Upload
filchibuff
View
218
Download
0
Embed Size (px)
Citation preview
8/12/2019 Skull, Muscles of Face and Neck Final Version
1/258
THE SKULL
by PASA MD
8/12/2019 Skull, Muscles of Face and Neck Final Version
2/258
INTRODUCTION
ANTERIOR ASPECT OF CRANIUM
LATERAL ASPECT OF CRANIUMOCCIPITAL ASPECT OF CRANIUM
SUPERIOR ASPECT OF CRANIUM
EXTERNAL SURFACE OF CRANIAL BASE
INTERNAL SURFACE OF CRANIAL BASE
TABLE OF CONTENTS
8/12/2019 Skull, Muscles of Face and Neck Final Version
3/258
INTRODUCTION
CRANIUM (SKULL)
skeleton of the head
2 PartsNeurocranium
Viscerocranium
8/12/2019 Skull, Muscles of Face and Neck Final Version
4/258
1. Neurocranium
Cranial vault
Is the bony case of
the brain plus the
cranial meninges,
proximal parts ofcranial nerves and
vasculature of the
brain
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
5/258
The neurocranium is
formed by a series of
8 bones
SphenoidalTemporal (2sets)
Occipital
Parietal (2 sets)Frontal
Ethmoidal
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
6/258
8/12/2019 Skull, Muscles of Face and Neck Final Version
7/258
Has a dome like roof called the calvaria or skullcap
Calvaria (superior view) Calvaria (inferior view)
FRONTAL
BONE
PARIETAL
BONE
PARIETAL
BONE
OCCIPITAL
BONE
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
8/258
Has a floor or cranial base called the basicranium
Basicranium
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
9/258
2. Viscerocranium
facial skeleton
forms the anterior part of the
cranium
consists of bones surroundingthe orbits, nose and mouth
Viscerocranium
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
10/258
consists of 15 irregular bones
A. 3 singular bones
Mandible
Ethmoid
Vomer
B. 6 bones as bilateral pairs
Lacrimal
Inferior nasal conchae
Maxillae
Palatine
Nasal
Zygomatic
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
11/258
Orbitomeatal Plane or The
Frankfort Horizontal Plane
In the anatomic position
the inferior margin of theorbit and superior margin
of the external acoustic
meatus lie in the same
horizontal plane
Orbitomeatal Plane
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
12/258
Development of Craniumbones of calvaria and
cranial base develop
by intramembranous
ossification and byendochondral ossification
at birth the bones of thecalvaria are smooth and
unilaminar
Cranium of Newborn
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
13/258
Development of Cranium
disproportionately large;
frontal and parietal
eminences are prominent
facial aspect is small
compared to calvaria
increase in size of calvaria
is greatest during the first
2 yrs. due to rapid brain
development. Cranium of Newborn
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
14/258
Development of Craniumat birth the frontal bones
consists of two halves; union
begins in the 2ndyr.
halves of frontal bone are
separated by frontal suture;
obliterated by the 8thyr.
frontal and parietal bones areseparated by the coronal
suture
INTRODUCTION
Cranium of Newborn
8/12/2019 Skull, Muscles of Face and Neck Final Version
15/258
Metopic Suture
remnant of frontal suture
that persists
in the middle of the glabella
8% of people
must not be interpreted as
fracture in radiograph
Metopic Suture
INTRODUCTION
CLINICAL NOTES
8/12/2019 Skull, Muscles of Face and Neck Final Version
16/258
Development of Craniumintermaxillary suture
separates the maxillae
INTRODUCTION
Cranium of Newborn
8/12/2019 Skull, Muscles of Face and Neck Final Version
17/258
Development of Cranium
mandibular symphysis
separates the mandible;
halves of the mandible
fuse early in the 2ndyr.
obliteration of sutures
begin bet. ages 30 and40 years on the internal
surface and 10 years
later on the external
surface
INTRODUCTION
Cranium of Newborn
8/12/2019 Skull, Muscles of Face and Neck Final Version
18/258
Development of Craniumno mastoid and styloid
process in newborn; facial
nerves are close to the
surface and can be injured
by forceps delivery
mastoid process formsduring the 1styr; SCM pulls
on the petromastoid parts
of temporal bonesCranium of Newborn
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
19/258
Development of Cranium1. Anterior Fontanelle
-diamond or star-shaped
-bounded by frontal bone
anteriorly and parietal bone
posteriorly
-18 mos. no longer palpable
-future site of bregma
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
20/258
Development of Cranium2. Posterior Fontanelle
-triangular
-bounded by parietal
bones anteriorly and
occipital bone posteriorly
-at junction of lambdoid
and sagittal sutures;future site of lambda
-no longer palpable at the
end of 1styr.
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
21/258
Development of Cranium
3. Sphenoid and Mastoid
Fontanelles
-temporal muscle overliesthese fontanelles
-fuse during infancy
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
22/258
palpation of fontanelles
enables the physician to
determine the:
progress of growth offrontal and parietal bones
degree of hydration
(depressed fontanelle
means dehydration)level of intracranial
pressure (bulging means
increased pressure)
Fontanelles
INTRODUCTION
CLINICAL NOTES
8/12/2019 Skull, Muscles of Face and Neck Final Version
23/258
Rapid Growth of Facecoincides with the eruption
of deciduous teeth
dento-alveolar development
of the alveolar bone
associated with the increase
in size of paranasal sinuses
Cranium of Newborn
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
24/258
Primary Craniosynostosis
premature closure of
cranial sutures1 per 2000 births
unknown cause/genetic
more common in males
usually does not affect
brain development
Craniocytosis
CLINICAL NOTES
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
25/258
A. Scaphocephaly
premature closure of
sagittal suture
anterior fontanelle is
small or absent
long, narrow wedge-
shaped cranium
Scaphocephaly
CLINICAL NOTES
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
26/258
B. Plagiocephaly
premature closure of the
coronal or lambdoid
suture on one side only
cranium is twisted and
asymetrical
Plagiocephaly
CLINICAL NOTES
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
27/258
C.Oxycephaly/Turricephaly
premature closure of the
coronal suture
high tower-like cranium
more common in females
oxycephaly
CLINICAL NOTES
INTRODUCTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
28/258
ANTERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
29/258
8/12/2019 Skull, Muscles of Face and Neck Final Version
30/258
ANTERIOR ASPECT OF CRANIUM
squamous (flat)part
forms the skeleton of the
forehead
articulates with nasal and
zygomatic bones inferiorly
articulates with lacrimal,
ethmoid and sphenoidsFrontal Bone
FRONTAL BONE
8/12/2019 Skull, Muscles of Face and Neck Final Version
31/258
ANTERIOR ASPECT OF CRANIUM
the intersection of the
frontal and nasal bones
is the nasion
the glabellais the smooth
prominence superior to the
root of the nose
