Dr. El Fiky Atlas Head & Neck Anatomy Mahmoud Abd Altawab

oronal suture

Frontal bone

Parietal bone

Glabella--

Sphenoid bone Lesser wirig

Orbital surface Nasal bone

lacrimal bone ~_~

Zygomaficbone Frontal process

'__

_--"l'r

Orbital plate

--

__

Perpendicular --Middle

plate

nasal concha

Orbital surface ---Inferior

Temporal process

nasal concha

Zygomaticofacial foramen

Mandible

Maxilla

Ramus Orbital surface ---' Infraorbital fora men Frontal process---, ~ __

Alveolar process A_nteriornasal spine

-----

Mental protuberance

Skull - Anterior View Posterior and Anterior ethmoidal foramina

Orbital surface of frontal bone Orbital surface of lesser wing of sphenoid bone

Orbital plate of ethmoid bone

Superior orbital fissure ----~_l:£.~ Optic canal (fora men) -----ft..-olJ---l Orbital surface of greate~r:-_--+'~-l wing of sphenoid bone

_--lacrimal --p--Wl----Fossa

bone for lacrimal sac

Orbital surface of zygomatic bone ----

Orbital process of Palatine bone

Inferior orbital fissure

Orbital surface of maxilla

Infraorbital groove

R"ight Orbit - Frontal and slightly lateral View

Parietal bone

Sphenoid bone Greater wing

Temporal bone

Temporal fossa

Squamous part

Superior temporal line

Zygomatic process

Inferior temporal line

Articular tubercle Groove for posterior (jeep temporal artery

Ethmoid bone Orbital plate

Fossafor Lacrimal sac Occipital bone External occipital protuberance

Maxilla Frontal process~ u·....:...-

Infraorbital foramen---

__

~~~·

Anterior nasal spin,~-- __ Alveolar process

.-I

Mandible Head of condylar process Mandibular notch Coronoid process Ramus line

Zygomatic bone Zygomaticofacial foramen -----~~~)~,...~'/Temporal process--~ Zygomatic arch

~---~~L--------Oblique ----~~~--------------Body

.,-.-------~ ,••• iI!:::::....----------

Mental foramen

----i:::'~"=~..", ••... ~

Infratemporal fossa exposed by removal of zygomatic arch and mandible' pterygomaxillary: fissu[e·------;~~~A~~tl.-..2 Inferior orbital fissure------~~L...:"I!iii~~~ Infratemporal surface of maxilla------.:~~~~~

Temporal bone Externalacoustic meatus

Alveolar foramina ---------~-~ Iuberosltv of maxilla

---------i":--......:.""'::"'::---

Mandibular fossa :t\rticulartubercle pterygopalatine

fossa

Styloid process

Sphenopalatine foramen

Skull - Lateral View .f)

Frontalbone

-----------.p...--

Coronal suture-

-/.~;::~~

-I-.:...-.

Bregma--

~~:::~~

--J~_

Parietal bone----

--:-:::;;:~f_t-------_~

Sagittal suture Parietal foramen (for emissaryve"n) Lambda

Occipital bone

-:::~~-----Frontal

bone Frontal crest

r-t-~-:lr-

Groove for superior sagittal slnu: Coronal suture

Parietalbone '!.--~~-~~;----

Granular foveolae (for arachnoid granulations)

~---Diploe

---"!" •....•~~---:....

Grooves for branches of middle meningeal vessels

--:::H7+----Groove

~:;:-----;:-:'H~~---

for superior sagittal slnui

Sagittal suture

._~~~~-----Lambdoid

~~~~~~~rF------

suture

Occipital bone

Calvaria (skull cap)

Maxilla Incisive fossa ----" Palatine process --~ Median palatine suture Zygomatic process

Zygomatic bone Frontal bone

Transversepalatine suture

Sphenoid bone Pterygoid process Hamulus---, Medial plate---.. ~Ptery~oid fossa} Lateral plate Scaphoid fossa Greater wing -..... Foramen ovale-_ Foramen spinosum Spine Temporal bone

