Head Factoids
Cranium
Neurocranium: bony covering of brain and meninges; calvaria is dome-like roof, cranial base is floor.
Made up of frontal, ethmoidal, sphenoidal, occipital, 2x temporal and 2x parietal bones
Viscerocranium: facial bones; mandible, ethmoid, vomer, 2x maxilla, 2x inf nasal conchae, 2x zygomatic,
2x palatine, 2x nasal, 2x lacrimal
NB. External occipital crest descends from ex occipital protuberance (inion), sup nuchal line extends
laterally from protuberance; hard palate formed by palatine processes of maxilla and horizontal plates of
palatine bones; post border of hard palate forms post nasal spine; choanae (post nasal apertures) are
separated from each other by the vomer (forms part of nasal septum); sphenoid is composed of greater and
lesser wings and pterygoid processes (consisting of lat and med pterygoid plates); cranium articulates with
vertebral column via occipital condyles; internal cranial base split into ant (highest), middle and post
(lowest) cranial fossa; bones consist of in and ex tables of compact bone separated by diploe (cancellous
bone)
Sella turcica is saddle-shaped area on top of sphenoid bounded by ant and post clinoid processes; made up
of tuberculum sellae (post to prechiasmiatic sulcus), hypophysial fossa (seat of saddle post to tuberculum
sellae), dorsum sellae (protrudes superiorly to form post clinoid processes)
Ant cranial fossa: frontal, ethmoid and body and lesser wings of sphenoid
Middle cranial fossa: separated from ant by sphenoidal crests of lesser wing and limbus; separated from
post by sup border of petrous temporal bone; formed by greater wings of sphenoid, squamous and petrous
temporal bone
Post cranial fossa: ant boundary is dorsum sellae of sphenoid; temporal bone forms walls; in occipital
protuberance marks where confluence of dural venous sinuses occur
Pneumatised bones: contain air spaces: frontal, temporal, sphenoidal, ethmoid
Orbitomeatal plane: lower margin orbit and upper margin acoustic meatus on same plane
Sutures: fibrous interlocking
Metopic suture is remnant of frontal suture
Synchondroses: hyaline cartilage
Foramens:
Foramen cecum
Cribiform foramina
Ant and post ethmoidal foramina
Optic canals
Superior orbital fissure
Foramen rotundum
Foramen ovale
Foramen spinosum
Foramen lacerum
Groove of greater petrosal nerve
Foramen magnum
Jugular foramen
Hypoglossal canal
Condylar canal
Mastoid foramen
In acoustic meatus
Supraorbital
Infraorbital
Mental
Zygomaticofacial
Palatine
Stylomastoid
Landmarks:
ANT CRANIAL FOSSA
Nasal emissary vein (only during fetal development)
Olfactory nerve (I) through sieve-like cribiform plate of ethmoid on either side of crista galli
Ant and post ethmoidal vessels
MIDDLE CRANIAL FOSSA
Optic nerve (II) and ophthalmic arteries
CN III, IV, VI; ophthalmic nerve (V1); ophthalmic veins
Between greater and lesser wings of sphenoid; communicates with orbit
Maxillary nerve (V2)
Mandibular nerve (V3) and accessory meningeal artery
Opens into infratemporal fossa
Middle meningeal artery and vein; meningeal branch of V3
In carotid artery
Closed by cartilage plate in life
Greater petrosal nerve, petrosal branch of middle meningeal artery
POSTERIOR CRANIAL FOSSA
Medulla, meninge, spinal cord, vertebral arteries, ant and post spinal arteries, dural veins, spinal accessory nerve (XI)
IJV, IX, X, XI, inf petrosal and sigmoid sinuses, meningeal branches of ascending pharyngeal and occipital arteries
Large opening between occipital and petrous part of temporal bone
Hypoglossal nerve (XII)
Emissary vein
Mastoid emissary vein from sigmoid sinus, meningeal branch of occipital artery
Facial (VII) and vestibulocochlear (VIII) nerves, labyrinthine artery
OTHERS
Supraorbital nerve and vessels
Infraorbital nerve and vessels
Mental nerve and vessels
Facial nerve (VII), stylomastoid artery
Pterion: greater wing of sphenoid, squamous temporal, frontal and parietal; overlies course of ant division
of middle meningeal artery
Lambda; junction of lambod and sagittal sutures
Bregma: junction of coronal and sagittal sutures
Asterion: junction of parietomastoid, occipitomastoid and lamboid sutures
Nasion: junction of frontonasal and internasal sutures
Scalp
1) Skin: many sweat and sebaceous glands and hair follicles
2) Connective tissue: thick, dense, richly vascular, many cutaneous nerves
3) Epicranial aponeurosis: attachment for muscle bellies (occipitofrontalis, temporoparietalis, sup
auricular – all innervated by facial nerve (VII)
