HE

NECK
 SCALP ↳ kneecaps
extends from Supraorbital margin
① to Norma ◦ capitals
1- ① lateral → zygomatic fascia
n

Slayers
/
→ S -
Skin (These three layer
surgical layer of
c-
Connection Tism scalp move when ⑨
applied)
A- ↳
Aponeurosis implant placed under it .

1- Loose Areolar tissue

P pericranium ( same Periosteum)
-

as

•ⁿ

Tissue

formative
-
loose As tissue
-

x
Skuee -

Diploe
Dural venous Sinus
(Blood + St)

Emissary vein to 2ⁿᵈ layer

i. e. connective tissue .

Skin : Thick

Hairy ( except forehead) → Sebaceous

gland
sweat gland site
for sebaceous cyst
'

t
opening close to root of
hair
follicle blocked
causing swelling and cyst
i.
-
-

Connective Tissue : .
Dense Fibrous Connective tissue
(DenseÉtui) •

Binds skin and Aponeurosis

*
large no of Nv and blood vessels
.

↳ When
injury
to these , bleed fvwfusely
as no vasoconstriction dueto tse
of
dense
fibrous connective tissue .

layerofttporeurosis : ( flattened tendon)

K /a Epi cranial Apo . or Celia Alponeusotica

helmet

( paired )
Ms 1st Oceifirto frontalis
-

difficult to differentiate
Post
×
Origin Ant →
'

no attachment,

tst on bone attach on skin .

3
fibers +sty loose Aaweae Tissue
↳ntaeyay

!÷÷É÷j
"" ""

tissue 1st above eyebrow Occipital belly

and boot of nose .

No Wrinkle
bony
:
attachment
+ st

( line tst in line of

Nose and Ext Auditory)
-

-
loose Areolas tissue

looseAeuol-tss.ve : Traversed by many emissary vein (No value)

(Dangerous layer ↓
ofscalp)
No value tst : chances that # layer Connecting I
layer to Dural venous Sinus

enfution may spread to Dural venous Sirius ① Connects intracranial to exta cranial
 N-dvantoyedfnovabn-i.NO expansion in skull
i.
emissary valve move blood outwards when ↑ blood
. .

CLINICAL :

Blaikeye Blood collection in loose Areolar Tissue cause blood to pool in this
.

This causes blood to move in around orbit : black

area eye
to
Bcz frontalis
have no
bony attachment -

Gapiwgofwound : Transverse wound →

Gape due to puke of ocupito
-

frontalis Mls
-
.

Safety valuetlaematoma :

→ # of cranial vault cause

Tearing of
durra and pericranium
.

Communicate to loose Areolar

→ Intracranial
Halmmorhage
Tissue
to
Avoids Cerebral Compression
-

i.

Pericranium : ◦ Can easily strip off stud bone

! ÷-
Move to suture and endocranium
from suture connects to
•

suture

endocranium
Capmatoma: subperitoneal bleeding
by as at Satures
Bounded
suture
+7
sens flow out
Pericamumm
(not allow to

·:
bluding takes shape of bone.
Usually place in Paristalbone
takes

⑧ Common in child as comprusion during partition,

Never
Sensory
ISUPPLY:
-

risTETTEro ni m oofo noho

(from orbit)

Opthalmic
(
(1)

(Mandibular D
Auriculo temporal (

Vental Ranus

Greater occipitano porsal Lenus

Third
or
[c2CsT Dorsal Revs-

Btpply;

issomeonreoomiI
1

Eminent ECA
Broadnax
↳

BEE _# Bo ooo
ICA win Neck
monthly
→

Sufitrochlar ④
Sup orbital A
/
-

(branch of Aorta)

Ganatomy : skill cut

from center as ④
and
not obstruct
remains him
:
- no
injury side
part
-

TEMPORAL FASCIA

Temporalis Mls origin

(mastication helps)
Temporalis Mfs
- - .

Temp nah fasia .

 f-
,-ACE_
lllormafeontalis

Fronto nasal
⑨ Medial 43 and
suture .

-
Lat 43 .

Intermodal -
_
Nasal bone
suture

① Infraorbital
( Nandu out
⑧ and ④ .

of Chin
)

Gnathion (fusion of mandible)

( )
joining of 2b one

sup -

orbital Notch → Supraorbital ④ and ④ .

Marginoforkit Uhhh - frontal bone

lateral frontal -1 bone
-

Zygomatic
Maxilla +
tower -

zygomatic
medial -

bust of lacrimal bone not maxilla

,
+ frontal bone
 SKI :

Thick , elastic , vascular

Supuficialfascia : •
Contains muscle of facial expression
Variable + St
fat
•

/ Fat absent
in eyelid
/ More stain buccal (more prominent in child)
+
region
↳
( For
* Suctorial pad of fat sinking , whistling

keepFascia : Absent

Except On Parotid gland Kla Porotidomassertive fascia

[
Mumps →
Swelling of Parotid
→ This fascia not allow
fascia to expand -

i. more
painful .

Facialmusde Remnant Panniculus Geno sus

of
:

L
sheet
of muscle
.

l
muscle + St in lower animal .
 # Corrugation Supercilli
( Frowning )

Proving ⑧ ⑧ Orbicularis Oculi

(Trans (closing of eye)
wrinkling of
.

nose )

÷÷÷ :
www.w.aisupai.a.is www.m.se,
Nasi ⑥
alaguae
•
elevation
of upper lip
dilates nostrils (
closing of mouth)
•

Risorius (grinning)
+ st at ala
of nose .

levator
→ angulioris
[ Wrinkling of Chin (confusion)) ( elevation of )
angle of mouth
(deepto
cygomatismeyoi)

0
µ

①
2ygomaticusmeno.ae -

Upper lip elevation

②
2ygomat.ws major Smiling
-

DMhmmtioh.tt?'mmmmn
③ levator Cakii
Superiors -
only upper lip elevation
.

④ (full lower down )

Depressor Labii inferiors lip
-
.

⑤ (sadness)
Depressor angnlioris
-

⑥ Buccinator : cheek muscle ( blowing , kissing)

↳ deep to Rosorius .

Very imp muscle

-
.
 Muscle supplied by
Cranial ⑨ →
⑦
# facial ⑧
Atlasimage
:

Muscle of neck
Fear
lsubcutaneous
mp)
 FACIALNERVE-VIcervicalNerve-paroti.cl
Ace
.

Parotid
duet with

gland .
-

Parotid -

gland .

Masseter Mls

1-
Common fascia
Parotid omassenkr
fascia .

Face

fY "
Musch pale
go.pt
Facial ④ my wed

facial MIS of app

.
.

side .

Side stretch wit

facial
⑧ injury site .
 B-fh -ly-of acet-ACIALARTERI.g
① Branch
of Ext Carotid
.

④
Cervical Part

Facial Part

Orbit ④

Nose

uhhueip

lower lip Angle of mandible

Ant Inf angle
of Masseter

Hyoid
.

↓
greater wanna
.
 Facial ④

:¥÷÷E¥÷¥÷
-

÷
int carotid and ext

Angular ④ -

"

Lateral
④
¥ facial ④
Nasal

Sup .

Labial _ =
④

. ÉÉÉ¥¥÷
Ant -

Inf angle
of Masseter
•
Pierces deep
.is.
Cervical greater wanna
Cervical
fascia of hyoid
. .

part

S -

sub mental ④
T -
Tonsilat ④
A -
Nsc Palatine ④
.

G- Glandular [Sub Mand ⑦

Sufi labial ⑧ -

gives off septal branch to Nose .

a
 Court : facial ④ starts
from just above to
greater Genna of hyoid .

6
Runs win neck and
gins
Pulse felt at off h branches -

Ant b
Inf angle of masseter
-

i.
Kla Anas thesis-1's ④ facial ④ goes deep to
angle of mandible

Glandular branch → Submandibular

gland
to
facial ④
emerges at lower

border of body of mandible

&
Comes out of beef cervical fascia
at
angle of masseter Cant
inf angle)
-

↓
Ala
of Nose
↓
Anastomose with dorsal
_
In orbit
Nasal ④ -

front of
(medial Angle of eye]

Toschurousfaiialto : Show
expression of face ,
muscle can work .

Faaal :

Torturous⑧

Facial Vein
,[AC1ALVE1N#,

Post to Sterno -

ant to Sterno Indomastoid

vein
Ext Jug
-
 __

Venice
Dangerous
-
Connection of vein :
-

No fimflr burst in dangerous area as bus can teared through vein

Danger aura
of fan due to no value in
-

veins
'

→ Nose and uhhh lip

 1

DEEP CERVICAL FASCIA

⑨ Not face and Ant Abd wall
foesert
'

on .

MODIFICATION OF DEEP CERVICAL FASUA :

Investing layer
)-
1

2 Preteaeheal layer all 3

forms
3 Prevuteksal layer Carotid Sheath .

4 Carotid sheath
5 Bucco pharyngeal
fascia

Imeistenglayer
cludomastoidiSubmandgeandPsetsFei2layees@Vis.ce
: encloses trapezius muscle , Sterno

al layer - Covers glands

③ Muscular layer -
covers midline
Mfs of neck

Psevertebsalheath : Muscle in relation to vertebral column

Bucuopharynge.ae#h:Bucunatoem/s- , pharynx
Cahotidshath : carotid vessels

Investing layer attachment -

Art attachment
-
.

*
 Investing layer

strap mys-
of
layer Petaheatre
enclosed
my
in is
T

(Post. lat to theroid

-
Investing layer
-
T
mething Layer
If chment
PostAttachment
-
Acromia proces
Jugular Notch, Clavicle,
Sup. Nucal line spine of scapula-

ICES TOPPED

Mom***
so

-Sation
of Neck:
Pretracheal fascia (Muscular

Deifi
e

i n
Investing -M
layer
S ⑧o strap muscles
Pretro Cheal
fascia
·

of 3 m/s
one

perivertebral
fascia
 suthment
INVESTING LAYER

⑧ Covers SCM and trapezius mys.

· Forms
roof of Post, and Ant. A
of Neck.

Encloses
-
① Parotid gland
② sub-mandibular gland

'Ahmentof Tristing layers

Coronal
-
section
Parotid
- gland:
Sndibular
.
gland:
A tooth

M -
Mandible

↳parofid mandibula
#
g

gland. Hyoid

Comal
see:
the
zygomatic
-

severandomitonionGo hamand
·
Deep layers
Style mandibules lig.

mandible,

Seprates mandibular
and parotid fascia.
-
-
SMG

Sup layer
stylomand.
liganent
·'Thekening of deep layer, -

Deep layer
 spacedby ursting layer
1.
Supracacular space
2.
Suprasternal space (Burn's space)

section (lat view

Saggital

-> skin below clavicle provided.

Fascia not allow vein to retract

Incase of picture of -

fas
·: air embolism may occurs

fasciaadhere
is
death.
causing
of
contuting layer
=>

wis Subclavius m/S

Superal
(Burn's
space:
DrI TI..
Content
->
of Burn's space

SM ⑥
Jugular venous arch
↳ both ant
joins
jugular vein.

⑥ Sometimes lymph mode also test.

 Rule of
2

&
2 enclosed
spaces
 ·Pulley needed by
mys with two belly

=ummunumnamum
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 with Carotid
Pretracheal layer: latually gor
sheath,

Gland's own fascia

Iecapsule:

other than
Ipsule: Ext.fascia
gland.

⑭t
⑱
 Suspensry
ligamentof Berry
degentition, Thyroid cartilage go
ccoid pull
In
above also
Cast inspira

Canical differentiation of thyroid (non-thyroid mid-line

swelling of neck.
-

Tidal swelling
-

moves up and down with

degentition on

Nthprodswelling:No movement of thyroid.

patebralfas
Bucopharyngial fascia

Scaleneus -

I
 thee

Metrophages
blow Prevertebral space
space.
Phrenic

⑭PI useromana
Prevertebral fascia
↳extends in axilla as
axillary sheath
 Sup: Base of spul

Prust. Fascia
KEny: At T1, T21T2

·
C2 longest fascia

Cs
goes up Gaygeal vertebr
· to as

Ch

Cs

Co
(Not visible on CT scan)
contr C7

post
to a
Ant long-ligament
Privetebral fascia attaches to it

atT1, T2, T3.

D+
Injection·
⑦
mto post. Mediastenum-
goes
Causes-Dysphagia, Dyspnea
Neck
->
Danger space of
 CAROTID SUFATH:

Pre-Racheal layer, Pre-vertebral layer.

contributed
by: Investing layer,
Extent: Arch
of Aosta to Base
of skull
is Foramen, ITV and ICA
for
Carofid Canal (ICA)

Jugular foramen (F5V)

· Carotid sheath around ITV is slightly thin to allow

expansion of vein.

Extent
of Carotid sheath:
 Content Carotid
·

of
-> carotid Canal
foramen
and jugular

Ant and Post Relation:

-
↳Loop of Never

(Not adherent)
 (Mesodermal thickening)

⑭Supply;
(Mandibular P

d (Facial expression)

->
Styeopharynges (ms of pharynx
-
↳
All are
skeletalm/s.

·
No cramal nerve nuclei for I and II pai
10lfactory) (opticl
·
Nerve have more than I function 4. Facial more than I nulie
>
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·

funn
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 CALNERUE CI Pain

I
I
Oefactory Newer (shortest carrial]
-

No Nuclei Sensory)
Cvision
If
Optic Neee

I Ucculomotor (motor Q of eye]

+Eye nerves.

If Trochlea (Fochleanm/s) (motor)

Trigeminal (sensory + motor)

# Abducent or CAbdiction of eyel (motoe)

I Facial (motor)

" Vestibulo cochlear O (special sensation)

If Gloesopharyngeal(Tongue +
Phanpx) (sensory)

Vagus (goes beyond Head and Needs

(largest component)
# Accessory
T (under tongue)
Hypogonal

Ganglion: Collation of cell body outside CNS

Nuclei: Cell body inside ONS.
 Muscles of Face :

Both skeletal and smooth Mls +St

Skeletal Mls > 2

Types

Pharyngeal Somite derived mls (skeletal Mls)

arch Mls
Mastication and Facial m/s extraocular Mls
•
•

Tongue Mls
-

Three
-
tykes of m/s ÷ Three types of nucleus hresent

/
→
Arranged in column of nuclei .

