Head and neck anatomy

1. HEAD AND
NECK
ANATOMY
1

2. Regions of the head
2

3. Bone
Surface
Markings
• Depressions and openings:
– Fissure: narrow
opening between
adjacent parts of
bones for nerves and
vessels
– Foramen: hole,
opening
– Fossa: shallow
depression
– Sulcus: groove
– Meatus: tubelike
passageway
• Processes that form joints
– Condyle: large
rounded prominence
– Facet: smooth flat
surface
– Head: rounded
articular projection
• Processes for tendon and
ligament attachment:
– Crest: prominent
border or ridge
– Epicondyle:
prominence above a
condyle
– Linea: line, less
prominent than a
crest
– Trochanter: large
projection of bone
found only on the
femur
– Tubercle: small
rough process
– Tuberosity: large,
rounded
3

4. 4
Gross Anatomy
Osteology of the Skull: Cranium

5. Skull
5
• (1) Frontal Bone
• (2) Temporal Bones
• (2) Parietal Bones
• (1) Occipital Bone
• (1) Sphenoid Bone
• (1) Ethmoid Bone
Cranium: Consists of 8 bones
• (2) Maxilla
• (2) Zygomatic bones
• (2) Lacrimal bones
• (2) Palatine bones
• (2) Nasal bones
• (2) Inferior nasal conchae
• (1) Vomer
• (1) Mandible
Face: Consists of 14 bones
(Studied in lecture 2)

6. 6
Bones of the Cranium

7. Frontal Bone
7

8. Frontal
Bone
8
The large bone that makes up the forehead and
supplies the upper edge and roof of the orbit
(eye socket).
The frontal bone articulates (comes together)
with a number of other bones including the
parietal, nasal, ethmoid, maxillary, and
zygomatic bones.
Landmarks:
• Squama: flat portion that forms the forehead
• Supraorbital margin: ridge under the eyebrow, forming
the upper part of the orbit (eye socket)
• Supraorbital foramen: small hole within supraorbital
margin for blood vessels and nerves
• Frontal sinuses: hollow spaces behind the squama, act as
sound chambers to give the voice resonance.

9. • Frontal Bone
(Anterior View) (Blue
Colored Bone)
9

10. 10
Frontal Bone (Lateral View) (Blue Colored Bone)

11. 11
Temporal Bones

12. 12
Temporal Bones
• A large irregular bone situated at the base and side of the skull. The temporal
bone is connected with the mandible (the jaw bone) via the
temporomandibular (TM) joint.
• The temporal bone is formed of three parts (squamous, tympanic and
petrous) that are distinct at birth but then fuse. The petrous portion of the
temporal bone contains the structures of the inner ear.
• Landmarks:
– Squama: flat portion of the temporal bone forming the anterior and superior part
of the temple
– Zygomatic process: process forming part of the cheek
– Petrous portion: internal, forming part of the floor of the cranium. Contains the
ear canal and internal ear structures.
– Mandibular fossa: socket between squama and petrous portion, articulates with
the condyle of the mandible (TMJ)
– External auditory meatus: opening to the ear canal
– Mastoid process: bony prominence behind the external auditory meatus
– Styloid process: looks like an elephant’s tusk located between the mastoid
process and the jaw. Acts as a point of attachment for muscles and ligaments.

13. 13
Temporal Bone (Lateral View) (Purple Colored Bone)

14. 14
Parietal Bones
• The main bone on the side of
the skull.
• The word "parietal" comes
from the Latin "parietalis"
meaning "belonging to the
wall."
• It articulates (joins) with the
other parietal bone in the
midline (top of the head),
with the frontal bone in front
of it, with the occipital bone
behind it, and with the
sphenoid and temporal bones
lower down on the side of
the skull.

15. 15
Parietal Bone (Lateral View) (Red Colored Bone)

16. 16
Occipital

17. 17
Occipital
• From the Latin, meaning the part of the head opposite the front.
• The bone that forms the rear and the rear bottom of the skull.
• The occipital bone articulates (joins) with the parietal and
temporal bones of the skull, the sphenoid bone in front of it, and
the first cervical vertebra (the atlas) beneath it
• Landmarks:
– Foramen magnum: large hole, allowing passage of the
spinal cord
– External occipital protuberance (EOP): prominent
projection on back of occipital
– Nuchal lines: a superior and inferior line running laterally
from the midline, serve as a point of muscle attachment

18. 18
Occipital Bone (Posterior View) (Orange Colored Bone)

