Summary Tables of significient Structures for Labs 23 & 24

Osteology

occipital

the bone forming the posterior surface of the skull, it articulates superolaterally with the parietal bones
through the lambdoid suture, anteroinferiorly with the temporal bone and anteriorly with the body of
the sphenoid bone

pharyngeal tubercle______projection located anterior to the foramen magnum, attachment site for the
superior pharyngeal constrictor m.

D:

palate

hard palate______concave vaulted structure whose space is filled by the tongue when at rest

D:

pterygopalatine fossa______pyramidal space inferior to apex of orbit, lies between the pterygoid
process of the sphenoid bone posteriorly and the posterior aspect of the maxilla anteriorly (Greek,
pterygoid = wing-shaped)

D:

vomer_______thin, flat bone that forms the posteroinferior part of the nasal septum (Latin, vomer = a
ploughshare, the latin word is said to have been derived from vomere, to vomit, because the plough
"throws up" the earth), the hyoid bone ossifies completely in middle life; the body articulates with the
greater horns via cartilage and with the lesser horns via fibrous joints prior to ossification; an important
site for muscle attachments (suprahyoid and infrahyoid muscle groups) (Greek, hyoid = U-shaped)

D:

maxilla_______upper jaw, consitute the supporting bone for the maxillary teeth

D:

sinus_______the largest of the paranasal sinuses; occupy the bodies of the maxillae

D:

ethmoid

pneumatized spaces (3-18 in number) within the ethmoid bone; located between the orbits; three
groups may be identified: anterior (drain into the hiatus semilunaris in the middle nasal meatus), middle
(drain onto the apex of the bulla ethmoidalis in the middle nasal meatus), posterior (drain into the
superior nasal meatus), (Greek, ethmoid = resembles a sieve)

perpendicular plate______superior part of the nasal septum that descends from the cribiform plate;
superior to the cribiform plate it is the crista galli

cribriform plate______perforated portion of ethmoid bone on either side of the crista galli; perforated
for passage of the olfactory nerves

superior nasal concha______medial projection of the ethmoid bone from the superolateral wall of the
nasal cavity; forms the superior nasal meatus below it and the sphenoethmoidal recess above it
middle nasal concha_______portion of the ethmoid bone that projects inferomedially from the lateral
wall of the nasal cavity; forms the superior nasal meatus above it and the middle nasal meatus (which
overlies the bulla ethmoidalis and hiatus semilunaris) below it

bulla ethmoidalis_______rounded elevation on the lateral wall of the nasal cavity; located under cover
of the middle nasal concha; middle ethmoidal air cells drain at its apex

nasal septum______divides the chamber of the nose into two nasal cavities, with three major
components: perpendicular plate of the ethmoid, vomer, and septal cartilage

nasal conchae______three curved bony plates on the lateral side of each nasal cavity; the superior and
middle concha are part of the ethmoid bone, the inferior concha is a separate bone

D:

sphenoid

an irregularly shaped bone forming the central portion of the skull it has many parts, including a
body, greater wing, lesser wing and pterygoid plates (Greek, sphenoid = wedge-shaped)

body_____central part, containing sinuses (Greek, sphenoid = wedge-shaped)

infratemporal fossa______bounded superiorly by the infratemporal surface of greater wing of the

sphenoid and inferiorly by the alveolar border of the maxilla; bounded laterally by the ramus of the
mandible and medially by the lateral pterygoid plate of the sphenoid bone, it is the attachment of the
superior pharyngeal constrictor m. & the pharyngobasilar fascia (Greek, pterygoid = wing-shaped)

foramen ovale______through greater wing between foramen rotundum & foramen spinosum; transmits
mandibular division of trigeminal nerve

foramen spinosum______through greater wing; transmits middle meningeal artery, it acts as a pulley for
the tendon of the tensor veli palatini m. (Greek, pterygoid = wing-shaped; Latin, hamus = hook)

lateral pterygoid plate______projects posterolaterally from pterygoid process; attachment of lateral &
medial pterygoid muscles (Greek, pterygoid = wing-shaped)

medial pterygoid plate______projects posteriorly from pterygoid process; attachment of superior

pharyngeal constrictor & pharyngobasilar fascia (Greek, pterygoid = wing-shaped)
pterygoid hamulus_____hook-like projection from the inferior end of the medial pterygoid plate; it acts
as a pulley for the tendon of the tensor veli palatini m. (Greek, pterygoid = wing-shaped; Latin, hamus =
hook)

sinus_____located in the body of the sphenoid and are separated by a bony septum; the sinuses make
the sphenoid fragile (Greek, sphenoid = wedge-shaped)

sphenopalatine foramen_____communicates with the pterygopalatine fossa medially through the nasal
cavity