Zygomatic process Articular tubercle------t::r Mandibular fossa -------l-Styloid process Petrotympanic fissure -----+--"~-::::-Carotid canal (external o)IP~e:n~i~n~g[::t:;:.:::~~~~~ Tympanic canaliculus ~ Externalacoustic meatus Mastoid canaliculus Mastoid process Stylomastoid fo~r=a::m.:.:e:.:.n.:...-_--~ Petrouspart Mastoid notch for digastric muscle Occipital groove (for occipital artery) Jugular fossa (jugular foramen in its depth)

--------f--.---....

Palatine bone Horizontal plate Greater palatine foramen Pyramidal process Lesserpalatine foramina ~or nasal spine

~--Choanae Vomer

Groove for pharyngotympanic (auditory) tube Foramen lacerum

Mastoid fora men Parietal bone

Occipital bone Hypoglossal canal UCcipital condyleCondylar canal and fossa Basilar part-----Pharyngeal tubercle----' Foramen magnum----Inferior nuchalline---------' External occipital crest-----' Superior nuchal line ------' External occipital protuberance ----'

-pCranial base - Inferior View

NECKCX

I I

Ethmoid bone

-:;::=======:J==:-----_-'~ =::::i

Cristagalli Cribriformplate========j--'--

__

I ,I .,1

Sphenoid bone Lesserwing-----------Anteriorclinoid process--------Greaterwing -----------_ Groove for middle meningeal Vessels(frontal branches) Body

