Exits the posterior cranial fossa by passing through the jugular foramen, lateral to and in front of the vagus and accessory nerves
Source: medulla
Branches: tympanic nerve to the tympanic plexus and lesser petrosal nerve, carotid sinus nerve, stylopharyngeus branches, pharyngeal branches
Motor supply to: stylopharyngeus (SVE); parotid gland (GVE- parasympathetic fibers via the otic ganglion)
Sensory supply to: carotid body, carotid sinus, pharynx, middle ear (GVA); skin of the external ear (GSA); taste from the posterior 1/3 of the tongue (SVA)
phrenic nerve
Source: ventral primary rami of spinal nerves C3-C5 (cervical plexus)
Motor supply to: skeletal muscles of the respiratory diaphragm
Sensory supply to: diaphragmatic pleura; some fibers contributed to the pericardium and to the adjacent mediastinal and costal pleurae
Both phrenic nerves run along the anterior surface of the anterior scalene muscle, deep to the carotid sheath
Right phrenic nerve passes over the right brachiocephalic artery, the subclavian vein, and the superior vena cava, and then crosses the root of the right lung and then leaves the thorax by passing through the vena cava hiatus opening in the diaphragm at the level of T8
Left phrenic nerve passes over the left ventricle and pierces the diaphragm separately
salpingopharyngeal fold
Located in the nasal part of the pharynx, a mucosal fold descending from the posterior margin of the torus tubarius
Contains the salpingopharyngeus muscle
ascending pharyngeal artery
Branch of the external carotid artery
Gives off the pharyngeal branches, inferior tympanic artery, posterior meningeal artery
Arterial supply to the pharynx and meninges
Arises from the medial side of the external carotid artery, close to the bifurcation
hypoglossal nerve
12th cranial nerve
Source: hypoglossal nucleus of the medulla
Motor supply to: intrinsic and extrinsic muscles of the tongue (except palatoglossus muscle)
No sensory supply
Exits the posterior cranial fossa by passing through the hypoglossal canal
median glossoepiglottic fold
Fold of mucosa located between the base of the tongue and the epiglottis
Separates the paired valleculae epiglottica
middle meningeal artery
Branch of the maxillary artery (one of two terminal branches of external carotid artery)
Gives off the frontal branch, parietal branch, petrous branch, and superior tympanic branch
Arterial supply to most of the dura mater (~80%) and the cranial vault (calvaria)
Passes through the foramen spinosum
Runs forward in a groove on the great wing of the sphenoid bone, and divides into two branches, anterior and posterior
superior thyroid artery
Branch of external carotid artery; is usually the first branch of the external carotid artery
Gives off the infrahyoid branch, sternocleidomastoid branch, superior laryngeal artery, cricothyroid branch, and glandular branches
Arterial supply to: thyroid gland, upper part of the larynx, infrahyoid muscles, sternocleidomastoid muscle
Arterial supply to: deep neck, cervical spinal cord, spinal cord; medulla (dorsal motor nucleus of cranial nerve X, nucleus ambiguus, spinal accessory nucleus and hypoglossal nucleus)
Anastomoses with the internal carotid artery in the cerebral arterial circle (of Willis)
It courses through the transverse foramina of vertebrae C1-C6
abducens nerve
6th cranial nerve
Source: abducens nucleus of the pons
Motor supply to: lateral rectus muscle (GSE)
No sensory innervation
Passes through the superior orbital fissure
facial nerve
7th cranial nerve
Source: medulla and pons
Gives off the following branches:
i. Greater petrosal nerve (preganglionic parasympathetic to pterygopalatine ganglion, postganglionic parasympathetic travels with branches of maxillary division of trigeminal nerve)
ii. Chorda tympani (SVA taste from anterior 2/3 of the tongue; preganglionic parasympathetic to the submandibular ganglion, postganglionic parasympathetic to the submandibular and sublingual glands)
iii. Nerve to stapedius
iv. Posterior auricular nerve
v. Intraparotid plexus with temporal, zygomatic, buccal, marginal mandibular and cervical branches
Motor supply to: stapedius muscle, stylohyoid muscle, posterior belly of digastric muscle, muscles of facial expression (GSE); secretomotor (GVE) to lacrimal, submandibular, sublingual, and mucous glands of the nasal and oral cavities
Sensory supply to: taste (SVA) from the anterior 2/3 of the tongue; part of the skin of the external auditory meatus (GSA)
Exits the posterior cranial fossa by passing into the internal acoustic meatus
Motor to muscles of facial expression exits the skull at the stylomastoid foramen
frontal nerve
Source: ophthalmic division of the trigeminal nerve (V1)
Gives off the supraorbital nerve and the supratrochlear nerve
Sensory supply to: skin of the forehead and the medial part of the upper eyelid; mucous membrane of the frontal sinus
No motor innervation
greater palatine nerve/artery
Nerve:
Source: maxillary division of the trigeminal nerve (V2)
Gives off posterior inferior lateral nasal branches
Sensory supply to: mucous membrane of the inferior part of the lateral nasal wall; mucosa of the hard palate (GSA?)
