Structures and functions

of the
head and neck
Chan Lap-Ki
School of Biomedical Sciences
[email protected]
39179077
At the end of the lecture, the students are
expected to be able to
• describe the basic anatomy of the skull.
• explain the origins of some of the names of the
bones of the skull.
• describe the major compartments of the head.
• describe the fasciae and compartments of the
neck.
• describe the triangles of the neck and their content.
The bony framework
Cervical spine
-has 7 cervical vertebrae
-gently convex forward (lordotic)
-sits on top of T1
-supports skull
Skull
Calvaria = surrounds the brain
(also called neurocranium)

Cranium = calvaria + upper half of face

Skull = cranium + mandible

Face
Superior veiw
-frontal bone
-parietal bone
-the ‘wall’
-occipital bone Frontal bone

-‘occiput’: the back of the skull

Parietal bone

Occipital bone
Superior view
-coronal suture
-sagittal suture
-parietal foramen (emissary vein)
-lambdoid suture; Coronal suture
-from Greek letter lambda

Sagittal suture

Lambdoid suture
Superior view
-bregma:
-‘bregma’: top of the head
-anterior fontanelle
-lambda Bregma
-posterior fontanelle

Lambda
Lateral view
-temporal bone
-squamous part
External
-mastoid process acoustic
meatus
-zygomatic process
Mastoid
-styloid process process
Styloid
-external acoustic meatus process

Zygomatic process
Lateral view
-zygomatic bone
-temporal process
-to temporal bone
-frontal process
-to frontal bone
-maxillary process
-to maxilla

-zygomatic arch =
maxilla
(zygomatic process)
+
zygomatic bone
+
temporal bone
(zygomatic process)
Lateral view
-sphenoid bone
-sphenoid: ‘wedge’, because it
is wedged in the middle of
the skull
-greater wing articulates with
frontal, parietal, temporal
and zygomatic bones
Lateral view
-sphenoid
-lateral pterygoid plate
-pterygomaxillary fissure:
-between lateral pterygoid
Pterygomaxillary
plate and maxilla fissure
Lateral
-leads into pterygopalatine pterygoid
Maxilla
fossa plate

Pterodactyl
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Lateral view
-maxilla
-bone of the upper jaw
-frontal process:
to frontal bone
forms medial border of orbit
-zygomatic process: Palatine
process
to zygomatic bone
forms zygomatic arch
-alveolar process:
bears teeth Frontal
process
-palatine process:
articulates with contralat max

Zygomatic
process

Alveolar
process
Anterior view Frontal bone Nasal bone

Supra-orbital
-frontal bone notch
-maxillary process
to frontal process of maxilla
to nasal bone
-zygomatic process
to frontal process of zygomatic
-supra-orbital notch

-nasal bone
Zygomatic process

Maxillary process
Anterior view
-maxilla
-frontal process
-zygomatic process
-alveolar process
-palatal process

-anterior nasal aperture

-infra-orbital foramen
Maxilla

Zygomatic process

Frontal process
Alveolar process
Anterior view
-orbit
-surrounded by frontal bone,
zygomatic bone and maxilla

-anterior nasal aperture

-surrounded by maxillae, nasal
bones
-bony part of nasal septum seen
through the aperture
Inferior view
-maxilla
-palatal process Maxilla:
palatal process
forms hard palate (with palatine bone)

Palatine bone
-palatine bone
Inferior view Medial
Vomer

pterygoid plate
-sphenoid bone Lateral
-medial and lateral pterygoid plates pterygoid plate

-foramen ovale
-foramen spinosum

-vomer bone
Foramen ovale

-posterior nasal apertures (choanae) Foramen spinosum

Inferior view
-temporal bone
-3 parts seen here
-petromastoid part
-tympanic plate
-styloid process

Tympanic plate

Styloid process

Petromastoid part
of temporal bone
Inferior view Foramen lacerum

-temporal bone
Jugular foramen
-mastoid (digastric) notch
-stylomastoid foramen
-carotid foramen
Carotid foramen
-jugular foramen
-foramen lacerum
Glenoid fossa
-mandibular (glenoid) fossa: for
articulating with head of mandible;
articular eminence