19. 19
Occipital Bone (Lateral View) (Orange Bone)

20. 20
Sphenoid Bone

21. 21
Sphenoid Bone
• A prominent, irregular, wedge-shaped bone at the base of the
skull. The sphenoid bone has been called the "keystone" of the
cranial floor since it is in contact with all of the other cranial
bones.
• The Greek physician Galan wrote that the sphenoid bone was "like
a wedge thrust between the skull and the superior maxilla."
• Landmarks
– Greater wings: large lateral projections of bone that help to
form the lateral border of the skull
– Lesser wings: smaller lateral projections of bone above the
greater wings
– Pterygoid processes: two long downward projections from the
greater wings that act as a point of muscle attachment.
– Sella turcica: known as the Turkish Saddle which cradles the
pituitary gland.

22. 22
Sphenoid Bone (Lateral View) (Green Colored Bone)

23. 23
Sphenoid Bone (Floor of Cranium) (Green Colored Bone)

24. 24
Ethmoid Bone
• An irregularly shaped, spongy bone that provides the floor of the front part of the
skull and the roof of the nasal cavity.
• The ethmoid consists of two masses of thin plates enclosing air cells and looks
like a sieve.
• Landmarks:
– Lateral masses: form most of the wall between the nasal cavity and the
orbits
– Perpendicular plate: forms the superior portion of the nasal septum
– Cribriform plate: forms the roof of the nasal cavity
– Olfactory foramina: small holes within the cribriform plate for passage of
the first cranial nerve (for smell)
– Crista Galli: upward extension of bone above the cribriform plate, acts as an
anchoring point for one of the coverings of the brain.
– Nasal concha (turbinates): two scroll-shaped projections with a mucus
membrane on either side of the nasal septum. Function to cause air
turbulence and trap inhaled particles.

25. 25

26. 26
Bones of the Face

27. 27
Maxilla

28. 28
Maxilla
• The largest bones of the face, except for the mandible and form,
by their union, the whole of the upper jaw.
• They hold the upper teeth, and connect on the left and right to
the zygomatic bones (cheek bones).
• Each assists in forming the boundaries of three cavities, namely,
the roof of the mouth, the floor and lateral wall of the nose, and
the floor of the orbit.
• Landmarks:
– Infra Orbital foramen: hole below the orbit, for blood
vessels and nerves
– Alveolar process: arch of the maxilla containing the upper
teeth
– Palatine process: horizontal projection of the maxilla
forming the anterior ¾ of the hard palate.

29. 29
Maxilla (Anterior View) (Yellow Colored Bones)

30. 30
Zygomatic Bones
Commonly referred to as
the cheekbone.
It is situated at the upper
and lateral part of the
face: it forms the
prominence of the cheek
and part of the lateral wall
and floor of the orbit.
It articulates with the
zygomatic arch of the
temporal bone.

31. 31
Zygomatic Bones (Anterior View) (Pink Colored Bones)

32. 32
Lacrimal Bones
Smallest and most
fragile bone of the
face, is situated at
the front part of the
Medial of the
orbit.
Contains the lacrimal
sac and the naso-
lacrimal duct.
Lacrimal bone

33. 33
Lacrimal Bones (Anterior View) (Blue Colored Bones below frontal bone)

34. 34
Palatine bones
It contributes to the
walls of three
cavities: the floor
and lateral wall of
the nasal cavity,
the roof of the
mouth, and the
floor of the orbit

35. 35
Nasal Bones
Varying in size and
form in different
individuals
They are placed side by
side at the middle and
upper part of the face
and form, by their
junction, "the bridge" of
the nose

36. 36
Nasal Bones (Anterior View) (Bridge of the nose, below frontal bone)

37. 37
Inferior Nasal Conchae
Extends horizontally
along the lateral wall
of the nasal cavity
and consists of a
lamina of spongy
bone, curled upon
itself like a scroll.
Inferior Nasal Conchae

38. 38
Inferior Nasal Conchae (Anterior View) (Inside nasal cavity on lateral walls)

39. 39
Vomer
One of the unpaired
facial bones of the
skull.
Located in
the midsagittal line,
and touches the
sphenoid, the
ethmoid, the left and
right palatine bones,
and the left and right
maxillary bones.

40. 40
Vomer (Anterior View) (Center wall in nasal cavity)

41. 41
Mandible
Largest and strongest
bone of the face.
Forms the lower jaw and
holds the lower teeth in
place.
The mandible consists of
a curved, horizontal
portion, the body, and two
perpendicular portions,
the rami, which unite with
the ends of the body nearly
at right angles.

