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Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Outlines of contentRegions of head and surface landmark of each region Regions of neck and surface landmark Underlying structures of head and neck
Skin MusclesGlandular tissueBlood vesselsLymphaticsFascial space
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Surface anatomy
Provide essential landmarks of deeper anatomical structures, by visualization and palpation.
Bone, cartilage, muscle and tendon provide most of visible and palpable landmarks.Superficial artery and nerve can be indicated as pulsation, or rolled under skin against bone.
Can give information about the health of deeper tissues, any changes in surface features may signal a condition of clinical significance.
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Pericraniocervical line
Separate between the head and neck
Anterior - Symphysis mentiPosterior - InionInferior border & angle of mandible, mastoid process, superior nuchal line, external occipital protuberance
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Regions of the head
Frontal, parietal, occipital, temporal Orbital, nasal, Infraorbital, zygomaticOral, mental, buccal, parotidRetromandibular fossa
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Frontal, parietal, occipital and temporal regions
ScalpSkin & hairConnective tissueAponeurosisLoose connective tissuePeriosteum
Calvaria / skullcapFrontal tuberosityParietal tuberosity
Frontal regionFrontal eminenceSuperciliary arch / eyebrow ridgeGlabella
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Temporal regionExternal earSuperficial temporal artery and vein Temporal musclePterion
Anterior branch of middle meningealartery
Frontal, parietal, occipital and temporal regions
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Orbital and nasal regions
Orbital regionBone
Orbital rimsSupraorbitalnotch
Soft tissueEyelidEyeball
Nasal regionNose NasionDanger triangle of face
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Infraorbital, zygomatic and buccal regions
Infraorbital regionInfraorbital foramenMaxillary sinusCanine eminence & fossa
Zygomatic regionBody of zygomaticboneZygomatic arch
Buccal region
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Infraorbital, zygomatic and buccal regions
Buccal regionMasseter muscleBuccinator muscleBuccal fat padParotid glandParotid ductFacial arterySuperficial temporal artery
TMJ
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Infraorbital, zygomatic and buccal regions
Temporomandibularjoint and related muscles
Masseter muscleTemporalis muscleLateral pterygoid muscleMedial pterygoid muscle
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Oral and mental regions
Oral regionNasolabial sulcusLabiomental sulcusLabiomarginalsulcusModiolus of faceLip
Mental regionChin Mental protuberanceMental foramen
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Retromandibular region
BoundaryAnt – mandibular neckPost – mastoid processSup – inferior wall of external acoustic meatus
ContentParotid glandFacial nerveExternal carotid artery & its branchesStyloid process & its attachment
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Neck
BoundarySuperior
pericraniocervicalline
Inferiormanubrium sterniclavicle spine of scapula
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Regions of neck
Triangle of neckAnterior Posterior
LandmarkBone
MandibleSuperior nuchallineClavicle
MuscleSternomastoidmuscleTrapezius
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Surface anatomy of neck Anterior aspect
Skeletal prominenceHyoid boneLaryngeal prominence & thyroid cartilageCricoid cartilageTracheal ring
MusclePlatysmaSternomastoid muscleTrapezius
Fossa / notchJugular notchLesser supraclavicularfossaGreater supraclavicularfossa
Superficial vein
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Surface anatomy of neck
Anterior aspectSuperficial veins
External jugular veinAnterior jugular vein
Artery SubclavianarteryCarotid arteryFacial artery
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Surface anatomy of neck
Lateral aspectCarotid linePlatysmaSternodomastoid muscleTrapezius muscleClavicle Anterior and posterior trianglesSupraclavicular fossaSuperficial vein
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Surface anatomy of neck
Posterior aspectExternal occipital protuberanceSuperior nuchal lineSpine of vertebraSpine of scapulaTrapezius muscle
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Underlying structures of head and neck
Skin MusclesGlandular tissueBlood vesselsLymphaticsFascial space
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Skin
The appearance of the skin can have considerable clinical significance. Its color and texture can reveal much about underlying physiology.
Color: Skin is moderately transparent. Light whichpenetrates the skin is reflected back from varying depthsby epidermal cells, by collagen, and by blood.Texture: Skin texture is affected the thickness and smoothness of the epidermis, by the quality of fibers in the dermis, and by the amount of fluid in dermal connective tissue.
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Skin lines of the head and neck
Line of Kraissl /Line of Langer / Relaxed skin tension lines
Tension lines
1861 Langer’s linemapped out pattern of parallel lines on cadaverwhich indicate the direction of elastic tension of skin in particular areas
1951 Kraissl’s lineLines of greatest tensionWhich coincide with wrinkle lineare more approprate lines for surgical incision
1962 Borges & Alexandertermed lines of greatest tension as ‘relaxed skin tension lines’
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Wrinkle lines
Caused by contraction of underlying muscleUsually disposed perpendicular to their axis of shorteningOn face, they are known as lines of expressionWith progressive loss of skin elasticity due to aging, they become permanent
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Muscles of facial expression
In superficial fasciaOriginate from bone Insert on skinCause wrinkles at right angle to muscle’s action line
Muscles of head
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Muscles of mastication4 pairs of muscles, attached to mandibleMove mandible during speech and mastication at TMJ
Muscles of head
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Glandular tissue in head and neck
Salivary glandsParotid glandSubmandibular glandSublingular gland
Lacrimal glandThyroid glandParathyroid gland
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Blood vessels of head and neck
HeadFacial artery and veinSuperficial temporal artery and veinDeep lingual vein
Neck Subclavian arteryCarotid arterySuperficial vein
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Blood vessels of head and neck
HeadFacial artery and veinSuperficial temporal artery and veinDeep lingual vein
NeckSubclavian arteryCarotid arterySuperficial vein
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Lymphatics of head and neck
Lymph nodesSuperficial LNDeep LN
Tonsillar tissuePalatine tonsilLingual tonsilPharyngeal tonsil
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Fascial space of head and neck
Potential spaces between layers of fascia, contain loose connective tissueThey are not actually spaces in healthy patientThese spaces are important, because they can be involved in infections from dental tissuesThese spaces can communication with each other directly, allow infection spread to deeper structure
Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol University
Bibliography
http://www.siumed.edu/~dking2/intro/skin.htm - Histology of skinhttp://www.kjm.keio.ac.jp/past/50/1/31.pdf - Arterial anatomy of subdermal plexus of the facehttp://www.utmb.edu/otoref/Grnds/Cicatrix-971119/Cicatrix-971119.html -Tension LinesFehrenbach MJ & Herring SW. Illustrated Anatomy of the Head and Neck, 1996.Moore KL & Dalley AF. Clinically oriented anatomy, 4th ed, 1999.Gray’s anatomy, 38th ed. 1995.Johnson & Moore. Anatomy for Dental Student, 2nd ed. 1997.Woodburne B. Essentials of Human Anatomy, 9th ed. 1994.จิรพันธ พันธวุฒิกร การวินิจฉัยและการบําบัดการติดเชื้อสาเหตุจากฟน, 2542
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