FRONTAL BONE
GlabellaNasion
8/12/2019 Skull, Muscles of Face and Neck Final Version
32/258
ANTERIOR ASPECT OF CRANIUM
supraorbital margin is the
angular boundary between
the squamous and orbitalparts
supraorbital foramen at the
supraorbital margin; forpassage of supra-orbital
nerve and vessels
FRONTAL BONE
Supra-orbital foramen
Supra-orbital margin
8/12/2019 Skull, Muscles of Face and Neck Final Version
33/258
ANTERIOR ASPECT OF CRANIUM
the superciliary arch is a
prominent ridge superior
to the supraorbital marginand deep to the eyebrows;
extends laterally on each
side from the glabella
FRONTAL BONE
8/12/2019 Skull, Muscles of Face and Neck Final Version
34/258
8/12/2019 Skull, Muscles of Face and Neck Final Version
35/258
ANTERIOR ASPECT OF CRANIUM
bilateral bony cavities
resemble quadrangular
pyramids
contain and protect the
eyeball and accessoryvisual structures
Orbits
ORBITS
8/12/2019 Skull, Muscles of Face and Neck Final Version
36/258
ANTERIOR ASPECT OF CRANIUM
superior wall (roof)
-orbital part of horizontal bone
-lesser wing of sphenoid
medial wall
-orbital plate of ethmoid-plus frontal process of maxilla,
lacrimal and sphenoid bones
Orbits
ORBITS
8/12/2019 Skull, Muscles of Face and Neck Final Version
37/258
8/12/2019 Skull, Muscles of Face and Neck Final Version
38/258
ANTERIOR ASPECT OF CRANIUM
inferior wall (orbital floor)
-maxilla and partly by
zygomatic and palatinebones
-demarcated from the
lateral wall by the inferior
orbital fissure
Orbits
ORBITS
8/12/2019 Skull, Muscles of Face and Neck Final Version
39/258
ANTERIOR ASPECT OF CRANIUM
fossa for the lacrimal gland is
the shallow depression in the
orbital part of the frontal bone
Orbits
ORBITS
ANTERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
40/258
ANTERIOR ASPECT OF CRANIUM
cheek bones or malar
bones
form prominences of
cheeks
lie on inferolateral sides
of orbits and rests on
maxillae
Zygomatic Bone
ZYGOMATIC BONE
8/12/2019 Skull, Muscles of Face and Neck Final Version
41/258
ANTERIOR ASPECT OF CRANIUM
articulates with the frontal,
sphenoid, maxillae and
temporal bones
zygomaticofacial foramen
pierces the lateral aspect
of the zygomatic bones
passage of zygomaticofacial
nerve and vesselsZygomaticofacial Foramen
ZYGOMATIC BONE
ANTERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
42/258
ANTERIOR ASPECT OF CRANIUM
Piriform Aperture
-pear-shaped anterior nasal
opening in the cranium-inferior to the nasal bones
Nasal Septum
-divides the nasal cavityinto right and left parts
Piriform Aperture
NASAL REGION
ANTERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
43/258
ANTERIOR ASPECT OF CRANIUM
Nasal Conchae
-curved bony plates on the
lateral wall of each nasal
cavity
Nasal Septum and Nasal Conchae
NASAL REGION
ANTERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
44/258
ANTERIOR ASPECT OF CRANIUM
form upper jaw; form the
infraorbital margins medially
alveolar processes include
the tooth sockets called
alveoli
supporting bone for maxillary
teeth
Maxillae
MAXILLAE
ANTERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
45/258
ANTERIOR ASPECT OF CRANIUM
surround piriform aperture
the two maxillae are united
at the intermaxillary suturearticulates with zygomatic
bone
infraorbital foramen for
passage of infraorbital nerve
and vessels
Infraorbital Foramen
MAXILLAE
ANTERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
46/258
Fractures of the Maxillae
Dr. Le Fort classified 3
variants of fractures of themaxillae
Le Fort I Fracture
Le Fort II Fracture
Le Fort III Fracture
Le Fort Fracture
CLINICAL NOTES
ANTERIOR ASPECT OF CRANIUM
ANTERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
47/258
Fractures of the Maxillae
Le Fort I Fracture
-horizontal fracture of themaxillae
-passing superior to the
maxillary alveolar process
crossing the bony nasalseptum
Le Fort I Fracture
CLINICAL NOTES
ANTERIOR ASPECT OF CRANIUM
ANTERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
48/258
Fractures of the Maxillae
Le Fort II Fracture
-passes from theposterolateral parts of the
maxillary sinuses through
the infra-orbital foramina
lacrimals or ethmoids tobridge of nose
Le Fort II Fracture
CLINICAL NOTES
ANTERIOR ASPECT OF CRANIUM
ANTERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
49/258
Fractures of the Maxillae
Le Fort III Fracture
-horizontal fracture
-passes through the superior
orbital fissures, ethmoid and
nasal bones, extending to the
greater wings of sphenoidand frontozygomatic sutures
Le Fort III Fracture
CLINICAL NOTES
ANTERIOR ASPECT OF CRANIUM
ANTERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
50/258
ANTERIOR ASPECT OF CRANIUM
U-shapedbone
alveolar process thatsupport mandibular teeth
consists of the body,
angle and ramus
Mandible
MANDIBLE
8/12/2019 Skull, Muscles of Face and Neck Final Version
51/258
CLINICAL NOTES
8/12/2019 Skull, Muscles of Face and Neck Final Version
52/258
CLINICAL NOTES
Fractures of the Mandible
fractures of the neck of the
mandible are transverse
fractures of the angle of
the mandible are usually
oblique
fractures of the body of
mandible pass through
socket of canine toothMandibular Fracture
CLINICAL NOTES
LATERAL ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
53/258
LATERAL ASPECT OF CRANIUM
LATERAL ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
54/258
LATERAL ASPECT OF CRANIUM
The lateral aspect consists of:
Temporal Fossa
Zygomatic Arch
Ext. Acoustic Opening
Mastoid Process
Infratemporal Fossa
Lateral aspects of maxillaand mandible
Lateral Aspect of Cranium
LATERAL ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
55/258
LATERAL ASPECT OF CRANIUM
bounded by:
-superiorly and posteriorly:
by the superior temporal line
and inferior temporal line
-anteriorly: by frontal and
zygomatic bones
-inferiorly by zygomatic arch
Temporal Fossa
TEMPORAL FOSSA
LATERAL ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
56/258
LATERAL ASPECT OF CRANIUM
formed by the union of
temporal process of
zygomatic bone and
zygomatic process oftemporal bone
Zygomatic Arch
ZYGOMATIC ARCH
LATERAL ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
57/258
LATERAL ASPECT OF CRANIUM
entrance to external
acoustic meatus or canal
External Acoustic Opening
EXTERNAL ACOUSTIC OPENING
LATERAL ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
58/258
LATERAL ASPECT OF CRANIUM
posteroinferior to the
external acoustic opening
anteromedial is a pointed
projection, the styloid
process
Mastoid Process and Styloid Process
MASTOID PROCESS
LATERAL ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
59/258
LATERAL ASPECT OF CRANIUM
inferior and deep to the
zygomatic arch and
mandible
posterior to maxilla
Infratemporal Fossa
INFRATEMPORAL FOSSA
LATERAL ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
60/258
LATERAL ASPECT OF CRANIUM
note: the pterion is an H-shaped
formation of sutures that unite the
frontal, parietal, greater wing of
sphenoid and temporal bones.