42. 42
Mandible
• Largest and strongest bone of the face.
• Forms the lower jaw and holds the lower teeth in place.
• Landmarks:
– Body: curved horizontal portion of the mandible
– Rami: two upward projections of bone that are perpendicular to the
body of the mandible.
– Angle of the mandible: angle formed where the body meets the
ramus
– Condylar process: a condyle on the posterior portion of the ramus
that articulates with the mandibular fossa of the temporal bone.
– Coronoid process: a sharp projection of bone on the anterior portion
of the ramus that acts as a point of muscle attachment.
– Alveolar process: arch of bone containing the lower teeth
– Mental foramen: small hole on the side of the body for blood vessels
and nerves.

43. 43
Mandible (Anterior View) (Lower Jaw)

44. 44
Mandible (Lateral View) (Lower Jaw)

45. 45
Palpation of the Cranium
Occipital: Prone; place hands on the back of the head between partner’s ears. Slide your
fingers superiorly to the External Occipital Protuberance (EOP) two to three inches.
Then slide fingers laterally to the mastoid process behind the ears.
Superior Nuchal Lines: Prone or supine; locate the EOP and then slide your fingers
laterally moving your finger pads up and down feeling for the edge of the superior
nuchal line.
Parietal Bone: Prone or supine; place both hands on the top of the cranium. Palpate the
sagittal suture between the parietals. From the suture, palpate the parietal bones down
towards the ears
Temporal Bone: Supine; locate the mastoid process by placing your fingers behind the ear
lobe. The zygomatic arch can be palpated by placing your fingers anterior to the
external auditory meatus. Palpate anteriorly along the arch with your finger and
thumb. The flat squamous portion can be palpated superior to the mastoids and
external auditory meatus. The styloid process can be palpated between the mandible
and the mastoid process (palpate very gently)

46. 46
Frontal bone: Supine; palpate the region of the forehead from the eyebrows up toward the
coronal sutures
Mandible: Supine: place your fingers inferior to the bottom teeth and palpate the body of
the mandible. Move inferiorly and palpate the base of the mandible from the chin to
the angle of the mandible. Then curl your fingertips underneath the edge to palpate the
submandibular fossa. To palpate the angle of the mandible slide posterior alone the
base of the mandible. The angle is located between the body and the ramus. To palpate
the mandibular condyle place your finger anterior to the ear canal and below the
zygomatic arch. Ask your partner to open his/her mouth fully, the condyle will protrude
laterally and become more palpable.
Nasal bones: Supine; locate the bridge of the nose
Zygomatic bone: Supine, return to the zygomatic arch of the temporal bone and continue
to move anteriorly until you reach the zygomatic (cheek) bone.
Maxilla: Supine; palpate inferior to the zygomatic bone down to the mouth. The maxilla
forms the center of the face. The alveolar processes can also be palpated where the
teeth insert into the maxilla.

47. HYIOD
BONE

48. HYIOD BONE
• the hyoid is suspended between the
mandible and the larynx
• it does not articulate with any other bone
• is suspended from the styloid process of
the temporal bone by two stylohyoid
ligaments.
48

49. HYIOD BONE CONTD.
• It is shaped like a horseshoe
• consists of a central body with
two lateral projections
• functions as a primary support for the
tongue and floor of the mouth
49

50. AUDITORY
OSSICLES

51. INCUS
51

52. STAPES
52

53. stapes
• The stapes or stirrup is a bone in the middle
ear of humans and other animals which is
involved in the conduction of sound vibrations
to the inner ear.
• This bone is connected to the oval window by
its annular ligament, which allows the
footplate to transmit sound energy through the
oval window into the inner ear.
• The stapes is the smallest and lightest bone in
the human body.
53

54. MALLEOUS
54

55. 55

56. TEMPOROMANDIBULAR
JOINT
56

57. TMJ
Composed of 3 bony parts
Glenoid fossa
Articular eminence
Condyle process
57

58. tmj
58

59. TMJ CONTD
59
• It is the only movable joint in the skull
• It have 2 type of movement
• Gliding action and hinge action
• Hinge action allows for opening and closing
to the jaw
• Gliding allows the side to side movement,
protrusion and retrusion

