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8/2/2019 Facial Skeleton
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Topographical anatomy of thefacial skeleton, spaces andcontents. Orbit, nasal cavityoral cavity, and pterygopalatinefossa
Dr Gallatz Katalin
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ORBIT
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1. optic canal middle cranial fossa optic nerve and ophth. art.
2. superior orbital fissure middle cranial fossa III., IV., VI., V/1., ophth.v.3. inferior orbital fissure pterygopalatine fossa infraorbital a.,v., n.
4. anterior ethmoidal foramen anterior cranial fossa ant. ethmoidal nerve, a.
5. posterior ethmoidal foramen ethmoidal cells post. ethmoidal a., n.
6. nasolacrimal canal inferior nasal meatus nasolacrimal duct
7. infraorbital canal canine fossa infraorbital a.,v., n.8. supraorbital foramen frontal region lat. supraorbital a., v., n.
9. frontal notch frontal region med. supraorb. a., v., n.
10. zygomaticotemporal for. temporal fossa zygomaticotemp. n.
11. zygomaticofacial for. lat. surface of the face zygomaticofacial n.
Connections of the orbit
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septum orbitale
superior and inferior tarsus
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Superficial layer of the orbit
trochlear neve,
frontal nerve,
lacrimal nerve and artery,
superior obligue muscle,
levator palpebrae superior,
superior rectus,
lateral rectus and abducens n.
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Middle layer of the orbit
- nasociliary nerve and artery cross
the optic nerve from medial to lateral,
- medial rectus muscle
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Branches of the ophthalmic artery
Contents
- central retinal artery
- lacrimal artery
- ciliary arteries
- long and short posterior
and anterior ciliary arteries
- muscular branches
- supraorbital artery
- ant., post. ethmoidal arteries- medial palpebral artery
http://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_artery8/2/2019 Facial Skeleton
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Branches of the ophthalmic nerve
- nasociliary nerve
- posterior ethmoidal nerve
- anterior ethmoidal nerve
- long ciliary nerves
- infratrochlear nerve
- lacrimal nerve
- frontal nerve
supratrochlear nerve
supraorbital nerve
http://en.wikipedia.org/wiki/Nasociliary_nervehttp://en.wikipedia.org/wiki/Posterior_ethmoidal_nervehttp://en.wikipedia.org/wiki/Anterior_ethmoidal_nervehttp://en.wikipedia.org/wiki/Long_ciliary_nervehttp://en.wikipedia.org/wiki/Infratrochlear_nervehttp://en.wikipedia.org/wiki/Lacrimal_nervehttp://en.wikipedia.org/wiki/Frontal_nervehttp://en.wikipedia.org/wiki/Supratrochlear_nervehttp://en.wikipedia.org/wiki/Supraorbital_nervehttp://en.wikipedia.org/wiki/Supraorbital_nervehttp://en.wikipedia.org/wiki/Supratrochlear_nervehttp://en.wikipedia.org/wiki/Frontal_nervehttp://en.wikipedia.org/wiki/Lacrimal_nervehttp://en.wikipedia.org/wiki/Infratrochlear_nervehttp://en.wikipedia.org/wiki/Long_ciliary_nervehttp://en.wikipedia.org/wiki/Anterior_ethmoidal_nervehttp://en.wikipedia.org/wiki/Posterior_ethmoidal_nervehttp://en.wikipedia.org/wiki/Nasociliary_nerve8/2/2019 Facial Skeleton
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deep layer of the orbit
- inferior branch of the oculomotor n.,
- inferior rectus muscle,
- medial rectus muscle
- infraorbital artery and nerve,
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CILIARY GANGLION:
- can be found between the lateral
rectus and optic nerve
- parasympathetic ganglion
of the oculomotor nerve,
- it gets preganglionic fibers
from the Edinger-Westfal nucl.,
- postganglionic fibers are called
short ciliary nerves,
- they innervate the sphincter of
the pupil and ciliary muscles
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Lateral wall of the orbit
Communicating branch of the zygomatic nerve (V/2) carries
postganglionic parasympathetic fibers from the pterygopalatine ganglion(VII.) to the lacrimal nerve (V/1)
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Nasal cavity
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WALLS OF THE NASAL CAVITYSuperior:
nasal bone, frontal bone, cribriform plate of ethmoid, body of the sphenoid
Inferior:hard palate (palatine process of the maxilla, horizontal plate of palatine bone
Medial:
nasal septum
Lateral:
maxilla, the perpendicular plate of the palatine bone, the medial pterygoid platethe labyrinth of the ethmoid and the inferior concha.