__

----------~~(E.1::]~

l Anterior

.,;? cranial . .,: II ," " I I I

fossa

J

~~~::~========:::::::::j~!:~t;~~~~::2=~~ Middle

Jugum Prechiasmaticgroove (Tuberculumsellae

cranial fossa

~=::===~ht-~::=~;~~~:;~,

Sella ) Hypophysealf~s~s~a~=====3~~~~~2~~~~~I~ Posteriorclinoid process turcica Dorsumsellae Carotid groove (for intocarotid a, Clivus

I

Temporal bone Squamouspart Petrouspart Groovefor lesserpetrosal nerve ---+-~ Groovefor greater petrosal nerve--I-~ Arcuate eminence Trigeminalimpression Groovefor superiorpetrosal sinus--+-" Groovefor sigmoid sinus

----------+-"

-------!-~ ------i--" ------+-~

Parietal bone Groovefor middle meningeal Vessels(parietal branches) Mastoidangle--------...r--

Posterior cranial fossa

-----1--

Occipital bone Clivus-------------;-Groovefor inferiorpetrosal sinus---:-Basilarpart -----------Groovefor posteriormeningeal vessels Condyle-----------Groovefor transversesinus------" Groove for occipital sinus------Internaloccipital crest Internaloccipital protuberance ----+--~ Groove for superiorsagittal sinus

---r-~

Cranial base - Internal View

NATOMY

~ fora men cecum

--Emissary vein to superior

Nasal slit ------------Anterior ethmoidal fora men

sagittal

sinus

t l Anterior ethmoidal artery. vein

lt

and nerve

Foramina of cribriform plate-- Olfactory nerve bundles Posterior ethmoidal foramen -Posterior ethmoidal artery. vein and nerve Optic canal

~Optic nerve (11) Ophthalmic artery

Superior orbital fissure -----

Oculomotornerve (Ill) Trochlearnerve (IV) lacrimal. frontal and nasociliary branchesof ophthalmic nerve (vl) Abducent nerve (vl) Superiorophthalmic vein

1

Foramen rotundum ---------

Maxillary nerve (v2)

Foramen ovale -----------

Mandibular nerve (V3) Accessory meningeal artery lesser petrosal nerve (occasionally]

.

Foramen spmosum ~~~~~:::==:l~rr==:SPhenoid

1

---------1

lMiddlemeningealarteryand vein

Meningealbranchof mandibularnerve

emissary fora men (vesalius) (inconstant)

r;::~?~~_-_~~:r[= Foramen lacerum Carotid canal for

~

~-

[Internet carot~d artery carotid nerve plexus

.-

Hiatus for-----

1 Internal -----------lesser

petrosal nerve

Hiatus for-----------------

Greater petrosal nerve

Internal acoustic meatus ---

Facial nerve (VII) Vestibulocochlear nerve (VIII)

External opening of vestibular aqueduct -------I

1

labyrinthine artery Endolymphatic duct

Mastoid foramen -------(inconstant)

Emissary vein (and occasional branch of occipital artery) Inferior petrosal sinus Glossopharyngeal nerve (IX) Vagus nerve (X) Accessory nerve (XI) Sigmoid sinus Posterior meningeal artery

Jugular foramen ---------

1

Condylar canal (inconstant)

JEmissaryvei~ and meningeal branch 1 of ascendmg pharyngeal artery

Hypoglossal canal---------

Foramen magnum

----

Hypoglossal nerve (XII) MedUllaoblongate Meninges Vert~bral arteries Meningeal branches of vertebral arteries Spinal roots of accessory nerves

l

Foramina of Cranial base - Superior View r

Skull, Inferior View Incisive foramen

Palatal process of maxilla Palatal process of palatine Greater palatine fora men Lesserpalatine foramen Tubercle of maxilla Zygomatic arch __ Hamulus-+--LJ~11 Infratemporal crest--..llt...--~ Scaphoid fossa-~f--r--=12:L. Articular tubercle _ Mandibular fossa -...;...a;;=Styloid process -I.,..........:::!! Externalauditory meatus Stylomastoid foramen

/

Maxilla Inferior orbital fissure Vomer Lateral pterygoid plate

•....-~

~~

Mastoid process

:::::::"-~P'"""""r--Medial pterygoid plate Foramen ovale ","-=:::=:+:==-:;1.= Foramen spinosum 11: Spine of sphenoid -~I-Petrous part of termporal bone ,---t~I-Carotid canal Tympanic part of temporal bone Jugular foramen Occipital condyle

Pharyngeal tubercle

Superior nuchal line Foramen magnum External occipital protuberance

Skull, Internal View Frontal c est Crista galli

Pterion Tuberculum sellae Sella turcica Posterior clinoid process Dorsum sellae Hiatus for greater petrosal nerve Arcuate eminence

li,

Basilar part of occipital

Frontal sinus Foramen cecum Cribriform plate Orbital plate of frontal Optic canal esser wing of sphenoid Anterior clinoid process Foramen rotundum Foramen lacerum Foramen ovale ~ •..,~~...Groove for middle meningeal orterv rr-c;2~~~~rr Foramen sptnosurn ~,p;;:.,.a,...j~-Squamous part of temporal ~·~~~i-+lH--Petrous part of temporal •.. Internal auditory meatus Groove for superior petrosal sinus Groove for sigmoid sinus

~\

Jugular foramen F oramen magnu·

..

~•."..~ .••.• Iio;.h. .~~:; ".

Internal occlpltol crest Occiput

.

",'" ~,,'"

transverse sinus

7':~-"~:'"""Hypoglossal canal "fiill:'-"y.~.

