Head 山东大学医学院解剖教研室李振华. Regions and landmarks of head Regions Cranium...

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Head

山东大学医学院解剖教研室李振华


Regions and landmarks of head

Regions Cranium 颅部 Face 面部


Regions and landmarks of head

Landmarks Superciliary arch Supraorbital notch Infraorbital foramen Mental foramen Pterion Zygomatic arch Mastoid process External occipital protub

erance


Landmarks of head

Pterion


Face 面部


The skin of face

Very thin and connected to the facial bones by loose connective tissue.

There is no deep fascia. The facial muscles lie in this connective tissue.


Muscles of head 头肌 Facial muscles 面肌 Epicranius 颅顶肌

Frontal belly 额腹 Occipital belly 枕腹 Galea aponeurotica 帽状腱膜

Orbicularis oculi 眼轮匝肌 Buccinator 颊肌 Orbicularis oris 口轮匝肌 Nasalis 鼻肌


Facial muscles 面肌


★Masticatory muscles 咀嚼肌

Temporalis 颞肌 Masseter 咬肌 lateral pterygoid 翼外肌 Medial pterygoid 翼内肌


★ Masticatory muscles 咀嚼肌 Temporalis 颞肌

Origin － temporal fossa Insertion － coronoid process of ma

ndible Action － elevates and retracts man

dible

Masseter 咬肌 Origin － inferior border and medial

surface of zygomatic arch Insertion － lateral surface of ramus

of mandible and angle of mandible Action － elevates mandible


★ Masticatory muscles 咀嚼肌

Lateral pterygoid 翼外肌

Medial pterygoid 翼内肌


Arteries of head

★ Facial a. 面动脉 Branch of external caroteid a. Runs forward over digastric and subm

andibular gland Loops around mandible (where it is pal

pable), at anterior border of masseter, to enter the face

Follows a tortuous course to medial angle of eye

Lies deep to most facial muscles Branches

Inferior labial a. 下唇动脉 Superior labial a. 上唇动脉 Angular a. 内眦动脉


Arteries of head

Superficial temporal a. 颞浅动脉 Terminal branch of external carotid a. Ascends in front of ear (where it is pal

pable) to supply temporal and anterior portion of scalp

Transverse facial a. 面横动脉 runs above parotid duct to supply the cheek region


Arteries of head

Maxillary artery 上颌动脉 Branch of external carotid a. Entrance to infratemporal fossa media

l to neck of mandible Branches

Inferior alveolar a. 下牙槽动脉 Middle meningeal a. 脑膜中动脉

enters the skull through foremen spinosum

Supplies cranium and dura mater Posterior superior alveolar a.

上牙槽后动脉


Veins of head

Facial vein 面静脉 Begins at medial angle of eye (angul

ar vein 内眦静脉 ) Runs downward and backward throu

gh the face, posterior to the facial artery

Below angle of mandible, joins anterior branch of retromandibular vein 下颌后静脉 to form common facial vein 面总静脉 , which drains into internal jugular vein 颈内静脉


Facial vein 面静脉 Connections with cavernous sinus

海绵窦 through the ophthalmic vein 眼静脉 , and also through pteygoid veous plexus 翼静脉丛 via the deep f

acial vein 面深静脉

Veins of head


Veins of head

“Danger triangle of the face” 面部危险三角

lies between root of nose and two angles of mouth

In this area the facial vein has no valves


Veins of head

Retromandibular v. 下颌后静脉 Formed by union of superficial tempor

al and maxillary veins Divides into an anterior branch that uni

tes with facial vein and a posterior branch that joins posterior auricular vein to become external jugular vein


Veins of headPteygoid venous plexus 翼静脉丛 Located between and around masticat

ory muscles Receives blood from all regions supplie

d by maxillary a. Communicates with

Face v. by deep facial veins Cavernous sinus by veins draining base

of skull Provides possible pathway for spread o

f infection to cranial cavity


The lymphatic drainage of head

Lymph nodes of head Located at junction of head and ne

ck Consist of

Occipital lymph nodes 枕淋巴结 Mastoid lymph nodes 乳突淋巴结 Parotid lymph nodes 腮腺淋巴结★ Submandibular lymph nodes 下