Neural Tube :

Aejiwi ew.nu?mmpeaie1-Aeesenan.nmeei
☐°ʳᵈ

( plate)
separates Two

Ventral Basal Plate ( Motor plate →

All motor CN nuclei

Gives rise to

4th Ventrical of
brain

Neuraltubeopensup :

(sensory
Nuclei ) ! Basal Plate
, Opp of GUE
SUE
Y ( motor nuclei) GSE
Med

oÉÉÉ
.

sulcus
limitanei to Lat
( Ant
.

(at )
 ① Never compare afflhlntandlffeeut @

Colunnoftvwln : where all Nuchieie

SKelem+( misnomer
oasderivedfeomsomite

/ senses
> where sensation
comes from
( Pain / Temp ,Touch)
distention etc .

ongqat.jo?rah?elf.TsiganimaeNO
i. Takenasviscera .
↳

g÷go&•
☆÷☆ff@-☆BBBtM0EBgB
 · One side of Brain Clotuns) Nisdamaged: All visual sensationgone.

Midline of Blain Smooth m/s

Parasymp
④ forpharyn column
·

fused column
Arch-
-geal NU.
Single
Midbeain

Dons md
-
Small
Granial mE
·

Coear
Ne
Vestibular e
(4nu)
Medula
oblongata larges
⑧ At ponto-med. Function
caudal

<Alone N u t

⑧ Collective Nucleus

·
..II also included
in Nucleus of Pharyngeal Azed

⑦ TNucleus Ipsiatal (same side m/sdamage)

↳) IX, I (

Edhinges Westphal ·
also have -

component of
Sup.Salivatory NU.
↑

Lacrimal
NU

NU
If Salivatory

⑨ PoesasNu slands of Thorns

Smoothms and and And Viser,

Met
he
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he
 (sympathetic)

Trigeminal Un

G A:

midblain----
(mesencephalon of brain) (Position Sense e. Jamopen)
Dons
I
Medulla
Ob
I
Note: Name not up, function of Nu up to drain into column

Example:
-
Facial Neve comes under

I
-
I N+ SVE column

SSN+GUE column
-

SVA
-

- GVA column
 Every ganglion Topographic and functional
->

+it med to lat. Pty.

lat to Med-Men- / Foramen spinosum.
below foramen oval

Typical Parasymp. Ganglion

Trigeminal W
Post
ganglionia
Relay fibres.
-
Ganglion

·
⑳n head.
I Dirt N to nearby gland.
Parasymp

Trgeminal - completes function of other menus also

her.
M topper
 Columns of Nucleus

SVE
AS A

Sensory ④

Motor ④

O-rigin-oft-ugeminal.NO/ Motor ④

and
fusion of sensory
Motor ⑨
IMINAL NERVE:
Opthalmic W
Maxillan
Mandifiutar N
Functional columns:
-

Motor me

Sensory he
(superior orbital fissure

skin of forhead and

scalp

ophthalmin -
Infratechee
Gasserian's Gangton)
↳> upper
eyelid

↑
Sensory Doo

Ptrigo palatine
TTTTTTTTJMaxilla and Teeth
Fossa.
↳
+se
of gangtion
Temporal
· bone

temporal N: LygomaticTemporal N Lacrimal i

cygomatic
↳ Parasymp. I goes beyond Ganglion
never

Branch of"Fail ends provide here to

lacrimal -This supply needed.

 Section
-se

Infratoch
ear o

⑭
uphertid ⑩

·mirfy
oa
redial al

Ant a
ethnoid lacrimal

lialy N:
long sensation
from cornea, atiary body and is

Post- ethmoidal P: ethroidal and air sins

- sphenoidal

Aut. ethroidal N Cranial duramate muoia Came

nasal
Nasa ext
out
- as
-
e

skin ofnose

X X * #ving-go
3 'x'
 ④ -

Int -

ethmoidal ⑧

⑨ Post
_

ethmoidal ⑨
-

Anglican

lot Pti
Maxilla
plate

I
Ptoigo Maxillary fossa tst here .

-M_A×1UIEEʰ¥

PG

① -

②
③
f- Three branches
Of Max .
and ITN .
1)PU TOPPER
 Zygomatic temporal ⑨ zygomaticTemporal @
⑨ : + Lacrimal ④

↳ Pasasymp .

④ never
goes beyond Ganglion
to
Blanch of facial @ ends here provide .
: to

lacrimal ④ → This supply needed

.

lacrimal ④ wifi lacrimal gland

.

#
#Zygomatictemporal ④

zygomaticfacial ④
Maxillary ④ PPG

Both sensory
MANDNE and Motori
, mennigialbeanonofmand.ir ②
① aikto Cranial cavity
⑨
Motor and sensory
/ joins here middle cranial
Fossa .

middle
(
Mastvjationmls) I④ not relay )
memmgial Otic

µ/
④
ganglion

loop Motor branch

(Stein)
(Tempo so Mand Joint )
-
-

Skin and mucosa ofcheek .

Swbmand Pierces buccinator but not suhhly it

ganglion
.

-
Mandible
sensory
( mylohyoid)
.

ALI branches
Auricula temporal @

f-
-

-
lingual ⑨
Inf alveolar ⑨
God of Anatomy
ii-ii-iiiiii-ii.ie
:

Fo -
foramen ovale

⑧ -
medial pterygoid @

"

"
Fyi
Ant:Diu

:@ Buccal
④

POSTERIOR DIVISION :
 (mainly motor)

motor me. ET.

Sup. salvatore
Nu

* Pentomedullary junction

imaOblongatar
I Internal Acoustic meates

(Int Auditory
meatus)

ofTrigemmal facial
⑧ Cource and
 N
Priganglioni Parasymp.
Greater Petersal N -
W to Pengord
Canal
DPN-Post Sanglionic sup.

I
↳
Ganglion in spinacord (external genu)
-

part
⑧ Petrons

swollen otemporalbone
↑

(
Facial ↳(sensory
ganglion (
Connicules ·
-
(mul+st
inside it) Ponto
meculary Medial wallof
But and meatus
function S

Deep Petrusa
Pengo
Palativeanglion
↑ ⑭
rosewall

CragIn -

(submandelnitar
-Temporofacial W gangion]

a -
upper buccal manch
Pontidduct
Clower) I Bual
beanch

sac
Cervice
M

occipital mis
5 mis of non-facial expression by facial NStapedis
Auricular m/s Post belly of digastric
Styco hyiral mys

&"Linjuries nextalide
 Facial ⑧

mediaewaee Segments of facial @

Cupto 1ˢᵗ gene)

Intracranial

Int auditory part

meatus
(before meatus)
(horizontal part
→ 2ndgenre

(vertical) / →
after Foramen
↳
extramarital part

⑨ to pterigoid canal

•
facial
⑧

chosda Tympani

Secreto motor pathway to Serb mandibular and

.

sublingual gland

sup Salivary
-
Nucleus

↓
Facial ⑨
↓

chosdatymp.am
↓ Submandibular@
(Relay ) Submandmlar →
lingual ⑥ →
Senblngnal @
ganglion
 -

Lasalsod
= a

vEmp
- ⑧ 3 neres used up to supply gland.
Salvatory Nucleus
Sup

faidy
I ↳
ophthalmic

Maxillary
 UPPER MOTOR NEURON AND LOWER MOTOR NEURON

'
Ipsilateral iryvry
⑥

¥¥
"° bᵈʰᵈʰᵗ°ʳʰ^ "
M
flaccid
'

Paralysis
-

LMN # →

KTVI
Motor neuron
UMN A- spastic paralysis
→

④ Outside CNS

↳ opposite
Brainstem / spinal cord
side
injured
can show conduction
?⃝
I

cerebral cortex

forhead spared
.
as it is provided
by both side of cortex .

in Pons)
(more dangerous)
(+St as UMM involved .

Ipsilateral
' '

both part of
Bellis Palsy
Provided
by
cortex ② and ⑧ '
 Injury to stylemastoid
-

Bell's Paralysis

[
LMN
Choordatendini
injury
i.
Post wall above _

chordal
tympani
nothin
(most common ) Stapeduis → damaged ,
at level
of lateral to manage sound hull
'

circular canal / Tympanic

.

segment
-

Injury at level of
extgemec labyrinth Seg ) .

Identification :

Facial Paralysis Notable to raise eyebrow

:
-

spastic paralysis
①
Identified by
tongue movement

- . ☆

Crocodile Teardrop
Syndrome During regeneration
:

to
Secretomotosr fibres for salivary gland
to
into endometrial tube of
Aceidlnley grow
hour to lacrimal gland

to lacrimation
stimulus
Salivary
→
saturation
during
-
 G LUSSOPUARYNGEAL NERVE

SC -
Sup
Constrictor

MC-Muddle
coust

IC-Tnl.
coust
↑......."-" glsponge
⑭

Hyo
glosses

Lesser Petrusal
#
Carotid wall

ovale
Promontory
due to
Oticganglion
Cocklea-

Parotid
- gland

Glonsupharyngeal
 Greater
Petrusor
⑭
&
--ssPetheo

ear test here

Foramen ovale - statues passes "MALE"

M Mandibular
-

A +
Mand @
1- lesser Petrosal
E-Emisary vein
I
G LOSSOPHARYNGEAL NERVE:
*

Mixed *
 Medial wall

a
smaller
•
sup gang
. .

•••
Larger into
ganglion ①
Tympanic branch
•oGa
Carotid body →
carotid
sinus
celuration)

\ Lonlymtsby ☒ ⑨

Tonsils branch -
mandibular ④
lingual ⑧
Amico temporal
④

Inf Salivary
.

Nucleus

(ATN)

④ Tonsilaebsanch :
Gensensation from tonsil and soft palate .

lingual
circumvent
⑥ branch : Task from Post ' /sad of tongue
and
papilla
 ④ Allan trigeminal ⑨ 0 Parasymp -

⑧ always

ophthalmic ⑨

[Maxillary NO]

Mandibular ⑧

Mandi ⑨ WN ( ☒ NO)
Otic
ganglion Trunk of

Vagus ⑨
 GSA
Superior ganglion
· Inf-ganglion
-

GUA+ SVA

Region
-

in Head
Vagus- -
Alderman's N/Arnold's
-
Skin of EAC

mim

~
matous

of
"
Pharyngeal
branch

(Not Herring ⑰) (pharyngelus

SCCB
↑ Mel
ICCB
⑧ vocal wed

To
6.
body,
Ay ENT procedure →
sitting position
stimulate
as
vagus @ may
else and cause
Syncope .

memb
Thysohyoid
-

SIP
~_

ICCP
Only Mls 8
larynx outside
 cord-
origint spinal
toT
(Joms -

at
justragus&
blw
4Es@

·
If @

G
goes it
above

enbrolgeial
is
above
 Hypoglossal o
Dura of Post
Granial Fossa Main function: Common my of palate and tongue

fo
Hhyboglossal

a
·
⑥ Not a strap mys

supplied by C
&
(typozoesal canal
I
yours
to

loop of
(Ant. Relation
c of Carotid Sheath)
Stapm/S
mid line below
⑧ mp of
hyoid bone

sternhyoid

Sternothyroid
IMP ->
-

Granial arr via vagu (Mand)

Vago"-Ar. Complex
a

Recurrent Layngeal & Ext Laryngeal

Funk,
of mad
 Glossopharyngeal ④

Ci Herring ④

(3

1-
Internal
laryngeal ⑧
Two Laya
of cranial
dura . ( makes cranial folds)

DVS- dural venous sinus

part
G goes in
forms of brain

Falx -
sicked
shaped
 PREBRI,
#

Sickelshaped Upper margin (Sag. sulcus (

Gis fa
Gale;
·f
semi
Ant-

↓
M

Straight Sinus
D
Post end
a

Enf. saggital

⑧
Sup surface of Tentorium
Grebelli

mCerebelli: Horizontally th
Ant.cinoid process

in
malmeirawom
Attached
<

up of Hansverse swers
 ③

Closed (ip)
b/w two central herphen.
(concour

-
Tent like
lends here

Free of

margin
-

Actained o

margm

Foramen
a magnum.
⑧ Turkish saddle
 ⑧ close to into one
*
protuberance

Crista Galli

Clargest sins)

↳
sgmoisince

caremous - petroxal
supping
IJV
 FM

mostof blood) Ceager than

(more Fab

(not always test

 of vein
-Noproperty

④ spheroidal emusary vein

(Phecysoeiplexus
venus

connected by it
w
↳both income outcome

I infection
·
can share pressure
may
speed.

allarond veteral

↳um.
1.
l
l
① Some Anatomists like

freaking out Poor

Med Students
.

blanches
16 furthur
.
ECA ,
Superficial
Temporal ④

Max .

④ Post Auricular ④

-hYz§y
.

Facial ④
( above guenter oaupitae ④
annual

lingual
④
(below greater

Asc .

Pharyngeal ④

[
/
Sup Thy ④-
.

ICA
① First branch -

CC A

Carotid triangle
① Some Anatomists like

Poor
freaking out

Med Students
.
Savian

⑧ Brachial
plexus and
subclavian pars
blw Scales Ant and Med

①
⑪
#
*
T B B
Cocceo

·golf
te
verkbea *

inf
E. Foramen Teams versalium

SupIK Costocervical
Trunk
of (sto C
(Vertebral vein
passes
·

It and 228 through [7)

I
&
Eng. They Sup

!
Thyro cereal
<

⑦
-

Transverse Corneal A
Trunk Deep
Dossal Scapular ① Supiascapular

Internal Thoracic

Note: Dorsal scapular only present when Deep branch of Transverse Cervical Absent

Only two present

·

one
among
 Anterior:
Ronof

ofp
h
Trans. Cervical

Supra scap was *

·
#

⑦
-

-
T Subclavian Vein
-
- Clavicle

Post Relation: Trunck

of Brachial plexus

Subclavian
 ① from 1ˢᵗ part :

( ④ from 2ⁿᵈpart .
 1
from thyrocervical
trunk
of subclavian

artery
R subclavian _ branch of
army brachia cephalic
artery
L subclavian → aortic
army arch
 1
Digastric A Post .
A-
Swbmanth A

Carotid A

• occipitalA-
Muscular A

Trapezius

f
mad '

stand
heed

fsuhraclaviwlar.ae)
subclavian A
IBom-m). belly of omohyoid

SBOU-Dosassell of diges fai

PBDC -
Post 11 11 I

⑧ Neckduded into two

region
by Stern cludo mastoid mis-

Stytohyoid mis

#
Myodhone

clavicle
Manub

Ocrpital +st

(Half 1)
·

SubclavianA+st
 Ant: Post border of sm

Post: Ant.bordu of Trapezius

Boundary:
-
Base: Middle's of clavice

Apex: Junction of SCM and Trapezius

line
at Sup. Nuchal
·
Investing layer

(C2, 23)
Roof of Al (Scalp Supply)
(along EJV)
· Nerves at Nerve point ((z)
(ExtJug.vein)

sower's)
(at upper 43
and

CC2, cs) Trapezuis

SCM

into
↓ - clavicle
(flooe)
subclavian
vein

(cs, (n. (i)

~subclavian
Vein. medial,
lateral
intermediate I
Limp * Coney non-Trigeminal N.
to supple face
(C2, (s)

and Parotid Region

Ccowerve of tongue piercing of east pain
 sensation lost at
· After surgery, shavgara
↳ is G AN
damaged
(injured in Parotid surgery (

Fuse

-
↳ #
sweat at ant-cheek behind ear sweat
region.