60. MALE VS FEMALE SKULL
60

61. 61

62. FUSION OF BONES
(POSTNATAL)
62

63. 63

64. Pterion
The pterion is the region where the frontal, parietal,
temporal, and sphenoid bones join.
• The pterion is known as the weakest part of the
skull. The anterior division of the middle meningeal
artery runs underneath the pterion.
• A traumatic blow to the pterion may rupture the
middle meningeal artery causing an epidural
hematoma.
• The pterion may also be fractured indirectly by
blows to the top or back of the head that place
sufficient force on the skull to fracture the pterion.
64

65. PTERION
65

66. LAMBDA
• The lambda is the meeting point of the
sagittal suture and the lambdoid suture. This
is also the point of the occipital angle.
• In the fetus, the lambda is membranous, and
is called the posterior fontanelle.
66

67. LAMBDA
67

68. BREGMA
• The bregma is the anatomical point on the
skull at which the coronal suture is
intersected perpendicularly by the sagittal
suture.
• The bregma is known as the anterior
fontanelle during infancy. The anterior
fontanelle is membranous and closes in the
first 18-36 months of life.
68

69. bregma
69

70. MYOLOGY
OF THE
HEAD AND
NECK
70

71. • Muscles of facial expression
• Muscles of mastication
• Muscles of the floor of the mouth
• Muscles of the soft palate
• Muscles of the tongue (extrinsic)
• Muscles of the tongue (intrinsic)
• Muscles of the neck
• Muscles of the pharynx
71

72. Muscles of
facial
expression
72

73. buccinator
73

74. buccinator
• Origin: alveolar processes
of the maxilla and mandible
• Insertion: orbicularis oris
• Function: compresses the
cheeks against the teeth and
is used in acts such as
blowing. It assists muscle of
chewing
in newborns it is used to
suckle.
74

75. 75

76. nasalis
76

77. Nasalis
• Origin: maxilla
• Insertion: nasal bone
• Function: flares the nostrils,
compresses the bridge of the
nose & depresses the tip of
the nose
77

78. 78

79. Orbicularis
oculi
79

80. Orbicularis
oculi
80
Origin: nasal part of the frontal
bone, maxilla and lacrimal bone
Insertion: skin of the orbital
region
Function: voluntary closing of
eyelids (winking and forced
squeezing) and pumping of tears

81. 81

82. frontalis
82

83. frontalis
• Origin: Galea aponeurotica
(epicranial aponeurosis)
• Insertion: orbicularis oculi
• Function: elevating
eyebrows
83

84. mentalis
84

85. mentalis
• Origin: Anterior mandible
• Insertion: Chin
• Function: Elevates and
wrinkles the chin , protrudes
the lower lip
85

86. risorius
86

87. RISORIUS
• Origin: Parotid fascia
• Insertion: Modiolus
• Function: draws back the
angles of the mouth
(sometimes referred to as
the smiling muscles)
87

88. Zygomaticus
major&
minor
88

89. Zygomaticus
major
• Origin: anterior of the
zygomatic
• Insertion: modiolus of the
mouth
• Function: draws angles of
the mouth upwards laterally
89

90. Zygomaticus
minor
• Origin: zygomatic bone
• Insertion: skin of the upper
lip
• Function: elevates three
upper lip
90

91. Orbicularis
oris

92. Orbicularis
oris
• Origin: maxilla and
mandible
• Insertion: skin around the
lips
• Function: puckers the lips (
sometimes referred to as the
kissing muscle)
92

93. 93

94. Depressor anguli oris
94

95. Depressor
anguli oris
• Origin: tuberosity of the
mandible
• Insertion: modiolus of the
mouth
• Function: depresses the
angles of the mouth
95

96. Depressor
labii
inferioris

97. Depressor
labii
inferioris
• Origin: oblique line of the
mandible, between the
symphysis and the mental
foramen
• Insertion: orbicularis oris
fibers
• Function: depresses the
lower lip
97

98. Levator
labii
superioris

99. Levator
labii
superioris
• Origin: medial infraorbital
margin
• Insertion: skin of the upper
lip
• Function: elevates the upper
lip
99

100. Levator
labii
superioris
aleaque
nasi

101. Levator
labii
superioris
aleaque
nasi
• Origin: nasal bone
• Insertion: nostril and upper
lip
• Function: dilates the
nostrils, elevates the upper
lip & wing of the nose
101

102. Depressor
supercilli

103. Depressor
supercilli
• Origin: medial orbital rim
• Insertion: medial aspects of
the bony orbits
• Function: depressing the
eyebrows
103