颌下淋巴结 lies near the submandibular gland, receive lymphatic vessels from the face, nose and mouth

submental lymph nodes 颏下淋巴结 Drain into deep cervical lymph n

odes


Nerves of head

★ Facial nerve ( )Ⅶ 面神经 Leaves skull through internal aco

ustic meatus, facial canal and stylomastoid foramen

Divided three parts First part － between styloma

stoid foramen and parotid gland

Second part － within parotid gland

Third part － outside of parotid gland


Nerves of head

★ Facial nerve ( )Ⅶ 面神经 Enters parotid gland and divides into its

five terminal branches for muscles of facial expression

Branches Temporal branches 颞支 Zygomatic branches 颧支 Buccal branches 颊支 Marginal mandibular branch 下颌缘支 Cervical branch 颈支


Facial nerve ( )Ⅶ 面神经


Nerves of head

Trigeminal nerve 三叉神经 Supraorbital n. 眶上神经

From the ophthalmic n. of trigeminal n. Exit the skull via the superaorbital fora

men (or notch) Infraorbital n. 眶下神经

From the maxillary n. of trigeminal n. Exit the skull via the infraorbital foram

en Mental n. 颏神经

From the mandibular n. of trigeminal n. Exit the skull via the mental foramen


Parotid gland 腮腺

Position: situated below the external auditory meatus and lies in a deep hollow behind the ramus of mandibular and in front of the sternocleidomastoid Superficial part: triangular in shap

e, lies below and in front of the external acoustic meatus, and partially covers the masseter

Deep part: extends forward between the medial pterygoid m. and ramus of mandible


Parotid gland 腮腺

Capsule of the parotid gland The parotid gland is enclosed

within a well-defined capsule which extension of the investing fascia of the neck.

The superficial capsule is thick and unyielding and tightly affixed to the underlying glandular tissue by numerous fibrous septa.

The deep capsule is quite thin and easily disrupted.


Parotid gland 腮腺★ Parotid duct 腮腺管 Arises front anterior border of gland Lies 1.5 cm below and parallel to z

ygomatic arch Passes forward over masseter, pier

ces the buccinator and oral mucosa to open opposite second upper molar tooth


★ Structures vertical passing through the parotid gland

External carotid a. 颈外动脉 Superficial temporal a. 颞浅动脉 Superficial temporal v. 颞浅静脉 Retromandibular vein 下颌后静

脉 Auriculotemporal n. 耳颞神经


★ Structures transversal passing through the parotid gland

Maxillary a. & v. 上颌动、静脉 Tranverse facial a. & v. 面横动、静脉 Branches of facial n. 面神经的分支


Relations of parotid gland

Superiorly External acostic meatus Poterior margin of temporoma

ndibular joint Zygomatic arch

Anteromedially Masseter Ramus of mandible Posterior part of medial pteryg

oid


Relations of parotid gland

Posteromedially Mastoid process Sternocleidomastoid Posterior belly of digastric Styloid process Internal carotid a. Internal jugular v. Ⅸ ～Ⅻ cranial nerves“Parotid bed” 腮腺床

Internal carotid a. Internal jugular v. Ⅸ ～Ⅻ cranial nerves Styloid process

Ⅹ

Ⅸ

Ⅺ Ⅻ


Spaces of face

Masseter space 咬肌间隙 Position: lies between the masset

er, and ramus of mandible Contens: vessels and nerves of

masseter


Spaces of face

Pterygomandibual space 翼下颌间隙

Lies between ramus of mandible and medial pterygoid

Contents: Lingual n. Inferior alveolar n., a., v.


Spaces of face

Sublingual space 舌下间隙 Position Between mucous membrane of floor

of mouth and mylohyoid and hyoglossus


Sublingual space 舌下间隙

Contents Sublingual gland 舌下腺 Deep part of submandibula

r gland and duct 下颌下腺深部及腺管

Submandibular ganglion 下颌下神经节

Linguial n. 舌神经 Hypoglossal n. and vessels

舌下神经及血管


Cranium 颅部


Calvaria 颅顶

Frontoparietooccipital region 额顶枕区

Temporal region 颞区


Frontoparietooccipital region额顶枕区

Boundaries Anterior － supraorbital margin Posterior － external occipital p

rotuberance and superior nuchal line

Lateral － superior temporal line


★ Layers of frontoparietooccipital region

Consists of five layers Skin 皮肤 Superficial fascia 浅筋膜 Epicranial aponeurosis and occipit

ofrontalis 帽状腱膜及枕额肌 Subaponeurotic space (loose conn

ective tissue) 腱膜下隙 Pericranium 颅骨外膜 The superficial 3 layer are closely k

nit together, called scalp 头皮



Skin 皮肤 Superficial fascia 浅筋膜 Epicranial aponeurosis and occ

ipitofrontalis 帽状腱膜和枕额肌 Subaponeurotic space 腱膜下隙 Pericranium 颅骨外膜



1. Skin 皮肤 thick and hair bearing and contains n

umerous sebaceous glands

皮厚、腺多、血运丰富2. The superficial fascia 浅筋膜 Dense connective tissue that binds t

he skin to the underlying epicranial aponeurosis

The vasculature of the scalp runs primarily in this layer. It is rich and widely anastomosis.