Pterion
LATERAL ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
61/258
Fracture of the Pterion
hard blow to side of head
life threatening because it
ovelies anterior branches of
middle meningeal vessels
if untreated may lead to
middle meningeal artery
hemorrhage Pterion
CLINICAL NOTES
LATERAL ASPECT OF CRANIUM
OCCIPITAL ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
62/258
OCCIPITAL ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
63/258
OCCIPITAL ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
64/258
OCCIPITAL ASPECT OF CRANIUM
the external occipital
protuberance is palpable
in the median plane
most prominent point of
the external occipital
protuberance is the Inion
External Occipital Protuberance
OCCIPITAL BONE
OCCIPITAL ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
65/258
OCCIPITAL ASPECT OF CRANIUM
the external occipital crestdescends from theprotuberance toward the foramen magnum
External Occipital Crest and Foramen Magnum
OCCIPITAL BONE
OCCIPITAL ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
66/258
OCCIPITAL ASPECT OF CRANIUM
the superior nuchal line
marks the superior limit
of neck and extends
laterally from each side
of the protuberance
the inferior nuchal line isless distinct
Superior Nuchal Line
OCCIPITAL BONE
8/12/2019 Skull, Muscles of Face and Neck Final Version
67/258
8/12/2019 Skull, Muscles of Face and Neck Final Version
68/258
SUPERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
69/258
SUPERIOR ASPECT OF CRANIUM
The superior aspect is
somewhat oval in form
and broadens posterolaterally
at the parietal eminences
Superior Aspect of Cranium
SUPERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
70/258
SUPERIOR ASPECT OF CRANIUM
Coronal suture-separates the frontal
and parietal bones
Sagittal suture-separates the parietal
bones
Lamdoid suture
-separates parietal andtemporal bones from
occipital bone
Sutures
CRANIAL SUTURES
SUPERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
71/258
SUPERIOR ASPECT OF CRANIUM
Bregma
-at junction of sagittal
and coronal sutures
Vertex-most superior pointof
the calvarianear the
midpoint of the sagittal
suture
Bregma and Vertex
CRANIOMETRIC POINTS
SUPERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
72/258
SUPERIOR ASPECT OF CRANIUM
Lambda
-at junction of lambdoid
and sagittal sutures
Lambda
CRANIOMETRIC POINTS
SUPERIOR ASPECT OF CRANIUM
8/12/2019 Skull, Muscles of Face and Neck Final Version
73/258
SUPERIOR ASPECT OF CRANIUM
Parietal foramen
-located posteriorly in the
parietal bone near the
sagittal suture
Emissary foramina
-transmit emissary veins
Parietal Foramen
PARIETAL LANDMARKS
8/12/2019 Skull, Muscles of Face and Neck Final Version
74/258
EXTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
75/258
EXTERNAL SURFACE OF CRANIAL BASE
External Surface of Cranial Basealso known as the Basicranium
inferior portion of neurocranium
and viscerocranium minus the
mandible
External Surface of Cranial Base
8/12/2019 Skull, Muscles of Face and Neck Final Version
76/258
8/12/2019 Skull, Muscles of Face and Neck Final Version
77/258
EXTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
78/258
EXTERNAL SURFACE OF CRANIAL BASE
A. Incisive Foramen
posterior to central
incisor teeth
depression in the
midline of bony palate
into which the incisivecanals open
Incisive Fossa and Greater Palatine Foramina
HARD PALATE
EXTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
79/258
EXTERNAL SURFACE OF CRANIAL BASE
B.Greater Palatine Foramen
medial to 3rdmolar tooth
transmit -greater palatine
nerves and vessels
C. Lesser Palatine Foramen
Posterior to greaterpalatine foramen
Transmit-lesser palatine
nerves and vessels Incisive Fossa and Greater Palatine Foramina
HARD PALATE
EXTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
80/258
SU C O C S
two large openings superior
to the posterior edge of the
palate
posterior nasal aperture
separated from each other
by the vomer
Choanae
CHOANAE
EXTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
81/258
trapezoidal in shape
flat, unpaired bone
forms a major part of the
bony nasal septum
Vomer
VOMER
8/12/2019 Skull, Muscles of Face and Neck Final Version
82/258
8/12/2019 Skull, Muscles of Face and Neck Final Version
83/258
EXTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
84/258
the foramen magnum is
the large opening in the
basal part of the occipital
bone
Foramen Magnum
FORAMEN MAGNUM
EXTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
85/258
large protuberances on the
lateral parts of occipital bone
where the cranium articulates
with the vertebral column
Occipital Condyles
OCCIPITAL CONDYLE
8/12/2019 Skull, Muscles of Face and Neck Final Version
86/258
8/12/2019 Skull, Muscles of Face and Neck Final Version
87/258
EXTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
88/258
lies posterior to the base
of the styloid process
transmits the facial nerve
and stylomastoid artery
Stylomastoid Foramen
STYLOMASTOID FORAMEN
8/12/2019 Skull, Muscles of Face and Neck Final Version
89/258
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
90/258
8/12/2019 Skull, Muscles of Face and Neck Final Version
91/258
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
92/258
formed by:
-frontal bone (anteriorly)
-ethmoid (middle)
-body and lesser wings of
sphenoid (posteriorly)
anterior and inferior partsof frontal lobe of brain occupy
this area
Anterior Cranial Fossa
ANTERIOR CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
93/258
A. Orbital Parts of the
Frontal Bone
the horizontal part of the
frontal bone forms the roofof the orbit and the floor of
the anterior cranial fossa
forms the greatest part ofthe anterior cranial fossa
surface show brain
markings of orbital gyri Frontal Bone as seen in theAnterior Cranial Fossa
ANTERIOR CRANIAL FOSSA