Zygomaticus major muscle Orbicularis oris muscle Mentalis muscle Depressor labii inferioris muscle Depressor anguli oris muscle Buccinator muscle

Platysma muscle

Pectoralis major fascia

Muscles of Facial Expression - Lateral View

Investing layer of (deep) cervical fascic

ANATOMY

Scalp-

i

-

\.A..

Skin and subcutaneous tissue Epicranial aponeurosis (galea aponeurotica) (cut to reveal skull)

Parietal emissary vein

Branches of - superficial temporal artery and vein

1

Middle temporal artery and vein Zygomaticoorbital

artery

Transverse facial artery and vein

Anterior auricular arteries

Supraorbital artery and vein Supratrochlear artery and vein Nasofrontal vein Dorsal noscl artery and vein

Mastoid emissary vein and meningeal branch of occipital artery (posterior meningeal artery) Deep facial vein (from pterygoid plexus)

ccipital artery and vein (cut) Posterior auricular artery and vein

Facial artery and vei

External jugular vein (cut) Retromandibular vein Internal jugular vein Internal carotid artery External carotid artery Common carotid artery Lingual artery and vein

Sources of arterial supply of face Black: from internal carotid artery (via ophthalmic artery) Red: from external carotid artery

Blood Supply of the Face

urlcular branch of vagus nerve (X)

From ophthalmic division of trigeminal nerve (V,) SupKlorbltal nerve --

•....••• ~

Supratrochlear nerve --

.•••..

Medial branches of dorsal rami lof cervical spinal nerves

Palpebral branch of lacrimal nerve -------:~ Infratrochlear nerve --

•••.....

Greater occipital nerve (C2)

External nasal branch of anterior ethmoidal nerve

3rd occipital nerve (C3)· From 4th. 5th. 6th and 7th nerves In succession below

From maxillary division of trigeminal nerve (V2) Infraorbltal nerve --~~~~ Zygomaticofacial

nerve

--~:p.~~,.;:;:~~~~~Il ... ~

Zygomaticotemporal nerve

--+t'"'~~

Branches from cervical plexus Lesser occipital nerve (C2. 3) Great auricular nerve (C2. 3)

From mandibular division of trigeminal nerve (V3) Mental nerve

Transverse cervlca nerve (C2. 3) Supraclavicular nerves (C3. 4)

Buccal nerve ------Auriculotemporal

nerve -----

Ophthalmic nerve (V,)

Trigeminal nerve (V)

Dorsal rami of cervical spinal nerves

---1--

Note: Auricular bran( of vagus nerve to external acoustic meatus and small . area on posteromed surface of auricle

Maxillary nerve (V2)

-r-;----Branches Mandibular nerve (V3)---,.----

from cervical plexus

Cutaneous Nerves of the Head and Neck

ANATOMY Superficial temporal artery and vein and auriculotemporal nerve Branches of facial nerve Transversefacial artery Accessory parotid gland

Buccinator muscle (cut) Masseter muscle lingual nerve Submandibular ganglio Tongue Sternocleidomastoid muscle

Frenulum of tongue Sublingual fold with openings of sublingual ducts

Parotid gland

Sublingual caruncle with opening of submandibular duct

Retromandibular vein (anterior and posterior branches) Digastric muscle (posterior belly)

--J>~ilJ-

Sublingual gland Submandibular duct

External jugular vein Common trunk receiving facial, anterior branch of retromandibular, and lingual veins Internal jugular vein

Mylohyoid muscle (cut) Digastric muscle (anterior belly) Submandibular gland

External carotid artery

Facial artery and vein

Horizontal section in parotid gland Medial pterygoid

muscle

Main trunk of facial nerve

Ramus of mandible

r;::?~~~~~~¥---Masseter muscle Parotid gland

Temporofacial division ••••• ~-~ Posterior auricular nerve-

•....•.. \ ~'-

-Zygomatic

branches

Main trunk of facial nerve Nerve to posterior belly of digastrics muscle and to stylohyoid muscle Cervicofacial

~--Buccal

branches

division Marginal mandibular branc

;:----,1----- Cervical

'A-•••.•

Facial nerve branches In the Parotid gland

Salivary glands

branch

Temporal fascia Superficial layer Deep layer

Levator labii superioris alaeque nasi muscle--""'I.

Zygomatic arch

Levator labii superioris muscle

Articular disc of temporomandibular joi Deep part ~ Masseter Superficial part S muscle

Zygomatics minor muscle Zygomaticus major muscleLevator anguli oris muscle

.••••.. ...::::::.:.; Buccinator muscle

Orbicularis oris muscle--l~$Z~~ Mentalis muscle Depressor labii inferiorismuscle

Depressor anguli oris muscle

'Iemporclls muscle

Insertion of temporalis muscle to coronoid process of mandible Parotid duct Buccinator muscle Orbicularis oris muscl

Lateral pterygoid muscle Masseteric nerve and artery axillary artery Insertion of masseter muscle

Muscles involved in mastication

Articular disc of temporomandibular joint Articular tubercle----ti--f~~~~~ lateral pterygoid muscle -

_

Sphenomandibular ligamentMedial pterygoid rnuscle-c- __

JI":

