Week 8: Deep Face Flashcards
fossa of deep face or or temporal region
- temporal fossa
* infratemporal fossa
temporal fossa
- lies superior to zygomatic arch
* contains temporalis muscle (mastication)
infratemporal fossa
- inferior and deep to the zygomatic bone
- contains lateral and medial pterygoids (mastication), mandibular nerve, and maxillary artery
- also contains otic ganglion, chorda tympani nerve, and pterygoid plexus of veins
temporomandibular joint (TMJ)
between temporal bone and mandibular condyle
muscles involved in elevation of mandible
- temporalis, masseter, and medial pterygoid
* close the mouth
muscles involved in protraction (protrusion) of mandible
lateral pterygoid
muscles involved in opening mouth
lateral pterygoid, assisted by digastric, mylohyoid, and geniohyoid
muscles involved in retraction of mandible
temporalis and masseter
muscles involved in side to side movement of mandible
medial and lateral pterygoids
innervation and supply of temporalis
deep temporal nerves; deep temporal arteries (branches of maxillary artery)
anterior division of mandibular nerve
- runs forward under lateral pterygoid and then continues as buccal nerve
- gives rise to the deep temporal nerves and the nerves that supply the masseter and lateral pterygoid muscles
•deep temporal nerves
- from anterior division of mandibular nerve
* supply temporalis muscle
posterior division of mandibular nerve
descends and divides into lingual, inferior alveolar (nerve to the mylohoid) and auriculotemporal nerve
lingual nerve location
- desends from under the lateral pterygoid, passing down and forward to the medial surface of the mandible
- joined by the preganglionic parasympathetic chorda tympani nerve (from CN VII)
chorda tympani synapses
in the submnadibular ganglion to innervate submandibular and sublingual glands
inferior alveolar nerve location
just posterior to lingual nerve and enters mandibular foramen along with inferior alveolar artery (branch of maxillary artery)
auriculotemporal nerve also conveys
CN IX postganglionic parasympathetic fibers from otic ganglion to parotid gland
otic ganglion located
medial aspect of CN V3 as it exits foramen ovale
maxillary artery arises
- posterior to the neck of the mandible as a branch of the external carotid
- runs through infratemporal fossa to enter pterygopalatine fossa
maxillary artery gives rise to
- inferior alveolar artery
- middle meningeal artery
- buccal artery
- sphenopalatine artery
- muscular branches
inferior alveolar artery enters
mandibular foramen with the inferior alveolar nerve
middle meningeal artery enters
foramen spinosum to the middle cranial fossa
muscular branches of maxillary artery supply
temporalis, medial and lateral pterygoids, and masseter
buccal artery accompanies
buccal nerve to the cheeck
sphenopalatine artery
the terminal artery of maxillary artery; enters posterior nasal cavity
nasal cavity
- 1st part of conduction portion of respiratory system
* has 3 regions: nasal vestibule, respiratory region, and olfactory region
nasal vestibule
most anterior part of nasal cavity; contains hair
respiratory region has
thick glandular mucosa
olfactory region
the superior third; contains minute filaments of the olfactory nerves entering the cribiform plate
medial wall of nasal cavity formed by
=nasal septum
•vomer and perpendicular plate of ethmoid bone
•anteriorly it completed by septal cartilage
nasal septum covered by
respiratory mucosa
air leaves the nose through
posterior nasal aperture, called the choana, where it enters the nasopharynx
superior, middle, and inferior conchae project from
the lateral wall of nasal cavity with superior, middle, and inferior meatuses (passages) lying below the conchae
4 paired paranasal sinuses are
air-filled cavities lined by respiratory mucosa that reduce the weight of the skull
paranasal sinuses open into
the roof or lateral wall of the nasal cavity
name the 4 paired paranasal sinuses
- frontal
- ethmoid
- maxillary
- sphenoid
sphenoid sinus drains into
sphenoethmoidal recess
ethmoid sinus drains into
superior and middle meatuses
frontal sinus drains into
middle meatus
maxillary sinus drains into
middle meatus
nasolacrimal duct drains into
inferior meatus
olfactory (CN I) innervation to nasal cavity
olfactory receptors (special sense of smell) through cribiform plate
ophthalmic (CN V1) innervation to nasal cavity
general afferents, anterior and posterior ethmoidal nerves
maxillary (CN V2) innervation to nasal cavity
general afferents, small nasal branches and nasopalatine nerve
blood supply to nasal cavity
- ophthalmic artery - anterior and posterior ethmoidal arteries
- maxillary artery - phenopalatine artery, septal branches, greater palatine
- facial artery - lateral nasal and septal branches, superior labial artery
nosebleed (epistaxis) often involves
- richly vascularized region of vestibule and anteroinferior aspect of nasal septum (kiesselbach’s area)
- usually result from trauma to septal branch of superior labial artery from facial artery
oral cavity proper includes
- palate (hard and soft)
- teeth
- gums
- tongue
- salivary glands
palatine tonsils are