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hyoid

body_____articulates with greater horns via cartilage and lesser horn via fibrous joint (Greek, hyoid = U-
shaped)

greater horn (cornu)_____posteriorly directed limbs of the "U"-shaped bone, each greater horn
articulates with the body and lesser horns anteriorly; origin of middle pharyngeal constrictor m. and
hyoglossus m.

lesser horn (cornu)______articulates with the greater horn at its junction with the body, the inferior end
of the stylohyoid ligament attaches to the lesser horn

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mandible

body_____U-shaped, halves fused at symphysis menti

coronoid process______anterosuperior projection from ramus; attachment of temporalis muscle

condyle______posterosuperior projection from ramus; articulates with mandibular fossa of temporal

bone; constricted below articular surface at neck of mandible (Greek, kondylos = knuckle)
mandibular notch_____notch between the coronoid and condylar processes; transmits masseteric
neurovascular bundle

lingula_____projection of bone medial to mandibular foramen; attachment of sphenomandibular

ligament (Latin, lingula = tongue)

mandibular foramen______on medial surface of ramus, opening to mandibular canal; transmits inferior
alveolar neurovascular bundle

pterygoid fovea_____depression on anterior side of neck of mandible; insertion of lateral pterygoid m.

(Greek, pterygoid = wing-shaped)

D:

Muscles of Chewing and Swallowing

masseter______o:zygomatic arch and zygomatic bone, i:lateral surface of ramus and angle of mandible,
a:elevates mandible, n:nerve to masseter, from mandibular division of trigeminal nerve (V), a powerful
chewing muscle (Greek, masseter = the chewer)

temporalis______o:temporal fossa and temporal fascia, i:coronoid process and anterior surface of the
ramus of the mandible, a:elevates mandible; retracts mandible (posterior fibers), n:anterior and
posterior deep temporal nerves from mandibular division of trigeminal nerve (V), a powerful chewing
muscle

pterygoid, lateral______superior head: greater wing of sphenoid; inferior head: lateral surface of lateral
pterygoid plate, i:superior head: capsule & articular disk of temporomandibular joint; inferior head: neck
of mandible, a:protracts mandible; opens mouth, n:lateral pterygoid branch of mandibular division of
trigeminal nerve (V), the only one of the muscles of mastication that opens the mouth; the superior
head of lateral pterygoid is sometimes called sphenomeniscus due to its insertion into the disc of the
temporomandibular joint (Greek, pterygoid = wing-shaped)

pterygoid, medial_____o:medial surface of the lateral pterygoid plate, pyramidal process of palatine
bone, tuberosity of maxilla, i:medial surface of ramus and angle of mandible, a:elevates and protracts
mandible, n:medial pterygoid branch of mandibular division of trigeminal nerve (V), this muscle mirrors
the masseter m. in position and action with the ramus of the mandible between (Greek, pterygoid =
wing-shaped)

digastric_____o:anterior belly: digastric fossa of the mandible; posterior belly: mastoid notch of the
temporal bone, i:body of the hyoid via a fibrous loop over an intermediate tendon, a:elevates the hyoid
bone; depresses the mandible, n:anterior belly: mylohyoid nerve, from the mandibular division of the
trigeminal nerve (V); posterior belly: facial nerve (VII), the digastric m. forms two sides of the
submandibular triangle; it is formed from mesenchyme derived from the first two pharyngeal arches,
hence its dual innervation

geniohyoid____o:mental spines of mandible, i:body of hyoid bone, a:elevates hyoid; depresses

mandible, n:C1 ventral primary ramus via fibers carried by hypoglossal nerve, thyrohyoid and geniohyoid
receive ansa cervicalis fibers that travel with the hypoglossal nerve distal to the superior limb of the ansa
cervicalis

genioglossus____o:mental spine on inner aspect of mental symphysis, i:fans out to insert into the
tongue from tip to base, a:protrudes tongue (inferior fibers); depresses tongue (middle fibers),
n:hypoglossal nerve (XII), an extrinsic muscle of the tongue; XII innervates all tongue muscles except
palatoglossus (innervated by vagus (X), as are most of the palate and pharynx muscles)

hyoglossus_____o:upper border of greater horn of the hyoid and body of the hyoid bone, i:mingles with
intrinsic muscles of the tongue, a:depresses sides of tongue; retracts tongue, n:hypoglossal nerve (XII),
an extrinsic muscle of the tongue

