Head

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Head

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• ???

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• Region and parts
• Cranium ??
• Face ??
• Landmaeks
• Superciliary
• Supraorbital notch
• Infraorbital foramen
• Mental foramen
• Pterion
• Zygomatic arch
• Mastoid process
• External occipital protuberance

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Muscles of head

• Facial muscles ??
• Epicranius ??? (oddipitofrontalis) ???
• Frontal belly ??
• Occipital belly ??
• Galea aponeurotica ????
• Orbicularis oculi ????
• Buccinator ??
• Orbicularis oris ????
• Nasalis ??
• Platysma ???

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• The skin of face is very thin and connected to
  the facial bones by loose connective tissue.
  There is no deep fascia. The facial muscles lie
  in this connective tissue.

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• Masticatory muscles
• Masseter ??
• Origin-inferior border and medial surface of
  zygomatic arch
• Insertion-lateral surface of ramus of mandible
  and angle of mandible
• Action-elevates mandible
• Temporalis ??
• Origin-temporal fossa
• Insertion-coronoid process of mandible
• Action-elevates and retracts mandible
• lateral pterygoid ???
• Medial pterygoid ???

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Arteries of head

• Facial a. ???
• Branch of external caroteid a.
• Runs forward over digastric and submandibular
  gland
• Loops around mandible (where it is palpable), at
  anterior border of masseter, to enter the face
• Follows a tortuous course to medial angle of eye
• Lies deep to most facial muscles
• Branches
• Inferior labial a. ????
• Superior labial a. ????
• Angular a. ????

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• Superficial temporal a.????
• Terminal branch of external carotid a.
• Ascends in front of ear (where it is palpable) to
  supply temporal and anterior portion of scalp
• Transverse facial a. ????-runs above parotid
  duct to supply the cheek region

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• Maxillary artery ????
• Branch of external carotid a.
• Entrance to infratemporal fossa medial to neck of
  mandible

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• Branches
• Inferior alveolar a. ?????
• Middle meningeal a. ?????
• enters the skull through foremen spinosum
• Supplies cranium and dura mater
• Posterior superior alveolar a.??????

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Veins of head

• Facial vein ???
• Begins at medial angle of eye (angular vein)
• Runs downward and backward through the face,
  posterior to the facial artery
• Below angle of mandible, joins anterior branch of
  retromandibular vein to form common facial vein,
  which drains into internal jugular vein

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• Connections with cavernous sinus ???through the
  ophthalmic vein???, and also through pteygoid
  plexus ???? via the deep facial vein ????
  

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• Danger area ????-lies between root of nose and
  two angles of mouth in this area the facial vein
  has no valves

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• Retromandibular vein ?????
• Formed by union of superficial temporal and
  maxillary veins
• Divides into an anterior branch that unites with
  facial vein and a posterior branch that joins
  posterior auricular vein to become external
  jugular vein

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• Pteygoid plexus ????
• Located between and around muscles of
  mastication
• Receives blood from all regions supplied by
  maxillary a.
• Communicates with
• Face by deep facial veins
• Cavernous sinus by veins draining base of skull
• Provides possible pathway for spread of infection
  to cranial cavity

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The lymphatic drainage of head

• Lymph nodes of head
• Located at junction of head and neck
• Consist of occipital, mastoid, parotid,
  submandibular, submental lymph nodes
• Drain into deep cervical lymph nodes
• Submandibular lymph node ?????? lies near the
  submandibular gland, receive lymphatic vessels
  from the face, nose and mouth

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Nerves of head

• Facial nerve (?) ???
• Leaves skull through internal acoustic meatus,
  facial canal and stylomastoid foramen
• Divided three parts
• First part-between stylomastoid foramen and
  parotid gland
• Second part-within parotid gland
• Third part-outside of parotid gland

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• Enters parotid gland and divides into its five
  terminal branches for muscles of facial
  expression
• Temporal ??
• Zygomatic ??
• Buccal ??
• Marginal mandibular ????
• Cervical ??

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Trigeminal nerve (?) ????

• Ophthalmic nerve ??? (?1) ? supraorbital n.
  ????
• Maxillary nerve ???? (?2) ? infraorbital
  n. ????
• Mandibular nerve ???? (?3) ?mental n. ???

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Parotid gland ??

• Position situated below the external auditory
  meatus and lies in a deep hollow behind the ramus
  of mandibular and in front of the
  sternocleidomastoid
• Superficial part triangular in shape, lies below
  and in front of the external acoustic meatus, and
  partially covers the masseter.
• Deep part lies deep to medial pterygoid .