Puntebral viscle base of skull

Carpet) -

medius Post

to Pustebral fascia
· major content deep · Brachial
plexus
· Terminal
part

Initial part

embolism may be
#EJV punctus caused
-
 branch ofECA
(fromcarotid D

acc. N
to
spira
⑭rijins withspiral
↳along

Ewher
medder
lowes
(Third part)
⑧ Spiral Accusory

(as it is already supplied

other
mys
also help in
there movement
:
weaknessne

⑦
Cs and on proporcaptive Supranscapulan

plexus (upper part

↓

⑧ Trunk of bracial
in to subclavins
⑨ Subclavianv
Cerical
Subclavian Trans
⑯
 (First part)
'

Trans cervical
④ .

Dorsal scapular
④
 Post -

Antborder of SCM

Boundary Ant.Sup.-PBDG
Ant Eng
is

Supply platysma
-

*
cutaneous

Not supplied
by
Ausa cervicalis

branches ofthis also

 · Carotid body/sinus

Hyoid bone

of carotid sheath.
mis ⑧ tet on
top
·
critthyroid
sunnied
a

text caryngeal) (Internal laryngeal (

·
Carotel sheath
·

sym-chain unquale -
cemboauricalis
·
Ansacervicalis
#

""
I PBDG
( Post belly of digastric)
i
↓ Carotid a

branch of I ✗
nerve

ILN
.
ELN

1-
spinal
accessory
nerve nerve CXI)
d
enkinal
Internal
①Structure b/w ECA and ICA :

Parotid

:*
ÉÉ¥E•
"" " ""

"
Ph branch
of I
.

Stylophaiyngeus
 Base C.superficial) Post interior
I boundary
->

mandible
of
o Base
------------ Postmg. boundary
①Imaginary line
connecting and a of -
-

mandible to
mastoid
an
-
-

ess ->

(deep)
·Anterior interior
boundary)
arises from
wat mandibular division of
(Deep My Conyoid) trigeminal
nerve (E)

I
to

ITry my here cause

taste and towel
sensations

·
open in floor of
Chypoglessathe
tongue B
Hyoid

Roof Skin
Sup. Fascia

platys ma and car be of VII (supplies platysma)

DCF
Investing layes of
 ECA)
I•
_

( branch
of
Content Of Digastric A

Ant part of A :O Superficial part of submandibular gland

0 Mylohyoid nv and Vess .

0 facial ④ and ①
XI ④
hypoglossal nerd
① l

Post
part of 0
:

lower part of parotid

@ Superficial content and ECA
-

⑥ btw F- CA and ICA

itself content Structure
-

② Deepest content -

IUA ,
F- JV , I ④
 INFRATEMPORAL FOSSA

test)
# Above
zygomatic arch →
Temporal fossa ( Temporalis Mls
Below
zygomatic arch →
InfraTemporal fossa

Bedoy :

Post
Ant surface of body of mama
:

Roof Infra temporal surface of greater

:

wing of sphenoid
medial : lateral ptegoid plate .

Cat :
Ramus
of Mandible

Post ,
floor
→
open
'

Cow :

① lateral and medial pkrigoid Mls

① Mandibular ④
⑨ Otic ganglion
①
Maxillary ④ and Post sup Alveolar ④
'
.

① Choe da
tympani
1ˢᵗ and 2nd Post Sup Alveolar ④
①
part of Maxillary ④ → . .

⑨
Pterygoid venous plexus
ISha
ARTERY
Terminal branch
of Ext. Carotid A
·
branch
largest lateral pagodmls
If branches
·

3
parts
·

eventof fempus -
o
Ramus, of
Mandible

#I part: Deep to the neck of mandible

II Part: Blw latptegoid mis (bluzhead)
II Part: Perigomax, finsure and pigopalatine fossa
Foramen ( middle meningeal AO)
spinosum
foramen -

ovale &EaaGaae
-
 (Through
messeteric notch)

Two in no ¥

(inflammation of cheek )

→ Molar ,premolar , Maximus

alveoli)
MSAA / ASAA (Max .
swims of
( out of infraorbital fossa ) ↳ Face and lower eyelid
→

Nasal Septum
-

Nasopharynx
Hard Palate

(eustachian canal) 1

Nasal cavity

(Nosebleed)

Food stink in lateral region of buccal cavity

.

# Facial Paralysis :

Buccinator Mls damaged .

 MINDIBLE
Mand
foramen canal and
forms mental
foramen
·
run as a

ABDG -Ant-belly
of digestric
xMastication Muscles
#RALI5 -

·
Large fan-shaped muscle
Ogin: Temporal fossa and Temporal fascia.

Directions: Ant Fibres: Vertically downward

Middle Fibus: Obliquely downward

Post Fibres:
Horizontally forward-

Eestion: Tip and medial

surface of coronoid process.
But border of ramus of mandible.

Nerve Supply:
- -
Deep temporal N Ant dieof vs 4
Auricuotemporal & Div of Ve #
Action: (Based on direction
of fibres
⑧
Elevationof mandible and closing of mouth. y

⑧
Retraction of protruded mandible.
⑧ side to side movement to chew

#
SETER
-

Orgin: layer: Ant 4 of lower border of

Sficial
zygomatic arch-

layer:
"h Posts of town borde of
arch
zygomatic
↳layer: Medial surface of zygomatic
arch.
 of
pination:
-
Downward and barward

Ination: Outer surface of Ramus of mandible.

Have: Masseteric & Ant dive of Vs t

#tion: Elevation of mandible and Protation

LATERAL
-
PTERYGOID
-

Orgin: Head: Crust

the on
greater wing
of sphenoid.
lat.
lower head:
- surface of latpty.
plate.

Dictions: Backward and laterally

Insation: Peygoid fora Check of mandible)

Capsule of TMT

Action:
-
·

Depression of mand
opening of mouth
Protsaution
Pull mandible to
off-side

O
(side ways movement)
PTERYGORD
#

Ogin: Sup head Max. tuberosity

Deep head Medial surface of lateral pterygoid plate.

Division: Downward, backward, laterally

Etion: Elevation

protrusion
side ways movement ↳

Heve: Trumbog Is

#T
-

Type: Condyear joint (synovial joint)

Articular structures:
-

space filled with

Adipose, prevents
Tymp-memb
· Articular disc feature.
 upper → Articular tubercle and Ant 213
of Mand .

fossa .

lower → Head of mandible

Post band
-

Articular disk
(
→

µE-ggE••=ggµ-
( fibro cartilage)
Post Bi laminar

Ant .
/ \ part

Part
Abntmd Intermediate
part

Artnilaedisk : Remnant of tendon of Lat -

Pty .

Divides TMJ

f-
-
Uphw Cavity
lower Cavity
:
Sliding / Gliding movement
movement
:
Rotatory

Supports :

Lt →
loose and laxative
~
True
=
:
① Capsule \
TT →
Tena and thick

② Lateral tempo sa Mand

ligament :
Priuntshyputukaition
.
.
Modified :

spine of sphenoid
Ñ%Fw

*¥☒¥
① Stylomand
.

ligament
.

② sphenomand.bg .

spnenomand .

ligament

Movem_ent :

① Elevation -

Temporalis ,
Messeter Medial .

Pty .

② Depression Lat Pty

- -

Against resistance
:
Ant .

belly of digestic
Mylohyoid
Genio hyoid
③ Protraction Lat
Pty Med Pty Masseter
'

- .
+
.
. +

⑥ Retraction -

Temporalis

⑤ Sideways moat Lat and Med : '

Pty .

NER : Auricula temp ④ [V3 ⊕] .

Messethic ⑨ ( Us)

Bloomy :
Maxillary
Sufi Temporal ⑧

M¥Xion Ant dislocation

:
.

(mouth tried to open more)

 Stone chances more in trick
secretion .

Note
:

largest salivary gland

•

Serous Secretion ( Thick secretion)

- Sterno
dado mastoid
RELATIONS-i E-E. E#
Masseter
Scm

Capsule : Covered with

investing layer of Deep cervical
fascia

(inside]
Superficial lamina (outside) Deep lamina
(Paratidomassetvic
fascia)
⑥ Thick and adherent to gland ① Thick and attached to

Mumps : No expansion on gland Styloid process Tym plate

,
.

i.more painful and

post border of ramus

of mandible
0 Attached to zygomatic Arch -

① Extension
btw istyloid process
and lamina
angle of Kla
style mandibular ligament .
 -

< Deep
superficial part
part
① 4 and 3 borders
surface

A-
Surface : 4
Superior (Base)
Superficial surface
Antero medial surface
Post medial surface
.

supuior/Base_
Relations : •
Ext auditory canal
•
TMJ

Superficial temporal vessels

•

•
Auricula temporal ⑧

Superficial : Skin

Superficial Fascia

Platysma
Risorius
Parotid
lymph nodes
 """"" "

be f
VI ⑨ Ant Medial
-

Ramus of Mandi Surface

Masseter

Medial Pty .

ECA

Stylovd process post .

.÷ .
"
Post belly of
Digestion
hhface
.

Mastoid process
Sterno Vido mastoid

BoRDER_ :

Interior Border : Parotid dent

Trans -

facial ④
VI ⑧ terminal branch .

Post Border : Sterno Indo mastoid Ms .

Medial border :

Pharyngeal wall .
?⃝
 structure " "" ' " "
'

Superficial Temp ⑨ Superficial Temp ④

-
-

Temporalbr

1
'

Trans
facial ④ I Zygomatic

f f
-
br .

,
'

"
÷ : "" " ⑧
MV
-
i ,
g- _

am @

ii.
.

ma , Reno
1 Mand vein .

" lower

f)
A

ECA
"
buccal @

/
•

Post .
Div
marginal
→

Ant Div hand NO

Awwad
.
. -

the
without damaging nerve

A- Deep part

superficial
part
fgg.fi?iTTrTsHmns
/ ↳ Paley
VI. ④
's Facio venous Plane
?⃝
BSupply:
⑧ ECA and branches within gland
⑧ EJV and I JV

tee
Supply
Say Great avicular N (C2, (e)
↳*

skin and
gasia over gland

Parasympathetic (t (Next page)

-

(Secretomotor Mr.

ES3ouT
Symp:

Preganglionic
-

Parotid Preuricular
LympLdrainage: or
lymph node
f
Deep cervical lymph node
,GENS0N'sDUCT_
'
'
Upper relation
5cm
long " "

?
'

Uhhh buccal ⑨
Ace .
Parotid gland

☐
lower relation
÷
lower buccal ④

;i¥¥ii
' ' Buccofharyngeal fascia
BBBM
Buccinator
- -

Buccalfat
in the
opening
vestibule opposite
upper 2nd molar

masseter
CLINICAL ANATOMY:

Parotid absers: pus formation gland

in
-
Stenson's dut Oral courty

Parotid Canaliculli: Stone in

gland
Radiopaque dye
Sialosartadio
inside duct

Parotid duct
pathos

Syme:
Trey
following parotidsurgery Regenating
ATN (seemotor)

Lingeing to ATN ↳
Accidently fuse
with GAN (sent

Salivary stimulus
k
Causes sweating on cheek

Earsanoo
 Parasympathetic:
---

⑧ Try. Salvatory
Nucleus
Naso labial fold ⑥ Anosmia
↳ when
sunk

Ala to mouth
from
.

-
NASAL CAVITY ↳ loss
of smell
senses .

⑥
Sup / mid '

Conca →
part of ethmoid bone

④
Inf .
Nasal Concha →
defeat bone

→
Crista Galli → part of ethmoid bone

Ethmoidal Air Three

→ Sinus →
parts sup
• .

◦
middle
in
•

f- Coronal section
⑨ Max Air Sims . → most dependent, largest
↳
difficult drainage of Sirius as
opening
(
is tst above
against gravity )
.

# Pneumaticbonesinbody : ethmoid ,
frontal Temporal
, ( Mastoid process)

maxillary sphenoid ,

①
Msinus :
In close relation to Mphil molar
i.
uphre molar cavity more dangerous than the lower molar cavity .

E- B- ethmoid bone

LB -
lacrimal bone

NB -

Nasal bone

① 3eugions of nasal cavity

 Bonypart Permission of smell
NASAL SEPTUM ↳
Kla Pawsmia

Cartilaginous part
@isoocartilagenous)

BoIput :
① 1- plate of ethmoid bone
Cartilaginous part : ① Septal cartilage (* I
② Vomer ② Septal process of 2 alar
cartilage (-1-1)

③ Nasal spine of frontal bone

④ Nasal crest
of Nasal bone
⑤ Spheroidal crest

⑥ Nasal crest of Palatine bone

⑦ Nasal crest
of mandible bone
Mediating

Sphenoid
Air
sinus *

#
#

↓ t
Max
palatine
.

Winningham :
Respiratory epithelium
Pseudo stratified ciliated Columnar epithelium

Btoodvesslls :
G- CA)
.

AEA PEA -1 Ant and Post

,

ethmoidal ④
ECI
+ branch opthalmic ④
of
V# : Two halves Ant and Post
age
.
-

Supply :
Gansen
Nerve
.

.
-

special
senses

goes through
→

Gen seen .
.

