Head and neck anatomy

Head and neck AnatomyDr Anupama Soman

Blood vessels of head and neck

Arterial & venous system

Carry blood away from heart

Arteries carry oxygenated blood except

Blood flow depends on pumping action of heart

No valves Branches of arteries

supplying adjacent areas anastomose

Carry blood to the heart Veins carry

deoxygenated blood except

Veins have got valves Two types of veins Superficial which are

close to the surface of body & no corresponding arteries

Deep veins which are deeper into the body and travels along with their corresponding arteries

Arterial system Venous system

Aorta – arch of aorta Left common carotid artery Left subclavian artery brachiocephalic trunk

Arteries of head & neckARTERIES1. Common carotid arteries 2. Subclavian artery CCA

ECA & its branchesICA & its branches

SUBCLAVIAN ARTERYVertebral Artery

ECA,ICA Branches of the External Carotid Artery (ECA) Branches in neck

STAPLe OF PAM STSuperior Thyroid – thyroid & parathyroid glandsAscending Pharyngeal – pharyngeal musclesLingual - tongueOccipital – scalp Facial - facePosterior AuricularMaxillary – maxilla and mandibleSuperficial Temporal -scalp

Branches of the Internal Carotid Artery (ICA)No branches in neck and enters cranial cavitySupplies brain, eyes, nose, scalp OPAAMOphthalmic arteryPosterior CommunicatingAnt Choroidal ArteryAnt cerebral ArteryMiddle Cerebral Artery

Subclavian artery Rt SCA arises from brachiocephalic trunk Lt SCA arises directly from arch of aorta SCA gives its contribution to CNS through one of

its major branches, vertebral artery – supplies CNS

Arteries of head and neck

VEINS Classification 1. Veins of exterior of head and neck2. Diploic & meningeal veins and dural venous sinuses of brain3. Veins of neck

Exterior of head Neck Brain and face

Supratrochlear *External Jugular *Diploic veins Supraorbital *Cerebral vein Facial vein Superficial temporal *Anterior Jugular *DuralVenous Maxillary vein *Internal Jugular Sinuses Pterygoid Venous *Subclavian plexus *Brachiocephalic Retromandibular Posterior auricular Occipital vein

VEINS…

THREE MAJOR PAIRS OF VEINS draining head &neck1. Lt & Rt Vertebral

veins2. Lt & Rt External

Jugular Veins3. Lt & Rt Internal

Jugular Veins

NERVE SUPPLY

Olfactory OpticOculomotorTrochlearTrigeminalAbducent

FacialVestibulocochlearGlossopharyngealVagusAccessoryHypoglossal

Cranial

nervesC1-C8 CERVICAL NERVEST1-T12 THORACIC NERVESL1-L5 LUMBAR NERVES

S1-S5 SACRAL NERVESCOCCYGEAL (1PAIR)

Spinal nerves

Nerves of head and neckCRANIAL NERVES 12 PAIRS● OOOTTA FAGVAH – SSMMBMBSBBMM● Sensory organs of head● Smell(olfactory) ● vision(optic, oculomotor, abducens, trochlear)● Taste(facial & glossopharyngeal)● Hearing(vestibulocochlear)● Muscles of head & neck (facial & accessory nerves)

SPINAL NERVES - C1-C8 CERVICAL NERVES forms a plexus k/a cervical plexus Skin & muscles of head and neck

Muscles of head and neck Muscles of facial expression Muscles of mastication Tongue muscles Extra ocular muscles Muscles of ear Neck muscles Muscles soft palate Muscles of pharynx

Nomenclature of muscles1.Location – lateralis, anterior, supra, infra, sub

2.Shape – deltoid, latissimus, orbicularis, serratus, trapezius

3.Size – maximus, minimus, vastus, longus, major, minor

4.Direction/orientation of fibres – transverse, rectus, oblique

5.No of origins – biceps, triceps, quadriceps

6.Origin & insertion - sternocleidomastoid

7.Action - flexor, abductor, extensor, levator

SCALP● Soft tissues covering the cranial vault● Five layers● Highly vascular● occipito frontalis S -- skin C -- dense Connective tissue A -- aponeurosis L -- loose connective tissue P -- periosteum

Face - Muscles of fascial expression

Scalp muscle● occipito-frontalisMuscles of eyelids● orbicularis oculi● corrugator supercilii● levator palpebre

superioris(EO)Muscles of nose● procerus● compressor naris● dilator naris● depressor septiMuscles of the neck● platysma

Muscles of ear● auricularis anterior● auricularis superior● auricularis posteriorMuscles around mouth● orbicularis oris● levator labii superioris alaque

nasi● zygomaticus major● levator labii superioris● levator anguli oris● zygomaticus minor● deprossor labii inferioris● mentalis● risorius● buccinator

EyesEXTRA OCULAR MUSCLES VOLUNTARY 1. (4 rectus) : superiour rectus medial rectus lateral rectus inferior rectus 2. (2Obliqui) : superior oblique inferior oblique 3.levator palpebre superopris