4) Loose areolar tissue: allows free movement of above 3 layers; pus and blood can spread easily in
this
5) Pericranium: external periosteum of neurocranium
Cranial Meninges
Extradural / epidural space: space pathologically; NOT continuous with spinal epidural space
1-Dura mater: tough, thick, fibrous; external
periosteal layer (adherent to int table of skull,
continuous with periosteum on ex surface of skull),
internal meningeal layer (continuous with spinal dura
mater at foramen magnum); internal layer adherent to
external except where infoldings occur
Infoldings:
Cerebral falx – in longitudinal cerebral fissure,
separates cerebral hemispheres, from frontal crest of
frontal bone and crista galli of ethmoid  internal
occipital protuberance
Cerebellar tentorium – separates cerebellum and
cerebrum; attaches to clinoid process of sphenoid,
petrous temporal bone, occipital bone and parietal
bone; divides brain into supratentorial and
infratentorial compartments; brainstem passes through
tentorial notch
Cerebellar falx- attached to internal occipital crest,
separates cerebellar hemispheres
Sellar diaphragm – between clinoid processes, roof
over hypophysial fossa containing pituitary gland
Subdural space: pathological space
2-Arachnoid mater: thin, intermediate
Subarachnoid space: contains CSF, formed by choroid plexuses
3-Pia mater: delicate, vasculated; Arachnoid and pia are continuous, make up leptomeninx
Dural Venous Sinuses
Spaces between periosteal and meningeal layers of
dura
Confluence of sinuses: where sup, straight, occipital
and transverse meet
Arachnoid granulations: collections of arachnoid villa
which protrude through meningeal layer into sinuses
Sup sagittal sinus: from crista galli to int occipital
protuberance; receives sup cerebral veins and lateral
venous lacunae
Inf: runs in border of cerebral falx
Straight: formed by union of inf CS and great cerebral
vein; runs where cerebral falx attaches to cerebellar
tentorium
Transverse x2: pass laterally along postlat margins of
cerebellar tentorium; become sigmoid at post aspect of
petrous temporal bones; form groove in occipital
bones; DRAINS confluence
Sigmoid x2: form grooves in temporal and occipital
bones; continues as IJV after transversing jugular
foramen
Occipital: in border of cerebellar falx; communicates with internal vertebral venous plexus
Sup petrosal: run in cerebellar tentorium; ends in transverse sinus
Inf petrosal: runs in groove between petrous part of temporal bone and basilar part of occipital
bone; ends in IJV
Basilar plexus: connects inf petrosal sinuses
Cavernous sinus: on either side of sella turcica on upper surface of sphenoid; extends from sup
orbital fissure to apex of petrous part of temporal bone; receives sup and inf ophthalmic veins,
sup middle cerebral vein and sphenoparietal sinus; drains through sup and inf petrosal sinuses
and emissary veins to pterygoid plexus; contains int carotid artery, abducent nerve (VI),
oculomotor (III), trochlear (IV), trigeminal (V)
Emissary veins: connect venous sinuses with external veins; valveless; usually flows away
from brain
Frontal emissary vein passes through foramen cecum, connects SSS with veins of frontal sinus and nasal
cavities; parietal emissary passes through parietal foramen connecting SSS with veins of scalp; mastoid
emissary passes through mastoid foramen connecting SS with occipital/post auricular vein; posterior
condylar emissary passes through condylar canal connecting SS with suboccipital plexus
Other Vasculature
Middle meningeal artery: from maxillary; enters floor of middle cranial fossa through foramen spinosum
 runs laterally  runs anteriorly on greater wing of sphenoid  ant branch runs pterion then around
vertex; post branch over post cranium
Middle meningeal vein: drains into pterygoid plexus
Brain
Cerebrum: occipital lobe separated from others by parietooccipital sulcus
Diencephalon: epithalamus, dorsal thalamus and hypothalamus
Midbrain: lies at junction of middle and post cranial fossae
Pons: in ant part of post cranial fossa
Medulla oblongata: in post cranial fossa
Cerebellum: 2 lateral hemispheres united by vermis
Ventricles
Blood Supply
Lateral ventricles x2  interventricular foramen x2  3rd
ventricle (between R+L ½’s of diencephalons  cerebral
aqueduct  4th ventricle (on post pons and medulla) 
central canal of spinal cord, enters subarachnoid space
through median aperture or lat apertures x2 (ONLY means
by which CSF enters SAS), enters interpeduncular and
quadrigeminal cisterns then superiorly through medial and
suplat surfaces.