1- plate of ethmoid -

(furthur goes
to

maxillary ⑧)
i

lymphaticdsaimage :

Ant Part :
Submandibular lymph nodes
Post pharyngeal lymph nodes
part Retro
- :

(LINKE :

Dtwm : Due to overgrowth of ethmoid /vomer bone ,

Nasal septum
deviates and moves to one side .

f-
-
blockage of one side of Nasal cavity
Blocked air sinus of one side .
 Cribriformfale#
↳
CSF
① Tearing of meninges →
dribbling down in Nasal septum
&
CSF Rhinorrhea

LATERAL ↳/ALL OF NOSE ( similar to medial

of orbit)

Benes : ① Nasal bone C¥e : ① Sup and Inf Nasal cartilage

② Frontal frown of Max ② 3-4 Alar cartilage #-)

③ Lacrimal bone
④ Sup .
and middle Con Chae (Ethmoid) Nasal bone

⑤ Inf -
Nasal Concha
•

⑥ bone
1- plate
of Palatine *

⑦ Med -

pty plate
.
#

#
# Meatus :
space below wnchea .

⑨ Bulla ethmoidales →
bulb like
=
Nasolachmial dint Ant 113 and Post 43 opening
.

function
:
.

(Hasler 's value)

Ethmoid_us Art
]
: F- AS middle meatus
•

middle F- AS
Post EAS
.
→
Sup Meatus
.

Infundibulum _

Atrium ←

Vestibule

Nasal Hair

(vibrissae)

Btoodsupfdy : 4 quel quadrants

AEA -1 Ant ethmoidal ④

-
GPA -1 Greaterpalatine ④

Stheno palatine ④ through sphenopalatine foramen

Venousdrainage :

Retrocoylumellarvem
: Runs downward behind columella
&
Common ofsite Joins with venous pbx .

venous bleeding
of Lat wall of nose
-
.

lymphaticdrainage :
Ant : sub mand
-
l -
n .

Post : Retro pharyngeal tin -

NIpf.ly :

AEN -1 Ant ethmoidal

-

④ ( v. ⊕)
( Naso ciliary →
opthalmic.NO)
ASAN 1 Ant Sup
-
-

Alvillar ④
(Infraorbital ④)
PPG →
Pterigo palatine ganglion
 lenity Examination Floor , Middle and Inf
Ant Nasal meatus and
Rhinoscopy sputum
→ →
Concha

≤
-

Rhinoscopy Nasal septum

post pninoswpy
(Deal cavity)
Rhinoscopy → Conch ae ,
Post part of
Mirror
nasal
septum

,AiRS
mucosal
Nasal cavity → duuituulum →
forms air sinuses
•

lined Pseudostratified ciliated columnar epithelium

by
•
-
.

FR0NTALA1RS1NI_ :

⑥ Not +St at birth , divulging at 3- 4 age

starts

⑨ Drains into ant -

part of Hiatus Semilunaris -

⑨ ④ >② (usually)

⑧ suphly :
supraorbital 1 branch of opthahniin )

Pain
of frontal sinus
Office headache
-

( Pain min in morning ,

Max in evening
 FTDALAÉ :

⑨ supply Drainage
Ant
)
EAS (upto Halls)
Ant Ethmoidal @
.

middle meatus
Middle EAS (I -3 cells)

Post EAS G- 7- cells) ] Post ethmoid ④ Sufi meatus

SPHENOIDALAi-R.ws :

•
Drains into Sphenoethmoidal recess
•

⑧ → Post ethmoidal ⑧
.

MAXILLARY AIR Sinus :

largestDrains
Air sinus
•
into post part of Hiatus semilunaris
-

Development : 1ˢᵗ PNAS to develop ( latest to complete)

⑨
Appears in 4th month
of IUL
6
Rudimentary at Birth
6- 7- years
Rapidly grows at
age of
to
fully develops with eruption of permanent teeth
(puberty)

Measurement :
Vert - 35cm
-

Trans -
2- 5 cm

Ant Post
-

3- s am
-
# Shae :
Pyramidal in
shape
--
orbit Orbit

Base Apex
Cat wall
of Nose Zygomatic bone
-

floor -
Alveolar process of Maxilla
(upper molar and premolar)
Base Lat wall
of Nose
- .

Apex Tyg process of

-
.
Maxilla

Roof -

Floor
of orbit (
Along with ④ and ④)

Ant wall
- -

maxilla ( Ant .

Sup .

Alveolar ④ and ④ '

b
④ ④
In Canal Kla Cannabis Sinuses

Post .

wall -
Maxilla -

Separately Max .
sinus with

infratemp .

fossa
Pierced by -
PSAN and PSAA
(Post sup Alveolar ⑨
'

.
and ⑧)

AÉhhy :
Post sup '

Abu ⑦
/ Maxillary ⑨[ IT
Middle
Ant '

sup
Sup .

Aln ④
Aln ④ u

1 Infraorbital⑨
]

lymfihdsainage : Submand .

lymph nodes

⑧_Suhhly : PSAN -

Maxillary ⑧
MSAN

ASAN / Infraorbital@
 Maxillary Hiatus Reduced in size
by :

⑨ UP -1 innumerate process of ethmoid Cnbove )

⑨ EP →
Ethmoidal process of Ivf Nasal Anchal
.

CInfront)
Nasal Concha Cbelow)
⑨ ethmoidal
process of Inf .

bone ( behind)
① 1- plate
of Palatine

DIge-ofmax.sn:10
Antsalpuntwe ② Caldweltlucofsesation

⑨Sterile water used to clean sinus

 -
endocrine gland

2 lobes , Isthmus ( Pyramidal

lobe)

oblique line

levator
glandular Thyeoidee
-

TÉÉ

Pyramidal lobe

infront of

limits

Dominions 5cm ✗ 2- 5cm ✗ 2- Tcm -

Gland

1. 2×1-2
→ Isthmus
 Condensation of own connective tissue

→
Capillary plexus deep to it -

'
of DCF
↳
Modification suspensory big of Berry
'
:

① No much bleeding in removal of gland

capillary
plexus

IN

Oesophagus
#
longitudinals

·zenGeneam 8AAEwa " of berry'

(movement in deglutition

Eine
degent:
⑧
long mk pulls Thyroid cartilage
↳
cricoid cast
ligament of berr
-

t
Thyroid gland
(moves
up and down)

EX:
·
limited by stenothyroid mis
·
Related to
Sup. Thyroid and ext. Laryngeal

BASE: Trf. Thyroid

S-ur-r.nu
lateral / Superficial → SCM , Sh , ST , Sup Belly
.

of Omo hyoid .

Medial surface →
2 tubes -
Trachea and oesophagus
2m Is -

Inf . constrictor ,
Chico thyroid
2⑨
-

EIN ,
RIN

Post .

Lateral Surface → Carotid sheath and contents .

B0RDER_
Ant Border-
-

Sup Thyroid
-

Post .

border -
Anas't btw STA and ITA
&
Parathyroid gland
( separates medial
and Post Iat surface)
- -

IISTHMUS
2 2 border
surface

@ Ant .

surface
→ Sterno thyroid and Sternohyoid @ Superior border
⑤ Inf border .

⑥ Post Surface → 2ⁿᵈ and 4th Tracheal

ring
-
.
 A#wppty : ( Ant .
branch → continues to
of
uhhh boedn
isthmus)
branch )
( first

Post branch of
sup Thyroid ④

(3- 4 branch)
Isthmus cut , imp to check .

ima ④
Thy to idea
( 7- 51 .
people )
① Branch of bsachiocelph
more chances than

Asch of ④

① STA closeto gland -1

spare F- LN

that
① IT A → selectively ligated close to gland so
blood supply to
parathyroid is not compromised .
Sup Thyroid vein
.

① Sometimes test

middle

qq.GFT.no?dsauisinto
!
② bsachiocephalic

Svc Md•N Clbsaihioupn longer)

-

-
,lYMPHAT
Upper Part Upper deep cervical lymph nodes
:

lower Part : lower deep cervical lymph nodes .

NERVOUS :

SCG
'
'

MCG → Vasomotor
ICG

brachial
⑥
PALATINE TONSILS
Hard
palate

- - - - - - - - - -

TS .

Tongue
Palatine tonsils

Borde :

Ant : Palateglobal arch with

falatoglossus muscles

Post :
Potatopharyngeal arch with Potatopharyngeal MIS .

Poles :

Upper Soft palate

:

Dorsal 113
lower :
surface of post of tongue .

Tsansveisesetion : -
Tonsilcubed

Peritonsilar
span
§ Paeatopharyngeus

Intsatomsilar cleft (aka brypta Magna)

( biggest )
"
mm" " "eminem "=ʳm•
Constrictor
Tonsil at Pouch '

crypts

Pharynges -

basilar
fascia
-

Palatoglossus
Bucco
pharyngeal
fascia
Medianeswfau :
stratified squamous dpi
12-15
crypts
largest Inka tonsillar cleft
-

latualswfau :
Btw capsule and Tonsillar bed
↓
loose areolar tissue
to
Plane
☒
of cleavage
① Site
for ( Tonsillectomy]
Peritomilar obsess

Note : Just
infront of insertion of PG and PP →
Suspensory ligament of Tonsil
( Prevents
swallowing of tonsil)
Nate :

µt^ "ˢ[
plica semilunar
( uphu part )
estrgeae mucosal
fold
Plica
triangularis _

(Ant inf find

-
.

Tonsilarbed

sup
.

constrictor
 BLOOD Supply :

Arterial supply :

ii¥E
""
Ase.

pharyngeal Great Palatine ⑨

•
Palatine bs of
. Asc.

pharyngeal ④

Facial④ Tonsil on ④ ( main branch)

Asc Palatine ④
.

Very lick
⑨ Supply Dorsal lingual ⑨
lingual ④

Venous
drainage
:

lower part of tonsils lower part

>
of Tonsils
to
Veins piercing Sup -
constrictor

b
Palatine vein , Pharyngeal vein
and facial vein

lymphaticdainage :

Jugulo digastric lymph nodes

Nervous Supply :

☒ (N) ( Post '

13 of mouth by this)

lesser Palatine ⑧
(Ptuigo palatine ganglion ]
CLINICAL :

Tonsil Itis :
Referred pain →
ear ( ☒ ④)

Quinn : Peritonsilar Abuses

Incision given to most
prominent part of tonsils
•
.

,MUSCLES_
#
longitudinal Mls test inside but circular outside .

↳ some opening in nasophasyx

cover it
Still test , this helps

'
'
: : : : : : : : : : : : : ::
-

2D

Killian 's Dehiscence

zone
of weakness btw Thy .

Phony . and
aiy .

1
VAC RLN
to
Neural incoordination btw 2m15
↳
Bolus may push wall of Phx
at site trillions Dehnsceme
of
b
Mucosal diverticulum comes out
↓
Zenker's diverticulum
( Post lat wall
of pharynx)
.
Stuutwre btw Snp and
inf
.
Constrictor

(
fascia test)
Tonsil
' _
' ( # ⊕)
by
=
-
.
.

"
:
only mis ~
by # ④

ILN
Sup
Larynplao
.

Thmemb
(STA branch)
-

(ITA branch)
Inflwupi
④
RLN

Sinus Of MORGOGNI

hstunturs ① Eustachian take

① levator Palatine
① Ase Palatine ⑧
.

① Palatine branch of the Palatine ④

#

stu tunblwo -nsitonmodgagmpnaymge.ae

Raphe
ˢiⁿˢ%

Backside

EUSTACHIAN TUBE
•
Also t.la Auditory tube
Connects Nasopharynx to middle ear

D¥n : Downward forward medially

tight , ,

⇐
 take all
Bompard :
① 12mm ( Post .

⑨ tst btw tympanic and petrous part of Temporal bone .

⑨ opens on ant .
wall
of middle ear

Cartpart : →
24mm ( Antero medial )
^
Medial wall

/
→

fibroelastic
Roof cartilage
Lat way
Uhhh part of
.

Floor
[ fibrous
→
membrane
lower
part of eat . waee

lining#um →
Pseudo stratified ciliated columnar efithi .

N-rkrial-suppyi.ms c. Pharyngeal ⑨
⑨ to
Middle Maxillary ④
ptuigoid Canal
↑
*
branch
of Maxillary ④

Venoige :

Pterygoid venous plexus

•

Pharyngeal plexus of veins

kym-ph-E.ge Retro pharyngeal 1- Node

:

Nerve :
Ostium '
Ha ⊕)
(medial opening]

Cartilaginous
:
Nv .

Spinosus Cvs)
plans (Ix)
Bony Tymp
: -
#
Tubal tonsils

gotcha
Bam

Note : ①
Activating levator veli
pelatiné
↓
Deglut →
by chewing gum , candy
to
① Attached to eustachian tube
Pulls it to efualise air pressure in
middle and outwear .
.

② Infants :
eustachian tube horizontal ,
short
middle ↑
0=0
I. chances
of ear infection
as
easy passage btw nasopharynx to middle eae

Adults :
tilted eustachian tube ( #)
 ( Pouch hischka)
of
Ant arch
of atlas
- Palatine tonsil

epiglottis

Power
of luschka : Adhesion of Notochord to dorsal
part of foregut -
%EaSEOFSKUI.io
Greater / lesser Palatine →
④ and ⑧

① Most
post part of maxillary bone →
Maxillary tuberosity

{ suture
Inter maxillary
Inter palatine
Polito maxillary
-

① lateral
pterygoid Mls → lateral partflat Pty plate .

① Medial
pterygoid Mls → medial
part flat Pty plate .

Fosamenlatrum -

Space lift
Gws -1
greater wing of sphenoid in between all bones
•
Covered with fibro caitrlage
MALE -
Mand -

⑨
Ace
Meningeal④
-

lessee fukusal ⑧
emissary vein

carotid Canal only

: visible in base
of skill not int
of skull
-

↳ Runs into
foramen laurum
 eustachian
take canal

"
Styeoid process
☐

Mastoid f-

Carotid
Jugular
Stybo mastoid canal
foramen
foramen
foramen
(v11 NO)
magnum

TVP Tensor Vahpalhtini around Palatine Hanmnlus

goes in front
- → → .

LVP -
levatorVali Pallnlini

Palatine Aponeurosis tendon of TVP

- Inserting
MU -
Musculus wink

Styloid
-

3m15 12
ligament
Mastoid of Sterno Undomastoid
Insertion
- •

origin of post belly if digastric

•
 %hhictor Sterno dido -

mastoid
-

# Soft Palate :
Sefsatu Nasopharynx and Oropharynx .

Ant
2 Post
Surfaces
.

Post

sup - -
Attached to post border
of Hard palate .

