Outlines of content - Mahidolelearning.dt.mahidol.ac.th/departments/anatomy/.../surface601_47.pdf · Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol

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


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.


Pericraniocervical line

Separate between the head and neck

Anterior - Symphysis mentiPosterior - InionInferior border & angle of mandible, mastoid process, superior nuchal line, external occipital protuberance


Regions of the head

Frontal, parietal, occipital, temporal Orbital, nasal, Infraorbital, zygomaticOral, mental, buccal, parotidRetromandibular fossa


Frontal, parietal, occipital and temporal regions

ScalpSkin & hairConnective tissueAponeurosisLoose connective tissuePeriosteum

Calvaria / skullcapFrontal tuberosityParietal tuberosity

Frontal regionFrontal eminenceSuperciliary arch / eyebrow ridgeGlabella


Temporal regionExternal earSuperficial temporal artery and vein Temporal musclePterion

Anterior branch of middle meningealartery

Frontal, parietal, occipital and temporal regions


Orbital and nasal regions

Orbital regionBone

Orbital rimsSupraorbitalnotch

Soft tissueEyelidEyeball

Nasal regionNose NasionDanger triangle of face


Infraorbital, zygomatic and buccal regions

Infraorbital regionInfraorbital foramenMaxillary sinusCanine eminence & fossa

Zygomatic regionBody of zygomaticboneZygomatic arch

Buccal region



Buccal regionMasseter muscleBuccinator muscleBuccal fat padParotid glandParotid ductFacial arterySuperficial temporal artery

TMJ



Temporomandibularjoint and related muscles

Masseter muscleTemporalis muscleLateral pterygoid muscleMedial pterygoid muscle


Oral and mental regions

Oral regionNasolabial sulcusLabiomental sulcusLabiomarginalsulcusModiolus of faceLip

Mental regionChin Mental protuberanceMental foramen


Retromandibular region

BoundaryAnt – mandibular neckPost – mastoid processSup – inferior wall of external acoustic meatus

ContentParotid glandFacial nerveExternal carotid artery & its branchesStyloid process & its attachment


Neck

BoundarySuperior

pericraniocervicalline

Inferiormanubrium sterniclavicle spine of scapula


Regions of neck

Triangle of neckAnterior Posterior

LandmarkBone

MandibleSuperior nuchallineClavicle

MuscleSternomastoidmuscleTrapezius


Surface anatomy of neck Anterior aspect

Skeletal prominenceHyoid boneLaryngeal prominence & thyroid cartilageCricoid cartilageTracheal ring

MusclePlatysmaSternomastoid muscleTrapezius

Fossa / notchJugular notchLesser supraclavicularfossaGreater supraclavicularfossa

Superficial vein


Surface anatomy of neck

Anterior aspectSuperficial veins

External jugular veinAnterior jugular vein

Artery SubclavianarteryCarotid arteryFacial artery



Lateral aspectCarotid linePlatysmaSternodomastoid muscleTrapezius muscleClavicle Anterior and posterior trianglesSupraclavicular fossaSuperficial vein



Posterior aspectExternal occipital protuberanceSuperior nuchal lineSpine of vertebraSpine of scapulaTrapezius muscle


Underlying structures of head and neck

Skin MusclesGlandular tissueBlood vesselsLymphaticsFascial space


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.


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’


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


Muscles of facial expression

In superficial fasciaOriginate from bone Insert on skinCause wrinkles at right angle to muscle’s action line

Muscles of head


Muscles of mastication4 pairs of muscles, attached to mandibleMove mandible during speech and mastication at TMJ

Muscles of head


Glandular tissue in head and neck

Salivary glandsParotid glandSubmandibular glandSublingular gland

Lacrimal glandThyroid glandParathyroid gland


Blood vessels of head and neck

HeadFacial artery and veinSuperficial temporal artery and veinDeep lingual vein

Neck Subclavian arteryCarotid arterySuperficial vein


Blood vessels of head and neck

HeadFacial artery and veinSuperficial temporal artery and veinDeep lingual vein

NeckSubclavian arteryCarotid arterySuperficial vein


Lymphatics of head and neck

Lymph nodesSuperficial LNDeep LN

Tonsillar tissuePalatine tonsilLingual tonsilPharyngeal tonsil


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


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

Documents

Outlines of content - Mahidolelearning.dt.mahidol.ac.th/departments/anatomy/.../surface601_47.pdf · Wanida Sripairojthikoon, Department of Anatomy, Faculty of Dentistry, Mahidol