Course Title:
Anatomy, Embryology, Histology
Course Code:
113 ANA
Course Credits: 2 hours; 2 h theory, 2 h practical per week
Prerequisite: None
Course Coordinator: Name: Moutaz Kheirallah, E-mail:
m.kheirallah@mu.edu.sa
Course Objectives for Head and Neck Anatomy
At the end of this course the student should be able to:
1. Use the anatomical terminology to better understand the scientific literature and
engage in professional discourse.
2. Identify, locate and describe the surgical gross anatomy of the head and neck
relevant to the practice of dentistry and its specialists.
Teaching Methodology:
• Lectures
• Practical Sessions (The explanation is composing of anatomical models on-screen
3D interactive demonstration and video films).
•
Assessment Tools:
•
The following percentages (%) of the total grade will be assigned:
•
o Quizzes ……………………………..
•
o Weekly practical exam ….……...…. 20%
•
o Midterm practical examination …
•
o Midterm written examination …… . 15%
•
o Oral exam …………………………… 10%
•
o Final practical examination………
10%
•
o Final written examination………
30%
•
Total…………………………………… 100%
•
Recommended Books, Teaching Materials
•
•
Illustrated anatomy of the head and neck. Margaret J. Fehrenbach, Susan W. herring.
Saunders Elsevier 2007.
•
•
Color atlas of head and neck anatomy, ed. 3, London, 2003, Mosby Ltd.
•
•
Practical manual.
•
•
Education films for head and neck anatomy
5%
10%
• Regional anatomy
• Descriptive anatomy
• Comparative anatomy
• Radiographic anatomy
• Pathoanatomy
ANATOMICAL POSITION
In this Anatomical Position, the
body is assumed to be standing, the
feet together, the arms to the side,
and the head and eyes and palms of
the hands facing forwards. To ensure
consistency of description it is
important to keep the anatomical
position constantly in mind. This last
point is an important one, since in a
normal relaxed position of the body,
the thumb points anteriorly. In
anatomical parlance, the thumb is a
lateral structure, not an anterior one.
Here's the Anatomical Position as
shown by a skeleton.
ANATOMICAL PLANES OF THE BODY
• FRONTAL (or coronal)
separates the body into
Anterior and Posterior parts.
• MEDIAN (or midsagittal)
separates body into Right
and Left parts.
• HORIZONTAL separates the
body into Superior and
Inferior parts.
• SAGITTAL any plane parallel
to the median plane.
TERMS OF RELATION OR POSITION
superior (closer to the
inferior (closer to the feet)
head)
posterior (dorsal) closer to anterior (ventral) closer to the
the posterior surface of
anterior surface of the body
the body
medial (lying closer to the lateral (lying further away from
midline)
the midline)
proximal closer to the
distal further away from the
origin of a structure
origin of a structure
superficial
deep
median
intermediate
external
internal
supine
prone
cephalad
caudad
reference point -- horizontal plane
reference point -- frontal or coronal plane
reference point -- sagittal plane
reference point -- the origin of a structure
reference point -- surface of body or organ
reference point -- along the midsagittal or
median plane
between two other structures
refers to a hollow structure (external being
outside and internal being inside)
face or palm up when lying on back, face or
palm down when lying on anterior surface of
body
toward the head, toward the tail (feet)
TERMS OF MOVEMENT
flexion
extension
increasing angle with frontal plane
decreasing angle with frontal plane
abduction
protraction
elevation
adduction
retraction
depression
moving away from or toward the sagittal plane
moving forward or backward along a surface
raising or lowering a structure
medial rotation lateral rotation
pronation
circumduction
opposition
supination
movement around an axis of a bone
placing palm backward or forward (in anatomical position)
combined movements of flexion,
extension, abduction, adduction
medial and lateral rotation
circumscribe a cone
bringing tips of fingers and thumb together
as in picking something up
FREQUENTLY USED TERMS IN ANATOMY
Ala
a wing-like process
Alveolus
a deep narrow pit, such as a tooth-socket
Ampulla
used to describe the dilated part of a duct.
Ansa
a loop, usually referring to a nerve
Antrum
a cavity
Artery
a blood vessel which conducts blood from the heart
Bone
a special form of connective tissue in which calcium salts are deposited and which provides a framework, or skeleton, for the other tissues of
the body.
Canal
a tubular and relatively narrow channel, or tunnel, often through a bone. A canaliculus is a smaller canal.
Capsule
a fibrous or membranous envelope surrounding an organ. An articular capsule surrounds each synovial joint, being attached to the bones
just beyond the limits of the joint cavity.
Cartilage
a firm white tissue, from which most parts of the bony skeleton are formed and which persists to protect the surfaces of bones and joints.
Caruncle
a small fleshy eminence
Cavity
a hollow space (or potential space) within the body or its organs.
Cervix
means neck and is applied to the neck like portion of an organ (e.g. cervix of uterus)
Commissure
a band of fibers which join corresponding right and left parts of a structure across the median plane.
Corpus
means body
Cortex