paired collections of lymphoid tissue that lie between palatoglossal and palatopharyngeal folds or arches and “guard” entrance to oropharynx
palate forms the
- roof of oral cavity
* floor of nasal cavity
hard palate
- bony anteior 2/3 of palate
* formed by palatal process of maxilla and horizontal process of palatine bone
soft palate
- posterior 1/3 of palate, with muscles that move the soft palate
- closes off nasopharynx during swallowing
tongue
•strong muscular organ consisting of intrinsic skeletal muscles innervated by hypoglossal nerve (CN XII)
genioglossus
extrinsic muscle of tongue that depresses and protrudes it
hyoglossus and styloglossus
extrinsic muscles of tongue that retract the tongue during swallowing
palatoglossus muscle
- muscle of both tongue and palate, but grouped with palate muscles because it’s innervated by vagus nerve
- elevates the tongue
blood supply to tongue
lingual artery (from external carotid)
Mandibular innervation of tongue
- via lingual nerve
* provides general sensation to anterior 2/3
facial innervation of tongue
- via chorda tympani nerve, which joins lingual nerve
* provides taste on anterior 2/3
glossopharyngeal innervation of tongue
general sensation to posterior 1/3
vagus innervation of tongue
- via internal branch of superior laryngeal nerve
* general sensation and taste on base of tongue at the epiglottic region
hypoglossal innervation of tongue
•motor to intrinsic and extrinsic muscles (except palatoglossus muscle = vagus)
parotid salivary gland- type, innervation, and duct:
- serous gland
- innervated by CN IX parasympathetics via lesser petrosal nerve, synapse in otic ganglion, with postganglionics to gland in auriculotemporal nerve (branch of V3)
- secretes via parotid (Stensen’s) duct
submandibular salivary gland- type, innervation, and duct:
- seromucous gland
- innervated by CN VII parasympathetics via chorda tympani branch that joins lingual nerve (branch of V3) to synapse in submandibular ganglion
- secretes via submandibular (Wharton’s) duct
sublingual salivary gland- type, innervation, and duct:
- largely mucous
- innervated by CN VII parasympathetics coursing similar to those of submandibular gland
- secretes via small ducts in sublingual fold
pharynx
=throat
•fibromuscular tube that connects nasal and oral cavities with larynx and esophagus
•extends from base of skull to cricoid cartilage, where it is continuous with esophagus
nasopharynx lies
posterior to nasal cavity above soft palate
oropharynx
from the soft palate to the epiglottis; lies posterior to oral cavity
layngopharynx
- from the epiglottis to the inferior cricoid cartilage
* aka hypopharynx
muscles of pharynx
- superior, middle, and inferior pharyngeal constrictors
- participate in swallowing (deglutition)
- contract serially from superior to inferior to move a bolus of food down
blood supply to pharynx
- branches of thyrocervical trunk (subclavian artery)
- esp. ascending cervical artery and external carotid (principally it’s sup. thyroid, facial, ascending pharyngeal, and maxillary branches)
sensory innervation of nasopharynx
pharyngeal branch of CN V2
sensory innervation of oropharynx
CN IX
sensory innervation of laryngopharynx
CN X
Motor innervation of pharynx
- CN X
* except sylopharyngeus muscle (CN IX)
gag reflex
- sensation conveyed by afferent branches of CN IX
* soft palate is elevated by efferent action of CN X
If food or foreign object reach the vestibule of the larynx…
very powerful gag reflex would be elicited by vagus nerve to protect vocal fold and avoid aspiration into trachea
larynx
- valve that closes the lower respiratory tract and an instrument used to produce sounds (commonly called voicebox)
- 2 pairs of mucosal folds divide it into 3 regions: supraglottic, glottic, and infraglottic
supraglottic region of larynx
(vestibule)
above the vestibular folds (false vocal cords)
glottic region of larynx
(ventricle)
between vestibular folds and vocal folds (true vocal cords)
infraglottic region of larynx
(subglottic)
below the vocal folds
larynx composed of
cartilages connected by elastic ligaments whose movement affects the tension and position of vocal ligaments
vocal ligaments
covered by mucosa and called vocal cords or folds
laryngeal cartilages moved by
laryngeal muscles
only laryngeal muscles that abduct or open the vocal forlds are
posterior cricoarytenoids
rima glottidis
the opening between vocal folds
position of rima glottidis during quiet respiration
open (vocal cords abducted)
postion of rima glottidis during swallowing
closed (vocal cords adducted) and epliglottis swings down to close the laryngeal vestibule
postion of rima glottidis during phonation (speech)
closed
if vocal folds are closed in an emergent situation…
an incision must be made inferior to vocal folds, usually through cricothyroid membrane (cricothyrotomy) to establish an airway
vagus innervation to larynx via superior laryngeal branch
- motor to cricothyroid
* sensory to mucosa above vocal folds
vagus innervation to larynx via recurrent laryngeal branch
- motor to all muscles except cricothyroid
* sensory to mucosa below vocal folds
cricothyroid function
tightens vocal folds