Zbosdbs
Inf. -
file
-

Bounds the
pharyngeal isthmus
•

Uvula

↳
joins
to
(Into pharynx)
sup const and
.

beiomsasidge
#

TVP -

up
gc

# palatineAponeuro.SI -
Extension of Tv P

MU -
Musculus while
 Mlsofsoftpalale :

Cosonatseition :

① TVP
LVP

0
⑤ Planto
MU
-

pharynges
 Nerve Supply of Soft palate :

④ Crago Au ④I Is ④
' '

Motor Ntl 1- UP →
MIS by VAC except
:
are
-

Gen Sensation ⑧ ¥w
PP%N
lesser
. : ①
palatine
(vi. ④)
① #
Glossopharyngeal ④)

Secretomotosrfikris :

Greater
sup -

Salivary → VI ⑧ → → PPG ( Pherigo palatine

ganglion)
Nucleus
pause @

(all gland except f. Inlay hurt

parotid)
lesser Palatine ⊕

1
Glands in soft palate

Tastesensation :

Nucleus of Traitors
Taste
from soft palate ↑ solitaries
to
VI ④
lesser palatine ⑧
to ↑
1pPG] (noway ) → GPN → Geniculate
( Greater futura ganglion
④)

#
Pasupathy :

( Pl h• PAS)
① Greater palatine ④ Max ⑨
→ .

② Asc .

Palatine ④ → Facial ④ branch (STE G)

③ Palatine br
of Asc
Pharyngeal ⑧ ECA
. →
Venous Pterygoid plexus
- Drainage
-
: venous
Tonsilar Venous
plexus

lymphatic drainage Upper deep cervical lymph nodes

:

Retro
pharyngeal TN -

PHARYNX :

Coni:

Insertion -1 On Rapheatbcnk .

Common insertion
 Buccinator mis

Tsoffharynx
⑥ Pharyngeal Mls .

→ covers both
buccinator /pharyngeal
Cextnoffvutracheal Mls

(Thick long
.band)
fascia)
lexthofpharyngobasilae fascia)

( innu)

(onlymls (Oulu)
bythis④)

① Common insertion
?⃝
·
longitudinal uscles Auditory tube
⑦
y

aningfrom
styloid pr

-
Ov
Stylopharyn.
(goes through
constrictor)

8 iscouse

oneII promonemonacomune

⑧
Different N supply of Thyropha and cricophery -
Seprates contraction of 2 muscle at

different point,

Blw thyrophary, and

cricophery weakened are Killian's Dehisence

when i imbalance, food pushed

this and cause
against
zember's divertictum (Post Lat Wall
of pharjux
 =

ae¥ .

¥ Passavant 's nose

( made up of falatopharyngeusts c) .

( Prevents nasal backflow of food

1. \'
Sc and seals it)

IC

①
Different ④ supply of Thyso alpha
.

and Chicophony . →
Sefraks contraction of 2 muscle at

different point .

Btw thysophary . and

oricophary .
→ weakened area Killian's Dehiscence .

when ④ imbalance , food pushed

this and cause
against
Zenker 's diverticulum ( Post -

Lat .
wall
of pharynx)
 Circular Muscles :

/
Mandible

④N

☆
style
pnanr .

A Thynohyoid membrane

III. Thyropha .

④
Rt

ILA
Cricobhary .

① Pharyngeal
Raphe

]@ supblu .

7.7

Sinus of Morgagni content

( btw baseefskullandsc)
① Aud tube
.

0 LVP
① Ascending Palatine ④ (facial④
CECA)
◦ Palatine bsofase Palatine ④
-
 Totals

◦
laryngeal hrominamce
(male)

( largest) ( move vocal wsd)

→ hyaline cartilage C.Ossify after some

time)

→ Elastic (may / may not

cartilage be present)

Epiglottis :

① Fibro it
cartilage as

needs to move .
 Most dat -

part of Ttyrohyoidmenb →
Thyewhyoid ligament

line
0
Oblique cipher limit of thyroid gland
-
.

(Later almost)

'

↳ IC
'

(plain synovial)

buioidart -1 .
Signet ring shaped
Arytenoid rests on lamina of
.

cricoid cartilage

ftp.gwltis-l neifoemsnicnlate
[ Plain synovial
joint
(joined to thyroid
cartilage)
0
Arytenoid cartilage

[
False
cos
vocal
d ]
Vestibular by → false vocal
cord
,

( Post Lat)
-

Hyoid
#
Hyo
Anyepiglottis membrane

Quadrangularembrane

L* epiglottis to

arytenoid

vocal
Chico menb .
 (False)

(True)

Mueusmemb .

ie
:

Cluadsatememb ) .

(Vestibule)

Rv - Rima vestibule /Ventricles

Rima Gloltidis
.RU -

Saccule
iantandupwaid
-

extension of sinus
tart
behind thyroid
- .
 (Pseudo stat . ciliated hmar ifn:)
Vocal coed
-
No mucus
gland (friction ,
stretch)

*
Saccule
of larynx provide
mucus to vocal cord .
Coral cavity )

.
'

.
saccule Kla oilcan friction)
of larynx .

(control epiglottis) ( Ad / Ab ofvocal WS d)

Rotate
Ascgchenoid Cart
.

p( of oblique arytenoid )
extension

(contract) -Eh

(Inter arytenoid Mls)

(one part ofInter arytenoid Mls)

(medial of Arytenoid)
A

Pulls epiglottis bark

(Thyroefugho Hairs)
 Vocal ligament

Ab .

Ad .

*
lateral Mico arytenoid
① Only Mls to
① Mlswnkait
Post Chico arytenoid keep airway open ↓
Intumemb .

part of
Rima closed only
aistst
2 Rima still tst
Spaublw
:

i. e.
Whispering .

✓
Vocalist/ a
④ Modulator of lahymx only Ant 113 → Mls attached to

ligtythsoid
vocal cart-

Ant 113→ tension as attachedto

vocal cord

a
Post '/ 3 → Slacking of vocal and

HT

lig
_
Vocal .

(Inner surface of Thy

.

to arytenoid )
↳
tension in Vocal cord Neutral Position
① Cause

Turning Foekiflarynx
Bending of
Thyroid
L

-
Thyroid
↑ dist btw Thyroid
.

and
any chemo id

Chicothyroid
( ext laryngeal
⑨)

①All Mls by Recurrent laryngeal ④ except on outside

Aricothyroid )
( ELN)
 Nerve supply :
-

Move ✓odd It "

sensory ④ ≤
-

Motor ④ -
All mfs
by RLN

Below Vocal Cord -

RLN
except Chico thyroid ( ELN)

Bep peg :

Above Vocal Cord -

Sup laryngeal ④ [sup Thyroid ④]

.
.

Below Vocal Cord Inf - .

Laryngeal ④ [Inf Thyroid ④]

.

Clinical Aspect
-
:

Ant V3

I •
Teacher's / Singer's Nodule
• ① When vocal Mls are overused .

Post 43

#
IYri-foI-als-mugguvs-P.ch : C Post View)
.

(small object) v9 this

Fish bones
may lu stuck pouch -

t
ILN +St here

i. it may
be
damaged
↳
No sensation in upper larynx (above V4
Uvula
(No sensation : Protective
sensation →then .
cough Reflex lost )
b
epiglottis : which doesn't allow any
-
Ahyefnglolticmcmb -

Arytenoid water to move into larynx .

✓
Cricoid -
Phy wall .
.

cart
-

Pyriformfossa btw pharyngeal wall

and any epiglottis
memb → simghrsfsouih
-

.
ORBITAL
F- DIAL WAIL :( Thinnest) →
but not the most
fractured
to
bone

① Frontal process of Maxilla (Floor of orbit)

② lacrimal bone
③ Orbital plate of ethmoid
④ Body
of sphenoid

Ant .
, post
ethmoid foremen .

lacrimal fossa
(lacrimal bae + St
)

LATERAL WALL :( Strongest)

① Orbital surface of zygomatic bone in front

② Orbital surface of greater wing of sphenoid behind .

Zygomatic
foramen ,

below suture
(zygomatic part of
• .

maxillary ⊕)
 FLOOR : most commonly fractured

orbital
groove / infraorbital ⑨ ④ +it
→
Infra Canal +st and
•
.

Medid → Trochlear
fossa
↳ trochlear ④ ④ both
Sup
.

ROOF :

Fossa
for lacrimal gland ( lateral side )
.

① Trochlear Notch

Optic canal
Coptic ④
+

ophthalmic⊕)

Note
:

Sphenoid bone in then

part of orbit -

Supraorbital foramen / Notch -

MARGINS :

Naso lacrimal canal

1-
Naso lacrimal dent

passes

OPENING OF ORBIT
Annulus Ringefzim
Divides sup
.
orbital
optic canal _

fusion into 3 parts

orbital fissure
superior

1
Recurrent

meningeal ④ Optic ④
Inf orbital
Ophthalmic ④
.

fiesweu

Content
of sup
.
Orbital fissure [ LET -36N ]
lower
upper part Middle Part part
( lacrimal ⑧
→ ( )
ul
sup diucf oculomotor ④
.
Infophthal -

④ mic ④
Frontal ④ ( v1)
f-
Infdiucf oculomotor ④
_

→
.

1- →
trochlear ④ Naso ciliary ④ ( CN v1)
Abducent ④ (6④)
SOV -1
Sup ophthalmic vein
.
In_f.0sbitalFis wre@Allowscontentfrominf.T
empoeal fossa and
go into groove

Note: Whitnall 's tubercle

=

t
① 3 ligament
① 1M$
① levator Pal ① Suspensory ligament
.

Sup
.

ofeye

ORBIT

CONTENT :
⑨ ☒ASCt

into orbit
Cextnofperioebita)
( Periorbital

Divide
✓

( Bulbar fascia)
Fascia bulbi

also
upto ciliaryMls and④ , ④
corneal
jmn .

① Tendinous
part of Mls also
covered
by this fascia
.

A
①
EffasciaBulbi_ :

① No bulbar
fascia around
¥; Sup
-

Rectus

EXTRAOCVLN-RMUSC.LT#CvImp)NotexHaocwlarm1S-
⑨ ORIGIN OF MUSCLE
#

(Annulus of wind
levator pal .

oblique
/
ʳ% Sup
.

①
greater wing of sphenoid
↓
① Annulus attaches

RECTUS MUSCLE
Rectus
Superior

↓
◦
greaterwing of sphenoid
( second head)

Inf oblique
.
 OBLIQUE MUSCLE
midline

(Pulley +St )

odd
floor

sup oblique
-

sup
-

Rectus
mid Rectus
.
ACt-NFM-ci.IO :

a.
Medial

Ab Ad

Ab Ad
Medial

SR , so -1 intorsion IR , IO →
extension

↓ ¥ ¥
locution
levator Palpebral Superiors :

NERVE OF ORBIT :
④ Nerve) ( son 426 )
↳ sup oblique ↳ by 6ᵗʰ ④
by④

( Nucleus )
UDILD - '
Naso ciliary ④ b/w them
Nucleus
fuses Swp
Ohlson
midline fissure

oculomotor ④
8

Midbrain l lateral wall )

(Edinger -
West Wall Nucleus)

(
Pasasymp Nu)
-

only Sup .
Rectus .

Same side neuron

opposite side
short ciliary
Nucleus .

→
④
Contralateral Nu ) .

to
Compressed btw too ④
hear
①
circle
of willis
① II Nu .
almost
fuses in

midbrain .
☒→ comes out of enter peduncular fossa and

then btw two ⑧ near circle of

willis '
,

( lateral wall)

cerebral
peduncle .

Liam ④

Coke : Midbrain
Einen :

Cmedialrutusgone)

lfu ball
-1 down and out

Caxisofbotneyesnotmatehed)

TROCH-LEAR.tl/ERVE : ( soy)

Dossal
aspect
① SOF
(upper part
of brain .

( inside cranium)
COUNSEL
'
CLINICAL :

#
for
① Injury tonuelun .

Mlsofothwside
damaged .

BDUCENT NERVE

From inside this sinus

④ ascends

Pons

↓
Petrous part
cflemporal
bone
Clinical :

in case
of haemorrhage
OPTHALMIC NERVE

Note : ⑧ and ④ mimics each other .

OPTHALMIC ARTERY (mimics Opthalmicn)

PE :
OPhthnt.tn#*EN--
 Orbit and Eyeball 293

ciliary arteries are usually seven in number. (Remember It communicates anteriorly at its commencement
that anterior ciliary arteries arise from muscular arteries.) with the supraorbital and angular veins.
4. Supraorbital artery accompanies the supraorbital nerve. 2. Inferior ophthalmic vein: It runs below the optic nerve
It passes through supraorbital notch to enter the scalp and ends either by joining the superior ophthalmic vein
and divides into medial and lateral branches. or drain directly into the cavernous sinus.
5. Posterior ethmoidal artery enters the posterior ethmoidal It communicates with pterygoid venous plexus by
foramen in the medial wall of the orbit and supplies the small veins passing through the inferior orbital fissure.
ethmoidal air sinuses, nasal cavity, and dura mater.
6. Anterior ethmoidal artery enters the anterior ethmoid N.B. There are no lymphatics in the eyeball.
foramen in the medial wall of the orbit and supplies the
ethmoidal air sinuses, medial and lateral wall of nasal Clinical correlation
cavity, and dura mater.
Because the ophthalmic veins drain into cavernous sinus
7. Dorsal (external) nasal artery supplies the lower part of and communicate with the extracranial veins, they act as
the dorsum of nose. routes through which infection can spread from outside to
8. Supratrochlear artery accompanies the supratrochlear inside the cranial cavity.
nerve to supply the forehead.
9. Medial palpebral branches, one to each eyelid,
anastomose with the corresponding lateral palpebral LACRIMAL GLAND
branches of the lacrimal artery.
It is a tubulo-acinar type of exocrine gland, which secretes
N.B. Branches of ophthalmic artery accompany all the watery lacrimal fluid. It consists of two parts: orbital and
branches of nasociliary frontal and lacrimal nerves (derived palpebral. The orbital part is located in the lacrimal fossa on
from ophthalmic nerve), and within the orbit supply all the the anterolateral part of the roof of the orbit, while palpebral
extraocular muscles, lacrimal gland, and the eyeball. part is located in lateral part of the upper eyelid. Lacrimal
gland has already been described in detail in Chapter 3.
OPHTHALMIC VEINS
The ophthalmic veins drain the orbit and receive tributaries, ORBITAL FAT
which correspond to the branches of the ophthalmic artery
It fills up the space between the eyeball, optic nerve, and cone
(Fig. 19.18). The ophthalmic veins are as follows:
of four rectus muscles. It serves as a cushion to stabilize the
1. Superior ophthalmic vein: It is a large vein and eyeball during its movements.
accompanies the ophthalmic artery. It commences above
the medial palpebral ligament and runs backwards above
the optic nerve along with the ophthalmic artery, passes EYEBALL (BULBUS OCULI)
through the superior orbital fissure to drain into
cavernous sinus. The eyeball (L. oculus; Gk. ophthalmos) or globe of the eye is
an organ of sight and closely resembles a camera in its
Angular vein structure. It has light-sensitive retina and is provided with a
lens system (cornea, lens, and refractive media) for focusing
Cavernous images and device for controlling the amount of light
sinus Superior
ophthalmic admitted (the iris diaphragm). Further, like a camera, its
vein inside is black to prevent reflection of light (Fig. 19.19).
Eyeball The eyeball is a highly durable structure for its wall
Inferior
enclosing the refractory media, is made up of three coats,
Inferior
orbital fissure ophthalmic and the fluid filled within it distributes hydraulic pressure
vein uniformly to maintain its shape.
Pterygoid Maxillary air sinus
venous plexus Location
Deep facial vein The eyeball occupies the anterior one-third of the orbital
Facial vein cavity and is embedded in the fat. It is enclosed in the thin
fibrous sheath (Tenon’s fascia), which separates the eyeball
from the fat. The optic nerve emerges from it, a little medial
Fig. 19.18 Ophthalmic veins. to its posterior pole.
294 Textbook of Anatomy: Head, Neck, and Brain