outer part, or rind, or some organs as distinguished from their inner part, or core usually called a medulla.
Crest
a projecting ridge, especially one which on a bone
Disc
a flat round structure usually applied to plates of cartilage in joints.
Duct
a tube for the passage of fluid, especially secretions of glands. A ductule is a small duct.
JOINTS
Places where bones meet each other
(articulate). Where bones are connected by
fibrous tissue, the joint is known as a fibrous
joint (i.e. suture of skull). Where bones are
united by cartilaginous tissue, the joint is
known as a cartilaginous joint (i.e. symphysis
pubis). Where a space intervenes between
the articulating ends of bones, the joint is
called a synovial joint (i.e. most of the joints
of the body). In these joints, there is an
articular capsule the encloses the joint. This
capsule is lined by a synovial membrane
which secretes a lubricating fluid.
Labium
Lamina
lip
A thin plate of bone or cartilage or a thin layer of softer tissues. A stratum is also
used to denote a layer
Ligament a band of fibrous connective tissue by which bones are connected to each other.
Sometimes bands of connective tissue which support the viscera or the thorax or
abdomen are also known as ligaments.
Lobe
Meatus
Muscle
a part of an organ, often separated from the rest by a fissure. A lobule is a small
lobe
a passage or opening
these structures vary in shape and size, but always consist of masses of special
contractile cells which are under nervous control. It is usual to describe a muscle
as possessing an origin and insertion, in the sense that when the muscle
contracts, the insertion moves toward the origin. It is probably more useful to
regard a muscle as possessing attachments which are approximated when the
whole muscle contracts. The original of a muscle is sometimes called the head
and the contractile part the belly.
Nerves
The nerves of the body can be divided into twelve pairs of cranial
nerves, which arise from the brain and brainstem, 31-33 pairs of
spinal nerves which arise from the spinal cord in segmental series
(8 cervical, 12 thoracic, 5 lumbar, 5 sacral and 1-3 coccygeal). The
spinal nerves emerge from the intervertebral foramina which lie
along side of adjacent vertebrae. The pass laterally into the neck or
trunk.
A typical spinal nerve is formed by the union of a dorsal root, which
arises from the dorsal aspect of the spinal cord and a ventral root
which arises from the ventral aspect of the spinal cord. The dorsal
root consists of sensory (afferent) fibers and contains a swelling
called the dorsal root ganglion. This ganglion contains the cells
bodies of the sensory nerve fibers. The ventral root consists of
motor
(efferent)
nerve
fibers.
The nerve trunk formed by the mergence of the two roots splits
immediately into a dorsal ramus and a ventral ramus. The dorsal
ramus supplies the deeper muscles of the back the their overlying
skin. The ventral ramus supplies muscles and skin on the lateral
and ventral aspects of the body. The nerve supply of the limbs is
derived entirely from the ventral rami of the spinal nerves.
•
Apex- The tip of the root of a tooth
•
Arch - Describes the alignment of the upper or lower teeth
•
Bite - The way in which the upper and lower teeth meet when closing the mouth
•
Buccal - Refers to the cheek side of back tooth.
•
Cavities - A decay lesion or hole in a tooth
•
Cusps - The raised round parts on the chewing surface of the teeth
•
Dentin - Inner layer of tooth structure, immediately under the surface enamel
•
Diastema - Space between teeth
•
Enamel - The hard tissue covering the portion of tooth above the gum line. The hardest substance
in the body
•
Facial - Refers to the cheek (lip) side of a front (or back) tooth.
•
Frenum - Muscle fibers covered by a mucous membrane that attaches the cheek, lips and or
tongue to associated dental mucosa.
•
Gingiva - The soft tissue that covers the jawbone. Also referred to as the gums.
•
Interproximal - The area between two adjacent teeth.
•
Intracoronal - The area inside the crown of a tooth.
•
Intraoral - The inside of the mouth.
•
Labial - The area pertaining to or around the lip.
•
Lingual - The area pertaining to or around the tongue. Also referring to the tongue-side as
opposed to the cheek-side. See "Buccal, Facial.“
•
Occlusal surface - The chewing surface of the back teeth. Compare to incisal edge.
•
Palate - The hard and soft tissues forming the roof of the mouth.
•
Periapical - The area that surrounds the root tip of a tooth.
•
Pericoronitis - An inflammation of the gum tissue around the crown of a tooth.
•
Periodontal - Relating to the tissue and bone that supports the tooth (from peri, meaning
"around," and odont, "tooth").
•
Periradicular - The area which surrounds a portion of the root of the tooth.
•
Quadrant - The dental term for the division of the jaws into four parts. There are four quadrants in
the mouth. Two upper and two lower quadrants, both divided at the midline of the mouth.
•
Root - The part of the tooth below the crown, normally encased in the jawbone. It is made up of
dentin, includes the root canal, and is covered by cementum.
•
Root canal - The hollow part of the tooth's root. It runs from the tip of the root into the pulp.