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• Parotid duct ???
• Arises front anterior border of gland
• Lies 1.5 cm below and parallel to zygomatic arch
• Passes forward over masseter, pierces the
  buccinator and oral mucosa to open opposite
  second upper molar tooth

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• Capsule of the parotid gland
• The parotid gland is enclosed within a
  well-defined capsule which extension of the
  investing fascia of the neck.
• The superficial capsule is thick and unyielding
  and tightly affixed to the underlying glandular
  tissue by numerous fibrous septa.
• The deep capsule id quite thin and easily
  disrupted.

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Structures passing through the parotid gland

• Vertical
• External carotid a.
• Retromandibular vein
• Superficial temporal a. v.
• Auriculotemporal n.
• Transversal
• Maxillary a. v.
• Tranverse facial a. v.
• Branches of facial n.

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Relationships of parotid gland

• Superior-external acostic meatus, poterior margin
  of temporomandibular joint
• Anteromedialy-masseter, ramus of mandible,
  posterior part of medial pterygoid
• Poateromedial-mastoid process, sternocleidomastoid
  , posterior belly of digastric, styloid process,
  internal carotid a., internal jugular v., ??
  cranial nerves
• Parotid bed-internal carotid a., internal
  jugular v., ?? cranial nerves

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Masseter space ????

• Lies between the masseter, and ramus of mandible

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Pterygomandibual space ?????

• Lies between ramus of mandible and medial
  pterygoid

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Sublingual space ????

• Between mucous membrane of floor of mouth and
  mylohyoid and hyoglossus

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Dissection
Skin incisions
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The cranial part
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Frontal parietal occipital region????

• Boundaries
• Anterior-supraorbital margin
• Posterior-external occipital protuberance and
  superior nuchal line
• Lateral-superior temporal line

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• Layers
• consists of five layers
• Skin ??
• Superficial fascia ???
• Galea aponeurotica and occipitofrontalis
  ????????
• Subaponeurotic space (loose connective tissue)
  ????
• Pericranium ????
• The superficial 3 layer are closely knit
  together, called scalp??

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• The skin has the greatest concentration of hair
  and sebaceous glands
• ??????????
• The superficial fascia is dense connective tissue
  that binds the skin strongly to the underlying
  galea aponeurotica
• The vasculature of the scalp runs primarily in
  the. lt is richand widely anastornotic-
• Wounds of the scalp bleed profusely but heal
  well.

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• Arteries, veins and nerves
• Anterior group
• Supratrochlear a. v. n.
• Supraorbital a. v. n.
• Posterior group
• Occipital a. v.
• Greater occipital n.
• ??????,??????,?????,??????,??????,??????,??????

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• Galea aponeurotica
• It is interposed between the frontalis and
  occipitalis portions of the occipitofrontalis
  muscle.
• These muscles place the aponeurosis under tension
  so that deep transverse lacerations of the scalp
  gape widely .
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• Subaponeurotic space (loose connective tissue)
• Extracranial hematoma, the result of bleeding in
  the subaponeurotic space, can extend over the
  cranium. lt can extend posteriorly, to the
  superior nuchal line anteriorly, into the
  eyelids to produce the black eye and
  lateraliy, to the temporal line.
• The loose connective tissue layer provides the
  plane of separation inany injury that tears the
  scalp from the calvaria or for the surgeon
  elevating thescalp from the periosteum.

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• Contains a rich network of deep arteries and
  veins. Therefore, this layer has been called the
  dangerous area.
• Infaction may spread to the substance of the
  bones, to venous channels within the cranial
  cavity, or to the brain.
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• Pericranium
• Fuses firmly with bone at the sutures and
  with the periosteum of theadjacent bone, thus
  limiting the subperiosteal space.
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Temporal region

• Boundaries
• Superior-superior temporal line
• Inferior-superior border of zygomatic arch
• Anterior-the junction of frontal and zygomatic
  bones
• Posterior-posterior portion of superior temporal
  line

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• Layers
• consists of five layers
• Skin ??
• Superficial fascia ???
• Temporal fascia ???
• Temporalis ??
• Periosteum ??

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• Superficial fascia ???
• Anterior auricular group
• Superficial temporal a. v.
• Auriculotemporal n.
• Posterior auricular group
• Posterior auricular a. v.
• Lesser occipital n.

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Temporal fascia ???
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Temporalis
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Periosteum