mylohyoid_____o:mylohyoid line of mandible, i:midline raphe and body of the hyoid bone, a:elevates
the hyoid bone and the tongue; depresses the mandible, n:mylohyoid nerve from the inferior alveolar
nerve, a branch of the mandibular division of the trigeminal nerve (V), the nerve to mylohyoid also
innervates the anterior belly of digastric m.; both muscles are derivatives of the second pharyngeal arch

styloglossus_____o:styloid process, i:side of the tongue, a:retracts and elevates tongue, n:hypoglossal
nerve (XII), an extrinsic muscle of the tongue

stylohyoid______o:posterior side of the styloid process, i:splits around the intermediate tendon of the
digastric m. to insert on the body of the hyoid bone, a:elevates and retracts the hyoid bone, n:facial
nerve (VII), facial nerve innervates both the stylohyoid m. and the posterior belly of the digastric m.
shortly after exiting from the stylomastoid foramen

omohyoid_____o:inferior belly: upper border of scapula medial to scapular notch; superior belly:
intermediate tendon, i:inferior belly: intermediate tendon; superior belly: lower border of hyoid lateral
to sternohyoid insertion, a:depresses/stabilizes hyoid bone ansa cervicalis, the intermediate tendon
of omohyoid is tethered to the clavicle by a fascial sling

sternohyoid_____o:posterior surfaces of manubrium and sternal end of clavicle, i:lower border of hyoid
bone, medial to omohyoid insertion, a:depresses/stabilizes hyoid bone, n:ansa cervicalis, sternohyoid
overlies sternothyroid and thyrohyoid
sternothyroid______o:posterior surface of manubrium below sternohyoid origin, i:oblique line of thyroid
cartilage, a:depresses/stabilizes thyroid cartilage of larynx, n:ansa cervicalis, sternothyroid lies deep to
sternohyoid

thyrohyoid_____o:oblique line of thyroid cartilage, i:lower border of hyoid bone, a:elevates larynx;
depresses/stabilizes hyoid bone, n:C1&2 fibers running with hypoglossal nerve that leave XII anterior to
the superior root of ansa cervicalis, thyrohyoid lies deep to the sternohyoid

constrictor, superior pharyngeal_____o:medial pterygoid plate, pterygoid hamulus, pterygomandibular

raphe, mylohyoid line of mandible, i:pharyngeal tubercle and midline pharyngeal raphe, a:constricts the
pharyngeal cavity, n:vagus (X), via pharyngeal plexus, none

constrictor, middle pharyngeal_____o:lesser and greater horns of hyoid bone and inferior part of the
stylohyoid ligament, i:midline pharyngeal raphe, a:constricts the pharyngeal cavity, n:vagus, via
pharyngeal plexus none

constrictor, inferior pharyngeal_____o:oblique line of thyroid cartilage, lateral surface of cricoid

cartilage, i:midline pharyngeal raphe, a:constricts pharyngeal cavity, n:vagus (X), via pharyngeal plexus,
with aid from superior laryngeal and recurrent laryngeal nerves, most external of the three pharyngeal
constructor mm.

stylopharyngeus_____o:medial side of styloid process, i:superior border of thyroid cartilage and also into
the pharyngeal wall, a:elevates the larynx, n:glossopharyngeal nerve (IX), stylopharyngeus, the only
muscle innervated by IX, is the only pharyngeal muscle NOT innervated by vagus (X) nerve

levator veli palatini______o:apex of the petrous part of the temporal bone and the medial surface of the
auditory tube,i: cartilage,muscles and fascia of the soft palate; palatine aponeurosis, a:elevates the soft
palate, n:vagus nerve (X) via the pharyngeal plexus, a derivative of the fourth pharyngeal arch (Latin,
levator = to lift)

tensor veli palatini_____o:scaphoid fossa, lateral wall of the auditory tube cartilage, i:palatine
aponeurosis, a:opens the auditory tube; tenses the soft palate, n:mandibular division of the trigeminal
nerve (V), remember: V3 innervates both tensor muscles (tympani and veli palatini); ALL other palatal
muscles are innervated by vagus

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Joints

temporomandibular joint______synovial, hinge, separated into 2 joint spaces by intracapsular fibrous

articular disc

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Nerves

Nerve Source Branches Motor SensoryNotes

auriculotemporal______o:mandibular division of trigeminal n. (V3), b:parotid brs., articular brs., anterior

auricular brs., m:secretomotor to parotid gland: postganglionic parasympathetic from communicating br.
of otic ganglion; preganglionic parasympathetic from lesser petrosal br. of glossopharyngeal n. (IX), s:skin
of anterior ear & anterosuperior to ear; part of external auditory meatus; temporomandibular joint, two
roots of auriculotemporal encircle the middle meningeal a.