~~~--.:~~

Parotid duCt--/~~A~Jt=---2~~ Buccinator muscle--"'~~:z!~~E pterygomandibular raphe Superiorpharyngeal constrictor muscl

lateral view

Choanae Cartilaginc' .("oort of pharyngotympanic (auditory) tu~. Masseteric nerve .~J~jh~"ll.I.:""-lateral

pterygOid plate

ddle meningeal artery emporomandibular join

lateral ptervqold muscle

Masseteric artery----t'-:'

--Medial

Maxillary artery

pterygoid muscle

Inferioralveolar nerve lingual nerve Medial ptervqold muscle Medial pterygoid plat

Tensorveli palatini muscle

pterygoid hamulus

levator veli palatini muscle

Nerve to mylohyoid

pterygoid hamulus

Posterior view

Muscles Involved in Mastication (continued)

Anterior division

Temporal fascia and temporalis muscle

Lateral view

Posterior! Deep temporal nerves Anterior ~

Foramen ovale

Masseteric nerve

Meningeal branch lateral pterygoid nerve and muscl

Foramen spinosum Middle meningeal arter Auriculotemporal nerve Posterior auricular nerve Facial nerve (VII) Chorda tympani nerve

Buccal nerve and buccinato muscle (cut)

lingual nerve Inferior alveolar nerve (cut) Nerve to mylohyoid Medial pterygoid muscle (cut) Digastric muscle (posterior belly) stvtonvoto muscle Hypoglossal nerve Submandibular gland

Inferior alveolar nerve (cut)

Sublingual nerve

Medial view

Digastric muscle (anterior belly)

Trigeminal (semilunar) ganglion

------~.....r--~~'1-_~..-!:I

Ophthalmic nerve

(\J....:l-~

Maxillary nerve (V2) ----"~:-1"'-

t_~~~~~e~~~~rr~GeniCUlum Tympanic cavity ~r--:~r4J~:.Elr;;.;-t-Chorda

Mandibular nerve (V3)

'\\"~~~f---

Anterior division

tympani nerve Facial nerve (VII) Tensor tympani muscle and nerve

Tensorveli palatini nerve and muscle

lesser petrosal nerve

otic ganglion

Auriculotemporal

Chorda tympani nerve

nerve

Medial pterygoid nerve and muscle (cut) pterygoid hamulus

Inferior alveolar nerve entering mandibular foramen

lingual nerve

Mandibular Nerve (V3)

AnteriOr} Deep temporal Lateral pterygoid

artery and muscle

Supraorbital

artery_-.-

Supratrochlear

Posterior

Masseteric

arteries and nerves artery and nerve

•...