http://en.wikipedia.org/wiki/Maxillahttp://en.wikipedia.org/wiki/Palatine_bonehttp://en.wikipedia.org/wiki/Medial_pterygoid_platehttp://en.wikipedia.org/wiki/Labyrinth_of_ethmoidhttp://en.wikipedia.org/wiki/Inferior_conchahttp://en.wikipedia.org/wiki/Inferior_conchahttp://en.wikipedia.org/wiki/Labyrinth_of_ethmoidhttp://en.wikipedia.org/wiki/Medial_pterygoid_platehttp://en.wikipedia.org/wiki/Palatine_bonehttp://en.wikipedia.org/wiki/Maxilla8/2/2019 Facial Skeleton
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NASAL SEPTUM
Bony nasal septum Cartilagineous nasal septum
- perpendicilar plate of the ethmoid
- vomer
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inferior nasal meatus nasolacrimal duct
middle nasal meatus semilunar hiatus (frontal sinus, anterior and middle
ethmoidal cells, maxillary sinus)
superior nasal meatus posterior ethmoidal cells
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BLOOD SUPPLY OF THE NASAL CAVITY
- sphenopalatine artery
- anterior and posterior ethmoidal artery (branches of the ophthalmic artery),
- superior labial arteries (branches of facial artery supplying the vestibuleof nasal cavit
http://en.wikipedia.org/wiki/Anterior_ethmoidal_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Facial_arteryhttp://en.wikipedia.org/wiki/Facial_arteryhttp://en.wikipedia.org/wiki/Ophthalmic_arteryhttp://en.wikipedia.org/wiki/Anterior_ethmoidal_artery8/2/2019 Facial Skeleton
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Kiesselbach's area, (also Kiesselbach's plexus, and Little's area)
is a region in the anteroinferior part of the nasal septum, where arteries
anastomose to form a vascular plexus called Kiesselbach's plexus.
90% percent of nose bleeds (epistaxis) occur in this area
The arteries are
Anterior ethmoidal artery
Sphenopalatine artery
Greater palatine artery
Septal branch of the superior labial artery
http://en.wikipedia.org/wiki/Nasal_septumhttp://en.wikipedia.org/wiki/Anastomosishttp://en.wikipedia.org/wiki/Epistaxishttp://en.wikipedia.org/wiki/Anterior_ethmoidal_arteryhttp://en.wikipedia.org/wiki/Sphenopalatine_arteryhttp://en.wikipedia.org/wiki/Greater_palatine_arteryhttp://en.wikipedia.org/wiki/Superior_labial_arteryhttp://en.wikipedia.org/wiki/Superior_labial_arteryhttp://en.wikipedia.org/wiki/Greater_palatine_arteryhttp://en.wikipedia.org/wiki/Sphenopalatine_arteryhttp://en.wikipedia.org/wiki/Anterior_ethmoidal_arteryhttp://en.wikipedia.org/wiki/Epistaxishttp://en.wikipedia.org/wiki/Anastomosishttp://en.wikipedia.org/wiki/Nasal_septum8/2/2019 Facial Skeleton
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INNERVATION OF THE NASAL CAVITY
General sensory innervation is by branches of the trigeminal nerve (V1 & V2):
- nasociliary nerve (V1) anterior and posterior ethmoidal branches
- posterior nasal branches of maxillary nerve (V2)
- infraorbital nerve external nasal branch vestibule of the nasal cavity
PARANASAL SINUSES
http://en.wikipedia.org/wiki/Trigeminal_nervehttp://en.wikipedia.org/wiki/Nasociliary_nervehttp://en.wikipedia.org/wiki/Maxillary_nervehttp://en.wikipedia.org/wiki/Maxillary_nervehttp://en.wikipedia.org/wiki/Nasociliary_nervehttp://en.wikipedia.org/wiki/Trigeminal_nerve8/2/2019 Facial Skeleton
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PARANASAL SINUSES
PARANASAL SINUSES
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PARANASAL SINUSES
- the maxillary sinus, the largest of the paranasal sinus, are under the eyes, in
maxillary bones. It opens into the posterior part of the semilunar hiatus
-the frontal sinus, superior to the eyes, in the frontal bone, it opens into the anterior
part of the semilunar hiatus through the ethmoidal infundibulum
- the ethmoid sinuses, which are formed from several air cells within the ethmoid.
Anterior and middle group open into the middle part of the
semilunar hiatus, posterior group open into the superior nasal meatus.
- the sphenoid sinus, in the sphenoid bone at the center of the skull base under the
pituitary gland. It opens into the sphenoethmoidal recess.