INVOLUNTARY1. superior tarsal2. inferior tarsal3. orbitalis

Function:Movements of eye a. around a transvers axis- elevation and depressionb. around a vertical axis - medial(abduction) &

lateral(adduction)c. around an anteroposterior axis - intortion &

extortionpathology

Eyes

Clinical anatomySquint – weakness or paralysis of a muscleNystagmus (dancing eyes)- involuntary movement of EyesPtosis –drooping of eyelids due to 3rd nerve paralysis

EarsMuscles Tensor tympani Stapedius Function : damp down intensity ofhigh pitched sound waves● Pathology ● Otitis media● Hearing defects due

to leisons of cochlear nerve

Nose

Paranasal sinuses Air filled cavities of skull bones, situated around

nose which are actually extensions of respiratory part of nasal cavity& also open into the nasal cavity

Functions : humidify the air, reduce the weight of skull and resonance of voice

Four paired sinuses1. Frontal2. Maxillary3. Ethmoidal 4. Sphenoidal

Paranasal sinuses…

Patholgy :Sinusitis – chronic/acuteCarcinoma of maxillary sinus

MouthMuscles of mastication Masseter Temporalis Lateral pterygoid Medial pterygoidFunction :Move the mandible during mastication & speech (depression, elevation, protrusion, retraction, lateral) Movements are possible by TEMPEROMANDIBULAR JOINT

Mouth …Soft palate● Tensor palati● Levator palate ● musculus uvulae● Palatoglossus● PalatopharyngeousFunction :Regulates the size of oropharynx or pharyngeal isthmus , or completely close them according to requirementsHelps in chewing ,swallowing, speech, coughing ,sneezingClinical anatomyCleft palate

Tongue Extrinsic - 4 pairs Genioglossus Hyoglossus Styloglossus PalatoglossusIntrinsic – 4 pairs Superior longitudinal Inferior longitudinal Transverse vertical

Function : Extrinsic muscles

attaches tongue to adjascent bones

Intrinsic muscles helps in speech and mastication ,by altering shape of the tongue

Clinical anatomyGlossitis – inflammation of tongueCarcinoma of tongue is commonInjury to HG nerve- paralysis of muscles

PharynxMuscles Three pairs of constrictors – superior,

middle and inferior (Thyropharyngeus, Cricopharyngeus)

Stylopharyngeus Palatopharyngeous Salpingopharyngeus

Neck● Muscles of neck – flexion,extension,rotation ● Side of neck and back of neck● Triangles

Anterior triangle midline of neckPosterior triangleSCM muscle

SCHEMATIC REPRESENTATION OF NECK

Side of neck -

SCM muscle -

Back of neck -

Triangles

Muscles of anterior triangle SUPRAHYOID1. Diagastric2. Mylohyoid3. Geniohyoid4. Stylohyoid INFRAHYOID1. Omohyoid2. Sternohyoid3. Sternothyroid4. Thyrohyoid

Muscles of posterior triangle Platysma Splenius capitus Levator scapulae Scalenus (anterior, medius,posterior)

Muscles of back of neck Trapezius Splenius capitis, splenius cervicis Semispinalis capitis, semispinalis cervicis Longissimus capitis, longissimus cervicis

LarynxCartilagenousThree paired(arytenoid, corniculate, cuneiform)& three unpaired(thyroid, cricoid ,epiglottic) cartilagesMuscles of larynx: Cricothyroid Lateral and posterior cricoarytenoid Transverse and oblique arytenoid Aryepiglotticus Thyroarytenoid, thyroepiglotticus, vocalisFunction: movement of cartilages and abduction and adduction of vocal cords producing soundPathology: laryngitis, characterised by hoarseness of voice

Thyroid and parathyroid glandsThyroid gland an endocrine gland situated in the lower

part of the neck in the midlineRegulates basal metabolic rate,stimulates

somatic and psychic growth & controls Ca metabolism

Parathyroid glandTwo pairs of endocrine glands, lying on the posterior border of tthyroid

Regulates Ca & P metabolism by secreting parathormone

Thyroid and parathyroid glandsPathology :enlargement of thyroid- goitrehyperthyroidismhypothyroidismbenign & malignant tumors of the glandshypoparathyroidism - tetanyhyperparathyroidism

Salivary glands● Parotid - largest● Submandibular● Sublingual● Minor – palatal , buccal

Clinical anatomyMumps – viral infection of parotid glandSialolithiasis

Lymph nodes of hed and neck

Clinical anatomyLymphadenopathyMetastasis of carcinoma

Teeth Types of dentition Primary(milk) teeth – 20Permanent teeth – 32

Tooth anatomy

Pathology Dental caries –decalcification & destruction of enamel and dentinDental abscess – infection at the root apex with pus collectionGingivitis – inflammation of gingiva

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