CSF secreted by choroidal epithelial cells in choroids
plexuses in roof of 3rd and 4th V’s, and inf horns of lat
ventricles, which are fringes of pia mater. Absorbed through
arachnoid granulations into venous system.
NB. Monro-Kellie doctrine – skull is rigid block, inc
contents cause inc ICp.
Cisterns separate arachnoid and pia: cerebellomedullary
(post and lat, gains CSF from 4th ventricle), pontocerebellar
(continuous with spinal SAS), interpeduncular (basal,
between cerebral peduncles of midbrain), chiasmatic (antinf
to optic chiasm), quadrigeminal (between corpus callosum
and cerebellum, contains great cerebral vein), ambient (lat to
midbrain)
In carotid artery (ant circulation of brain): arises from common carotid  to cranial base  enters cranial
cavity through carotid canals in petrous temporal bone  go ant through cavernous sinus (with III, IV, VI
above it, optic nerve passes ant to it) in carotid groove in side of sphenoid  split into ant and middle
cerebral arteries
Vertebral artery (post circulation of brain): 1st branch of 1st part subclavian artery  L larger than R 
cervical parts ascend through transverse foramina of C1-6, atlantic parts perforate dura and arachnoid and
pass through foramen magnum  intracranial parts unite at pons to form basilar artery  ascends to clivus
through pontocerebellar cistern to sup border pons  divides into post cerebral arteries
Cerebral arteries: ant (medial + sup surfaces, frontal pole), middle (lat surface and temporal pole), post (inf
surface, occipital bone)
Venous drainage: valveless; sup cerebral  sup sagittal sinus, inf and sup middle cerebral  straight,
transverse and sup petrosal sinuses, great cerebral  forms straight sinus, sup and inf cerebellar 
transverse and sigmoid
Facial Muscles
Muscles develop from mesoderm in 2nd pharyngeal arches
Occipitofrontalis: occipital (bony attachments, lat 2/3 sup
nuchal line  epicranial aponeurosis) and frontal (no bony
attachments, epicranial aponeurosis  skin and subcut tissue)
bellies; surprised
Orbicularis oris: med maxilla and mandible, perioral skin,
angle of mouth  m membrane of lips
Buccinator: mandible, alveolar processes, pterygomandibular
raphe (thickening of buccopharyngeal fascia)  angle of
mouth, orbicularis oris; deep muscles; blow out cheeks
Orbicularis oculi: med orbital margin, med palpebral ligament,
lacrimal bone  skin of margin of orbit, sup and inf tarsal
plate; palpebral (gently closes eyelids), lacrimal (pulls lids
medially), and orbital part (tightly closes eyelids)
Corrugator supercilli: med end superciliary arch  skin sup to
middle of supraorbital margin and superciliary arch; confused
Procerus: fascia aponeurosis over nasal bone and lat nasal
cartilage  skin of inf forehead
Levator labii superioris: infraorbital margin  skin of upper
lip
Zygomaticus minor: ant aspect zygomatic bone  skin of
upper lip; curl lip
Zygomaticus major: lat aspect zygomatic bone  angle of mouth (modiolus); curl lip
Risorius: parotid fascia and buccal skin  modiolus
Depressor angularis oris: antlat base of mandible  modiolus
Depressor labii inferioris: platysma and antlat body of mandible  skin of lower lip
Mentalis: body of mandible  skin of chin; big sad bottom lip
Nerves of Face
Cutaneous: from cervical plexus
Great auricular nerve: inf aspect auricle, parotid region of face;
Trigeminal: from lat surface of pons; sensory to face, motor to
muscles of mastication (massester, temporal, medial + lateral
pterygoids
Ophthalmic: sensory; enters orbit through sup orbital fissure 
trifurcates into frontal, nasociliary and lacrimal
 frontal runs in roof of orbit  splits into supraorbital and
supratrochlear nerves  forehead and scalp
 nasociliary divides in orbit into post ethmoidal, ant
ethmoidal (gives off ex nasal nerve) and intfatrochlear nerves
 lacrimal is sensory and secretomotor to lacrimal glands
Maxillary: sensory; leaves cranium through foramen rotundum
in base of greater wing of sphenoid  enters pterygopalatine