Shape and Size OUTER FIBROUS COAT OF THE EYEBALL

It is almost spherical in shape and has a diameter of about
Sclera
24 mm.
The sclera is the posterior five-sixth of the outer coat. It
consists of dense fibrous tissue. It is opaque and a small
TUNICS OF THE EYEBALL portion of it is seen as the white of the eye in the palpebral
The eyeball consists of three concentric coats (Fig. 19.19), viz. fissure. The sclera is continuous anteriorly with the cornea.
The junction between the sclera and cornea is termed
1. An outer fibrous coat consisting of sclera and cornea.
corneoscleral junction. Just behind the corneoscleral
2. A middle vascular coat consisting of choroid, ciliary
junction, within the sclera is a circularly running canal called
body, and iris.
sinus venosus sclerae (canal of Schlemm). Posterior to the
3. An inner nervous coat consisting of the retina.
canal is a triangular projection—the scleral spur—which
points forwards and inwards and provides attachment to the
ciliary muscle (Fig. 19.20). It is thinnest at the equator and
Lens
Iris thickest at the back but weakest at the site of emergence of
optic nerve.
Cornea
Ciliary body
Corneoscleral Functions
junction
1. Helps to maintain the shape of the eyeball.
2. Protects internal structures.
3. Provides attachment to muscles that move the eyeball.
Visual axis
Structure Piercing the Sclera
Sclera
Choroid 1. Optic nerve pierces the sclera, a little inferomedial to the
Retina posterior pole of the eyeball. The perforating fibres of
nerve make the area sieve-like (hence called lamina
cribrosa).
2. Posterior ciliary vessels and nerves around the optic nerve.
Hyaloid 3. Anterior ciliary arteries pierce the sclera close to
canal
corneoscleral junction.
Optic disc 4. Four choroidal veins (also called venae vorticosae) pierce
Fovea
the sclera, just behind the equator.
centralis
Cornea
Fig. 19.19 Horizontal section of the eyeball showing its The cornea is the anterior one-sixth of the outer coat. It bulges
internal structure including three coats and visual axis. forwards from the sclera at the corneoscleral junction called

Cornea
Anterior chamber
Corneoscleral junction
Canal of Schlemm
Iridocorneal angle Scleral spur
Iris
Posterior Sclera
chamber
Meridional fibres of ciliary
Oblique fibres muscle
Lens

Ciliary process
Ora serrata
Suspensory
ligament of lens

Fig. 19.20 Meridional section of the eyeball showing ciliary region and the iridocorneal angle.

limbus. It is transparent and more convex than sclera because
it represents the segment of a smaller sphere. Its thickness is
about 1 mm at the periphery and 0.5 mm at the centre.
Features
1. It is avascular and nourished by permeation of nutrients
=
from loops of capillaries at the limbus, aqueous humour,
and lacrimal fluid.
2. It not only permits the light to enter the eye but also
reflects the entering light.
3. It is highly sensitive and supplied by the ophthalmic
division of trigeminal nerve.
4. The nerves of cornea form the afferent limb of the corneal
reflex (closure of the eyelids on stimulation of the cornea).
Structure
It consists of five layers, from outside inwards these are as
follows (Fig. 19.21):
1. Corneal epithelium: It consists of non-keratinized
÷ The middle coat is often called vascular coat because it contains
-
stratified squamous epithelium.
2. Anterior limiting membrane (or Bowman’s membrane):
It is made up structureless homogeneous mass without
any elastic fibres.
3. Substantia propria (corneal stroma): It is made up of
:
about 200–250 lamellae of fine collagen fibres, which
cross each other at right angles to form corneal spaces.
Flattened fibroblasts are located between the lamellae.
The transparency of cornea is due to precise lattice
arrangement of its lamellae embedded in the ground
substance.
4. Posterior limiting membrane/Descemet’s membrane: It is
made up of structureless homogeneous mass containing
elastic fibres.
5. Endothelium: It consists of a single layer of low cuboidal
✓
cells.
Clinical correlation
• The periphery of the cornea frequently displays a whitish
ring in older persons, owing to fatty degeneration. This
whitish ring is termed arcus senilis.
Stratified squamous epithelium
Anterior limiting membrane
Substantia propria
Inner limiting membrane
Endothelium
Fig. 19.21 Layers of the cornea.
Orbit and Eyeball 295
• Plastic lens: The central part of the cornea receives
oxygen from the outside air. Therefore, the soft plastic
contact lenses worn for long periods must be permeable
to the air so that oxygen can reach the cornea.
• Corneal opacity: The injury to cornea may cause opacity
that may interfere with vision. The most common injuries
of the eye are the cuts or tears of the cornea caused by
foreign bodies.
• Corneal graft: The normal lack of vascularity and of
lymph vessels accounts for the great success of corneal
grafts. The cornea is successfully grafted from one person
to the other.
• The corneal reflex is elicited clinically by gentle touching
of the cornea with wisp of cotton wool. As the cornea is
touched both the eyes are closed.
Pathway: Ophthalmic nerve (afferent limb) → Main sensory
nucleus of trigeminal nerve → Reticular formation → Both
the facial nerves (efferent limbs).
MIDDLE VASCULAR COAT OF THE EYEBALL
most of the blood vessels of the eyeball. It is frequently
known as uveal tract by the clinicians. This coat also contains
a large number of melanin-containing cells. It consists of three
parts; from behind forwards these are: choroid, ciliary body,
and iris. These three parts together form uvea or uveal tract.
_
Choroid
The choroid is the posterior part of the vascular coat of the
eyeball. It is brown, thin, and highly vascular membrane
lining the inner surface of the sclera. Anteriorly, it is
connected to the iris by the ciliary body and posteriorly, it is
pierced by the optic nerve.
Arteries: They are derived from short ciliary arteries, which
pierce the sclera around the optic nerve.
Veins: They are arranged in the form of whorls, which
converge to form the 4 or 5 venae vorticosae, which pierce the
sclera just behind the equator to open into the ophthalmic
veins.
N.B. The inner surface of the choroid is firmly attached to
the retina and nourishes the rods and cones of the retina by
diffusion.
Structure
It consists of four layers (from outside inwards), viz.
1. Suprachoroid lamina (lamina fusca): It consists of loose
network of elastic and collagen fibres and is traversed by
long posterior ciliary vessels and nerves.
2. Vascular lamina: It consists of loose areolar tissue and
pigment cells. It contains branches of short posterior
ciliary arteries and veins, which converge in whorls to
form 4 or 5 venae vorticosae, which pierce the sclera and
drain into ophthalmic veins.
296 Textbook of Anatomy: Head, Neck, and Brain

3. Capillary lamina (capillary layer of choroid): It consists of
fine network of capillaries, which nourish photoreceptors
of the retina (rods and cones) by diffusion.
4. Basal lamina (membrane of Bruch): It is a thin
transparent membrane, which is firmly attached to the
pigment cell layer of the retina.
The last three layers form the choroid proper, which is
separated from sclera by suprachoroid lamina.
N.B. In some animals such as cat, tiger, lion, etc. the
specialized cells of choroid form a reflecting media called
tapetum, which produces greenish glare in the eyes of these
animals in the night.
Ciliary Body
The ciliary body is the thickening in the vascular tunic. It is
continuous with the choroid behind and the iris in front. It
is situated posterior to the corneoscleral junction in front of
the ora serrata of the retina.
The ciliary bodies suspend the lens via suspensory ligaments.
Parts of the Ciliary Body
The ciliary body is triangular in cross section, thick in front
and thin behind. The ciliary body consists of (a) ciliary ring,
(b) ciliary processes, and (c) ciliary muscle.
Ciliary ring is an outer fibrous ring, which is continuous
with the choroid, viz.
Ciliary processes are a group of 60–90 folds on the inner
aspect of the ciliary body. They are arranged radially between
the ciliary ring and the iris. The grooves between the processes
provide attachment to the fibres of suspensory ligament of
the lens.
The ciliary processes are a complex of capillaries and
cuboidal epithelium, which secretes aqueous humour. The
ciliary processes may be compared with choroidal plexus of
the brain ventricles involved in the secretion of CSF.
The ciliary muscle is a small unstriped (smooth) muscle
mass consisting of mainly two types of fibres, viz.
1. Outer radial fibres.
2. Inner circular fibres.
surface of the ciliary body. Peripheral to this attachment the
ciliary body and narrow rim of sclera form the iridocorneal
angle.
Structure
The iris consists of four layers; from before backwards, these
are as follows:
1. An anterior mesothelial lining.
2. A connective tissue stroma containing pigment cells and
blood vessels.
3. A layer of smooth muscle, which consists of two parts.
(a) Constrictor pupillae—an inner (near the margin of
the pupil) part made of circular fibres.
(b) Dilator pupillae—a peripheral part made up of
radial fibres.
Nerve supply: Constrictor pupillae is supplied by the
parasympathetic fibres and dilator pupillae by the
sympathetic fibres.
Actions: The constrictor and dilator pupillae constricts
and dilates the pupil, respectively.
4. A posterior layer of pigment cells, which is continuous
with the ciliary part of the retina.
INNER NERVOUS COAT OF THE EYEBALL (RETINA)
The retina is the innermost coat of the eyeball (Fig. 19.22). It
consists of two layers, viz.
1. An outer pigment layer.
2. An inner sensory layer.
The space between the two layers contains a gummy substance
that glues the two layers.
Pigmented
epithelium
Cones
Rods

Functions
Its main function is to focus the lens for near vision. The Bipolar
ciliary muscle as a whole acts as a sphincter, therefore, when neurons
its muscle fibres, both radial and circular contract, the
choroid is pulled towards the lens reducing the tension on
the suspensory ligaments. This allows the lens to assume a
more spherical form because of its own elastic nature. Now
Optic
lens can cause more refraction needed for accommodation. nerve
Ganglion
cells
Iris
The iris is a contractile diaphragm between the cornea and
the lens. An opening in its centre is called the pupil. The iris
is attached at its periphery to the middle of the anterior Fig. 19.22 Structure of the retina.
 Orbit and Eyeball 297

The retina is present between the choroid and the hyaloid
membrane of the vitreous. The retina diminishes in thickness
from behind forwards. Anteriorly, it presents an irregular
edge called ora serrata.
Structure
1. The outer layer of the retina is insensitive to light and
made up of pigmented cuboidal epithelium.
2. The inner sensory layer of the retina is sensitive to light
and is made up of photoreceptors cells called rods and
cones; as well as numerous relay neurons, viz. bipolar
neurons and ganglion cells. The very thin non-cellular
continuation of the retina in front of the ora serrata
covers the ciliary body and iris. Thus the photosensitive
part of the retina lines the inner surface of the eyeball
posterior to the ciliary body. The nerve fibres arising
from its ganglion cells covers inner surface and collect in
the inferomedial region, where they pierce the outer two
coats of eyeball and emerge as the optic nerve.
N.B. Histologically, the retina is composed of following 10
layers:
1. Outer pigmented layer
2. Layer of rods and cones (photoreceptor cells)
3. External limiting membrane
4. Outer nuclear layer (Cell bodies of rods and cones)
5. Outer plexiform layer
6. Inner nuclear layer (Cell bodies of bipolar neurons)
7. Inner plexiform layer
8. Ganglion cell layer
9. Nerve fibre layer
10. Internal limiting membrane
Blood Supply
The deeper part of the retina, i.e., up to the bipolar neurons
is supplied by the central artery of the retina (a branch of the
ophthalmic artery), while the superficial part of the retina up
to the rods and cones is nourished by diffusion from the
capillaries of the choroid.
Venous Drainage
It is by central vein of the retina, which drains into the cavernous
sinus.
Development of the Retina (Fig. 19.23)
The retina develops from a hollow outgrowth the optic
vesicle from diencephalon of primitive brain. The optic vesicle
becomes invaginated to form the optic cup, consisting of two
layers of cells. The outer layer differentiates to form the pigment
cell layer and the inner layer differentiates to form the neural
layer. The neural layer forms the remaining layers of the retina
with photoreceptor cell (rods and cones) outermost, i.e., next
to pigment cells. The ganglion cells are innermost. Therefore
light has to pass through them to stimulate the rods and
cones.
The two layers of optic cup remain separate during
embryonic period but fuse later during early fetal period with
potential space between the two. Therefore in retinal
detachment, the plane of cleavage is between pigment cell layer
and neural layer.
Clinical correlation
• Retinal detachment: In retinal detachment there is
separation of two layers of the retina (i.e., pigment and
neural layers).
• Appearance of the retina as seen through an
ophthalmoscope: The posterior region of retina (fundus)
can be examined by an ophthalmoscope, a procedure
called fundoscopy (funduscopic examination). The
following features are observed (Fig. 19.24):
– Macula lutea, a pale yellowish area near the posterior
pole.
It is approximately 4 mm in diameter. A small pit
(1.5 mm in diameter) in its center is called fovea
centralis, which is the point where light is normally
focused.
The fovea is the portion of retina with maximum
concentration of cone receptors, hence the site of
greatest visual acuity, i.e., the ability to see the fine
images (keenest vision).