Stylomastoid foramen

Digastric notch
Inferior view
-occipital bone
-foramen magnum
-occipital condyles
-articulate with atlas

Occipital condyle

Foramen magnum
Internal view
-markings of arteries and venous sinuses
Internal view
-cranial fossae
-3 levels (staircase):
-anterior
-frontal lobe of brain
-above orbit

-middle
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-temporal lobe of brain
-above zygomatic arch

-posterior
-cerebellum
-below sup nuchal line http://www.rotten.com/library/medicine/lobotomy/
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-stepmother was simply tired -the ice pick “treatment” -at the age of 56, he said, "I've
of his "youthful defiance" always felt different - wondered if
something's missing from my
soul. I have no memory of the
operation".
The mandible
-body
-ramus
-condylar process (head articulates with
glenoid fossa of temporal bone)
-coronoid process
-mandibular notch / condylar notch
-angle
The temporomandibular joint
-between mandibular condyle and glenoid fossa (of temporal bone)
-synovial joint, lax capsule anteriorly
-intra-articular disc:
-biconcave, fibrocartilaginous
-mould to the incongruity of the articulating surfaces
The temporomandibular joint
-3 basic movements:
-jaw opening:
-combination of hinge and sliding movement
-forward gliding
-grinding:
-movement to left and then right, oblique movement
-involves movements through a sagittal axis and a vertical axis

Jaw opening
The temporomandibular joint
-dislocation
-when condyle displaced anterior to articular eminence
-muscle spasm prevents return of condyle into glenoid fossa
-reduction: first push condyle inferiorly and then posteriorly

www.rad.washington.edu/ mskbook/facialfx.html www.ncemi.org/ cse/cse0402.htm

General plan of
the head
Head: major compartments
-cranial cavity
-for protecting the brain
-brain floats in cerebrospinal fluid
-brain surrounded by layers of meninges
Head: major compartments
-2 orbits: vision
-stereoscopic vision
-2 ears: hearing
-located in petrous part of temporal bone
-on 2 sides of head
-for locating sources of sound
-2 nasal cavities: olfaction
-no directionality
-oral cavity: taste
Head: major compartments
-2 nasal cavities
-opens anteriorly at anterior nasal aperture
-opens posteriorly at posterior nasal apertures (choanae)
-goes through the face

-part of airway
-for olfaction
-for preparing the air
-moisturing
-warming
-filtering
Head: major compartments
-2 nasal cavities
-paranasal sinuses
-air-filled, in bones around nasal cavity (frontal, maxillary, ethmoid, sphenoid)
-communicates with nasal cavity
-for resonance in voice production; reducing weight of skull
Frontal sinus

Maxillary sinus
Head: major compartments
-oral cavity
-separated from nasal cavity by the hard palate
-the upper end of the digestive tract
-for preparing the food (mastication): coordinated movement of the upper and
lower jaws at temporomandibular joint, by muscles of mastication
-for swallowing: food bolus pushed posteriorly by tongue, into pharynx
General plan of
the neck
Neck: extent
-inferior boundary
-sternum, clavicle, acromion, C7
spinous process

-superior boundary
-anterior: mandible
-posterior: basicranium
 Neck: fasciae and compartments
-superficial fascia:
-subcutaneous tissue connecting skin to deep fascia
-contains cutaneous nerves, superficial veins, and platysma muscle
-deep fascia:

Pretracheal layer
-surrounds visceral compartment (larynx,
trachea, pharynx, esophagus, and the
glands in the neck: thyroid, parathyroid,
thymus)

Carotid sheath
Flexor muscles group -surrounds vascular compartment
(common and internal carotid arteries,
Prevertebral layer internal jugular vein, and vagus nerve)
-surrounds vertebral compartment
(cervical spine and muscles)
-vertebral compartment is for
positioning the head Deep investing layer
-invests like a collar
Extensor muscles group -splits to enclose some muscles
(e.g., sternocleidomastoid and
trapezius)
Cross-section of the neck through C7
Pharynx
-a half cylinder made of thin layers of muscles and fascia
-attaches to
-the base of the skull
-the back of the face (nasal cavity and oral cavity)
-the larynx
-continues distally as esophagus
Pharynx
-nasopharynx: behind nasal cavity
-oropharynx: behind oral cavity
-laryngopharynx: behind larynx
Pharynx
-contains upper end of respiratory and
digestive tracts
-nasopharynx
-only for air
-closed off from oropharynx during
swallowing by the soft palate
-oropharynx and laryngopharynx
Air
-shared by both the respiratory and
Food
digestive tracts
Larynx
-a specialized region of airway
-attached superiorly to hyoid bone, inferiorly
to trachea
-opens superiorly to pharynx, inferiorly to
trachea