fossa  enters orbit through inf orbital fissure where it
becomes inf orbital nerve
 zygotamic runs in lat wall of orbit  gives off
zygomaticofacial and zygomaticotemporal (secretomotor to
lacrimal) nerves, sensation to lat cheek and temple
 infraorbital  palatine branches, branches to mucosa of
maxillary sinus, to post teeth (via sup alveolar nerves) 
passes through infraorbital foramen
 pterygopalatine nerves – suspend pterygopalatine ganglion in
fossa; sensory to nose, palate, tonsil, gingivae
Mandibular: union of sensory and motor root in foramen ovale in
greater wing of sphenoid  divides into auricotemporal (to parotid
gland), buccal and mental nerves
Innervation of scalp post to auricles is from spinal cutaneous nerves
(greater auricular, lesser, greater and third occipital nerves). Ant to
auricles from trigeminal (supratrochlear, supraorbital,
zygomaticotemporal, auriculotemporal)
Motor:
Facial: motor root to facial expression muscles – root around
temporal bone  emerges through stylomastoid foramen
between mastoid and styloid processes  gives off post
auricular nerve (passes postsup to auricle of ear, supplies
auricularis post and occipital belly of occipitofrontalis  rest
of facial nerve runs forward through parotid gland  branches.
Temporal: from sup aspect parotid gland  crosses zygotmatic
arch  auricularis sup and ant, frontal belly occipitofrontalis,
sup orbicularis oculi
Zygomatic: inf orbicularis oculi and facial muscles inf to orbit
Buccal: passes external to buccinator  upper orbicularis oris
and inf levator labii superioris
Marginal: to risorius and muscles of lower lip and chin;
emerges from inf border of parotid, and crosses inf border of
mandible
Cervical: passes inf from inf border of parotid gland then post
to mandible
Vasculature of Face
Face and scalp mostly from ex carotid artery
Facial: from ex carotid; passes to inf border of mandible
deep to platysma  crosses mandible, buccinator and
maxilla  to med canthus of eye; deep to zygomaticus
major and levator labii superioris; branches are sup and inf
labial, lat nasal and angular arteries
Superficial temporal: terminal branch of ex carotid;
emerges between TMJ and auricle  temporal fossa 
ends by dividing into frontal and parietal branches
Transverse facial: from sup temporal; superficial to
masseter; supplies parotid gland, masseter and skin of face
Maxillary: split into 3 parts relative to lat pterygoid
1st (mandibular): prox to lat pterygoid, runs deep to
condylar process of mandible, but lat to stylomandibular
ligament
 deep auricular (to ex acoustic meatus, ex TM, TMJ
 ant tympanic (in TM)
 middle meningeal (enters cranial cavity via foramen
spinosum; to periosteium, bone, red BM, dura mater,
trigeminal ganglion, gacial nerve, geniculate ganglion,
tympanic cavity, tensor tympani)
 accessory meningeal (enters cranial cavity via foramen
ovale; to infratemporal fossa, sphenoid bone, mandibular
nerve, otic ganglion
 inf alveolar (via mandibular foramen; mandible, chin,
myloyoid
2nd (pterygoid): at lat pterygoid muscle, medial to temporal muscle
 masseteric (TMJ and masseter)
 deep temporal (deep to temporal muscle, to muscle)
 pterygoid (to pterygoid)
 buccal (to buccal fat pad, buccinator, buccal mucosa)
3rd (pterygopalatine): distal to lat pterygoid, passes through pterygomaxillary fissure to pterygopalatine
fossa, lies ant to pterygopalatine ganglion
 post sup alveolar (maxillary molar and premolar teeth)
 infraorbital (traverses infraorbital foramen; to IO and IR, lacrimal sac, maxillary canines and incisors,
maxillary sinus, skin of face)
 pterygoid canal (mucosa of upper pharynx, pharyngotympanic tube, tympanic cavity)
 pharyngeal (nasopharynx, sphenoidal air sinus)
 descending palatine (hard and soft palate)
 sphenopalatine (nasal cavity, sinuses, anterior palate)
Scalp supplied by occipital, post auricular, superficial temporal arteries from ex carotid; in carotid 