8/12/2019 Skull, Muscles of Face and Neck Final Version
94/258
8/12/2019 Skull, Muscles of Face and Neck Final Version
95/258
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
96/258
D. Crista Galli
thick, median ridge
posterior to foramen
cecum
projects superiorly from
the ethmoid bone
Latincocks combCrista Galli
ANTERIOR CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
97/258
E. Cribriform plate of
the ethmoid
lie on each side of
the crista galli
the tiny foramina of
the cribriform plate
transmit the olfactorynerves (CN I) to the
olfactory bulbs of the
brainCribriform Plate of the Ethmoid
Cribriform
Plate of the
Ethmoid
ANTERIOR CRANIAL FOSSA
8/12/2019 Skull, Muscles of Face and Neck Final Version
98/258
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
99/258
G. Lesser Wing of Sphenoid
sphenoidal crest separates the
anterior cranial fossa from the
middle cranial fossa laterally
sphenoidal limbus separates
the anterior cranial fossa fromthe middle cranial fossa
centrally
ANTERIOR CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
100/258
butterfly-shaped
postero-inferior to theanterior cranial fossa
separated from the anterior
cranial fossa by the ff:
-spenoidal crests (laterally)
-sphenoidal limbus(centrally)Middle Cranial Fossa
MIDDLE CRANIAL FOSSA
8/12/2019 Skull, Muscles of Face and Neck Final Version
101/258
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
102/258
the lateral parts of the
fossa are formed by
Greater wings of the
sphenoidSquamous part of
the temporal bone
Petrous part of the
temporal bone
MIDDLE CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
103/258
A. Sella turcica
saddle-like bony
formation
surrounded by theanterior and posterior
clinoid processes
composed of 3 parts:Tuberculum sellae
Hypophysial fossa
Dorsum sellae Sella Turcica
MIDDLE CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
104/258
Tuberculum Sellae
-median elevation
-forms the posterior
boundary of the
prechiasmatic sulcus
and anterior boundary
of hypophysial fossa
Tuberculum Sella
MIDDLE CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
105/258
Hypophysial Fossa
-median depression in the
body of the sphenoid
-accomodates the pituitary
gland
Hypophysial Fossa
MIDDLE CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
106/258
Dorsum Sellae
-square plate of bone
-forms the posterior
boundary of the sellaturcica
-superolateral angles
make up the posterior
clinoid process
Dorsum Sellae
MIDDLE CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
107/258
A. Optic Canal
transmits the:
Optic nerve
Ophthalmic artery
Optic Canal
MIDDLE CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
108/258
B. Superior Orbital Fissure
-located between the
greater and lesser wing
of sphenoid-opens anteriorly in the
orbit
Supraorbital Fissure
MIDDLE CRANIAL FOSSA
8/12/2019 Skull, Muscles of Face and Neck Final Version
109/258
8/12/2019 Skull, Muscles of Face and Neck Final Version
110/258
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
111/258
D. Foramen Ovale
-large foramen postero-lateral
to the foramen rotundum
-opens into the infratemporal
fossa
Foramen Ovale
MIDDLE CRANIAL FOSSA
-transmits:
Mandibular nerveAccessory meningeal artery
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
112/258
E. Foramen Spinosum
-posterolateral to the
foramen ovale
-opens into the infratemporal fossa
Foramen Spinosum
MIDDLE CRANIAL FOSSA
-transmits:
Middle meningeal
artery and vein
Meningeal branch of
mandibular nerve
8/12/2019 Skull, Muscles of Face and Neck Final Version
113/258
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
114/258
G. Groove for the Greater andLesser Petrosal Nerve
-lie on the anterosuperior
surface of the petrous part oftemporal bone
-extends laterally from the
foramen lacerum
-contents:
Greater petrosal nerve
Petrosal br. of middle meningeal
artery
MIDDLE CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
115/258
largest and deepest
formed mostly by the
occipital bone
lodges the ff:
cerebellum
pons
medulla oblongata
Posterior Cranial Fossa
POSTERIOR CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
116/258
the dorsum sellae of the
sphenoid marks its anterior
boundary centrally
petrous and mastoid parts
of the temporal bones
contributes its anterolateralwalls.
Posterior Cranial Fossa
POSTERIOR CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
117/258
A. Clivus
located in the center of
the anterior part of the
fossa leading to theforamen magnum
clivus
POSTERIOR CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
118/258
B. Cerebellar Fossae
bilateral concave impressions
Cerebellar Fossae
POSTERIOR CRANIAL FOSSA
8/12/2019 Skull, Muscles of Face and Neck Final Version
119/258
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
120/258
E. Jugular Foramen-located at the petrous
ridge of the temporal bone
Jugular Foramen
POSTERIOR CRANIAL FOSSA
-transmits:
Meningeal br. of ascendingpharyngeal and occipital a.
Accessory nerve
Sigmoid sinus
Sup. bulb of int. jugular veinInferior petrosal sinus
Vagus nerve
Glossopharyngeal nerve
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
121/258
E. Internal Acoustic Meatus
-located anterosuperior to
the jugular foramen
-transmits:Facial nerve
Vestibulocochlear nerve
Labyrinthine artery
Internal Acoustic Meatus
POSTERIOR CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
122/258
F. Hypoglossal Canal
-located superior to the
anterolateral margin of
the foramen magnum-transmits:
Hypoglossal nerve
Hypoglossal Canal
POSTERIOR CRANIAL FOSSA
INTERNAL SURFACE OF CRANIAL BASE
8/12/2019 Skull, Muscles of Face and Neck Final Version
123/258
G. Foramen Magnum
major structures passing
through this large foramen
are:Dural veins
Ant./post. Spinal arteries
Medulla and MeningesSpinal accessory n.
