HEAD & NECK – PART 1

Institute of Anatomy,
Madras Medical college.
1

A) Identify the pointed structure.

B) Write its origin and Insertion.

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A) Sternocleidomastoid muscle
B)
Origin :
• sternal head ( tendinous) arises from the superolateral part of the
front of the manubrium sterni
• Clavicular head ( musculoaponeurotic ) arises from the medial
third of the superior surface of the clavicle.
Insertion :
➢A thick tendon on the lateral surface of the mastoid process
➢A thin aponeurosis into the lateral half of the superior nuchal line of
the occipital bone.
2

A) Identify the pointed structure.

B) write its nerve supply.

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A) Sternocleidomastoid muscle
B) Nerve supply
1. spinal accessory nerve.
2. Also supplied by the ventral rami of C2 and C3, which are mostly
sensory and carry proprioceptive sensations from the muscle.
3

A) Identify the pinned structure.

B) Write its origin and insertion.

 3
A) Anterior belly of Digastric muscle

B) Origin : Digastric fossa of mandible

Insertion : Body of hyoid bone via intermediate tendon and its fibrous
sling.
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A) Identify the pinned structure.

B) write its action and nerve supply.
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A) Anterior belly of Digastric muscle

B) Action : Depresses mandible, elevates hyoid bone during chewing,

swallowing.
Nerve supply : Mylohyoid nerve ( br of inferior alveolar nerve )
5

A) Identify the pointed structure.

B) Name the duct and where does
it drains?
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• A) Submandibular gland
• B) submandibular duct ( Wharton’s duct ).
It drains the secretion into the oral cavity on the summit of a
sublingual papilla on either side of frenulum of the tongue
6

A) Identify the pointed structure.

B) Name its terminal branches and at what
level these terminal branches arises.
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A) Common carotid artery

B) Terminal branches are : External carotid artery ( ECA ) and Internal

carotid artery ( ICA ) given at the level of upper border of the thyroid
cartilage
7

A) Identify the pointed structure.

B) Write its any 4 branches.

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A) External carotid artery
B) Branches are : Superior thyroid artery
Ascending pharyngeal artery
Lingual artery
Facial artery
Occipital artery
Posterior auricular artery
Maxillary artery
Superficial temporal artery
8

A) Identify the pointed structure.

B) Write its relations within the

carotid sheath.
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A) Vagus nerve

B) Vagus nerve lies within the carotid sheath between the internal
jugular vein (laterally) and carotid artery medially (common carotid in
the lowerpart and internal carotid in the upper part ).
9

A) Identify the pointed structure.

B) Write its attachments.

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A) Masseter muscle
B)Origin :
Superficial layer – from maxillary process of zygomatic bone and
ant 2/3 of the inferior border of the zygomatic arch.
Middle layer – from lower border of the post 1/3 of the zygomatic arch.
Deep layer – from deep surface of the zygomatic arch
Insertion :
Superficial fibres - into the angle and lower posterior half of the lateral
surface of the ramus of the mandible.
Middle fibres – into the central part of ramus.
Deep fibres – into the upper part of the mandibular ramus and its
coronoid process.
10

A) Identify the pointed structure.

B) Write its nerve supply and action.

 10
A) Masseter muscle

B) Nerve supply – Masseteric nerve (Mandibular nerve)

Action – Elevates the mandible
 11

A) Identify the pointed structure

B) Write the structures present within it

 11

A) Parotid gland

B)Superficial to deep
Facial nerve, Retromandibular vein, External carotid artery
12

A) Identify the pointed structure.

B) Where does it open?

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A) Parotid duct (stensen’s duct)

B) Parotid duct, about 5 cm long emerges from the middle of the

anterior border of the gland and opens into the vestibule of the
mouth opposite the crown of upper 2nd molar tooth.
13

A) Identify the pointed structure.

B) What are the parts and its action?

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A) Orbicularis oculi
B)
* Orbital part – closes the eye tightly to protect the eye from
intense light and dust particles.
* Palpebral part – it closes the eyelids gently as in sleep or in
blinking.
* Lacrimal part – It dilates the lacrimal sac by exerting traction on
the lacrimal fascia, thus helping in the drainage
of lacrimal fluid.
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A) Identify the pointed structure.

B) Write its nerve supply and action

 14

A) Orbicularis Oris

B) Nerve supply – Buccal branch of facial nerve

Action –Mouth closing, pouting, pursing, twisting.
15

A) Identify the pointed structure.

B) Write its origin and insertion.

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A) Temporalis muscle

B)
* Origin – from whole of the floor of temporal fossa except the
part formed by the zygomatic bone
Also arises from deep surface of the temporal fascia.
* Insertion - into the medial surface, apex, anterior, border of
the coronoid process of ramus of mandible and into the anterior
border of the ramus of mandible, almost up to the last molar tooth.
16

A) Identify the pointed structure.

B) What are the medial surface relations

 16

A) Thyroid gland.

B) 2 tubes – Trachea and oesophagus

2Muscles – Inferior constrictor and cricothyroid
2 Nerves – External laryngeal and recurrent laryngeal nerve
Tracheo- oesophageal groove – recurrent laryngeal nerve
17

A) Identify the pointed structure.

B) Write its blood supply

 17
• A) Thyroid gland
• B)
- Superior thyroid artery ( branch of external carotid artery)
- Inferior thyroid artery ( branch of thyrocervical trunk )
- Thyroidea ima artery ( branch of arch of aorta or brachiocephalic trunk )
18

A) Identify the pointed structure.

B) Write its branches in the face.

 18
• A) Facial artery
• B)
* Inferior labial artery
* Superior labial artery
* Lateral nasal artery
* Muscular branches
* Angular artery (termination)
19

A) Identify the pointed structure.

B) write its terminal branches.

 19
• A) Facial nerve
• B)
* 5 in number :
- Temporal branch
- Zygomatic branch
- Buccal branches ( upper & lower buccal nerve )
- Marginal mandibular branch
- Cervical branch
 20
20

A) Identify the pointed structure.

B) Write its formation.

 20
A) Facial vein
B) It is formed at the medial angle of the eye
by the union of supratrochlear and supraorbital veins. After
formation, it runs behind the facial artery to reach the anteroinferior
angle of the masseter.
Joins the anterior division of retromandibular vein below the angle
of the mandible to form the common facial vein, which drains into
internal jugular vein.
21

A) Identify the tied structure.

B) Write its tributaries.

 21
A) Internal jugular vein
B) Inferior petrosal sinus (first tributary)
Facial vein,
Lingual vein,
Pharyngeal vein,
Superior and middle thyroid vein
Occipital vein ( occasionally )
22

A) Identify the pointed structure.

B) Write its origin and insertion

 22
A) Trapezius muscle
B)
Origin
Arises from the medial 3rd of the superior nuchal line, external occipital
protuberance, ligamentum nuchae, spine of C7 and spines of all the
thoracic vertebrae.
Insertion
•Upper fibres sweep downwards to be inserted into the posterior
border and upper surface of the lateral 3rd of the clavicle.
•Middle fibres run horizontally to be inserted into the medial border of
the acromion and the upper lip of the spine of the scapula.
•Lower fibres ascend to be inserted into the tubercle of the spine of the
scapula near its root.
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A) Identify the pointed structure.

B) Name the muscles innervated

by the pointed structure.
 23

A) Spinal accessory nerve

B) Sternocleidomastoid and Trapezius muscle

24

A) Identify the pointed structure.

B) How it is formed?
 24

A) Ansa cervicalis

B) Descendens hypoglossi carrying C1 fibres

Descendens Cervicalis (C2 and C3 fibres)
THANK YOU