Wounds of the scalp bleed profusely but heal well.



A. v. and n. in superficial fascia Anterior group

Supratrochlear a. v. n. 滑车上动、静脉和神经 Supraorbital a. v. n. 眶上动、静脉和神经

Posterior group Occipital a. v. 枕动、静脉 Greater occipital n. 枕大神经

炎症不易扩散，肿胀疼痛剧烈，血管吻合多，止血应呈环状，局麻范围要广，切口呈放射状，皮瓣蒂在下方



3. Epicranial aponeurosis and occipitofrontalis 帽状腱膜和枕额肌

It is interposed between the frontalis and occipitalis portions of the occipitofrontalis muscle.

These muscles place the aponeurosis under tension so that deep transverse lacerations of the scalp gape widely

坚韧致密，前连额腹，后连枕腹， 1 、2 、 3 层，合称头皮



4. Subaponeurotic space 腱膜下隙 (loose connective tissue) Extracranial hematoma, the result of bleedi

ng in the subaponeurotic space, can extend over the cranium. lt can extend posteriorly, to the superior nuchal line; anteriorly, into the eyelids to produce the “black eye”; and laterally, to the temporal line.

The loose connective tissue layer provides the plane of separation in any injury that tears the scalp from the calvaria or for the surgeon elevating the scalp from the periosteum.



4. Subaponeurotic space 腱膜下隙 Contains a rich network of deep

arteries and veins. Therefore, this layer has been called the “dangerous area”.

Infection may spread to the substance of the bones, to venous channels within the cranial cavity, or to the brain.

出血化脓，漫及全顶，有导血管，颅内外交通



5. Pericranium 颅骨外膜 Fuses firmly with bone at the sutu

res and with the periosteum of the adjacent bone, thus limiting the subperiosteal space.

薄而致密，易于颅骨分离，如有血肿，与骨一致


Temporal region 颞区 Boundaries Superior － superior temporal line Inferior － superior border of zygomati

c arch Anterior － the junction of frontal and

zygomatic bones Posterior － posterior portion of superi

or temporal line


Layers of temporal region 颞区

Consists of five layers: Skin 皮肤 Superficial fascia 浅筋膜 Temporal fascia 颞筋膜 Temporalis 颞肌 Periosteum 骨膜


Layers of temporal region

Superficial fascia 浅筋膜 Anterior auricular group

Superficial temporal a. & v. 颞浅动、静脉

Auriculotemporal n. 耳颞神经 Posterior auricular group

Posterior auricular a. & v. 耳后动、静脉

Lesser occipital n. 枕小神经


Layers of temporal region 颞区

Temporal fascia 颞筋膜 Two layers Attached above to the superior tempo

ral line and below to the superior border of the aygomatic arch

Temporalis 颞肌 Periosteum 骨膜 thin and strongly adherent to the tem

poral bone

.


Skin incisions


★You must identify follow structures ！

Facial a. & v. Branches of trigeminal n.

Supratrochlear a. v. n. Supraorbital a. v. n. Mental n. Auriculotemporal n.

Parotid duct Branches of facial n.

Temporal branches Zygomatic branches Buccal branches Marginal mandibular branch Cervical branch

Head 山东大学医学院解剖教研室李振华. Regions and landmarks of head Regions Cranium...

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Transcript of Head 山东大学医学院解剖教研室李振华. Regions and landmarks of head Regions Cranium...

Head 山东大学医学院 解剖教研室 李振华. Regions and landmarks of head Regions Cranium...

Documents

Transcript of Head 山东大学医学院 解剖教研室 李振华. Regions and landmarks of head Regions Cranium...

Head 山东大学医学院解剖教研室李振华. Regions and landmarks of head Regions Cranium...

Transcript of Head 山东大学医学院解剖教研室李振华. Regions and landmarks of head Regions Cranium...