Supraorbital and supratrochlear are branches of ophthalmic artery
Valveless
Deep facial vein: drains into pterygoid plexus deeply
Facial vein: joins by ant communicating branch of
retromandibular vein  into IJV
Sup ophthalmic: drains into cavernous sinus
Retromandibular: formed by joining of sup temporal and
maxillary; runs superficial to ex carotid and deep to facial
nerve; ant branch joins with facial, post branch joins post
auricular to form EJV
Scalp drained by supraorbital, supratrochlear, superficial
temporal and post auricular, occipital, deep temporal
Lymph
From scalp, face and neck drains into superficial ring of LN’s
(submental, submandibular, parotid, mastoid, occipital)  deep
cervical LN’s (mainly located along IJV)  jugular lymphatic
trunk to join thoracic duct or BC vein
Lat face/scalp  superficial parotid LN
Upper lip + lat lower lip  submandibular LN
Chin and central lower lip  submental LN
Parotid Gland
Enclosed in tough fibrous parotid sheath, from investing layer of deep cervical fascia; wedged
between ramus of mandible and mastoid process; apex at angle of mandible, base related to
zygomatic arch; duct passes anteriorly from ant edge  turns medially at ant border of masseter 
pierces buccinator  enters mouth at 2nd maxillary molar
From sup to deep in gland: parotid plexus of facial nerve, retromandibular vein, ex carotid artery
Gland SUPPLIED by greater auricular (C2-3, supplies sheath), auriculotemporal (from trigeminal,
secretory)
Orbits
Roof: orbital frontal, lesser wing sphenoid
Medial: ethmoidal, lacrimal, frontal, sphenoids
Inf: maxilla, zygomatic, palatine; split from lat by inf orbital fissure
Apex: at optic canal in lesser wing of sphenoid, med to sup orbital fissure
Palpebral conjunctiva is continuous with bulbar conjunctiva (adherent to
periphery of cornea); deep recesses at sup and inf conjunctival fornices; eyelids
strengthened by tense band of connective tissue (sup and inf tarsi), orbicularis
oculi is superficial to this; tarsal gland lubricate eyelashes and lids, ciliary
glands are assoc with eyelashes; med and lat palpebral commissures define
angles of eye at med and lat canthi; medial and lat palpebral ligament connects
tarsi to med margin of orbit, orbicularis oculi inserts onto med one; orbital
septum extends from tarsi to margins of orbit
Lacrimal glands: secrete lacrimal fluid  lacrimal duct  in lat sup
conjunctival fornix  conjuctival sac  lacrimal canaliculi at lacrimal
punctum on lacrimal papilla near med angle eye  lacrimal sac 
nasolacrimal duct  inf nasal meatus; fluid production stimulated by paraS
from facial (VII) and maxillary (V)
3 layers:
Fibrous: sclera and cornea (sensory from ophthalmic V);
provides attachment for muscles of eye
Vascular: choroid, ciliary body, iris; vascular lamina externally,
capillary lamina of choroid deeper; ciliary body attaches
choroid to iris; ciliary processes are folds on internal surface of
ciliary body, secrete aqueous humour; post chamber is space
between iris and ciliary body; sphincter pupillae closes pupil,
dilator pupillae opens pupil
Inner: retina; consists of neural (light detection) and pigment
cell (vision) layers; optic disc contains no photoreceptors and is
insensitive to light; macula lutea is lateral to optic disc, fovea
centralis is central depression is macula lutea; optic part
terminates at ora serrata, post to ciliary body; supplied by
central artery of retina (from ophthalmic) and central vein of
retina
Capsule of lens is anchored by zonular fibres to ciliary body,
encircled by ciliary processes (contraction  fat lens)
Aqueous humour drains into scleral venous sinus at
iridiocorneal angle  removed by limbal plexus  drain into
vorticose and ant ciliary veins
2: sup rectus 3: inf rectus 4: med rectus 5: lat rectus 6: sup oblique
8: inf oblique
7: trochlea 9: levator palpebra superioris 10: sup tarsus 11: sclera
12: optic nerve
Extraocular:
LPS: from lesser wing of sphenoid  sup tarsus and skin; oculomotor