104. Corrugator
supercilli

105. Corrugator
supercilli
• Origin: supraorbital ridge
• Insertion: skin of the
forehead near the eyebrows
• Function: wrinkles the
foreheads and draws the
eyebrows medially
105

106. Muscles of
mastication

107. Temporalis
/ temporal
muscle
107

108. temporalis
• Origin: temporal lines of the
parietal bone and the
superior temporal surface of
the sphenoid bone
• Insertion: coronoid process
of the mandible and the
retromolar fossa
• Function: elevation and
retraction of the mandible
108

109. masseter
109

110. masseter
• Origin: zygomatic arch and
maxillary process of the
zygomatic
• Insertion: coronoid process,
angle and lateral surfaces of
ramus
• Function: elevation
(closing) and protrusion of
the mandible
110

111. Internal/
medial
pterygoid
111

112. Medial
pterygoid
• Origin: deep head-medial
side of the lateral pterygoid
plate
superficial head-
process of the palatine bone
and maxillary tuberosity
• Insertion: angle of the
mandible
• Function: elevates the
mandible and closes the jaw
and side to side movements
112

113. External/lateral
pterygoid
113

114. Lateral
pterygoid
• Origin: superior head- sphenoid
bone
inferior head- lateral
pterygoid plate
• Insertion: superior head- anterior
side of the
condyle
inferior head- pterygoid
fossa
• Function: depresses and
protrudes the jaw
side to side movement
of the mandible
114

115. Muscles
of the
floor of
the
mouth

116. digastric
116

117. digastric
• Origin: anterior body-
mandible
posterior body- mastoid of
the temporal
bone
• insertion: hyoid bone
• Function: opens the jaw
when the masseter and
temporalis are relaxed
117

118. mylohyoid
118

119. mylohyoid
• Origin: mylohyoid line of
the mandible
• Insertion: body of the hyoid
bone
• Function: raises the floor of
the oral cavity
elevates the tongue
depresses the mandible
119

120. geniohyoid
120

121. geniohyoid
• Origin: genial tubercle
• Insertion: hyoid bone
• Function: draws the tongue
and the hyoid bone forward
121

122. stylohyoid

123. stylohyoid
• Origin: styloid process of
temporal bone
• Insertion: hyoid process
• Function: Elevates the
hyoid bone during
swallowing
123

124. Muscles of
the soft
palate
124

125. Palatoglossus/anterior
faucal pillar
12
5

126. palatoglossus
• Origin: arises from the soft
palate
• Forms the anterior arch on
each side of the throat
• Insertion: tongue
• Function: arching the
tongue against the soft
palate
depressing the soft palate
towards the tongue
126

127. Palatopharyngeal/posterior
faucal pillar
12
7

128. palatopharyngeal
• Origin: soft palate, posterior border of the
thyroid cartilage
• Insertion: upper borders of the thyroid
cartilage
• Function: helps to shut the nasopharynx
• Forms the posterior arch of the throat
128

129. Isthumus fauces
129

130. Isthumus fauces
• The fauces is a part of the oropharynx
Between these two arches on the lateral
walls of the oropharynx is the tonsillar fossa
which is the location of the palatine tonsil.
The arches are also known together as the
palatine arches.
130

131. tonsilitis
131

132. tonsilitis
• Tonsillitis is inflammation of the tonsils in
the upper part of the throat. It can be acute
or chronic.
• Acute tonsillitis typically has a rapid onset.
Symptoms may include sore throat, fever,
enlargement of the tonsils, trouble
swallowing, and enlarged lymph nodes
around the neck.
• Can be caused by viral or bacterial
infections
132

133. TONSILLAR HYPERTROPHY
• Tonsillar hypertrophy is the enlargement of
the tonsils, but without the history of
inflammation. Obstructive tonsillar
hypertrophy is currently the most common
reason for tonsillectomy. These patients
symptoms of loud snoring, irregular
breathing, nocturnal choking and coughing,
frequent awakenings& sleep apnea.
133

134. TONSILLAR HYPERTROPHY
134

135. Extrinsic muscles of the tongue
135

136. styloglossus

137. styloglossus
• Origin: styloid process of
the temporal bone
• Insertion: the sides of the
tongue
• Function: retraction and
elevation the tongue
137

138. genioglossus

139. genioglossus
• Origin: superior part of the
symphysis menti
( genial tubercle)
• Insertion: under surface of
the tongue
• Function: protrudes and
depresses the tongue
139

140. hyoglossus

141. hyoglossus
• Origin: hyoid bone
• Insertion: side of the tongue
• Function: depresses and
retracts the tongue
141