buccal_____o:mandibular division of trigeminal n. (V3), s:skin of cheek, oral mucosa, not a motor nerve

chorda tympani_____o:facial (VII), m:secretomotor to submandibular & sublingual glands (preganglionic

parasympathetic to submandibular ganglion), s:taste to anterior 2/3rds of tongue, joins lingual nerve in
infratemporal fossa and continues with it to the tongue (Latin, corda = cord; Greek, tympanum = a kettle
drum)

facial____o:pons & medulla: nucleus solitarius of medulla via nervus intermedius (SVA sensory root)
from geniculate ganglion; superior salivatory nucleus (GVE preganglionic parasympathetic) of pons via
nervus intermedius, facial motor nucleus of pons via motor root, b:greater petrosal (preganglionic
parasympathetic to pterygopalatine ganglion, postganglionic parasympathetic travels with brs. of
maxillary div. of V), chorda tympani (SVA taste from anterior 2/3rds of tongue; preganglionic
parasympathetic to submandibular ganglion, postganglionic parasympathetic to submandibular &
sublingual glands), n. to stapedius, posterior auricular, intraparotid plexus with temporal, zygomatic,
buccal, marginal mandibular & cervical brs., m:stapedius, stylohyoid, posterior belly of digastric, muscles
of facial expression; secretomotor to lacrimal, submandibular, sublingual, and mucous glands of nasal &
oral cavities, s:taste (SVA) from anterior 2/3rds of tongue; part of skin of external auditory meatus, also
known as: CN VII, 7th cranial nerve; passes into internal acoustic meatus, goes through facial canal, exits
at stylomastoid foramen

ganglion, submandibular______o:preganglionic parasympathetic from chorda tympani accompanying

lingual n., b:postganganglionic parasympathetic to submandibular & sublingual glands, m:secretomotor
to submandibular & sublingual glands, hangs off lingual n. above deep part of submandibular gland

glossopharyngeal_____o:medulla: spinal trigeminal nucleus from superior ganglion (GVA); nucleus

solitarius from inferior ganglion (SVA); nucleus ambiguus (GVA); inferior salivatory nucleus (GVE
preganglionic parasympathetic), b:tympanic nerve to tympanic plexus & lesser petrosal n., carotid sinus
n., stylopharyngeus brs., pharyngeal brs., m:GSE: stylopharyngeus; GVE: secretomotor to parotid gland
(preganglionic parasympathetic via tympanic n. to lesser petrosal n. to otic ganglion, postganglionic
parasympathetic via auriculotemporal n.), s:GVA: carotid body & sinus, pharynx, middle ear; GSA: skin of
external ear; SVA: taste from posterior 1/3rd of tongue, also known as: CN IX, 9th cranial nerve; passes
through jugular foramen; may penetrate the stylopharyngeus m.

hypoglossal_____o:medulla: hypoglossal nucleus, b:branches of C1 carried by this nerve are not

considered to be branches of the hypoglossal , m:intrinsic and extrinsic muscles of the tongue (except
palatoglossus m.), also known as: CN XII, 12th cranial nerve; passes through the hypoglossal canal;
superior root of ansa cervicalis travels with the hypoglossal n.

inferior alveolar______o:mandibular division of trigeminal (V3), b:n. to mylohyoid; inferior dental plexus;
terminates as mental nerve, m:mylohyoid muscle via n. to mylohyoid, s:teeth of mandible; skin of chin

inferior laryngeal_____o:recurrent laryngeal br. of vagus (X) , m:all muscles of larynx except
cricothyroid: thyroarytenoid, oblique & transverse arytenoid, posterior & lateral cricoarytenoid,
aryepiglottic, thyroepiglottic, vocalis; secretomotor to mucous glands of larynx below vocal fold,
s:mucous lining of larynx below vocal fold, continuous with recurrent laryngeal at inferior border of
cricopharyngeus

lingual_____o:mandibular division of trigeminal (V3), s:general sense from anterior 2/3rds of tongue,
floor of mouth, joined by chorda tympani (taste & pregang. parasymp.) from facial n. in infratemporal
fossa; submandibular gang. hangs from lingual nerve in paralingual space

mandibular_____o:trigeminal ganglion; motor root of trigeminal from pons, b:meningeal br., medial &
lateral pterygoid, masseteric, anterior & posterior deep temporal, buccal, auriculotemporal, lingual,
inferior alveolar, m:mylohyoid, anterior belly of digastric; tensor tympani, tensor veli palatini; muscles of
mastication (temporalis, masseter, medial & lateral pterygoid), s:GSA: skin of lower lip & jaw extending
superiorly above level of ear; GVA: tongue, & floor of mouth, lower teeth & gingiva also known as:
V3, mandibular division of trigeminal; passes through foramen ovale; otic ganglion hangs off medial side
of V3 below foramen ovale; auriculotemporal n. carries postganglionic parasympathetic to parotid gland;
submandibular ganglion hangs off lingual n. near submandibular gland; postganglionic parasympathetics
reach this gland & sublingual gland