Passes through the greater palatine canal and foramen
Artery:
Branch of the descending palatine artery
Arterial supply to: hard palate, palatine glands, palatine muscosa
Accompanies the greater palatine nerve
Endangered by anesthetic injections for dental procedures
inferior alveolar nerve
Source: mandibular division of the trigeminal nerve (V3)
Gives off nerve to mylohyoid, inferior dental plexus, and mental nerve
Motor supply to: mylohyoid muscle and anterior belly of the digastric muscle via the nerve to mylohyoid muscle (GSE)
Sensory supply to: teeth of the mandible (GSA?); skin of the chin (GSA)
infraorbital nerve/artery
Nerve:
Source: maxillary division of the trigeminal nerve (V2)
Gives off middle alveolar nerve and anterior superior alveolar nerve
Sensory supply to: mucous membrane of the maxillary sinus; upper premolar, canine and incisor teeth; maxillary gingiva; skin of the lateral nose, lower eyelid, upper lip and zygomatic region (GSA)
* Passes through the infraorbital groove, canal and foramen
Artery:
Branch of the maxillary artery
Gives off anterior superior alveolar artery and middle superior alveolar artery
Arterial supply to: maxillary sinus, maxillary incisors, canine and premolar teeth, skin of the cheek below the orbit, mucosa over the maxillary alveolar arch and the adjacent cheek
One of four terminal branches of the maxillary artery (infraorbital artery, descending palatine artery, sphenopalatine artery, posterior superior alveolar artery)
lingual nerve
Source: mandibular division of the trigeminal nerve (V3)
Sensory supply to: anterior 2/3 of the tongue and floor of the mouth (GSA)
Joined by the chorda tympani (taste and preganglionic parasympathetic) from the facial nerve in the infratemporal fossa
Submandibular ganglion hangs from the lingual nerve in the paralingual space
maxillary artery
Branch of the external carotid artery
Gives off the following branches: deep auricular artery, anterior tympanic artery, middle meningeal artery, inferior alveolar artery, masseteric arter, posterior deep temporal artery, anterior deep temporal artery, buccal artery, posterior superior alveolar artery, infraorbital artery, artery of the pterygoid canal, descending palatine artery, sphenopalatine artery
Arterial supply to: deep face, infratemporal fossa, tympanic cavity, muscles of mastication
Courses medial or lateral to the lateral pterygoid muscle
superficial temporal artery
Branch of the external carotid artery
Gives off the transverse facial artery; anterior auricular branches; zygomatico-orbital artery; middle temporal artery; frontal branch; and parietal branch
Arterial supply to the scalp of the lateral side of the head, lateral face, and temporalis muscle
Superficial temporal and maxillary arteries are terminal branches of the external carotid artery
tensor veli palatine
A broad, thin, ribbon-like muscle that tenses the soft palate and opens the auditory tube
Located lateral to the levator veli palatini muscle
Origin: scaphoid fossa, lateral wall of the auditory tube cartilage
Insertion: palatine aponeurosis
Innervated by the mandibular division of the trigeminal nerve (V3)
Arterial supply from the ascending pharyngeal artery
torus tubarius
Mucosal fold covering the anteromedial end of the auditory tube cartilage
projects toward the midline from the lateral wall of the nasopharynx (Latin, torus = knot)
facial artery
Branch of external carotid artery
Gives off ascending palatine artery, tonsilar branch, submental artery, superior labial artery, inferior labial artery, lateral nasal artery, and angular artery
Arterial supply to: lower part of the palatine tonsil, submandibular gland, facial muscles and fascia
Angular branch anastomoses with the ophthalmic artery
levator veli palatine
Origin: apex of the petrous part of the temporal bone and the medial surface of the auditory tube cartilage
Insertion: muscles and fascia of the soft palate, and palatine aponeurosis
Action: elevates the soft palate
Innervated by the vagus nerve (X) via the pharyngeal plexus
Arterial supply from ascending pharyngeal artery
Derivative of the 4th pharyngeal arch
parotid duct
Drains the parotid gland through cheek to the oral vestibule near upper 2nd molar tooth
Thick duct that crosses the superficial surface of the masseter muscle
submandibular duct
AKA Wharton’s duct
Drains the submandibular gland to the sublingual caruncle
Connects the submandibular gland to the floor of the oral cavity
Begins by numerous branches from the deep surface of the submandibular gland, and runs forward between the mylohyoideous and the hyoglossus and genioglossus, then between the sublingual gland and the genioglossus, and opens by a narrow orifice on the summit of a small papilla, at the side of the frenulum linguae
true vocal chord
Infoldings of mucous membrane stretched horizontally across the larynx
Covers the vocal ligament and thyroepiglottic muscle
Located just above the trachea
Open during inhalation, closed when holding breath, and held apart just a tiny bit for speech or singing
Controlled via the vagus nerve (X)
White in color (scant blood circulation?)