Vertebral arteriesForamen Magnum
POSTERIOR CRANIAL FOSSA
END OF CHAPTER 1
8/12/2019 Skull, Muscles of Face and Neck Final Version
124/258
8/12/2019 Skull, Muscles of Face and Neck Final Version
125/258
TABLE OF CONTENTS
8/12/2019 Skull, Muscles of Face and Neck Final Version
126/258
MUSCLES OF FACIAL EXPRESSIONOCCIPITOFRONTALISORBICULARIS OCULI
CORRUGATOR SUPERCILLI
PROCERUSNASALIS
LEVATOR LABII SUPERIORIS ALAE QUE NASI
ORBICULARIS ORISLEVATOR LABII SUPERIORIS
TABLE OF CONTENTS
8/12/2019 Skull, Muscles of Face and Neck Final Version
127/258
MUSCLES OF FACIAL EXPRESSIONZYGOMATICUS MAJOR AND MINOR
LEVATOR ANGULI ORIS
RISORIUS
BUCCINATORDEPRESSOR ANGULI ORIS
DEPRESSOR LABII INFERIORIS
MENTALISPLATYSMA
OCCIPITOFRONTALIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
128/258
flat digastric muscle
(+) frontal and occipitalbellies that share a
common tendon the
epicranial aponeurosis
OCCIPITOFRONTALIS (Frontal Belly)
8/12/2019 Skull, Muscles of Face and Neck Final Version
129/258
ORIGINepicranial aponeurosis
INSERTIONskin and subcutaneous
tissue of eyebrows and
forehead
OCCIPITOFRONTALIS (Frontal Belly)
8/12/2019 Skull, Muscles of Face and Neck Final Version
130/258
ACTION
elevates eyebrows
contraction of the frontal
belly protracts the scalp
transverse wrinkles across
the forehead
gives the face a surprised
look
OCCIPITOFRONTALIS (Occipital Belly)
8/12/2019 Skull, Muscles of Face and Neck Final Version
131/258
ORIGINlateral 2/3 of superior
nuchal line
INSERTION
epicranial aponeurosis
OCCIPITOFRONTALIS (Occipital Belly)
8/12/2019 Skull, Muscles of Face and Neck Final Version
132/258
ACTION
contraction of the occipital
belly retracts the scalp
the occipital belly with bonyattachments works as a
synergist with the frontal belly
retracts the scalp;increasing
effectiveness of frontal belly
ORBICULARIS OCULI (ORBITAL PART)
8/12/2019 Skull, Muscles of Face and Neck Final Version
133/258
concentric circles aroundorbital margin
closes eyelids and wrinklesforehead vertically
assists in the flow of lacrimal
fluid (tears)
ORBICULARIS OCULI (ORBITAL PART)
8/12/2019 Skull, Muscles of Face and Neck Final Version
134/258
ORIGINmedial orbital margin
medial palpebral ligament
lacrimal bone
INSERTION
skin around margin of orbit
superior and inferior tarsal
plates
8/12/2019 Skull, Muscles of Face and Neck Final Version
135/258
8/12/2019 Skull, Muscles of Face and Neck Final Version
136/258
ORBICULARIS OCULI (PALPEBRAL PART)
8/12/2019 Skull, Muscles of Face and Neck Final Version
137/258
ORIGIN
medial palpebral ligament
INSERTIONlateral palpebral raphe
ORBICULARIS OCULI (PALPEBRAL PART)
8/12/2019 Skull, Muscles of Face and Neck Final Version
138/258
ACTIONcloses eyelids gently
CORRUGATOR SUPERCILLI
8/12/2019 Skull, Muscles of Face and Neck Final Version
139/258
ORIGINMedial end of superciliary
arch
INSERTION
Skin superior to middle of
supraorbital margin and
superciliary arch
CORRUGATOR SUPERCILLI
8/12/2019 Skull, Muscles of Face and Neck Final Version
140/258
ACTIONDraws eyebrow medially
and inferiorly creating
vertical wrinkles above
the nose
Demonstrate concern or
worry
PROCERUS PLUS TRANSVERSE PART OFNASALIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
141/258
ORIGINFascia aponeurosis
covering nasal bone and
lateral nasal cartilage
INSERTION
Skin of inferior forehead
between eyebrows
PROCERUS PLUS TRANSVERSE PART OFNASALIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
142/258
ACTIONDepresses medial end of
eyebrow
Wrinkles skin over dorsum
of nose
Convey disdain or dislike
ALAR PART OF NASALIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
143/258
ORIGINMaxilla
INSERTIONAla of nose
ALAR PART OF NASALIS PLUS LEVATORLABII SUPERIORIS ALAEQUE NASII
8/12/2019 Skull, Muscles of Face and Neck Final Version
144/258
ORIGINFrontal process of maxilla
(inferomedial margin of
the orbit)
INSERTION
Major alar cartilage
ALAR PART OF NASALIS PLUS LEVATORLABII SUPERIORIS ALAEQUE NASII
8/12/2019 Skull, Muscles of Face and Neck Final Version
145/258
ACTIONDepresses ala laterally
dilating anterior nasal
aperture
Flaring nostrils during
anger or exertion
ORBICULARIS ORIS (ORAL SPHINCTER)
8/12/2019 Skull, Muscles of Face and Neck Final Version
146/258
Encircles the mouth
within the lips
Control entry and exitthrought oral fissure
Important during speech
ORBICULARIS ORIS (ORAL SPHINCTER)
8/12/2019 Skull, Muscles of Face and Neck Final Version
147/258
ORIGINMedial maxilla and
mandible
Deep surface of perioralskin
Angle of mouth
INSERTION
Mucous membrane of
lips
ORBICULARIS ORIS (ORAL SPHINCTER)
8/12/2019 Skull, Muscles of Face and Neck Final Version
148/258
ACTIONCloses oral fissure
Compresses andprotrudes lips (kissing)
Resists distention
(when blowing)
LEVATOR LABII SUPERIORIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
149/258
ORIGINInfraorbital margin (maxilla)
INSERTIONSkin of upper lip
LEVATOR LABII SUPERIORIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
150/258
ACTIONPart of dilators of mouth
Retract (elevate) / evertupper lip
Deepen nasolabial sulcus(sadness)
ZYGOMATICUS MINOR
8/12/2019 Skull, Muscles of Face and Neck Final Version
151/258
ORIGINAnterior aspect of zygomatic
bone
INSERTION
Skin of upper lip
ZYGOMATICUS MINOR
8/12/2019 Skull, Muscles of Face and Neck Final Version
152/258
ZYGOMATICUS MINOR
8/12/2019 Skull, Muscles of Face and Neck Final Version
153/258
ACTIONPart of dilators of mouth
Retract (elevate) or evertupper lip
Deepen the nasolabial sulcus
(showing sadness)
ZYGOMATICUS MAJOR
8/12/2019 Skull, Muscles of Face and Neck Final Version
154/258
ORIGINLateral aspect of zygomatic
bone
INSERTION
Angle of mouth
ZYGOMATICUS MAJOR
8/12/2019 Skull, Muscles of Face and Neck Final Version
155/258
ZYGOMATICUS MAJOR
8/12/2019 Skull, Muscles of Face and Neck Final Version
156/258
ACTIONPart of dilators of mouth
Elevates labial commissurebilaterally to smile(happiness)
Unilaterally to sneer(disdain)
BUCCINATOR (CHEEK MUSCLE)
8/12/2019 Skull, Muscles of Face and Neck Final Version
157/258
thin, flat rectangular
more closely related to
the buccal mucosa
fibers mingle medially
with orbicularis oris
BUCCINATOR (CHEEK MUSCLE)
8/12/2019 Skull, Muscles of Face and Neck Final Version
158/258
ORIGINMandible