142. Intrinsic muscles of the tongue
142

143. Transverse/horizontal
muscle & Vertical
muscle

144. Transverse muscle
• Origin: median fibrous septum
• Insertion: sides of the tongue
• Function: makes the tongue narrow and
elongated
144

145. Vertical
muscle
• Origin: Submucosal fibrous
layer of the dorsum of the
tongue
• Insertion: inferior surface
borders of the tongue
• Function: flattens and
broadens the tongue
145

146. Superior
longitudinal
& inferior
longitudinal

147. Superior
longitudinal
muscle
• Origin: median fibrous
septum
• Insertion: edges of the
tongue
• Function: retracts the
tongue making the tongue
short and thick
147

148. Inferior
longitudinal
muscle
• Origin: root of the tongue
• Insertion: apex of the
tongue
• Function: retracts the
tongue making it short and
thick
148

149. Muscles of the neck
149

150. sternocleidomastoid

151. sternocleidomastoid
• Origin: sternum and clavicle
• Insertion: mastoid process
• Function: divide the neck
into anterior and posterior
triangles important in
extraoral examination
151

152. trapezius

153. trapezius
• Origin: occipital bone
• Insertion: clavicle and
scapula
• Function: shrugging of the
shoulders, rotation,
retraction and elevation of
the scapula
153

154. platysma

155. platysma
• Origin: clavicle
• Insertion: base of the
mandible, orbicularis oris,
angle of the mouth, skin of
the cheeks and lips
• Function: draws the angles
of the mouth inferiorly
155

156. CRANIAL NERVES
156

157. 157

158. Cranial nerves
158
NERVE TYPE FUNCTION
I. OLFACTORY SENSORY SENSE OF SMELL
II. OPTIC SENSORY SENSE OF SIGHT
III. OCULOMOTOR MOTOR EYE MUSCLES
IV. TROCHEAR MOTOR EYE MUSCLES
V. TRIGEMINAL MOTOR& SENSORY MUSCLES OF MASTICATION,
SENSATION IN THE
MOUTH.TEETH, TONGUE & FACE
VI. ABDUCENS MOTOR EYE MUSCLES
VII. FACIAL MOTOR & SENSORY FACIAL EXPRESSION MUSCLES,
SALIVARY GLANDS AND SENSE
OF TASTE
VIII.
VESTIBULOCONCLEAR
SENSORY SENSE OF BALANCE
IX.
GLOSSOPHARYNGEAL
MOTOR & SENSORY PAROTID GLAND
SENSATION AROUND THE EARS
X. VAGUS MOTOR & SENSORY SOFT PALATE, PHARYNIX &
LARYNIX MUSCLES
SENSE OF TASTE, SENSATION
AROUND EARS
XI. ACESSORY MOTOR MUSCLES OF THE NECK &

159. 159

160. Trigeminal
nerve
160

161. Trigeminal
branches
16
1
• V1 Ophthalmic nerve
• V2 Maxillary nerve
• V3 Mandibular nerve

162. 162
TRIGEMINAL
OPHTHALMIC MAXILARY MANDIBULAR

163. V1 (ophthalmic nerve)
• The ophthalmic nerve is purely a sensory
nerve
• Supplying sensory innervation to certain
parts of the eye, the lacrimal gland & some
paranasal sinuses
• Also supplies the upper eyelid, dorsum of
nose and anterior part of the scalp
163

164. 164

165. V2 (maxillary)
• Has 5 branches that innervates the oral
cavity
1. Anterior Superior Alveolar nerve
2. Middle Superior Alveolar Nerve
3. Posterior Superior Alveolar Nerve
4. Greater palatine Nerve
5. Nasopalatine Nerve
165

166. 166

167. 167

168. 168
MAXILLARY
NASOPALATINE
MUCOPERIOSTEUM
OG ANTERIOR TEETH
GREATER PALATINE
MUCOPERIOSTEUM
OF ANTERIOR TEETH
ANTERIOR SUPERIOR
ALVEOLAR NERVE
INCISORS AND
CANINES
MAXILLARY
SINUSES
MIDDLE SUPERIOR
ALVEOLAR NERVE
1ST & 2ND PREMOLARS
MESIOBUCCAL ROOT
OF 1ST MOLAR
POSTERIOR
SUPERIOR
ALVEOLAR NERVE
2 ROOTS OF 1ST
MOLAR, 2ND AND 3RD
MOLARS