Optic
vesicle Optic
stalk Optic Outer layer of Inner layer of
cup the optic cup the optic cup

Pigment epithelium Light sensitive

(pigment cell layer) neural layer

Fig. 19.23 Stages in the development of the retina.

298 Textbook of Anatomy: Head, Neck, and Brain
Macula lutea with fovea centralis
Optic disc
A B
Fig. 19.24 Features in the fundus of eye as seen during ophthalmoscopy: A, actual photograph; B, schematic diagram of
fundus. (Source: Fig. 8.102, Page 852, Gray's Anatomy for Students, Richard L Drabe, Wayne Vogl, Adam WM Mitchell.
Copyright Elsevier Inc. 2005, All rights reserved.)
– Optic disc (1.5 mm in diameter), a white spot about
3 mm medial to the macula. The depressed area in the
center is called physiological cup.
The nerve fibres from retina meet and pass through
this region (optic disc) of the eyeball to form the optic
nerve. The blood vessels of retina also pass through
this spot.
Since there are no photoreceptor cells in the optic
disc, it does not respond to the light. Therefore, the
optic disc is also called blind spot.
– The central artery of the retina enters the eye through the
center of the optic disc. It divides into superior and
inferior branches. Each of them further divides into
temporal and nasal branches. The retinal veins follow the
arteries. The branches of the central artery of retina are
seen radiating over the edges of the optic disc. They are
smaller and paler than veins. At points where they cross
veins, the vein wall can be seen through the artery.
The normal optic disc appears as a cup-shaped area paler
than the surrounding area (fundus). The edges of the disc
are sharp and well-defined.
The congestion of the optic disc from increased
intracranial pressure is called papilledema in which the
optic cup is obscured and the disc margin is blurred.
N.B. The fovea centralis is the thinnest part of retina and its
size is comparable to optic disc.
ARTERIAL SUPPLY OF THE EYEBALL
The eyeball is supplied by the following arteries (Fig. 19.25):
1. Central artery of the retina.
2. Long and short posterior ciliary arteries.
Superior temporal
branch
Superior nasal
branch
Macula
lutea
Central
vein of
retina
Optic disc Fovea
centralis
Central
artery of
retina
Inferior
nasal branch
Inferior temporal
branch
3. Anterior ciliary arteries.
In the region of ciliary body, a major arterial circle is formed
by the anastomosis between long posterior ciliary artery and
anterior ciliary artery. From major arterial circle the vessel
passes centripetally and anastomoses close to the pupillary
margin to form the minor arterial circle.
COMPARTMENTS OF THE EYEBALL
The interior of the eyeball is divided into two compartments
by the lens: a small anterior compartment in front of the lens
and a large posterior compartment behind the lens (Fig. 19.26):
1. Anterior compartment: It is divided into two chambers:
a smaller anterior chamber and a larger posterior chamber.
The anterior chamber lies between the iris and cornea
and posterior chamber between iris and lens. The two
compartments communicate with each other through
pupil.
The two chambers are filled with an aqueous
humour, which helps in maintaining the intraocular
pressure. The aqueous humour is rich in ascorbic acid,
glucose, and amino acids. It nourishes the cornea and
the lens which are otherwise avascular.
Circulation of aqueous humour: The aqueous humour is
secreted in the posterior chamber by the ciliary processes.
From here it passes into the anterior chamber through the
pupil. Here it passes through the spaces in the iridocorneal
angle, located between the fibres of ligamentum pectinatum
and then enter into the canal of Schlemm, from where it is
drained by the anterior ciliary veins.
 Orbit and Eyeball 299

Dura mater 2. Posterior compartment: It is behind the lens and much

Arachnoid mater Choroid larger than the anterior compartment (comprising
Subarachnoid space four-fifth of the eyeball). It is surrounded almost
Optic nerve
Rectus muscle completely by the retina and is filled with colorless,
transparent jelly-like substance called vitreous humour/
vitreous body. The vitreous humour is enclosed in a
Iris delicate hyaloid membrane. Anteriorly, the hyaloid
membrane forms a depression the hyaloid fossa in which
Lens Minor rests the lens. The vitreous humour helps in maintaining
arterial circle
intraocular pressure and therefore the shape of the
Central artery of
retina Major eyeball. Further, it holds the lens and the retina in place.
arterial circle The hyaloid canal extends from optic disc to the lens.
Pia mater Anterior
ciliary artery
The canal marks the site of the hyaloid artery in the fetus.
Short posterior ciliary artery The hyaloid artery is a continuation of central artery of
Long posterior ciliary artery the retina which disappears 6 weeks before birth.

Fig. 19.25 Arterial supply of the eyeball. LENS

The lens is an unusual biological structure. It is a
transparent, biconvex body, 1 cm in diameter and 4 mm
compartment
Anterior

Pupil Anterior chamber thick, placed between the anterior and posterior
Iris
Limbus Posterior chamber compartments of the eyeball.
Iridocorneal Canal of Schlemm
angle
External Features
Ciliary body
Lens The lens presents the following external features:
1. Anterior and posterior surfaces.
Hyaloid
membrane Posterior 2. Anterior and posterior poles.
compartment 3. A circumference—the equator.
Hyaloid
fossa Vitreous body The line connecting the anterior and posterior poles is called
the axis of the lens.

Structure
The lens is enclosed in a transparent elastic capsule. Anteriorly
Optic disc
deep to capsule lies capsular epithelium. In the center, the
Optic nerve epithelium is made up of a single layer of cuboidal cells. The
Fovea centralis
cells at periphery prolongate to give rise to lens fibres. These
fibres get arranged concentrically and form the lens substance.
Fig. 19.26 Compartments of the eyeball. The center (nucleus) of the lens consists of oldest fibres. Here
the lens fibres lose their nuclei and organelles. As a result, a
special set of proteins called crystallines lie in the center. The
Clinical correlation center of the lens is, therefore, hard. The periphery of the lens
(cortex) is soft because it is made up of more recently formed
Glaucoma: If the drainage of aqueous humour is blocked,
there occurs an abnormal increase in the intraocular fibres.
pressure—a condition called glaucoma. As a result, there is
severe pain in the eye due to pressure on the highly sensitive Clinical correlation
cornea.
The glaucoma may cause variety of visual problems, • Presbyopia (short vision): The lens plays an important
viz. blindness due to compression of retina and its blood role in accommodation. The lens absorbs much of the
supply. ultraviolet light and becomes increasingly yellowish with
The intraocular pressure which normally is about age. It also becomes harder with age. As a result of which
15 mmHg can be measured on anesthetized cornea the power of accommodation is lessened in old age
(tonometry). producing a clinical condition called presbyopia.
300 Textbook of Anatomy: Head, Neck, and Brain

3. Accommodation of the lens to focus the light waves.

• Cataract: The opacity of the lens is termed cataract. With
increasing age and in certain disease states, the lens
4. Regulation of amount of light entering the eye through
becomes opaque. The increasing opacity leads to pupil by iris diaphragm.
increasing visual impairment. This can be treated 5. Convergence of eyeballs.
surgically by excision of opaque lens and replacement
with an artificial lens. The stimulation of photoreceptors of retina generates
action potentials that are relayed through the optic path-
ways to the visual cortex of the brain, where image is
Suspensory Ligaments of the Lens (Zonule of Zinn) formed. The visual impairment may result if any one or
The lens is suspended between the anterior and posterior more of these processes fail to function properly.
compartments of the eye by suspensory ligaments of the
lens. These ligaments extend from ciliary body to the lens REFRACTIVE MEDIA OF THE EYE
capsule mostly in front.
These include:
FUNCTIONS OF THE EYE 1. Cornea (very refractive but not adjustable).
2. Aqueous humour.
The main function of the eye is focusing of light waves and 3. Lens (refractive and adjustable).
stimulation of photoreceptors of the retina. This requires 4. Vitreous humour/vitreous body.
five basic processes, viz.
All these media together form the refractive apparatus of the
1. Transmission of light waves through transparent media eye.
of the eyeball.
2. Refraction (bending) of light waves through different N.B. Most of the refraction by eye takes place at the anterior
refractive media of different densities. surface of the cornea (not in the lens as generally thought).
 TONGUE
1-1

Root
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toot : Attached to
hyoid bone ,
mandible , Styloid process
①
⑧ and ④ enters throughohoot.IS .

① Prevent swallowing of one's own

tongiiu .

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Content with central incisors

hsal Surface
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ventral surface

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FY
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Ant ' 13 Post 213

( oral
part) (pharyngeal part
b b
① Median furrow /swans '

lymphoid tissue
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0
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#

part of Dorsal Body: (Ant)

Lingual Papillas
-

Projection of Lamina papillar (Lorium)

① Vallate Papillar (circumvallak papillar (Moat)

-

↳Suews
largest
Deam-1-2 m m
Number-8-10
D Taste bad test within

living epithelum of sules

Infront of sulcus Terminalis

②
Filliform Papillae:

the
- - -

Almost entire dorsum of tongue

·Narrowest
projection
-

Most Conical
numerous
·

Responsible for velity afflarance of tongue.

·

③
Fungiform papillar:
Taste bud
Tip and
margin of tongue R
·

Second (<1mm)
largest
·

Red round headed

·

④ Folate
- - - - -
papillar
Inconstant vertical grooves
·

Infront of sulcus terminalis

·

Rudimentary in human.
·
CharyngealPt"99): S

No
·

papillar
·
Uneven -
of lymphoid follicles (equal tonsils)
Musous memb is cont. With tonsils (Palatine) and post to via median and
efigetis
·

lat glossoefuglotic fold

Valuuea space blw

efightis and tongue

Note: Lateral continues

epigetic fold as
any epiglotti fold.
Vendwfaiecf tongue :
(
Inf surface)

Frenulum lingual → Mucosal fold connecting tongue to the floor of mouth .

lingual ④ and ④ →
medial to dup lingual vein
( deep : not visible)

①
Sublingual fold overlying
- - -
: the

sublingual gland .

1MusckofT_ongue-l@InterinsicMusclisi.N
#

of attached to bone
'

⊕ in upper part
•

Can change shape

@
Sufi longitudinal Mls - Makes dorsum concave

⑨ Transverse MIS Maths tongue and

narrow
elongate
-

Maths dorsum convex

⑨
Inf long
.
.

Mls -

⑨ Vertical m/s
-
makes
tonge broad and flat
 Exkinsiemnsle :
hmuselis

⑨ Genio glossies
⑤ Hyo glossies
② Palatoglossus
⑨ Stylvgeossus

# Coronation :

①
Ex1mK :

¥
by compressing
the lot side .
.
Genioglossies : prevents tongue swallowing .

Ilyin Sufi genial tubercle

:
(mandible inner
surface)

Indian : Upper fibres

:
Tip of tongue Retracts

Middle
fibers
:
Dorsum of tongue Defuses
town Hyoid bone Protrudes (safety m /s)
fibres
:

tongue swallow
◦ Not allow

Arterial Supply : Venousdsainage

◦
Deep lingual vein -

Punahou ① of
tongue .

0 Venae lomuitantes

/ µ lingual
with mayor ⊕ , ↳
Along with ④
this is +st
with XI ④
'

4- mfhage
:

Tip of tongue Submcntae 1. N '

-

Suk
Side and dorsum
of tongue
-
Mand .
GN .

Post 113 →
Deep cervical tin .
 Nsupply:

Ms of tongue by
except
plantoglossus (NAC)

Clinical Aspect:
-

Hypoglossal injury
* -
ask
patient to protude the
On one side
tongue
↳
· Apsilatual devisition
ofTongue
(Not seen in anysther injury)

Sorbitrate:
*
Sublingual medicine (Angina Pictoris
b
Rich circulation ->
Bypass portal circulation
 *
AR,
supplyof ear:
We

Asterial Supply:
-

Sup-temporalOAJECA hashe

Tympantemb
·
Shape and size: Oval Carxiomm)
·
Anger of 330 with
floor of meatus
↳ Fibro cant
ring
Umbo-Point of max convexity.

-
Outer
radiating Fibus
Middle layer -
(collagen) Ine circular fibres
 Fi#ageRing : made
of outer
radiating fibres Ctmikened)
① Attached in Tymp .

sulcus ( absent in alpha part)

# Tympanic sulcus not ⊕ in uphw part → Tympanic notch + St

• Pass Florida :
Flaccid due to + se
of Tymp .
notch -

•
Pars Tensai Tensed due to + se
of Tympanic Sulcus

Tympanic notch

Tympsnkus

Pais faceda

bhoedaeTympani ⑧
Cumin side)
tone of light
# Inside
-
Tymp -
.
Membrane

Arterial Supply :
.
-

Outer Deep awuiularAO.br if I part ofMax ④

Surface
: -

Imu sulfate : Ant FOA ④

Tympanic ⑧
.

Post Post Auricular

Tympanic bit Stylomastoid④
'
←

Venous
- drainage -

Outer → EJV
surface
Inner
surface
→ Team Sirius

bymphaticdrainage :

Outer
surface > pre auricular and Retro pharyngeal 1- N -

Inner
surface

Nerinsuppy :

IMUSmfau_ Tymp branch of

glossopharyngeal
OWI Post sup
-
.
Am branch of #
.

⑧
: -

④ .

Ant -

inf
.

ATN ( Amico temporal④

 Anatomy
Clinical
Incision of TM-Myringotomy (careful about Choeda tympani

Incudomalleolas
Issicles: -cus: F
Joint Saddle joint

extra tympania
Recess
t

B
4

Incudostapedial
I

To unt
(Bale and socket)
Incus:
-
Spes:
EAR
*

lateral
Wall-Tympanic membrane

Tigmen tympant thin layer of temporal bone

-seprates mid car
from brain (Temporal lobe)

Jugular Wall-Sup.bub of into

jugular vein teste

Ant-wall: Two
opening +st

Boney extension test ka Processus Cochlean formis (blw two openg)

-

cout as pulley for Tensor Tympani

#Sympathetic plexus Around ICA

Sup]
②nevers- Canotistympanic (Symp. O
i

Medial wall: PM-promontory (Cochlear elevation on

media Wald
↳ basal turn

Round window-I tympanic memb attached.

>Posting to PM (
Oval
window-foot plate of stakes is attached.
(Postsup to PM)
TO
-Tympanic plexus (Jacobson's &
Tympanic branch
of ex
Center from floor to medial wall) (Parasympathetic

· Facial D: Runs on medial Wall and then on Post Wall.