masseteric_____o:mandibular division of trigeminal , m:masseter, passes over mandibular notch

mylohyoid, n. to_____o:inferior alveolar, m:mylohyoid, anterior belly of digastric, arises near lingula of
mandible

olfactory nn.______o:the filaments of the bipolar olfactory epithelial cells constitute the olfactory
nerves, b:second order olfactory nerve cell bodies located in the olfactory bulb, m:none, s:smell (SVA),
also known as CN I, 1st cranial n.; multiple olfactory filaments pass through the cribriform plate to enter
the anterior cranial fossa and synapse in the olfactory bulb; the olfactory tract carries the signal from the
bulb to olfactory cortex of the forebrain

recurrent laryngeal______o:vagus (X), b:esophageal brs., tracheal brs., cardiac brs., pharyngeal brs.,
inferior laryngeal n., m:upper esophagus, lower pharynx, laryngeal ms. (except cricopharyngeus);
smooth muscle of trachea; secretomotor to mucous glands in upper esophagus, lower pharynx, larynx
below vocal fold, trachea; cardiac muscle of heart (slows rate, decreases force of contraction), s:upper
esophagus, lower pharynx, larynx below vocal folds, GVA from heart, right recurrent loops posteriorly
around right subclavian a.; left recurrent loops posteriorly around aortic arch & ligamentum arteriosum;
inferior laryngeal br. supplies all intrinsic muscles of the larynx EXCEPT cricothyroid m.

superior laryngeal_____o:vagus (X), b:internal & external brs., m:cricothyroid, inferior pharyngeal
constrictor, secretomotor to mucous glands of larynx above vocal folds, s:mucous lining of larynx above
vocal folds, external br. supplies cricothyroid m.; all other intrinsic muscles of the larynx are supplied by
the recurrent laryngeal nerve

temporal, anterior deep____o:mandibular division of trigeminal (V3), m:temporalis

temporal, posterior deep_____o:mandibular division of trigeminal (V3), m:temporalis

trigeminal_____o:pons: trigeminal motor nucleus (SVE) to motor root; spinal trigeminal nucleus from
trigeminal ganglion (GSA) via sensory root, b:ophthalmic, maxillary & mandibular divisions, m:SVE:
temporalis, masseter, lateral & medial pterygoid, anterior belly of digastric, mylohyoid, tensor veli
palatini, tensor tympani, s:skin of face, nasal & oral cavities, ant. 2/3rds of tongue (GSA only), also known
as: CN V, 5th cranial nerve; some brs. carry pre- or postganglionic parasympathetic fibers; divides into
three divisions at trigeminal ganglion; SVE supplies muscles of branchial arch origin

vagus____o:medulla: dorsal nucleus (GVA & GVE preganglionic parasympathetic) from inferior ganglion,
nucleus ambiguus (SVE); spinal trigeminal nucleus (GSA) from superior ganglion; nucleus solitarius (SVA)
from inferior ganglion, b:auricular br., pharyngeal br., superior laryngeal, superior & inferior cervical
cardiac brs., recurrent laryngeal, thoracic cardiac brs., brs. to pulmonary plexus, esophageal plexus,
anterior & posterior vagal trunks, m:SVE: intrinsic muscles of larynx, pharynx (except stylopharyngeus), &
palate (except tensor veli palatini); GVE: smooth muscle of respiratory tree & gut (proximal to splenic
flexure), heart; secretomotor: mucous glands of larynx, respiratory tree, pharynx & gut, digestive glands,
s:GSA: skin of external auditory meatus; GVA: viscera of head, neck, thorax & abdomen proximal to
splenic flexure; SVA: taste to epiglottis, also known as: CN X, 10th cranial nerve; passes through jugular
foramen; (Latin,vagus = wanderer, because of its wide distribution to the body cavities)

D:

