Anatomy

Questions:
1. Limit between head and neck:
Superficial limit:
- External occipital protuberance
- Superior nuchal line
- Base of the mastoid process
- Anterior border of sternocleidomastoid muscle
- The angle of the mandible (gonion)
- Inferior border of the mandible
- Mental protuberance

Deep limit:
- Anterior: the floor of the mouth
- Posterior: angle between mandible and cervical vertebral column

2. Vascular supply and innervation of frontal region:

Vessels and nerves of the frontal region:

a. Supraorbital neurovascular bundle:

- Supraorbital artery - branch of ophthalmic artery
- Supraorbital nerve - branch of frontal nerve
- Supraorbital vein - drains in angular vein
b. Supratrochlear neurovascular bundle:
- Supratrochlear artery - branch of ophthalmic artery
- Supratrochlear nerve - branch of frontal nerve
- Supratrochlear vein - drains to angular vein
c. Temporal neurovascular bundle:
- Frontal branch of superficial temporal artery
- Temporal branch of parotidian plexus
- Superficial temporal veins
- Lymphatics of frontal region: - superficial parotid lymphatic node
- facial and submandibular lymphatic nodes

3. Limits of Temporal region

Superior: superior temporal line of parietal bone.

Inferior: A horizontal plane through zygomatic arch
Posterior: supramastoid crest, inferior temporal line of parietal bone.
Anterior: frontozygomatic arcade, temporal line of frontal bone.
4. Content of infratemporal fossa

- Maxillary artery
- Maxillary nerve
- Mandibular nerve
- Lingual nerve
- Posterior superior alveolar nerves
- Otic ganglion
- Pterygomaxillary venous plexus
- Lateral pterygoid muscle
- Sphenomandibular ligament

5. Communication of the pterygopalatine fossa:

- Inferior orbital fissure - orbit
- Sphenopalatine foramen - nasal fossa
- Pterygomaxillary fissure - infratemporal fossa
- Foramen rotundum - middle cranial fossa
- Greater and lesser palatine foramen - oral cavity

6. Articular surface of temporomandibular joint

- Temporal bone:
- articular eminence= convex, anterior limit mandibular fossa.
- Mandibular fossa= concave.
- Mandibular condyle= convex, slightly curved.

7. Parotid ducts
Excretor canal of parotid gland, length=4 cm, diameter= 3mm, color= white-pearl
Located: posterior part of the gland, (union of 2 separated canals).
1 intraparotid segment, 3 extra parotid segments
- Intraparotid part: emerges from the gland, ⅓ superior, ⅔ inferior.
- Extra parotid part- 3 segments
a. The masseteric segment.
b. The buccal segment.
c. Submucous segment.
The mute zone (Seres Sturm) is the region where the incisions does not affect the branches of the
facial nerve because they are protected by the buccal fat pad and fibrous tissue from the masseteric
fascia;
8. Stratigraphy of anterior walls of oral cavity

1. Skin:
- hair follicles
- sebaceous glands
- sweat glands.
- skin continues with the red zone of the lip.
2. Muscular layer:
- labial part of orbicularis oris and the adjacent muscles form modiolus at angle of
mouth.
3. The glandular layer is made of serous and mucous glands.
4. Mucosa:

- thick non-keratinizing stratified squamous epithelium

- well vascularized
- numerous minor salivary glands

9. Intrinsic muscles of the tongue

- Superior longitudinal

- Shortens the tongue, makes the dorsum concave.

- Inferior longitudinal

- Extends from the root of the tongue to the apex, shortens the tongue, and makes the
dorsum convex.

- Transverse

- Narrows and elongates the tongue.

- Vertical

- Extends from dorsal to inferior part of the tongue, it flattens the tongue- makes it wider.