Facial Canal: Facial I passes

·
Cateral Semiarcular canal:.Just above Facial Canal (PostSup)
Injury to Facial No aws here
·
 Post-war .
Also Kla mastoid wall

Additus to mastoid antrum : Middle ear to mastoid anthem

Fossa

inch ,

Processes
cochhbornis

Fossaincudes:_ Small depression

Imus bone rests here

#
 #
Incas putto Latgale
:

→ Ant wall removed :

Arterial Supply :
-

① Ant tympanic branch of maxillary ④

.

⊖ Post
of stylomastoed ④ Post Auricular ④
tymp
-
.

branch
-0
MMA

Pharyngeal⑧
⊖ Be of asc .

①
Tym .
be
of ICA
 lh#age_ lymphaticdsainage.RU
auricular l -
N

sup fvtvosal Sinus Retro pharyngeal tin

'
.

Pterygoid venous
plexus

ISuphly :

A④ ( Jacob's
*
Tympanic be -

of )
nerve

↳
Pairasymp ④ -

Supply mucus mennb of Tym cavity

-

, mastoid air cells

and auditory tube .

Sufi and
inf Carotid tympanic ④ Csymp Air )
.

# Clinicalaspeit
' '
Otitis Media -
More krone are young fuson
↳
Inflammation of middle ear
Pus
drainage from Tympvmemb
↳ .
 .NO/2MABASAus-
④
Occipital condyles -

Kidney shaped
 fERVICALVERTEBRAF-ci.AT
Cz -
as

Axis
↳ (6 Vertebrae
Typical
- -

G- -

Vertebrae Prominence

# Ant tubercle also

Iypicalvertebsae
:

Kla Carotid Tubercle

# € : (Thoracic vertebrae like)

No
foramen Tsansvirsomum
•

long spinous fmomrnanu (Not Bifid)

-

Atlas ligament
'

# Named Ant arch and Transverse

'
:
after greek god ⊖ .

keeps dense in plan .

①
Nobody
① No
spinous flows -
 #
Axis :
Foramen trans . Ht

A-It-0.IT#-*: Ellipsoid Joint

More Convex :
Occipital condyles
Articular
surface
.
/
[ Below Contain :
Sap .
Artinian
faut of Atlas

ligaments :

s-aggi.com :

① Ant Atlanta ou memb → extension of Ant

long ligament
-
.
. .

Remnant of Notochord → Apical

⊖
big of dense
0 Membsana teutonia
↳
of Post long ligament
"
cont
-
.
.

£
P $ I
> A

¥
# Ligament

Thick Post Lat

~
ligaments
- .
-

(fibrous Capsule) \ Thin -

Post medial
-

① Ant -

Atlantis Oauhrlal membrane

↳ Below to Atlas
ant arch of
and above to ant
margin of foramen magnum
-
-

① Post Atlantis Occipital memb

'

↳
Below to post arch of Atlas
and above to
post margin of Foramen magnum .

¥Kfhly : Vert -

Artery

N-snhhhi.ci Nerve

Movements
 Atlantis Axial Joint
- ( 3 Joints)

--
9- medial 2 lateral ( Plane synovial)

ligaments
Transverse
ligament : attuned to eat mass
of atlas
-

↳ extension _¥ Attained to basilar part of bone

↳ Supband
.
band →
Ocu

Inf . →
To body of axis

sup band +
Inf .
band + TL
Cruciform ligament

Kgam#ing axistoocuifutalbone
:

Afnial ligament of dens .

from dens to basilar part of occipitalbone

Alar Side dens to the tubercle

ligament of on medial aspect of our condyle
↓ " "

Also Kla Cheek

ligament
↳ Cheeks excessive location

and flexion .

Membranateitoria upward :
cont
-

of post long ligament

.
.
.

#
Clinicalaput :

Languidfracture : Not causes death when hanged .

 When Hanged, Abrupt extension of neck .

b
Dense finished ant .

Dense
goes backward
to
Confession of Medulla oblongata
↓
Compression of Vital centres .

SUB OCCIPITAL TRIANGLE

-
:

Post Part
①
of skull
-

B0MdIl%☐ :

Rectus capitis Post minor

guy medial { Rectus Cahitus post
.

-
.

major

sup .
Lateral -

Oblique capitis sup .

Inferior Oblique Cahitirsinf

.
-

semi spiralis
Roof fibrous septum
: covered
by capitis

Fleer Boney Post arch

: -

of Atlas
Post ateonto -

occipital membrane

Content :
-
-
II
part of Vert -

④
Dorsal Of Cinema
_

Samus
Sub
oanfntal plexus
-
venous
-
 CERVICAL PLEXUS it )
( stomochido mastoid covers

•
Formed by Venkat Rami of G-Cu
•
Rami comes out between Scalenus ant and medius .

Kla Plexus of loops

ÉÉ_ ÷"
* .
Transverse Process of Atlas

④ enter→ while , exit →

guy

M lNormal=

Only guy Sami test in cervical

Ñ plexus no white Rami

-

communication

(A)
.

Sufi U ⑧
.

Branches :

@ Superficial branches ⑤ Deep Branches

①
Communicating branches
① Great auricular ④ (Gt3) guy Rami communions
from hip Cervical
-

② lesser ounfutal ④ (Cz ) ganglion

.

'

⑧ cfneik (kik)
'

③ Trans Cut
.
-

② Muscular branches Ansa uwicalis

( (I (3)
-

④ Sufnaclavicnlar ⑧ (↳ icu g. Raters Capitis ant , strap mls

Rectus Catulus lat , Teapizins Cena)
longus Whitis ,
stvmocbido mastoid (G)

Scalenus Mls Ccs Csi

, diaphragm -
#
Dupbsanctns Rufus

§#
'

XI④

•
aeniomoia

DEojwolisa.a.1@Ja.any.g.m.A
Spinal Thywhyoid .

,☒
0
TO SCM ((2)

] ÷:-

eating

Antonioni
→ SBON

# i.
A ST IBOM
Phrenic④

ORBICULARIS OCULI :

NIK :
Eyelid :

Tassi -

fibrous Connective tissue which

gave shuhlal framework to

eyelids
.

-
 (when rain / dust
tries to enter eye)

BUCCINATOR :

'
Middle fibers crosses parotid dent -

Aden : •

Flattening of cheek against gums

•
Prevents Food accumulation in vestibule
◦

Whistling
 LACRIMAL APPARATUS Orbital
part

① lacrimal gland ( J shaped)

② Lavwinal dunt (lo th dints) -

③ (btw and eyeball)

Conjunctival bae eyelid
⑨ lacrimal fountain
③ lacrimal Cannaliculi

⑥ Laminal bae ( behind medial tpalpihsal ligament

⑦ Nasolacrimal dent
.

# lacrimal Gland

J shaped gland (serous gland)

Around ups →
larger Orbital part (⊕ in lacrimal fossa)
↳ Smaller
-

Palpebral part (④ in hat -

part of uphn eyelid]

Burt :

4- 5 dents ( from orbital part)

12 b- 8 dents ( from palpebral part)

1- me of lacrimal fluid / day .

Acc lacrimal
gland
.

small serous
glands near
conjiutival forni us .

Upper eyelid : 35-40 glands

lower eyelid : 6-8 glands

Arterial Supply : Venous

Sufhly ?

Lacrimal ④ Copthalmic ④ Opthalmic vein

Neiwoussuppty :

① Sensory Nerve :
lacrimal ④ Cv , Num)

②
Parasymp Innervation
. :

Sup salivary
.
Nu → Nv Intermedius Lvn ⑨I
- → Gouatupekusar ⑧ →
Pterigo palatine
ganglion (Relay)
to
lacrimal Nerve ←
(V1 ④ )
Zygomatictemporal ←
Zygomatic ⑧ ← I- ④
⑧
to
lacrimal
gland
③
Sympatheticpathway :

④ →
Sup -

cervical ganglion
→
Postganglionic fibres →
Sym plums .

C.Relay) ( around ICA)

to
lacrimal
c- zygomatictemp ← zygomatic .

_ Ptougo Palatine ←
Dup futursor Nerve
⑧ ④ Nerve Ganglion
↓ (No relay)
Lacrimal
gland
.

Cory actual bar :

Btw palpebral and Bulbar Conyutiva
lacrimal Canaliculi ?

Horizontal part -8mm ,%→

←
Vertical
part 2mm
-

Opens in lacrimal Sav

lacrimal Sar : 12mm

long ✗ 5mm wide

Behind med .

palpebral ligament
Nasolacrimal dint : 18mm long
Deiution →
Downward , backward and laterally Incomplete value .

①
opens in inf meatus ① Value
of Masoner
 Clinical :

1) aero
cystitis lacrimal Sai
inflammation
: .

lacrimal
* As all dart
passes from Palp part of gland
.
.

f.
Removal of Palp part eyual to the
removal
of entire gland
.

lacrimal
Epiphora :
fluid over the cheeks

CERVICAL SYM (HAIN .

Q 9
coccyx ( 1ˢᵗ)
Extent Base the
of skull to
:

9 9
Position Paravertebral
:
9 °

' 0
Termination : and ends in Ganglionic vinpar;
Fuse in
front of way ✗ impaired

Cervical
ganglion (3)
§ym.Chain_ Thoracic
ganglion
( "l

lumbar
ganglion 14
Sacral
ganglion 141

# fym chain
.
:

① Behind Carotid Sheath

frocks of Cervical Vert

①
Infront of Ts .

Cervical ④ cervical
Sup ganglion fusion of uhhw
:

gang
.

Middle cervical 5ᵗʰ and 6ᵗʰ cervical

ganglion fusion of
:

gang
.

Inf cervical
ganglion
:

fusion of 7- " and 8ᵗʰ cervical

ganglion
.
 Features
-
specific : .

① No white ramus communicants .

①
Guy Ramus Communions to all 8 cervical nv

① lateral horn cells of IT -

Ty
b
"

Psrganglionic
"
Fibres

a-c.IT#sch5-up.*anglion- :

#↳
(( 21(3)

largest Ñ→
II
MCG ( Co)
•

spindle shaped (2.5cm)

I↳ Ich (G)
Infront Of frowns of C2 and ( 3
•

Transverse . Ciao

Dilator
hey Ramus pahillae
Communicant µ¥
b-
-

&,
pharyngeal Plexus
(3
d
ch Sup -
cervical
cardiac be .

Middle Cervical
Ganglion ←
:

- Middle cervical
GRU
↳
Cardiac hi Grey Ramus Commins -

①In
µ
\ - Cans .

front of Ts fr of covert
,,
Thy gland
-
.

O#
.

①
⊕
first above inf
.

Thyroid ④ Inf Thoracic④

:%¥¥÷÷
"
Inf cervical Ganglion :

* Cardiac bs .

Cst
Oesophageal④
'

G- Vert
①
Infront of Ts fvwass of
-
.

Generally , ICG fused with

first thoracic ganglion " "
.

subclavian④
Ganglion J
'

-
-

Together K/ a stellate .

Ansa Subclavian loop

of connection b/w middle and Inf ④
: -

subclavian

loop of ④ around C) sea .

Subclavian ④ 1
C) MCG

Ica .

Subclavian
0¥
④
?⃝
?⃝
 LYMPHATIC DRAINAGE :

Total IN in
body → 1400-500-1 in body .

t
180-1001=1 in MNF

* lymph from MNF →

Dimethyl Indirectly
&

Deep cervical lymph Nodes (DUN)

(LN + st
along I JV )

Pericervical Column → All LN

along base of Strutt
Inner Girth ⊕ around alimentary canal and resp passage
→ .
.

Submncosal t tissue →
Waldeyu is lymph Ring
☆

↓
④ and ①
Jugulartrunk
→
④ ②
I ↓
④ lymph dent thoracic dint
# Deep cervical lymph nodes
- - .

① tst
along IJ vein
① Not visible unless Sterno Iudomastoid removed .

hbhu ghouls →
Jugulo digastric LN
DC
lower
group →
Juguloomohyoid IN

↳ Sufaaibauiwlart N '

→
 "

Iugu.to#gas-ulyzphNode- :
Principle node of Palatine Tonsil "

Afferent Palatinetonsil and

-
Post .

part oftongue
lower

DCLNIugulo0@yo_idlyn_nphNode_e.A
Efferent
-

ffuent Deviltry from tongue

:

Indirectly Submentul, Smbmand and tiffin Deep cervical

from
-

lymph nodes .

Efferent Jugular trunk

:

"

Additional lower DCLN

S-ufra-d.ly Impede
"
:

scalene LN (Infront of Scalene LN-1

(Virchow 's lymph node )
↳ ② scalene LN swells up in
case of metastasis of stomachcarcinoma cells -

# Outward ( Pericervical collar )

t
 Drainageoflymph

I
->

Tip of tongue Central part of forhead

Floor of medial
angle of eye
mouth
-> submental
lower L.N
submand. 1.N
gems (incisors) Ant
part of nasal cavity
Central part of lower lip Check

Chin Angle of mouth

uppen lip
Ant 4 of to
syne --

Frontal, maxillary and

I
air Sens
Upper part of Forehead Ant-ethmoral

Temporal region
Parotid L-N
Upper part of bit surfall of avide
Ant wall of Ext And Canal

Latangle of eye

Mastod LN-Medial
- surface of upper part
Crupto SCM) of anside
Adjounny scalp
Post Wall of EAC.

Pipit
LN: Post
part of scalp
CApex of One Al
 D-isplacedl-Nofpeuiceruicalcoelau-i.IO
Superficial cervical LN → Related to EJV

② Ant cervical tin →

Related to AJV

Sup .
cervical LN → Angle of mandible
lobulu of ear
lower
part of parotid

Ant cervical LN → Ant *

☐
of neck
-

.
.

# Innerk :

Pretsacheal IN Just about isthmus of thyroid gland .

Pre Conus elastins

laryngeal 1- N
Infront of
Pasa tracheal L N -
.

Btw trachea and oesophagus (along RLN)

a-
Afferents
:
larynx Efferent Neighbouring
:
DCLN
Trachea

Oesophagus
Thy gland
.

Retro
pharyngeal TN In Retro
pharyngeal space
:
.

Afferent Pharynx :
Audi tube
Efferent :
upper DCLN

Jugnlo digastric Tymp cavity

-

soft palate spheroidal and

Nasal
Post
part of Cavity Post etn air sinus .
# lymphatic Ring
Waldeyu 's : Submurosae :
fruit mfution from outside
REVISION