Arteries

Artery Source Branches Supply Notes

alveolar, inferior_____o:maxillary artery, b:lingual branch, mylohyoid, dental, nutrient, mental, s:lower
teeth & gingiva, mandible, closely associated muscles, runs with the inferior alveolar nerve within the
mandibular canal

alveolar, posterior superior_____o:maxillary artery, b:dental, mucosal, s:upper molar teeth, part of
maxillary sinus, enters the maxilla in the infratemporal fossa

buccal_____o:maxillary, m:cheek and associated muscles, runs with the buccal branch of CN V

carotid, external_____o:common carotid, b:superior thyroid, ascending pharyngeal, lingual, facial,

occipital, post. auricular, maxillary & superficial temporal (terminal brs.), s:upper neck, face & scalp,
primary blood supply to face & superficial head
lingual____o:external carotid, b:suprahyoid br., dorsal lingual brs., deep lingual, sublingual, m:tongue,
suprahyoid muscles, palatine tonsil

inferior thyroid____o:thyrocervical trunk, b:ascending cervical, inferior laryngeal, esophageal brs.,

tracheal brs., glandular brs., s:thyroid gland, lower larynx, upper trachea & esophagus, neck muscles

inferior laryngeal_____o:inferior thyroid, s:lower larynx internally

internal carotid_____o:common carotid, b:none in the neck; in the head: ophthalmic, post.
communicating, ant. & middle cerebral (terminal brs.), s:brain, eye, forehead, primary blood supply to
the brain; anastomoses with vertebral aa.

masseteric____o:maxillary, m:masseter m.

maxillary_____o:external carotid, b:deep auricular, anterior tympanic, middle meningeal, inferior

alveolar, masseteric, post. & ant. deep temporal, buccal, post. superior alveolar, infraorbital, art. of
pterygoid canal, descending palatine, sphenopalatine, s:deep face, infratemporal fossa, tympanic cavity,
muscles of mastication, may course medial or lateral to the lateral pterygoid m. in equal frequency

middle meningeal_____o:maxillary, b:frontal br., parietal br., petrous br., superior tympanic, s:most of
the dura mater (approx. 80%), cranial vault bones passes through foramen spinosum; may be torn
by fracture at pterion

superior laryngeal_____o:superior thyroid, s:upper larynx internally

superior thyroid______o:external carotid, b:infrahyoid br., sternocleidomastoid br., sup. laryngeal,

cricothyroid br., ant., post. & lat. glandular brs., s:thyroid gland, upper larynx, infrahyoid muscles,
sternocleidomastoid

temporal, anterior deep_____o:maxillary, s:temporalis anteriorly, branches in the infratemporal fossa

and runs deep to temporalis m.

temporal, posterior deep______o:maxillary, s:temporalis posteriorly branches in the infratemporal

fossa and runs deep to temporalis m.

D:

Veins
Vein Tributaries Drains Into Region Drained Notes

anterior jugular_____t:submental, communicating, d:external jugular, rd:anterior neck superficially,

(Latin, jugulum = throat)

external jugular____t:formed by the union of the retromandibular & posterior auricular vv.; tributaries:
posterior external jugular, transverse cervical, suprascapular, anterior jugular, d:subclavian v., rd:head &
neck, shoulder, (Latin, jugulum = throat)

inferior thyroid_____d:left and right brachiocephalic vv., rd:thyroid gland inferiorly

internal jugular_____t:formed by the union of the sigmoid & inferior petrosal sinuses; tributaries:
pharyngeal vv.; lingual, common facial, sternocleidomastoid, superior & middle thyroid vv.,
d:brachiocephalic v., rd:brain & skull, face, viscera of neck, largest vein of the head and neck (Latin,
jugulum = throat)

middle thyroid_____t:internal jugular v., rd:thyroid gland laterally

pterygoid plexus_____t:descending palatine, sphenopalatine, infraorbital, posterior superior alveolar,

ant. & post. deep temporal, middle meningeal, masseteric, inferior alveolar, d:maxillary v., rd:meninges,
nasal cavity, infratemporal fossa, valveless; connects with cavernous sinus & pharyngeal plexus (Latin,
plexus = a braid)

superior thyroid_____t:superior laryngeal v., d:internal jugular v., rd:superior portion of thyroid gland
and surrounding structures, cross the common carotid a.

D:

Lymphatics

Structure Location Afferents from Efferents to Regions drainedNotes

nodes, deep cervical____in and around carotid sheath, a:lymphatic vessels from head & neck, e:jugular
trunk, rd:head & neck, superior and inferior subdivisions are delineated by the crossing of the omohyoid
m.