(III); deep lamina includes sup tarsal muscle
Recti muscles: arise from common tendinous ring surrounding optic
canal
SR: common tendinous ring  sclera; oculomotor (III), look up and
in; muscular sheath fused with LPS so when look up eyelid opens
IR: common tendinous ring  sclera; oculomotor (III), look down
and in
LR: common tendinous ring  sclera; abducent (VI); look out
MR: common tendinous ring  sclera; oculomotor (III); look in
SO: body of sphenoid  through fibrous ring of trochlea  sclera deep to SR; trochlear (IV); look down
and out
IO: ant floor of orbit  sclera deep to LR; oculomotor (III); look up and out
NB: medial movement of sup pole is intorsion, lat movement of sup pole is extorsion; triangular expansions
from LR and MR attach to lacrimal and zygomatic bones forming check ligaments, fuse with fascia of IO
and IR to form suspensory ligament of eyeball; III, IV, VI enter through sup orbital fissure
Nerves:
Ciliary ganglion comes from V1 – receive branches from communicating branch of nasociliary nerve (V1),
paraS/oculomotor root of ciliary ganglion (III), sym root of ciliary ganglion (int cervical plexus)
 short ciliary nerve: from V1, paraS and sym fibres to ciliary body and iris
 long ciliary nerve: from V1, sym fibres to dilator pupillae
Blood supply:
In carotid  ophthalmic artery
 central artery of retina (runs in dural sheath of optic nerve, then within optic
nerve, emerges in optic disc)
 supraorbital (passes through supraorbital foramen to scalp and forehead0
 supratrochlear
 lacrimal (along sup border of LR to lacrimal gland, conjunctiva, eyelids)
 dorsal nasal (along dorsum of nose)
 post ciliary arteries (supply choroid (short) and ciliary body and iris (long))
 post ethmoidal (ethmoid)
 ant ethmoidal (also supplies frontal sinus, nasal cavity, dorsum nose)
 ant ciliary (network in iris and ciliary body)
Ex carotid  maxillary  infraorbital artery
Venous drainage through sup and inf ophthalmic veins (pass through sup orbital
fissure  cavernous sinus), central retinal vein goes straight into cavernous sinus
Temporal Region
Temporal fossa: post and sup by temporal lines, ant by frontal and zygomatic bones, lat by zygomatic arch,
inf by infratemporal crest, floor by pterion (frontal, parietal, temporal, greater wing of sphenoid), filled by
temporal muscle covered by temporal fascia (attached to sup temporal line, zygomatic arch)
Infratemporal fossa: lateral is ramus of mandible, medial is lateral pterygoid plate, ant is post aspect of
maxilla, post is tympanic plate and mastoid and styloid processes, sup is inf surface of greater wing of
sphenoid, inf is med pterygoid muscle attaching to mandible. Contains:
Inf temporal muscle, lat and med pterygoid muscles
Maxillary artery: from ex carotid, arises post to neck of mandible
Pterygoid venous plexus: between temporal and pterygoid muscles; anastomosis with facial vein via deep
facial vein, cavernous sinus via emissary vein
Mandibular nerve: descends through foramen ovale; divides into inf alveolar, auriculotemporal, lingual,
buccal nerves in fossa; supplies muscles of mastication (except buccinator)
Otic ganglion: inf to foramen ovale, med to V3, post to med pterygoid muscle
TMJ
Hinge
Cndyle of mandible, articular tubercle of
temporal bone, mandibular fossa
Joint capsule is loose
Has sup and inf synovial membranes relative to articular disc; temporomandibular ligament prevents post
dislocation; stylomandibular ligament is thickening of capsule of parotid (styloid process to angle);
sphenomandibular ligament (spine of sphenoid to lingula of mandible) bears weight
Movement produced by muscles of mastication – temporal, masseter, med and lat pterygoids – all
innervated by V3
Temporal: from temporal fossa  tip of coronoid process and ant border of ramus
Masseter: from inf border of maxillary process of zygomatic bone and zygomatic arch  angle and lat
surface ramus