169. V3 (mandibular)
• Has 3 branches that innervates the oral
cavity
1. Inferior alveolar nerve( branches out into)
• mylohyoid nerve
• incisive nerve
• mental nerve
2. Lingual nerve
3. Buccal nerve
169

170. 170

171. 171
Mandibular
Inferior
alveolar nerve
mental
incisive
mylohyoid
lingual Buccal

172. Trigeminal neuralgia
• This chronic pain condition affects the trigeminal nerve,
which carries sensation from your face to your brain.
Symptoms may include:
• Severe shooting pain that may feel like an electric shock
• Pain or attacks activated by touching the face, biting,
talking or brushing
• Pain areas include the ear, eyes, forehead, jaw, or mouth
and face
• Over sensitivity, sensitivity to pain, or uncomfortable
tingling and burning
• Can be only one attack of pain, some may experience sharp
pain every hour or every few seconds
172

173. Blood
circulation
arteries

174. CAROTID ARTERY
• Rises from the aorta
• Branches into
1. internal carotid- supplies the brain and
eyes
2. external carotid- oral cavity. Sinuses ,
nose and tongue
174

175. 175

176. External carotid branches
• Facial artery- supplies muscles of the face,
nasal septum, tonsils and posterior part of
the tongue
• Lingual artery- supplies the tongue, soft
palate and tonsils
• Maxillary artery – oral cavity and the teeth
176

177. 177

178. Maxillary branches
• It divides into 3 branches
1. Pterygoid – supplies muscles of
mastication and the upper jaw
2. Pterygopalatine- gingiva, maxillary
sinuses. Palate & nasal septum
3. Mandibular- supplies the lower jaw, chin
and lower lip
178

179. 179

180. Pterygoid artery branches
• Greater palatine artery- supplies the hard
palate & nasal septum
• infraorbital artery-
• Anterior superior alveolar artery
• Anterior and middle superior alveolar artery
• Posterior superior alveolar artery
180

181. Mandibular artery branches
• Divides into 5 branches
1. Inferior alveolar artery
2. Lingual artery
3. Mylohyoid artery
4. Incisive artery
5. Mental artery
181

182. 182

183. Veins
• Maxillary vein corresponds with the
maxillary artery
• The retromandibular vein is formed by the
union of the maxillary vein and the
temporal vein.
• The retromandibular has 2 branches
1. The anterior branch which joins the facial
vein
183

184. Veins contid
2. Posterior vein joins the auricular vein to
make the external jugular vein
• The facial vein joins the anterior division of
the retromandibular vein to form the
common facial vein
• The external jugular vein empties into the
subclavian vein
184

185. Veins contid
• The common facial vein and the deep facial
vein enter the internal jugular which
empties into the superior vena cava
• The superior vena cava returns blood from
the upper body to the right atrium of the
heart
185

186. 186

187. 187

188. 188

189. Lymph
nodes

190. DEEP AND SUPERFICIAL
NODES
• The superficial cervical lymph nodes are
lymph nodes that lie near the surface of the
neck.
• The deep cervical lymph nodes are a group
of cervical lymph nodes found near the
internal jugular vein in the neck.
190

191. Cervical lymph nodes
191

192. • Cervical lymph node swelling can be a reliable
indicator of infection or other inflammation in the
area
• Generally, swollen cervical lymph nodes
(lymphadenopathy) are nonthreatening. Many
things can cause cervical lymph node swelling,
including:
• bronchitis
• common cold
• ear infection
• scalp infection
• strep throat
• Tonsillitis
• Oral infections
192

193. Axillary
lymph
nodes

194. • also known as adenopathy
• Unilateral swelling is often (but not always) a
symptom of an infection or disease on that side of the
body.
• Bilateral swelling tends to point to systemic illness—
that is, an illness affecting the entire body.
• Common causes of axillary lymphadenopathy include;
• Localized infection and short-term inflammation(e.g.,
a tattoo on arm)
• HIV
• Breast cancer
• Lymphoma
• Vaccinations
194

195. Abdominal/
inguinal
lymph
nodes

196. • More often than not, swollen inguinal lymph nodes are
caused by infections or injury affecting the lower body.
This can include the:
• groin
• genitals
• urinary tract
• leg
• Foot
• In rare cases, swollen lymph nodes in the groin could be
due to cancer. Some of these types of cancer include:
• melanoma
• testicular cancer
• ovarian cancer
196