thoracic duct______between esophagus & thoracic vertebral bodies, a:union of lumbar lymph trunks,
sometimes dilated to form cisterna chyli, e:junction of the left subclavian and left internal jugular vv.,
rd:all of the body and limbs below the diaphragm; the left side of the body, limbs, head and neck above
the diaphragm, the largest lymph vessel; passes up through aortic hiatus on right side of aorta, swings to
left side of esophagus at T4-T5 intervertebral disc (at the level of the sternal angle)

tonsil, lingual_____superior surface of root of tongue, a:superior deep cervical nodes, "guards" entrance
of oropharynx, part of tonsillar ring (of Waldeyer)

tonsil, pharyngeal____roof and posterior wall of the nasopharynx, a:lymphatic vessels of the wall of the
pharynx superior deep cervical nodes, "guards" the entrance to the nasopharynx, part of the
tonsillar ring (of Waldeyer); known as adenoids when inflamed

tonsil, palatine_____lateral wall of the oropharynx between the palatoglossal and palatopharyngeal
arches, a:lymphatic vessels of the posterior tongue and palatoglossal/palatopharyngeal arch region
superior deep cervical nodes, especially the jugulodigastric node, "guards" the entrance of the
oropharynx, part of the tonsillar ring (of Waldeyer); often referred to as "the" tonsils

D:

Viscera/Fascia

Organ Location/Description Notes

intrinsic muscles of the tongue_____includes the superior and inferior longitudinals, transverse, and
vertical muscles

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submandibular triangle______comprised of the submandibular gland and lymph nodes, hypoglossal
nerve, mylohyoid nerve, and parts of the facial artery and vein, blends anteriorly with the investing and
pretracheal layers of fascia and posteriorly with the prevertebral layer of deep cervical fascia

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submandibular gland_____salivary gland; located beneath mylohyoid in submandibular triangle;

innervated by postgang. parasymp. fibers from submandibular gang., location of carotid body and sinus

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sublingual gland_____salivary gland; located beneath oral mucosa in floor of mouth; drains via multiple
small ducts,serves as a chemoreceptor that monitors the amount of oxygen and carbon dioxide in the ,D:

submandibular duct______drains submandibular gland to sublingual caruncle in floor of mouth, serves

as a baroreceptor that reacts to changes in arterial pressure

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foramen cecum (of tongue)_____located on midline of tongue in sulcus terminalis; remnant of thyroid
diverticulum (Latin, foramen cecum = blind apeture), penetrated by the passage of the auditory tube
into the nasopharynx
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vallate papillae_____located in line anteriorly along sulcus terminalis of tongue; possess taste buds in
circular sulcus; a.k.a. circumvallate papillae, (Latin/Greek, choanae = a funnel-shaped hollow in the
brain)

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frenulum of tongue______fold of mucous membrane under tongue, (Latin, frenulum = a bridle, a narrow
reflection or fold of mucous membrane, passing from a more fixed to a movable part)

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sublingual caruncle_____papilla on lateral side of frenulum of tongue; opening of the duct of the
submandibular gland, (Latin, uva/uvula = a grape)

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pharynx

connects nasal & oral cavities with larynx & esophagus, divided into 3 parts: nasopharynx, oropharynx &
laryngopharynx

nasopharynx
connects nasal cavity with oropharynx; located posterior to posterior nasal apertures and superior to
pharyngeal isthmus (soft palate & posterior wall of pharynx), contains torus tubarius, pharyngeal recess,
pharyngeal tonsil

torus tubarius_____mucosal fold covering the anteromedial end of the auditory tube cartilage, torus
tubarius projects toward the midline from the lateral wall of the nasopharynx (Latin, torus = knot)

auditory (pharyngotympanic) tube_____joins the middle ear to the nasopharynx

soft palate_____the movable posterior third of the palate, which is suspended from the posterior border
of the hard palate

choanae____posterior opening of the nasal cavities into the nasopharynx, (Latin/Greek, choanae = a
funnel-shaped hollow in the brain)

pharyngeal recess_____posterosuperior to the torus tubarius, pharyngeal tonsil may extend variably into
the pharyngeal recess

uvula____conical process that is the posteroinferior extension of the soft palate, (Latin, uva/uvula = a
grape)

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oropharynx

connects: anteriorly with oral cavity through oropharyngeal isthmus (palatoglossal arch), superiorly with
nasopharynx through pharyngeal isthmus (posterior margin of soft palate), inferiorly with
laryngopharynx at superior margin of epiglottis, contains palatine tonsil in tonsilar bed between
palatoglossal & palatopharyngeal arches

palatoglossal fold____fold of mucosa covering the palatoglossus m., palatoglossal fold marks the
anterior boundary of the tonsillar fossa or bed of the palatine tonsil

palatopharyngeal fold____fold of mucosa covering the palatopharyngeus m., palatopharyngeal fold

marks the posterior boundary of the tonsillar fossa or bed of the palatine tonsil

