Head, Neck And TMJ Anatomy PDF

Head, Neck And TMJ Anatomy ​ Maxillae: 2 and conditions ​ Nasal bones: 2 ​ Lacrimal bones: 2 ​ Vomer: 1 Scalp - Soft tissue that...

Head, Neck And TMJ Anatomy ​ Maxillae: 2 and conditions ​ Nasal bones: 2 ​ Lacrimal bones: 2 ​ Vomer: 1 Scalp - Soft tissue that cover and protects the ​ Palatine bones: 2 cranial vault ​ Inferior conchae: 2 Layers of the scalp ​ Mandible: 1 1.​ Skin. outermost layer of the scalp. Found a sebaceous gland and hair Sutures follicle. “Synarthrodial joints” 2.​ Connective tissue. Major arteries and veins. 3.​ Aponeurosis AKA: Galea aponeurosis. Sheath like structure that connects 2 muscle (occipitalis and frontalis) 4.​ Loose areolar tissue area. Emissary veins (valveless), “dangerous layer” 5.​ Periosteum. “Pericranium”, the ​ Lateral view. Temporal: 2 innermost layer of the scalp. ○​ Squamosal suture: connects the a.​ Outermost layer of the skull temporal bone to the parietal b.​ It provides nutrition to the scalp bone. Fontanelles Skull Bones 1.​ Anterior fontanelles. Close between Cranial Bones 18-24 months ​ Frontal bone: 1 a.​ Bregma. The point where the ​ Parietal bones: 2 coronal and sagittal suture ​ Occipital bone: 1 intersect ​ Temporal bones: 2 2.​ Posterior fontanelle. Close between 9-12 ​ Sphenoid bone: 1 months ​ Ethmoid bone: 1 a.​ Lambda. The point where the sagittal and lambdoid suture Facial Bones intersect ​ Zygomatic bones: 2  Landmarks of the skull Facial muscles Sensory supply. Trigeminal nn (CN V) Motor supply. Facial nn (CN VII) 1.​ Nasion. (also known as bridge of the nose) is the midline bony depression 1.​ Occipitofrontalis. Elevates the between the eyes where the frontal and eyebrows “muscle for surprise” two nasal bones meet, just below the 2.​ Corrugator supercilii. Pulls the glabella. eyebrow together “muscle for frowning” 2.​ Glabella. area of skin between the 3.​ Procerus. It wrinkles the bridge of the eyebrows and above the nose. nose “muscle for disgust/distaste” a.​ Glabellar tap reflex. (+) myerson's 4.​ Zygomaticus Major. Primary muscle for sign (persistent blinking) smiling 3.​ Nasolabial folds. (smile lines) creases in 5.​ Zygomaticus minor. Secondary mm to your skin extending from both sides of zygomaticus major (smiling) your nose to the corners of your mouth “elevates/protrudes the upper lip” 4.​ Philtrum. vertical groove between the 6.​ Risorius. Muscle for grimace/fake base of the nose and the border of the smile. (-)/absent risorius = dimples upper lip. 7.​ Orbicularis oris. Closes the lips “mm for 5.​ Pterion. Thinnest portion of the lateral kissing” skull. The middle meningeal artery lies 8.​ Buccinator. Pouts the cheeks “mm for beneath this area. blowing, sucking, and whistling” 6.​ Inion. the most prominent point on the 9.​ Levator anguli oris. Elevates the angle external occipital protuberance. This of the mouth “mm for sneering” protuberance is a bony projection that 10.​Mentalis. “Mm for doubting” can be easily felt at the back of the head 11.​ Platysma. Depresses the angle of the on the occipital bone. mouth “EGAD mm” a.​ Landmark for head circumference.  12.​ Levator labii supercialis. Elevate upper 5.​ Superior oblique. Downward and lips inward 13.​Levator labii inferioris. Depresses the 6.​ Inferior oblique. Upward and inward lower lip EYE MUSCLES Vertical diplopia MUSCLES FOR EYE OPENING 1.