• Socket - The hole in the jawbone into which the tooth fits.
• Systemic - Relating to the whole body.
• Temporomandibular joint (TMJ) - The connecting hinge
mechanism between the upper jaw and the base of the skull the jaw joint.
• Torus - A bony elevation or protuberance of normal bone. Usual
locations are the middle of the roof of the mouth and on the
tongue-side of the lower jaw bone.
REGIONS OF THE FACE
• Forehead: Extending from the eyebrows to the
hairline
• Temples: Anterior to the eyes
• Orbital: Eye area that is covered by the eyelids
• External nose
• Zygomatic (malar): Prominence of the cheek
• Mouth and lips
• Cheeks
THE LIPS
• The lips are also known as labia.
• The lips are outlined by the vermilion border.
• The labial commissure is the angle at the corner of the
mouth where the upper and lower lips join.
• The nasolabial sulcus is the groove extending upward
between each labial commissure and the ala of the
nose.
THE ORAL CAVITY
• The oral cavity is lined with mucous membrane tissue. The oral cavity consists
of two areas:
• The vestibule is the space between the teeth and the inner mucosal lining of the
lips and cheeks.
• The oral cavity proper is the space contained within the upper and lower dental
arches.
• Labial Frenula
• A frenum is a narrow band of tissue that connects two structures.
• The labial frenum passes from the midline of the maxillary or mandibular arch to
the midline of the inner surface of the lip.
• The buccal frenum passes from the oral mucosa near the maxillary or
mandibular first molars to the inner surface of the cheek.
THE GINGIVAE
• The gingivae, commonly referred to as the gums, are masticatory
mucosa that cover the alveolar processes of the jaws and
surround the necks of the teeth.
• Characteristics of Normal Gingivae
• Normal gingivae surround the tooth in collarlike fashion and are
self-cleansing.
• It is firm and resistant and tightly adapted to the tooth and bone.
• The surfaces of the attached gingivae and interdental papillae are
stippled and similar in appearance to the rind of an orange.
• The color of the surface varies according to the individual's
pigmentation.
UNATTACHED GINGIVA
• Unattached gingiva, which is also known as marginal gingiva or free gingiva,
is the border of the gingiva surrounding the teeth in collarlike fashion.
• It consists of the tissues from the top of the gingival margin to the base of the
gingival sulcus.
• The unattached gingiva is usually about 1 mm wide and forms the soft wall of
the gingival sulcus.
• Interdental gingiva is known as the gingival papilla.
• Gingival groove is a shallow groove that runs parallel to the margin of the
unattached gingiva and marks the beginning of the attached gingiva.
• Attached gingiva extends from the base of the sulcus to the mucogingival
junction.
THE ORAL CAVITY PROPER
• The oral cavity proper is the area inside of the dental arches. In
back of the last molar, there is a space that links the vestibule
and the oral cavity proper.
THE HARD PALATE
•
The hard palate separates the nasal cavity above from the oral cavity below.
•
The nasal surfaces are covered with respiratory mucosa, and the oral surfaces are covered with oral mucosa.
•
The mucosa of the hard palate is tightly bound to the underlying bone, and therefore submucosal injections
into the palatal area can be extremely painful.
•
Landmarks on the Hard Palate
•
Incisive papilla is a pear-shaped pad of tissue that covers the incisive foramen.
•
Palatal rugae are irregular ridges of masticatory mucosa extending laterally from the incisive papilla.
•
Palatine raphe runs posteriorly from the incisive papilla at the midline.
•
Palatal glands are numerous small glands that open onto the palatal mucosa as small pits.
•
The Soft Palate
•
The soft palate is the movable posterior third of the palate.
•
It has no bony skeleton and hangs like a limp curtain into the pharynx behind it.
•
It ends posteriorly as a free edge with a hanging projection called the uvula.
•
The soft palate is supported posteriorly by two arches (the fauces).
•
The anterior arch runs from the soft palate down to the lateral aspects of the tongue as the palatoglossal arch.
•
The posterior arch is the free posterior border of the soft palate and is called the palatopharyngeal arch.
•
The opening between the two arches is called the isthmus of fauces and contains the palatine tonsil.
THE TONGUE
• The tongue is an important organ and is responsible for a number of functions:
• •
Speech
• •
Manipulation and positioning of food
• •
Sense of taste
• •
Swallowing
• •
Cleansing of the oral cavity
• Parts and Surfaces of the Tongue
• Taste Buds
• The taste buds, which are the receptor cells for the sense of taste, are located on
the dorsum of the tongue.
• A substance must be mixed with liquid before it can stimulate the taste buds on the
tongue.
THE TEETH
• Teeth are either single or multirooted.
• Teeth sit in bony sockets, or alveoli, within the alveolar
process of the maxilla and mandible.
• In the mouth, a cuff of gingival tissue surrounds the
tooth.
• The portion of the tooth that is visible in the oral cavity
is called the crown.
MAJOR BONES OF THE SKULL