Alveolar processes of
maxilla and mandible
Pterygomandibular raphe
INSERTION
Angle of mouth
Orbicularis oris
BUCCINATOR (CHEEK MUSCLE)
8/12/2019 Skull, Muscles of Face and Neck Final Version
159/258
ACTIONPresses cheeks against
molar teeth
Works with tongue to
keep food between
occlusal surfaces and
out of oral vestibule
Resists distention (whenblowing)
LEVATOR ANGULI ORIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
160/258
ORIGINInfra-orbital maxilla
(canine fossa)
INSERTION
Angle of mouth
LEVATOR ANGULI ORIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
161/258
ACTIONPart of dilators of mouth
Widens oral fissure(grinning or grimacing)
RISORIUS
8/12/2019 Skull, Muscles of Face and Neck Final Version
162/258
ORIGINParotid fascia
Buccal skin
INSERTION
Angle of mouth
8/12/2019 Skull, Muscles of Face and Neck Final Version
163/258
DEPRESSOR ANGULI ORIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
164/258
ORIGINAnterolateral base of the
mandible
INSERTION
Angle of mouth
DEPRESSOR ANGULI ORIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
165/258
8/12/2019 Skull, Muscles of Face and Neck Final Version
166/258
DEPRESSOR LABII INFERIORIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
167/258
ORIGINPlatysma
Anterolateral body
of mandible
INSERTION
Skin of lower lip
DEPRESSOR LABII INFERIORIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
168/258
ORIGINPlatysma
Anterolateral body
of mandible
INSERTION
Skin of lower lip
DEPRESSOR LABII INFERIORIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
169/258
ACTIONPart of dilators of mouth
Retracts (depresses)and/or everts lower lip
(pouting, sadness)
MENTALIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
170/258
ORIGINBody of mandible
(anterior to roots of
inferior incisors)
INSERTION
Skin of chin (mentolabial
sulcus)
MENTALIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
171/258
ACTIONElevates and protrudes lower
lip
Elevates skin of chin
(showing doubt)
PLATYSMA
8/12/2019 Skull, Muscles of Face and Neck Final Version
172/258
ORIGINSubcutaneous tissue of
infraclavicular and
supraclavicular regions
INSERTION
Base of mandible
Skin of cheek and lower
lipAngle of mouth
Orbicularis oris
PLATYSMA
8/12/2019 Skull, Muscles of Face and Neck Final Version
173/258
ACTIONDepresses mandible
against resistance
Tenses skin of inferior
face and neck
(tension and stress)
CLINICAL NOTES
8/12/2019 Skull, Muscles of Face and Neck Final Version
174/258
BELL PALSY
injury to facial nerve
(CN VII)
paralysis of facial
muscles on affectedside result to:
sad look when face is
relaxed
markedly contorted smile
weakened lips affect
speech
food accumulation
CLINICAL NOTES
8/12/2019 Skull, Muscles of Face and Neck Final Version
175/258
Thrombophlebitis of Facial Veindanger triangle of the face
-triangular area from upper lip to
bridge of nose
inflammation of facial vein with
secondary thrombus formation
and pieces of an infected clot
result from laceration of the noseby squeezing pimples
END OF CHAPTER 2
8/12/2019 Skull, Muscles of Face and Neck Final Version
176/258
CHAPTER 3
8/12/2019 Skull, Muscles of Face and Neck Final Version
177/258
MUSCLES OF THE NECK
TABLE OF CONTENTS
8/12/2019 Skull, Muscles of Face and Neck Final Version
178/258
CUTANEOUS AND SUPERFICIAL MUSCLES OF NECK
MUSCLES OF THE ANTERIOR CERVICAL REGION
PREVERTEBRAL MUSCLES
LATERAL VERTEBRAL MUSCLES
8/12/2019 Skull, Muscles of Face and Neck Final Version
179/258
CUTANEOUS AND SUPERFICIALMUSCLES OF THE NECK
PLATYSMASTERNOCLEIDOMASTOID
TRAPEZIUS
PLATYSMA
8/12/2019 Skull, Muscles of Face and Neck Final Version
180/258
(G. flat plate)
Broad thin sheet of
muscle
Covers the anterolateral
aspect of the neck
PLATYSMA
8/12/2019 Skull, Muscles of Face and Neck Final Version
181/258
Decussate over the chin
and blend with facial
muscles
Inferiorly the fibersdiverge
Deep to the platysmaare the extenal jugular
vein and cutaneous
nerves of the neck
8/12/2019 Skull, Muscles of Face and Neck Final Version
182/258
PLATYSMA
8/12/2019 Skull, Muscles of Face and Neck Final Version
183/258
INNERVATIONCervical branch of facial
nerve (CN VII)
note: refer to netter-facialnerve schema
PLATYSMA
ACTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
184/258
ACTION
Draws corners of mouth
inferiorly and widens it
(grimace/sadness/fright)
PLATYSMA
ACTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
185/258
ACTION
Draws the skin of neck
superiorly when teeth
are clenched producing
vertical skin ridges
PLATYSMA
8/12/2019 Skull, Muscles of Face and Neck Final Version
186/258
TESTING THE PLATYSMAThe platysma can be seen
as a sheet of muscle by
asking the patient to
clench the jaws firmly.
STERNOCLEIDOMASTOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
187/258
Divides each side of theneck into anterior and
lateral cervical region
Broad strap-like muscle
Has two heads
a. Sternal Headb. Clavicular Head
STERNOCLEIDOMASTOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
188/258
Has two headsa. Sternal Head
b. Clavicular Head
The two heads are
separate inferiorly by a
space called the lesser
supraclavicular fossa
STERNOCLEIDOMASTOID
SUPERIOR ATTACHMENT
8/12/2019 Skull, Muscles of Face and Neck Final Version
189/258
SUPERIOR ATTACHMENT
Lateral surface of mastoid
process of temporal bone
Lateral half of superior
nuchal line
STERNOCLEIDOMASTOID
INFERIOR ATTACHMENT
8/12/2019 Skull, Muscles of Face and Neck Final Version
190/258
INFERIOR ATTACHMENT
Sternal head:anterior surface of
manubrium of sternum
Clavicular head:
superior surface of medial
third of clavicle
STERNOCLEIDOMASTOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
191/258
INNERVATIONSpinal accessory nerve
(CN XI, motor)
C2 and C3 nerves
(pain and proprioception)
note: refer to netter
-accessory nerve schema
STERNOCLEIDOMASTOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
192/258
ACTIONUnilateral contraction:
tilts head to same side
and rotates it so face is
turned superiorly towardthe opposite side
STERNOCLEIDOMASTOID
ACTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
193/258
ACTION
Bilateral contraction: Flexion
Flexes cervical vertebrae so
that the chin approaches the
manubrium
Flexion of the Neck
STERNOCLEIDOMASTOID
ACTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
194/258
ACTION
Bilateral contraction: Flexion
Flexion also occur when
lifting the head off the
ground while lying supineprotruding the chin while
keeping the head level
Lifting head off the ground
STERNOCLEIDOMASTOID
ACTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
195/258
ACTION
Bilateral contraction:Extension
(especially for posterior
fibers of the SCM)
Extends neck at atlanto-
occipital joints; elevating
the chin
STERNOCLEIDOMASTOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
196/258
TESTING THE SCMThe head is turned to the
opposite side against
resistance (hand against
the chin)
Normal when muscle is
seen and palpated
L fl t t i l l
TRAPEZIUS
8/12/2019 Skull, Muscles of Face and Neck Final Version
197/258
Large flat triangular muscle
-muscle of neck
-muscle of pectoral girdle
-superficial muscle of back
Covers the posterolateral
aspect of the neck and thorax
Attaches the pectoral girdle to
the cranium and vertebral
column
TRAPEZIUS
ORIGIN
8/12/2019 Skull, Muscles of Face and Neck Final Version
198/258
ORIGIN
Medial third of
superior nuchal line
External occipital
protuberance
Nuchal ligament
Spinous process (C7-
T12)Lumbar and sacral
spinous processes
8/12/2019 Skull, Muscles of Face and Neck Final Version
199/258
TRAPEZIUS
INNERVATION
8/12/2019 Skull, Muscles of Face and Neck Final Version
200/258
INNERVATION
Spinal Accessory Nerve
(CN XI; motor)
C2 and C3 Nerves
(pain and proprioception)
note: refer to netter
-accessory nerve schema
8/12/2019 Skull, Muscles of Face and Neck Final Version
201/258
TRAPEZIUS
8/12/2019 Skull, Muscles of Face and Neck Final Version
202/258
ACTIONUnilateral contraction:
-produces lateral flexion
on the same side
Bilateral contraction:
-extends the neck
Lateral Flexion on same side
TRAPEZIUS
8/12/2019 Skull, Muscles of Face and Neck Final Version
203/258
TESTING THE TRAPEZIUSThe shoulder is shrugged
against resistance
Normal when the superior
border of the muscle is
seen and palpated
If the muscle is paralyzed
the shoulder droops
8/12/2019 Skull, Muscles of Face and Neck Final Version
204/258
SUPRAHYOID MUSCLES
8/12/2019 Skull, Muscles of Face and Neck Final Version
205/258
Superior to the hyoid and connect it to the cranium
These muscles constitute the substance of the
floor of the mouth
Support the hyoid in providing a base from which
the tongue functions
Elevate the hyoid and larynx in relation to
swallowing and tone production
MYLOHYOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
206/258
ORIGINMylohyoid line of mandible
INSERTIONMylohyoid raphe and body
of hyoid
Note:refer to netter
-Mandible and Floor of Mouth
MYLOHYOID
INNERVATION
8/12/2019 Skull, Muscles of Face and Neck Final Version
207/258
Nerve to mylohyoid, a
branch of inferior alveolar
nerve (from mandibular
nerve, CN V3)
Note: refer to netter
-nerves of oral and pharyngeal
regions
MYLOHYOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
208/258
ACTIONElevates the following during
swallowing and speaking:
Hyoid
Floor of mouth
Tongue
GENIOHYOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
209/258
ORIGINInferior mental spine of
mandible
INSERTION
Body of hyoid
Note: refer to netter
-tongue and mandible
GENIOHYOID
INNERVATION
8/12/2019 Skull, Muscles of Face and Neck Final Version
210/258
C1 via hypoglossal nerve
Note: refer to netter
-Hypoglossal nerve schema
GENIOHYOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
211/258
ACTIONPulls hyoid anterosuperiorly
Shortens floor of mouth
Widens pharynx
STYLOHYOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
212/258
ORIGINStyloid process of the
temporal bone
INSERTION
Body of hyoid
STYLOHYOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
213/258
INNERVATION
Stylohyoid branch of the
preparotid facial nerve
Note: refer to netter
-Facial nerve schema
STYLOHYOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
214/258
ACTIONElevates and retracts hyoid;
elongating the floor of the
mouth
Has two bellies joined by
DIGASTRIC
8/12/2019 Skull, Muscles of Face and Neck Final Version
215/258
Has two bellies joined by
an intermediate tendon
A. Anterior Digastric
B. Posterior Digastric
A fibrous sling connects
the intermediate tendon to
the body and greater hornof the hyoid
DIGASTRIC
ORIGIN
8/12/2019 Skull, Muscles of Face and Neck Final Version
216/258
Anterior Belly: digastricfossa of mandible
Posterior Belly: mastoid
notch of temporal bone
INSERTION
Intermediate tendon tobody and greater horn of
hyoid
DIGASTRIC
8/12/2019 Skull, Muscles of Face and Neck Final Version
217/258
INNERVATIONAnterior Belly: nerve to
mylohyoid, a branch of
inferior alveolar nerve
Posterior Belly: digastric
(preparotid) branch of
facial nerve
DIGASTRIC
8/12/2019 Skull, Muscles of Face and Neck Final Version
218/258
ACTIONWorking with infrahyoid muscles,
depresses mandible against
resistance
Elevates and steadies hyoid
during swallowing and speaking
MUSCLES OF THE ANTERIOR
8/12/2019 Skull, Muscles of Face and Neck Final Version
219/258
CERVICAL REGION
INFRAHYOID MUSCLESSTERNOHYOID
OMOHYOID
STERNOTHYROIDTHYROHYOID
INFRAHYOID MUSCLES
8/12/2019 Skull, Muscles of Face and Neck Final Version
220/258
Often called strap muscles because of their
ribbon like appearance
Anchor the hyoid, sternum, clavicle and scapula
Depress the hyoid during swallowing and speaking
Work with the suprahyoid muscles to steady thehyoid providing a firm base for the tongue
INFRAHYOID MUSCLES
8/12/2019 Skull, Muscles of Face and Neck Final Version
221/258
Arranged in two planes
A. Superficial Plane
-Sternohyoid
-OmohyoidB. Deep Plane
-sternothyroid
-thyrohyoid
STERNOHYOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
222/258
ORIGINManubrium of sternum and
medial end of clavicle
INSERTION
Body of hyoid
STERNOHYOID
INNERVATION
8/12/2019 Skull, Muscles of Face and Neck Final Version
223/258
C1-C3 by a branch of
ansa cervicalis
Note: refer to netter-Hypoglossal nerve schema
to see the ansa cervicalis
STERNOHYOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
224/258
ACTIONDepresses hyoid after
elevation during swallowing
OMOHYOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
225/258
Has two bellies united byan intermediate tendon