​ Levator Palpebrae Superioris. Responsible For 80% of eye opening Horizontal diplopia a.​ Innervated: Oculomotor nn (CN III) b.​ Ptosis. Lesion 2.​ Mueller's Muscle. Responsible For 20% *weakness CN VI: Medial strabismus of eve opening a.​ Innervated: Sympathetic nerves Neck region Muscle for eye closing Cervical vertebrae 1.​ Orbicularis oculi. Innervated: CN VII - “Small body; triangular shaped foramen” facial nn “Short and bifid spinous process” ​ C1. “atlas” no body and no spinous Extraocular muscles - (“IO MR. SO”) process. Jefferson fx ○​ Atlanto occipital joint. “Yes jt” ​ C2. “Axis” dens/ odontoid process (epistropheus) = Teardrop fx ○​ Hangman fx = C2 ○​ Atlanto axial joint. “No joint” ​ C3. Hyoid ​ C4. thyroid (primary) ​ C5. thyroid Muscle ​ C6. cricoid 1.​ Superior rectus. Upward and outward ​ C7. vertebral prominence; long and 2.​ Inferior rectus. Downward and outward non-bifid spinous process 3.​ Lateral rectus. ABD the eyeball ○​ Clay Shoveler's fx 4.​ Medial rectus. ADD the eyeball Muscles of the neck  1.​ SCM. innervated by CN XI (spinal ​ Thyrohyoid. 1st cervical mm accessory nn) ​ Omohyoid. a.​ Unilateral action ​ Sternohyoid. i.​ Ipsilateral flex ​ Sternothyroid ii.​ Contralateral rot b.​ Bilateral action Triangles of the neck i.​ Cervical flex Anterior Triangles Eg. R torticolis ​ Submental. ​ R lat flex, (L) rot (position) ○​ Ant neck line, Anterior Digastric, ​ LOM: L lat flex, R rot (position to hyoid bone. stretch) ​ Submandibular/Digastric. 2.​ Scalene ○​ Anterior and Posterior Digastric, a.​ Unilateral action Mandible i.​ Ipsilateral flex ​ Carotid. ii.​ Ipsilateral rot ○​ Posterior Digastric, Superior b.​ Bilateral action Omohyoid, Ant SCM i.​ Cervical flex ​ Muscular. ​ Hyoid bone. “No direct articulation”; ○​ Superior Omohyoid, Ant SCM, styloid ligament: connects the hyoid post belly of digastric bone to the base of the skull Posterior Triangles Suprahyoid ms (“DMSG”). Ms that are ​ Occipital. attached ABOVE the hyoid bone ○​ Post SCM, Upper Trapezius, ​ Digastric Inferior Omohyoid ○​ Ant belly. CN V ​ Supraclavicular/Jugular. ○​ Post belly. CN VII ○​ Post SCM, Inferior Omohyoid, ​ Mylohyoid. CN V Clavicle ​ Stylohyoid. CN VII ​ Geniohyoid. CN XII Temporomandibular joint (TMJ) “Articulation between mandibular condyle and Infrahyoid ms. Ms that are attached BELOW mandibular fossa” the hyoid bone “Modified hinge joint.”  “Ginglymoarthrodial joint” opening Superior joint: translation ○​ LOM in mouth opening and Interior joint: rotation contralateral deviation ​ Open packed position. Mouth slightly ○​ (+) Swelling open, lips together, teeth not in contact ​ TMJ Hypomobility: (+) Limitation of ​ Closed packed position. Tightly Mouth opening and contralateral dev. clenched teeth ​ TMJ Hypermobility: Excessive mouth ​ Capsular pattern. Limitation in mouth opening and contralateral dev. opening *most common direction of dislocation of Muscles of mastication TMJ. ANTERIOR* Mouth closing ​ Temporalis. ○​ Post fiber. Retrusion ○​ Ant fiber. ○​ Superior fiber ​ Internal pterygoid. Protrusion ​ Masseter. Protrusion Mouth opening ​ External pterygoid. Protrusion TMJ conditions ​ TMJ Disc Displacement: (+) click upon mouth opening ​ TMJ Displacement: (+) click upon mouth closing ​ TMJ Capsulitis: (+) pain upon mouth opening. ○​ LoM in mouth opening contralateral deviation. ○​ (-) swelling ​ TMJ Synovitis: (+) Pain upon mouth