loose
Lateral ligament strengthen laterally
Stylomandibular ligament - parotid gland- styloid process to angle of mandible
Sphenomandibular ligament- spine of sphenoid to lingula of mandible
These ligaments connect mandible to cranium
Movements are produced by muscles of mastication
Movement of TMJ joint
Elevation depression
Protrusion retrusion
Lateral movements
Elevation closes mouth muscles are:
Temporalis masseter and medial pterygoid
Depression - open mouth - muscles
Lateral pterygoid and suprahyoid and infrahyoid muscles
Protrusion muscles
Lateral pterygoid masseter and medial pterygoid
Retrusion muscles
Temporalis and masseter
Lateral movements muscles
Grinding and chewing
Temporalis pterygoid opposite sides and masseter