The paranasal air sinuses are lined with respiratory epithelium
(ciliated pseudostratified columnar epithelium)
http://en.wikipedia.org/wiki/Human_eyehttp://en.wikipedia.org/wiki/Frontal_bonehttp://en.wikipedia.org/wiki/Ethmoid_sinushttp://en.wikipedia.org/wiki/Sphenoid_bonehttp://en.wikipedia.org/wiki/Pituitary_glandhttp://en.wikipedia.org/wiki/Respiratory_epitheliumhttp://en.wikipedia.org/wiki/Respiratory_epitheliumhttp://en.wikipedia.org/wiki/Pituitary_glandhttp://en.wikipedia.org/wiki/Sphenoid_bonehttp://en.wikipedia.org/wiki/Ethmoid_sinushttp://en.wikipedia.org/wiki/Frontal_bonehttp://en.wikipedia.org/wiki/Human_eye8/2/2019 Facial Skeleton
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Borders of the semilunar hiatus
- ethmoid bulla
- uncinate process
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MAXILLARY SINUS
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Recesses of the maxillary sinus
1. infraorbital recess
2. zygomatic recess
3. alveolar recess
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MAXILLARY SINUS
Structures narrowing the maxillary hiatus
- ethmoidal bulla
- uncinate process
- inferior nasal concha,
- perpendicular plate of the palatine bone
- lacrimal bone
Maxillary sinus opens into the posterior part of the semilunar hiatus (middle
nasal meatus)
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Maxillary sinus
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OLFACTORY EPITHELIUM
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OLFACTORY EPITHELIUM
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RESPIRATORY EPITHELIUM
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RESPIRATORY EPITHELIUM
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Walls of the pterygopalatine fossa
anterior: maxilla post.surface
posterior: ant. surface of the
greater wing,
and pterygoid process
medial: perpendicular plate of
palatine bone
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Th t l ti f t i
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The pterygopalatine fossa contains
- the pterygopalatine ganglion suspended by nerve roots from the maxillary nerve
- the terminal third of the maxillary artery
- the maxillary nerve (CN V2, the second division of the trigeminal nerve),
- the nerve of the pterygoid canal, a combination of the greater petrosal nerve
(preganglionic parasympathetic) and the deep petrosal nerve (postganglionic
sympathetic).
To obtain block anesthesia of the entire
second division of the trigeminal nerve,
an intraoral injection can be administered
into this area through the greater palatine
foramen.
http://en.wikipedia.org/wiki/Pterygopalatine_ganglionhttp://en.wikipedia.org/wiki/Maxillary_nervehttp://en.wikipedia.org/wiki/Maxillary_arteryhttp://en.wikipedia.org/wiki/Nerve_of_the_pterygoid_canalhttp://en.wikipedia.org/wiki/Greater_petrosal_nervehttp://en.wikipedia.org/wiki/Parasympathetichttp://en.wikipedia.org/wiki/Deep_petrosal_nervehttp://en.wikipedia.org/wiki/Sympathetic_nervous_systemhttp://en.wikipedia.org/wiki/Sympathetic_nervous_systemhttp://en.wikipedia.org/wiki/Deep_petrosal_nervehttp://en.wikipedia.org/wiki/Parasympathetichttp://en.wikipedia.org/wiki/Greater_petrosal_nervehttp://en.wikipedia.org/wiki/Nerve_of_the_pterygoid_canalhttp://en.wikipedia.org/wiki/Maxillary_arteryhttp://en.wikipedia.org/wiki/Maxillary_nervehttp://en.wikipedia.org/wiki/Pterygopalatine_ganglion8/2/2019 Facial Skeleton
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Contents of the pterygopalatine fossa
maxillary artery, maxillary nerve (V.), pterygopalatine ganglion (VII.)
Connections of the pterygopalatine fossa
infraorbital fissure orbit infraorbital a.,v., n.
foramen rotundum middle cranial fossa maxillary nerve
sphenopalatine foramen nasal cavity sphenopalatine a.,
post. nasal nerves.
greater and lesser palatine canal oral cavity palatine nerves,
desc.palatine artery
pterygoid canal base of the skull greater petrosal nerve
deep petrosal nerve
pterygomaxillary fissure infratemporal fossa maxillary artery
P t f th l it
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Parts of the oral cavity
Vestibule of the oral cavity
Oral cavity proper
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ISTHMUS OF THE FAUCES
Borders:
superior: soft palate
inferior: root of the tonque
lateral: palatoglossal and
palatopharngeal arch
f h h d l
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Structure of the hard palate
Hard and soft palate
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Hard and soft palate
Muscles of the soft palate
Levator veli palatini
Tensor veli palatini
Palatoglossus m.
Palatopharyngeus m.
M. uvulae
h h d d f l
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The hard and soft palate
Bl d l d i ti f
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Blood supply and innervetion of
the hard and soft palate
SUBLINGUAL REGION
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SUBLINGUAL REGION
FEATURES OF THE FLOOR- frenulum of tongue
- ridge formed by deep lingual vein- sublingual fold- sublingual caruncle (papilla)opening of submandibular and sublingualduct
ORAL DIAPHRAGMA MYLOHYOID M
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ORAL DIAPHRAGMA MYLOHYOID M.
Lateral groove (sulcus) of the tongue
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Lateral groove (sulcus) of the tongue
Borders:
medial: hyoglossus m.
lateral: mylohyoid m.
superior: sublingual mucous
membrane
Content: lingual nerve
submandibular duct
hypoglossal nerve
Medial groove (sulcus) of the tongue
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Medial groove (sulcus) of the tongue
Borders:
medial: genioglossus m.
lateral: hyoglossus m.
Content: lingual artery
(glossopharyngeal nerve)
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Thank you for your attention!
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