vagus nerve
10th cranial nerve
Source: medulla
Gives off the following branches: auricular branch, pharyngeal branch, superior laryngeal, superior and inferior cervical cardiac branches, recurrent laryngeal nerve, thoracic cardiac branches, branches to the pulmonary plexus, branches to the esophageal plexus, anterior and posterior vagal trunks
Motor supply to: intrinsic muscles of the larynx, pharynx (except stylopharyngeus), and palate (except tensor veli palatini) (SVE); smooth muscle of the respiratory tree and gut (proximal to the left colic flexure), heart; secretomotor: mucous glands of the larynx, respiratory tree, pharynx and gut; secretomotor to digestive glands (GVE)
Sensory supply to: skin of the external auditory meatus (GSA); viscera of head, neck, thorax and abdomen proximal to the left colic flexure (GVA); taste from the epiglottis (SVA)
Passes through the jugular foramen to exit the posterior cranial fossa
buccal nerve
Source: mandibular division of the trigeminal nerve (V3)
Sensory supply to: skin of the cheek (GSA), mucosa lining the cheek
Not a motor nerve; easily confused with the buccal branch of the facial nerve, which is a motor nerve
deep temporal artery
Anterior:
Branch of the maxillary artery
Arterial supply to: anterior part of temporalis muscle and surrounding deep tissues
Branches in the infratemporal fossa and runs deep to temporalis muscle
Posterior:
Branch of the maxillary artery
Arterial supply to: posterior part of the temporalis muscle
Branches in the infratemporal fossa and runs deep to temporalis muscle
inferior nasal concha
Extends horizontally along the lateral wall of the nasal cavity
Consists of a lamina of spongy bone, curled upon itself like a scroll
Medial surface is convex, perforated by numerous apertures, and traversed by longitudinal grooves
Lateral surface is concave, and forms part of the inferior meatus
internal laryngeal nerve
Branch of superior laryngeal nerve, which is a branch of the vagus nerve (X)
Descends to the hyothryroid membrane, pierces it with the superior laryngeal artery, and is distributed to the mucous membrane of the larynx
Sensory supply to: mucous membrane of the larynx above the vocal folds
maxillary nerve
Source: trigeminal ganglion
Gives off the following: meningeal branch, posterior superior alveolar nerve, pharyngeal, posterior superior medial and lateral nasal branches, nasopalatine nerve, greater and lesser palatine nerves, zygomatic nerve, and infraorbital nerve
Sensory supply to: skin of the upper lip, cheek, lower eyelid; mucous membrane of the palate; teeth and gingiva of the maxillary alveolar arch; the mucous membrane lining most of the nasal cavity; the mucous membrane lining the maxillary sinus (GSA)
Passes through the foramen rotundum to enter the pterygopalatine fossa
nerve to mylohyoid
Source: inferior alveolar nerve, a branch of the mandibular division of the trigeminal nerve (V3)
Motor supply to: mylohyoid muscle and anterior belly of the digastric muscle (SVE)
Arises near the lingula of the mandible
Courses within the mylohyoid groove of the mandible
occipital artery
Branch of the external carotid artery
Gives off sternocleidomastoid branches, auricular branch, mastoid branch, descending branch, and occipital branches
Arterial supply to: lateral neck, posterior neck, and posterior scalp
Anastomoses with the deep cervical artery
Courses with the greater occipital nerve on the posterior surface of the head
stylohyoid muscle
Origin: posterior side of the styloid process
Insertion: splits around the intermediate tendon of the digastric muscle to insert on the body of the hyoid bone
Action: elevates and retracts the hyoid bone
Innervated by the facial nerve (VII)
Arterial supply from the ascending pharyngeal artery
thyrocervical trunk
Branch of the first part of the subclavian artery
Gives off the inferior thyroid artery, transverse cervical artery, and suprascapular artery
Arterial supply to: lower neck, posterior shoulder, and thyroid gland
Arises between the origin and inner border of scalenus anterior muscle
thyrohyoid muscle
Origin: oblique line of the thyroid cartilage
Insertion: lower border of the hyoid bone
Lies deep to sternohyoid muscle
Action: elevates the larynx; depresses/stabilizes the hyoid bone
Innervated by ansa cervicalis (via fibers running with the hypoglossal nerve)
Arterial supply from the superior thyroid artery
articular disc
Of the temporomandibular joint?