-consists of a number of cartilages

-contains the vocal cords
-for voice production

Hyoid

Larynx

Trachea
Neck: triangles
-neck divided into 2 triangles on each side by:

-sternocleidomastoid (SCM):
-inferior: sternum and clavicle
-superior: mastoid and occipital
-trapezius:
-axial attachment: skull, ligamentum nuchae,
thoracic vertebrae (spinous processes and
supraspinous ligaments)
-shoulder girdle attachment: lateral third of
clavicle, acromion, scapular spine

Trapezius
SCM
Neck: triangles

Trapezius
SCM
Posterior triangle
-area between SCM and trapezius

-spiral in shape:
-apex: back of skull
-base: in front at the root of neck, middle of clavicle
-floor: flexor and extensor muscles of cervical spine
-roof: deep investing layer of cervical fascia

-contents
-omohyoid muscle
-lymph nodes
-accessory nerve (XI)
Posterior
-brachial plexus (cervical plexus covered by SCM) triangle
-arteries: subclavian, suprascapular, dorsal
scapular, occipital artery
-veins: external jugular
Anterior triangle
-area between
-midline
-SCM anterior border
-lower border of the mandible

-contains the viscera of the neck

Anterior
triangle
 Mylohyoid

Anterior triangle (geniohyoid deep

to mylohyoid)

Thyrohyoid
-contents
Omohyoid
-trachea
-esopahgus Sternohyoid

-strap muscles:
sternothyroid
-geniohyoid
-sternohyoid
-omohyoid
-thyrohyoid
-sternothyroid
-for controlling position of larynx
Anterior triangle
-contents Thyroid gland
(isthmus)
-thyroid gland
-2 lobes united by isthmus
-each lobes lies deep to ST and
SH, on side of larynx and
trachea
-enclosed by splitting of
pretracheal fascia
-parathyroid gland
-4 in total
-2 behind each lobe of thyroid
Anterior triangle
Submandibular triangle

-divided into 4 smaller triangles:

-submandibular triangle
-inferior border of mandible, anterior
and posterior bellies of digastric
-floor: mylohyoid and hyoglossus
-contains submandibular gland, facial
artery and vein,hypoglossal nerve, Submental
submandibular lymph nodes; triangle
external and internal carotid
arteries, internal jugular vein, deep
cervical lymph nodes, vagus nerve

-submental triangle
-midline, anterior belly of digastric,
hyoid bone
-floor: mylohyoid
-contains submental lymph nodes,
beginning of anterior jugular vein
 Carotid triangle

Anterior triangle Muscular

triangle
-divided into 4 smaller triangles:
-carotid triangle
-upper belly of omohyoid, stylohyoid
muscle, posterior belly of digastric,
SCM
-floor: thyrohyoid, hyoglossus, pharynx
-contains: common carotid artery
dividing into external and internal
carotid arteries, internal jugular
vein, hypoglossal nerve, vagus
nerve, accessory nerve, deep
cervical lymph nodes

-muscular/visceral triangle
-midline, hyoid bone, upper belly of
omohyoid, SCM
-floor: sternohyoid, sternothyroid
-contains: thyroid gland, larynx,
trachea, esophagus
End
Sources of illustrations
Drake RL, Vogl W, Mitchell AWM. 2005 Gray’s Anatomy for students. Churchill
Livingstone, Philadelphia.
Last RJ. 1985 Anatomy. Regional and applied. English Language Book Society /
Churchill Livingstone, Edinburgh.
Netter, FH, Hansen JT. 2002 Atlas of Human Anatomy. Third edition. ICON Learning
Systems.

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