Lateral ligament of temporomandibular

artery

Ophthalmic

artery -~

Middle menin eal arter Auriculotemporal nerve

•...••--iiiIiiiI~

Dorsal nasal artery Angular artery Infraorbital

Maxillary

-c..-

Posterior auricular artery Facial nerve ~_~.,-

Inferior alveolar artery and nerve

Buccal artery and nerve

Sphenomandibular

Medial pterygoid artery and muscle

Digastric

Lingual nerve

External carotid

artery

Artery of pterygoid

~

~U£ik-:g

(!!/'

Lingual artery

Pharyngeal Posterior lateral nasal branch

artery

Facial artery

--==~•••.•...•

Anterior } Dee temporal arteries Posterior and nerv s Accessory meningeal artery

canal

artery

Sphenopalatine foramen

Middle meningeal

artery

Anterior tympanic artery Deep auricular artery uriculotemporal nerve

artery

Posterior superior alveolar artery Sphenopalatine

muscle (posterior belly)

StylohYOid muscle

Facial artery----.l~~""'"'~~=-~..ft Mental branch of inferior alveolar artery Submental artery

Infraorbital

ligament

MylohYOid nerve and branch of inferior alveolar artery

raphe

Sphenopalatine

artery

Superficial temporal artery

artery - ...••

Superior { Posterior alveolarMiddle --+~'--;, arteries Anterior --..,..~-,

Pterygomandibular

joint

artery

Posterior septal branches Descending palatine artery in pterygopalatine fossa ---:~~----::f--~~""u..._..:; Buccal artery

-~~--~~~fIIII7J~~-1M Superficial temporal artery Ascending pho.vnqeol artery Ascending palatine :utery

Anastomsis in incisive canal----_+.:: Left and right greater palatine Left and right lesser palatine

arteries

Tonsillar branches Tonsillar artery

arteries

External carotid artery Facial artery Superior pharyngeal constrictor muscle

Pterygoid arteries Masseteric artery Inferior alveolar

artery

Styioglossus muscle

Maxillary artery

Communicating branch Posterior ethmoidal nerve

Anterior ethmoidal nerve Supraorbital nerve Supratrochlear nerve

Long and short ciliary nerves

Lacrimal gland Infratrochlear nerve (from nasociliary nerve) Cutaneous branch of lacrimal nerve Zygomaticotemporal nerve Zygomaticofacial nerve External nasal branch of anterior ethmoidal nerve

Trigeminal (semilunar) ganglion Trigeminal nerve (V)

-~--=::-~

~OZJ (jJf lr« Anterior superior alveolar nerve

Mucous membrane of maxillary sinus Nerve (vidian) of pterygoid canal Superior dental plexus

Pterygopalatine ganglion

Infraorbital nerve entering infraorbital canal

Greater and lesser palatine nerves Ganglionic branches to pterygopalatine

ganglion Posterior superior alveolar nerve

Ophthalmic (vl) and Maxillary(V2)

Lateral, slightly inferior view Hyoglossus muscle Mylohyoid muscle Fibrousloop for intermediate digastric tendon Digastric muscle (anterior belly) Mastoid process Styloid process Digastric muscle (posterior belly) Stylohyoid muscle

Median raphe between mylohyoid muscles

Anteroinferior view

Greater horn~ lesser horn Hyoid bone 'Body Thyrohyoid muscle Omohyoid muscle Sternohyoid muscle Digastric muscle (anterior belly) Mylohyoid muscle Stylohyoid muscle Digastric muscle (posterior belly)

/7f'7""';

~U£ik:9 ~'

Fibrous loop for intermediate digastric tendon

Posterosuperior view Inferior alveolar nerve and artery

~oI......-.

Mylohyoid nerve and artery Submandibular gland and duct

--.lL.......

Mylohyoid muscle,-_.......: Geniohyoid muscle --Hyoid bone

t

lesser horn Body-------f Greater horn

Floor of Mouth

Hyoglossus muscle (cut)

Parotid gland

(cut)

Masseter muscle Submandibular

gland

Hyoglossus muscle

Mastoid

process

Body of mandibl

Digastric muscle (posterior belly) Middle pharyngeal constrictor muscle Longus capitis

Digastric muscle (anterior belly)

muscle

Splenius muscle

----~~L.

Sternocleidomastoid

muscle .•.••••.•••....

~"'~:-