Lat pterygoid: 2 heads from infratemporal surface of greater wing of sphenoid, and lat surface lat pterygoid
plate  joint capsule and articular disc, condyloid process
Med pterygoid: 2 heads from med surface lat pterygoid plate and pyramidal process of palatine bone and
tuberosity of maxilla  med surface ramus of mandible
Suprahyoids: digastric, stylohyoid, mylohyoid, geniohyloid
Infrahyoids: omohyoid, sternohyoid, sternothyoid, thyrohyoid
Close mouth: temporal, masseter, medial pterygoid
Open mouth: lat pterygoid, and supra and infrahyoids
Protrude chin: lat and med pterygoid, masseter
Retrude chin: temporal and masseter
Lateral: temporal of same side, pterygoids of opposite side
Oral Cavity
Oral vestibule: slit-like space between teeth and buccal gingival inc lips
Oral cavity proper: between upper and lower dental arches, communicates with oropharynx
Lips: contain orbicularis oris and sup and inf labial muscles; labial frenula on inner surface in midline;
blood from sup and inf labial arteries (from facial, infraorbital and mental); sup lip supplied by infraorbital
nerve, lower by mental nerve
Cheeks: prominence occurs at junction of zygomatic and buccal regions; buccinators and buccal fat pads;
supplied by buccal branches of maxillary artery and mandibular nerve
Gingivae: composed of fibrous tissue covered with mm
Teeth: deciduous (20) then permanent (32); 2x incisors, 1x canine, 2x premolars, 3x molars; vestibular
inward, lingual outward; crown projects from gum, neck between crown and root, root held in socket by
peridontium; made of dentin, covered by enamel at crown and cement at root; root canal transmits nerves
and vessels to pulp cavity through apical foramen; tooth sockets are in alveolar proceses, separated by
intraalveolar septa; roots of teeth and bone of alveolus form dento-alveolar syndesmosis, peridontium
extends between cement of root and periosteum of alveolus; supplied by sup and inf alveolar branches of
maxillary artery; lymph to submandibular LN’s; sup (V2) and inf (V3) alveolar nerves form dental plexuses
Palate:
Hard (ant 2/3 have bony skeleton formed by palatine processes of maxillae and horizontal plates of palatine
bones; nasopalatine nerves pass from nose though incisive canals into incisive fossa behind incisors in
midline, ant to fossa is elevation called incisive papilla; greater palatine foramen opens medial to 3rd molar,
contains greater palatine vessels and nerve (branch of V2); lesser palatine foramen is post to greater in
palatine bone, contains lesser palatine vessels and nerve (branch of V2))
Soft (post 1/3, palatine aponeurosis from tensor veli palatine muscle attaches to post aspect of hard palate;
other muscles are levator veli palatine, palatoglossus, palatopharyngeus, musculus uvulae; conical uvula
hangs from it; joined by palatoglossal and palatopharyngeal arches to tongue and pharynx (these are the
pillars of fauces, glossal anterior, pharyngeal posterior); palatine tonsils found on either side of oropharynx,
in tonsillar fossa between 2 arches); palatine glands are found deep to muscosa; palatine raphe is line
passing in midline
Venous drainage via pterygoid plexus; soft palate also supplied by nasopalatine nerve (V2); muscles are
supplied by pharyngeal plexus, except tensor veli palatine supplied by V2
Tongue: root rests on floor of mouth = post 1/3; body = ant 2/3; dorsum has v-shaped terminal
sulcus pointing posteriorly to foramen cecum, divides tongue into ant and post parts; vallate
papillae (ant to sulcus in v-shaped row), filiform papillae (sensitive to touch, ant tongue),
fungiform papillae (at apex), foliate (at margins); has midline groove; post tongue has underlying
lymphoid nodules (make up lingual tonsil); deep lingual vein visible on either side of frenulum
along with sublingual caruncle (opening of submandibular salivary gland); muscles separated by
lingual septum
Extrinsic muscles: alter position; genioglossus (sup mental spine of mandible  dorsum of