A. Superior Belly
B. Inferior Belly
The fascial sling for the
intermediate tendon
connects to the clavicle
OMOHYOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
226/258
ORIGINSuperior border of scapula
near suprascapular notch
INSERTION
Inferior border of hyoid
OMOHYOID
INNERVATION
8/12/2019 Skull, Muscles of Face and Neck Final Version
227/258
C1-C3 by a branch ofansa cervicalis
Note: refer to netter
-Cervical plexus schema tosee the ansa cervicalis
OMOHYOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
228/258
ACTIONDepresses, retracts and
steadies hyoid
STERNOTHYROID
8/12/2019 Skull, Muscles of Face and Neck Final Version
229/258
Wider than the sternohyoid
Covers the lateral lobes of
the thyroid gland
8/12/2019 Skull, Muscles of Face and Neck Final Version
230/258
STERNOTHYROID
8/12/2019 Skull, Muscles of Face and Neck Final Version
231/258
INNERVATIONC2 and C3 by a branch of
ansa cervicalis
STERNOTHYROID
ACTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
232/258
ACTION
Depresses hyoid and larynx
THYROHYOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
233/258
Appears to be thecontinuation of the
sternothyroid muscle
Runs superiorly from
the oblique line of the
thyroid cartilage to thehyoid
THYROHYOID
ORIGIN
8/12/2019 Skull, Muscles of Face and Neck Final Version
234/258
Oblique line of thyroid
cartilage
INSERTION
Inferior border of body
and greater horn of hyoid
THYROHYOID
8/12/2019 Skull, Muscles of Face and Neck Final Version
235/258
INNERVATION
C1(via hypoglossal nerve-CN XII)
Note: refer to netter-Hypoglossal nerve schema
THYROHYOID
ACTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
236/258
Depresses hyoid
Elevates larynx
PREVERTEBRAL MUSCLES
8/12/2019 Skull, Muscles of Face and Neck Final Version
237/258
LONGUS COLLILONGUS CAPITIS
RECTUS CAPITIS ANTERIOR
RECTUS CAPITIS LATERALISSPLENIUS CAPITIS
LEVATOR SCAPULAE
ANTERIOR SCALENE
MIDDLE SCALENE
POSTERIOR SCALENE
PREVERTEBRAL MUSCLES
8/12/2019 Skull, Muscles of Face and Neck Final Version
238/258
Deep to prevertebral layer of deep cervical fascia
Can be grouped to either:
A. Anterior Vertebral Muscles
-Longus colli
-Longus capitis
-Rectus capitis anterior
-Anterior scalene
B. Lateral Vertebral Muscles
-Rectus capitis lateralis-Splenius capitis
-Levator scapulae
-Middle Scalene and Posterior Scalene
LONGUS COLLI
SUPERIOR ATTACHMENT
8/12/2019 Skull, Muscles of Face and Neck Final Version
239/258
anterior tubercle of C1
bodies of C1-C3
transverse processes of
C3-C6 vertebrae
INFERIOR ATTACHMENT
bodies of C5-T3
transverse processes of
C3-C5 vertebrae
LONGUS COLLI
8/12/2019 Skull, Muscles of Face and Neck Final Version
240/258
INNERVATION
Anterior rami of C2-C6
spinal nerves
Note: refer to netter
-cervical plexus in situ
LONGUS COLLI
ACTION
8/12/2019 Skull, Muscles of Face and Neck Final Version
241/258
Acting unilaterally:
Flexes the neck with
rotation (torsion) to
opposite side
LONGUS CAPITIS
SUPERIOR ATTACHMENT
8/12/2019 Skull, Muscles of Face and Neck Final Version
242/258
Basilar part of occipital
bone
INFERIOR ATTACHMENT
Anterior tubercles of C3-
C6 transverse processes
LONGUS CAPITIS
INNERVATION
8/12/2019 Skull, Muscles of Face and Neck Final Version
243/258
Anterior rami of C1-C3
spinal nerves
Note: refer to netter
-Cervical plexus in situ
ACTION
Flex head
RECTUS CAPITIS ANTERIOR
SUPERIOR ATTACHMENT
8/12/2019 Skull, Muscles of Face and Neck Final Version
244/258
Base of cranium, anterior
to occipital condyle
INFERIOR ATTACHMENT
Anterior surface of lateral
mass of atlas C1 vertebra
8/12/2019 Skull, Muscles of Face and Neck Final Version
245/258
ANTERIOR SCALENE
SUPERIOR ATTACHMENT
8/12/2019 Skull, Muscles of Face and Neck Final Version
246/258
Transverse processes of
C3-C6 vertebrae
INFERIOR ATTACHMENT
1strib
8/12/2019 Skull, Muscles of Face and Neck Final Version
247/258
RECTUS CAPITIS LATERALIS
SUPERIOR ATTACHMENT
8/12/2019 Skull, Muscles of Face and Neck Final Version
248/258
jugular process of occipital
bone
INFERIOR ATTACHMENT
transverse process of atlas
(C1 vertebra)
RECTUS CAPITIS LATERALIS
INNERVATION
8/12/2019 Skull, Muscles of Face and Neck Final Version
249/258
Branches from loop
between C1 and C2
spinal nerves
ACTION
Flexes head and helps
stabilize it
SPLENIUS CAPITIS
SUPERIOR ATTACHMENT
8/12/2019 Skull, Muscles of Face and Neck Final Version
250/258
Inferior half of nuchal
ligament
spinous processes of
superior 6 thoracic vert.INFERIOR ATTACHMENT
lateral aspect of mastoid
processlateral third of superior
nuchal line
SPLENIUS CAPITIS
8/12/2019 Skull, Muscles of Face and Neck Final Version
251/258
ACTION
laterally flexes and rotates
head and neck to same side
acting bilaterally, extends
head and neck
LEVATOR SCAPULAE
SUPERIOR ATTACHMENT
8/12/2019 Skull, Muscles of Face and Neck Final Version
252/258
Posterior tubercle of
transverse processes
C2-C6 vertebrae
INFERIOR ATTACHMENT
Superior part of medial
border of scapula
LEVATOR SCAPULAE
INNERVATION
8/12/2019 Skull, Muscles of Face and Neck Final Version
253/258
Dorsal scapular nerve C5
and cervical spinal nerves
C3 and C4
ACTION
Downward rotation of
scapula and tilts its
glenoid cavity inferiorlyby rotating scapula
MIDDLE SCALENE
SUPERIOR ATTACHMENT
8/12/2019 Skull, Muscles of Face and Neck Final Version
254/258
posterior tubercles of
transverse processes
C5-C7 vertebrae
INFERIOR ATTACHMENT
Superior surface of 1strib;
posterior to groove forsubclavian artery
MIDDLE SCALENE
INNERVATION
8/12/2019 Skull, Muscles of Face and Neck Final Version
255/258
Anterior rami of cervical
spinal nerves
ACTIONFlexes neck laterally
Elevates 1st
rib duringforced inspiration
POSTERIOR SCALENE
SUPERIOR ATTACHMENT
8/12/2019 Skull, Muscles of Face and Neck Final Version
256/258
posterior tubercles of
transverse processes of
C5-C7
INFERIOR ATTACHMENT
external border of 2ndrib
POSTERIOR SCALENE
INNERVATION
8/12/2019 Skull, Muscles of Face and Neck Final Version
257/258
Anterior rami of cervical
spinal nerves C7 and C8
ACTIONFlexes neck laterally
Elevates 2ndrib during
forced inspiration
REFERENCES
1. Clinically Oriented
Anatomy
8/12/2019 Skull, Muscles of Face and Neck Final Version
258/258
Anatomy
By Keith Moore
2. Clinical Anatomy by
RegionsBy Richard Snell, MD
3 Atlas of Human Anatomy