Separates the two joint spaces
cricothyroid membrane (ligament)
The larger part of the laryngeal membrane, continuing inferiorly as a median or anterior part and twin lateral ligaments
Median cricothyroid ligament is a flat band of white tissue joining the cricoid and thyroid cartilages
Lateral cricothyroid ligament is also known as the cricothyroid membrane
* Elastic membrane attaches on the upper margin of the arch of the cricoid cart and ends in the vocal ligament
dorsal scapular nerve
Source: brachial plexus (branch of C5 ventral primary ramus)
Motor supply to: rhomboideus major and minor muscle; levator scapulae muscle
Passes through the scalenus medius muscle
ethmoid bulla
A bulging of the inner wall of the ethmoidal labyrinth in the middle meatus of the nose, just below the middle nasal concha
It is regarded as a rudimentary concha
external carotid artery
Branch of the common carotid artery (bifurcation into internal and external)
Begins opposite the upper border of the thyroid cartilage
Gives off the following branches: superior thyroid artery, ascending pharyngeal artery, lingual artery, facial artery, occipital artery, posterior auricular artery, maxillary artery, superficial temporal artery
Arterial supply to the upper neck, face, and scalp
Primary blood supply to the face and superficial head
Maxillary artery and superficial temporal artery are its terminal branches
falx cerebri
An extension of the protective dura mater that projects into the longitudinal fissure that separates the two cerebral hemispheres
Narrow anteriorly, where it is attached to the crista galli of the ethmoid
Broad posteriorly, where it is connected with the upper surface of the tentorium cerebelli
Superior (convex) margin contains the superior sagittal sinus
Inferior (concave) margin contains the inferior sagittal sinus
inferior meatus
The largest of the three meatuses of the nose
Space between the inferior concha and the floor of the nasal cavity
Extends almost the entire length of the lateral wall of the nose
Presents anteriorly the lower orifice of the nasolacrimal canal
inferior oblique
Origin: floor of the orbit lateral to the lacrimal groove
Insertion: sclera on the inferior surface of the eyeball
Action: elevates and abducts the corneal part of the eye; rotates the superior pole of the iris laterally; when the eye is adducted, this muscle elevates the cornea
Innervated by the inferior division of the oculomotor nerve (III)
Arterial supply from the ophthalmic artery
levator palpebrae superioris
Origin: apex of the orbit above the optic canal
Insertion: skin and fascia of upper eyelid and the superior tarsal plate
Action: elevates the upper eyelid
Innervated by the oculomotor nerve (III) and sympathetics (to the superior tarsal portion)
Arterial supply from the ophthalmic artery
Fibers inserting into the superior tarsal plate are called superior tarsal muscle and are smooth muscle
long thoracic nerve
Source: brachial plexus (ventral primary rami of spinal nerves C5-C7)
Motor supply to serratus anterior muscle
After the 3 cervical roots join, the nerve runs from behind the clavicle to reach the first rib
Pierces the middle scalene muscle
Then descends on the lateral wall of the thorax
mandibular branch of trigeminal
AKA V3
Source: trigeminal ganglion; motor root arises from the pons
Gives off the following branches: meningeal branch, medial pterygoid and lateral pterygoid nerves, masseteric nerve, anterior and posterior deep temporal nerves, buccal nerve, auriculotemporal nerve, lingual nerve, inferior alveolar nerve
Motor supply to: mylohyoid muscle, anterior belly of the digastric muscle; tensor tympani muscle, tensor veli palatini muscle; muscles of mastication (temporalis, masseter, medial pterygoid and lateral pterygoid) (SVE)
Sensory supply to: skin of the lower lip and jaw extending superiorly above level of the ear; mucous membrane of the tongue and floor of the mouth; lower teeth and gingiva of the mandibular alveolar arch (GSA)
Passes through the foramen ovale to exit the middle cranial fossa
medial pterygoid muscle
Origin: medial surface of the lateral pterygoid plate, pyramidal process of the palatine bone, tuberosity of the maxilla
Insertion: medial surface of the ramus and angle of the mandible
Action: elevates and protracts the mandible
Innervated by medial pterygoid branch of the mandibular division of the trigeminal nerve (V3)
Arterial supply from pterygoid branch of the maxillary artery
Mirrors the masseter muscle in position and action with the ramus of the mandible between the two muscle
mental nerve
Source: inferior alveolar nerve
Sensory supply to: skin of the chin and the lower lip (GSA)
Passes through the mental foramen
styloid process
The spike of bone that projects inferiorly from the petrous part of the temporal bone
The attachment site for the stylohyoid, styloglossus and stylopharyngeus muscle, and the stylomandibular and stylohyoid ligaments
Comments and Suggestions
Andrea, were these in order? If so, I have to replace the numbering. lae -- LorenEvey - 16 Oct 2006 - 01:59
I have begun annotating the HITS list for head and neck. Here is the first 50 terms (I have not included the radiology terms). I will be doing as much of the list as I can.