197. Salivary
glands

198. Importance of saliva
• Lubricates and cleanses the oral cavity
• Aids in digestion through enzymatic process
• Helps to soften and mix food in mechanical
digestion
• Maintains the integrity of tooth surfaces
through chemical protection
• Prevents infections and promotes healing in
the oral cavity through antibacterial
protection
198

199. Types of saliva
• Serous saliva (protein fluid)
• Predominantly produced by the parotid
gland
• Mucous saliva (carbohydrate fluid)
• Produced by the sublingual and
submandibular gland (these two are
seromucous)
199

200. Saliva
• Serous saliva is watery, thin and contains
enzymes, antibodies and inorganic ions
involved in digestion and immune defense
• Mucous saliva is this and viscous involved
in lubrication
200

201. Minor salivary
glands
• Located through out the mouth
• Produces 5% of saliva in the mouth
• The von Ebner gland Is located on
the posterior surfaces of the tongue
alongside the circumvallate papillae

202. Parotid
gland
202

203. Parotid
gland
• Found of both sides of the
mouth in front of the ear
• connects to the stensen’s duct
which empties saliva into the
mouth
• Produces 25% of saliva
• Produces serous saliva, rich in
enzymes
• A small projection called the
parotid papillae is the opening
to the parotid duct can be felt
on the buccal vestibule
203

204. Sublingual
gland

205. Sublingual
• Located under the tongue, it
is the smallest of the major
glands and has the most
dispersal
• Produces 10% of saliva
• Associated with the
Bartholin’s duct
• Has small ducts known as
Rivinus ducts
205

206. RIVINUS
DUCTS
• Small ducts
associated with the
sublingual gland
20
6

207. Submandibular
gland
207

208. Submandibular gland
• Located below the mandible
• Produces 65% of saliva
• Releases saliva through the Wharton’s duct
208

209. Salivary glands diseases
• Sialolithiasis : occurs when stones made of
calcium form in the salivary glands. These
stones can block the glands, and that can
partially or completely stop the flow of
saliva.
• Sialadenitis (or sialoadenitis) is an infection
involving a salivary gland. It often results
from stones blocking the gland. Staph or
strep bacteria can cause this infection. Older
adults and infants are most likely to develop
this condition.
209

210. Sialolithiasis
(salivary
stones)
210

211. Sialadenitis
(swollen
salivary
glands)

212. Sjogren syndrome
• the immune system primarily attacks the
glands that produce tears (the lacrimal
glands) and saliva (the salivary glands),
impairing the glands' ability to secrete these
fluids.
212

213. 213

214. Cancerous and noncancerous
tumors
• Salivary gland tumors, also known as
mucous gland adenomas or neoplasms, are
tumors that form in the tissues of salivary
glands.
214

215. Parotid
gland tumor
• Could be benign or malignant
215

216. Paranasal
sinuses
21
6

217. Paranasal sinuses
• Paranasal sinuses are a group of four paired
air-filled spaces that surround the nasal
cavity.
• The paranasal sinuses have several
functions of which reducing the weight of
the head is the most important. Other
functions include air humidification and
aiding in voice resonance .
217

218. Maxillary
sinuses
21
8

219. MAXILLARY SINUSES
• They are the largest of the paranasal sinuses
• They are the first of the paranasal sinuses to
form
• Account for both transverse and vertical
growth of the face
• At birth, its 5-8 cubic cm in volume and
continues to increase in size up to the age of
18years
219

220. Frontal
sinuses
22
0

221. FRONTAL SINUSES
• Frontal sinuses are absent at birth but are
developed and well functioning by ag 6-8
years
• Maximum growth is achieved after puberty
• 5% of people have absent frontal sinuses
• Assists in immune defense and air filtration
performed by the nose
221

222. Ethmoid
sinuses
22
2

223. ETHMOID SINUSES
• Present at birth and is complete by 5 years
• Acute ethmoiditis in childhood and
ethmoidal carcinoma may spread superiorly
causing meningitis and cerebrospinal fluid
leakage
223

224. Sphenoid
sinuses
22
4

225. Sphenoid sinuses
• They are not present at birth, they slowly
develop with the growth of the skull. Just
after puberty the sinuses finish
development.
225

226. Paranasal sinuses disease
• characterized by decreased aeration,
mucosal thickening, soft tissue masses (e.g.,
mucus retention cyst, polyp, mucocele,
tumor), air-fluid levels, and
demineralization or bone destruction.
• Inflammation in the posterior ethmoid and
sphenoid sinus causes optic nerve
dysfunction
226