Frontal Bone

Inferior nasal concha

Parietal bone

Lacrimal bone

Occipital bone

Vomer

Temporal bone

Nasal

Maxilla
Palatine bone

Sphenoid bone


Ethmoid bone


Zygomatic bone
Mandible
LATERAL ASPECT OF THE
MANDIBLE:
•
BODY
•
RAMUS
•
INFERIOR BORDER
•
POSTERIOR BORDER
•
CORONOID PROCESS
•
HEAD OF CONDYLE
•
NECK OF CONDYLE
•
MANDIBULAR NOTCH
Other items of lateral skull:
•
temporomandibular joint
•
external auditory meatus
•
zygomatic arch
•
coronal suture
OCCIPITAL BONE
•
Single cranial bone located in the most posterior portion.
•
Articulate with the parietal, temporal sphenoid and with the first cervical vertebra.
•
Lateral and anterior to the foramen magnum are the paired occipital condyles, articulate with the
atlas.
•
Phayngeal tubercle: anterior to foramen magnum
•
Hypoglosssal canal: Opening anterior and lateral to to foramen magnum.
FRONTAL BONE
•
Single, forms the forehead and superior portion of the orbit.
•
Articulate with parietal, sphenoid, lacrimal, nasal, ethmoid, zygomatic and maxillae.
•
Contain frontal sinus.
•
The orbital plate creat the superior wall of the orbital roof.
•
Supraorbital ridges subjacent to the eyebrows.
•
Supraorbital notch located on the medial portion of the supraorbital ridge (artery and nerve travel from the orbit to the for ehead)
•
Between the supraorbital ridges is the glabella (smooth elevated area).
•
Frontal eminence.
•
Zygomatic process of the frontal bone.
•
Lacrimal fossa
•
Lacrimal gland.
PARIETAL BONE
•
Paired articulate with each
other at the sagittal suture.
•
Articulate with occipital, frontal,
temporal and sphenoid bones.
• Paired forms lateral wall of the
skull. Articulate with zygomatic,
parietel, occipital, asphenoid and
mandible. Each temporal is
composed of aquamous, tympanic
and petrous portions.
• On the inferior surface of the
zygomatic process we can see the
articular fossa, and anteriorly of it
there is articular eminence.
• The tempanic portion forms the
most of the external acoustic
meatus.
• Posterior to the meatus we can
see the mastoid process which is
composed of air cells.
• Inferior and medial to the meatus
there is the styloid process.
• The stylomastoid foramen carries
the facial nerve.
TEMPORAL BONE
• Single, is a midline bone, articulates with
frontal, parietel, ethmoid, temporal,
zygomatic, maxillary, palatine, vomer and
occipital.
• Has important foramena: ovale,
rotundom and spinosum, which carry
important nerves and blood vessels of
the head and neck.
• The body contains sphenoidal sinuses.
•
Anterior process is lesser wing which
comprises up the base of the orbital
apex.
• The posterolateral process is the greater
wing. Inferior to the greater wing is the
pterygoid process which is an area for
the attachment of some of mastication
muscles. Each greater wing is divided
into two smaler surfaces by the
infratemporal crest.
SPHENOID BONE
ETHMOID BONE
•
Single, contains ethmoidal sinuses.
•
Articulates with frontal, sphenoid,
lacrimal, and maxillary bones.