10. The limits of the carotid triangle

The carotid triangle is limited:

- posteriorly by sternocleidomastoid

- anteroinferiorly by the superior belly of omohyoid

- superiorly by stylohyoid and the posterior belly of digastric

Questions of romanian class:

1. temporal fascia
- Fibrous, resistant structure, that covers temporalis
- Insterions:
- Ant: temporal line of frontal bone, posterior
border of frontozygomatic arcade
- Inf: divides into two sheets -> insert on sup.
Border of zygomatic arch
- Sup: sup. Temporal line
- Post: inf. Temporal line, supramastoid crest

2. The frontal sinuses:

- pneumatic cavities separated by
osseous septum
- situated at the level of glabella and the
superciliary arches
- communicate with the nasal cavity
through the frontonasal canals
- Their size is variable : small (at the level
of glabella), middle size, big (men),
- The walls of frontal sinuses:
- anterior: compact osseous layer of glabella and superciliary arches
- posterior: meninges, superior sagittal sinus, frontal pole of the cerebral
hemispheres
- medial: septum that is incomplete and asymmetrical

3. Limits of temporal fossa

Sup: superior temporal line of parietal bone
Inf: zygomatic arch
Post: inf temporal line of parietal bone, supramastoid crest
Ant: temporal line of frontal bone, zygomaticofrontal arcade

4. Content of infratemporal fossa

- Maxillary artery
- Maxillary nerve
- mandibular nerve
- Lingual nerve
- Posterior superior alveolar nerve
- Otic ganglion
- Pterygomaxillary venous plexus
- Lateral pterygoid muscle
- Sphenomandibular ligament
 5. communications of the pterygopalatine fossa
Inferior orbital fissure - orbit
Sphenopalatine foramen - nasal fossa
Pterygomaxillary fissure - infratemporal fossa
Foramen rotundum - middle cranial fossa
Lesser and greater palatine foramen- oral cavity

6. mandibular ramus
- Mandibular ramus: Quadrilateral shape, two surfaces, four borders and two
processes (coronoid, condylar)
- Medial surface: Contains mandibular foramen, lingula, mylohyoid groove
- Superior border: Mandibular incisure, coronoid process, condylar process
- Anterior border: Thin above, thicker below, temporal crest, retromolar fossa
- Attachment for muscles of mastication: Masseter, medial pterygoid,
temporalis, lateral pterygoid

7. temporal muscle

Origin:

● Osseous, on the temporal fossa: the external surface of parietal bone, the temporal
surface of frontal bone, the temporal surface of great wing of sphenoid bone, the
external surface of temporal bone.
● Fascial origin: on deep surface of temporal fascia.

Actions:

Temporalis is one of the most powerful elevator of the mandible.

Other actions of temporalis are:

● side-to-side grinding movements, together with medial pterygoid

● protrusion
● retraction
Innervation: deep temporal branches of the mandibular nerve.

8. anterior floor of the exobase (etajul anterior al exobazei) external skull

9. innervation of the tongue

Motor XII cranial nerve

 Sensitive (general sensation) Lingual nerve (Vc): Anterior ⅔ of tongue
IXth cranial nerve: Post ⅓ of tongue

Sensory (taste sensation) Chorda tympani nerve (VII): Anterior ⅔ of tongue

IX cranial nerve: Posterior ⅓ of the tongue

10. Binding elements of TMJ connection

Fibrous capsule
a. External fibrous and internal synovial membrane.
b. Lower part= Surrounded by tight fibres that attach the mandibular condyle to the
disc.
c. Upper part= surrounded by loose fibres that attach the disc to the temporal bone.
Ligaments
d. Lateral ligaments= intrinsic ligaments (close)
- attached above to the articular tubercle
- fibrous, resistant, on the external surface ™ joint, acts to prevent posterior
dislocation of the joint.
e. Medial ligaments= extrinsic ligaments (distance)
- Sphenomandibular ligament:
- Medial to the capsule, flat and thin.
- Descend from the spine of the sphenoid to lingula of mandibular
foramen.
Stylomandibular ligaments:
- From the styloid process to the angle of the mandible.
- Limits protrusive movements of the mandible.