tongue), hyloglossus (body and greater horn of hyoid  inflat tongue), styloglossus (ant distal
styloid process, stylohyoid lig  postlat tongue), palatoglossus (palatine aponeurosis of soft
palate  postlat tongue)
Intrinsic muscles: alter shape; sup + inf longitudinal, transverse, vertical; confined to tongue with
no attachment to bone
Innervated by motor: hypoglossal (XII) (except palatoglossus, from pharyngeal plexus); sensory:
lingual (V3) ant 2/3, post by lingual branch of glossopharyngeal (IX); taste: chordae tympanii
nerve (VII) ant 2/3, post by lingual branch of glossopharyngeal (IX); small area just ant to
epiglottis supplied by int laryngeal nerve (X); sensory fibre carry paraS nerves to glands of
tongue
Sweetness @ apex, saltiness lat, sour and bitter post
Artery: lingual (from ex carotid, dorsal to post, deep to ant, passes deep to hyoglossus, dorsal communicate,
deep don’t 2y to septum)
Veins: dorsal and deep lingual veins  sublingual vein
Lymph: post 1/3  sup deep cervical LN; med ant 2/3  inf deep cervical LN; lat ant 2/3 
submandibular LN; apec and frenulum  submental LN
Salivary glands: submandibular (along body of mandible partly deep to mylohyoid; duct passes medially,
lingual nerve loops under it, opens into sublingual papilla @ base of frenulum; supplied by submental
arteries, paraS from lingualr nerve via shorda tympani nerve, sym from sup cervical ganglion; lymph to
deep cervical LN); sublingual (in floor between genioglossus and mandible, glands unite around lingual
frenulum; numerous ducts open among sublingual folds; blood from sublingual and submental arteries from
lingual and facial arteries; same nerves as submandibular); parotid see above
Pterygopalatine Fossa
Between pterygoid process of sphenoid and post aspect of maxilla, med is perpendicular plate of palatine
bone, roof is greater wing of sphenoid, floor is pyramidal process of palatine bone; communicates with
infratemporal fossa through pterygomaxillary fissure, with nasal cavity via sphenopalatine foramen, with
orbit via inf orbital fissure, with middle cranial fossa via foramen rotundum and pterygoid canal; contains
terminal part of maxillary artery, maxillary nerve
Nose
Supporting skeleton made by bone (nasal bones, frontal processes of maxilla, nasal part of frontal, bony
parts of nasal septum) and hyaline cartilage (2 lat cartilages, 2 alar cartilages, 1 septal cartilage); septum
partly bony and cartilage (perpendicular plate of ethmoid, descends from cribiform plate; vomer, postinf
part; septal cartilage, articulates with bone); roof = frontal, nasal, ethmoid, sphenoids bones; floor =
palatine process of maxilla, horizontal plates of palatine bone; medial = nasal septum; lateral = nasal
conchae; nasal vestibule is lined with skin, otherwise lines with mucosa; inf 2/3 of mucosa is respiratory,
upper 1/3 is olfactory; conchae separated by meatus which lie inf to related conchae; sup meatus received
post ethmoidal sinus, middle meatus has ethmoidal infundibulum where receives frontal sinus via
frontonasal duct; inf meatus receives nasolacrimal duct; postsup is sphenoethmoidal recess (receives
opening of sphenoid sinus), medially is common nasal meatus
Artery:
Med/lat wall: ophthalmic  ant and post ethmoidal
Maxillary  sphenopalatine (through spenopalatine foramen), greater palatine (through
incisive canal)
Facial  septal branch of sup labial
Submucosal venous plecus drains into sphenopalatine, facial and ophthalmic veins; ex nose drains into
facial vein via angular and lat nasal veins
Postinf = maxillary via nasopalatine to septum, via greater palatine nerve to lat wall; antsup = ophthalmic
nerve via ant and post ethmoidal nerves; ext nose = V1 (via infratrochlear and ex nasal branch of ant
ethmoidal nerve), alae by nasal branch of infraorbital nerve (V2)
Olfactory nerves pass through cribiform plate  olfactory bulb
Monday thur 7.30 – 9.30
30
cashmere club
bottom of columbo st
on l
past beckenham library