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laryngopharynx

connects: superiorly with oropharynx at superior border of epiglottis, anteriorly with larynx through
laryngeal inlet (epiglottis, aryepiglottic folds, arytenoid cartilages), inferiorly with esophagus at lower
border of cricoid cartilage, contains piriform recesses lateral to aryepiglottic folds

lateral glossoepiglottic fold____located between base of tongue & epiglottis lateral to valleculae
epiglottica

median glossoepiglottic fold____located between base of tongue & epiglottis, separates the paired
valleculae epiglottica

piriform recess_____located lateral to aryepiglottic folds, (Latin, pirum = pear + forma = form)

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esophagus

connects: superiorly with laryngopharynx at lower border of cricoid cartilage, inferiorly through
diaphragm at t10 vert. level to reach stomach; upper third is skeletal muscle innervated by recurrent
laryngeal, lower 2/3rds is smooth muscle innervated by vagus via esophageal plexus

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laryngeal inlet

pathway through which the laryngopharynx communicates with the larynx

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larynx

located anterior to laryngopharynx at level of C4-6 vert.; composed of thyroid, cricoid, epiglottic,
arytenoid, cuneiform & corniculate cartilages, contains vocal ligaments

vestibular fold_____mucosal fold located between laryngeal vestibule & ventricle, also known as: false
vocal fold

vocal folds______mucosal covering of vocal ligament & thyroepiglottic muscle (vocalis part), located
inferior to laryngeal ventricle

laryngeal ventricle_____lateral diverticulum of larynx located between false & true vocal folds (or
vestibular fold & vocal fold)

laryngeal vestibule_____part of larynx, located below epiglottis between aryepiglottic & vestibular folds,
lateral wall contains quadrangular membrane (submucosa)

glottis_____the opening or space between the vocal folds, glottis and rima glottidis are used
interchangeably

infraglottic cavity____the portion of the laryngeal cavity that lies inferior to the vocal folds; it is bounded
superiorly by the glottis and opens inferiorly into the trachea, receives sensory innervation from inferior
laryngeal n.

supraglottic cavity_____the portion of the laryngeal cavity that lies superior to the vocal folds; it is
bounded inferiorly by the glottis and opens superiorly to the laryngopharynx at the laryngeal inlet,
receives sensory innervation from the internal branch of superior laryngeal n.

vocal ligaments_____located in larynx within (true) vocal folds; connect inner anterior surface of thyroid
cart. to vocal process of arytenoid cart.; represents thickened superior margin of conus elasticus,
vibration creates sound; brought together by arytenoid & lateral cricoarytenoid ms., moved apart by
posterior cricoarytenoid ms.

thyrohyoid membrane______connects the superior border of the thyroid cartilage to the hyoid bone,
suspending the larynx, penetrated by the internal branch of superior laryngeal n. & superior laryngeal a.

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Clinical Terms

Term Definition

adenoidectomy______surgical removal of adenoids or inflamed pharyngeal tonsils. Indications include

airway obstruction, nasal obstruction, sleep apnea and chronic ear infections

carotid stenosis & endarterectomy_____carotid stenosis is a result of atherosclerotic thickening of the

intima of the carotid artery. Partial occlusion of this artery may cause transient ischemic attack - a
sudden focal loss of neurological function (e.g., dizziness and disorientation) that disappears within 24
hours. Arterial occlusion can also lead to a minor stroke - loss of neurological function such as weakness
or sensory loss on one side of the body that exceeds 24 hours but disappears within 3 weeks. The
symptoms resulting from carotid stenosis depend on the degree of bloodflow obstruction. To help the
situation endarterectomies are performed in which part of the athersclerotic plaque on the intima is
stripped off. The common site for this procedure is the internal carotid artery just superior to its origin.
Drugs are administered after the procedure to inhibit clot formation. Cranial nerve injury can occur
during this procedure to the following nerves: glossopharyngeal, vagus, accessory, hypoglossal, and
superior laryngeal nerves. (Greek, stenosis = a narrowing)

cervical rib_____a rib which arises from the seventh cervical vertebrae (above the normal first rib).
Occurs in only about 0.5% of people. May cause nerve and artery problems

cricothyrotomy_____an emergency procedure where a cut or passageway is made in the cricothyroid

membrane.

epistaxis______nosebleed, hemorrhage from the nose. Usually from superficial vessels in the anterior
part of the nasal septum (cartilaginous portion). Bleeding from more posterior vessels is more serious
and can be life-threatening requiring prompt care and deep packing.

Kiesselbach's area_____an area on the anterior portion of the nasal septum where nosebleeds often
occur

sinusitis______inflammation of a sinus. The condition may be purulent or nonpurulent, acute or chronic.

Depending on the site of involvement it is known as ethmoid, frontal, maxillary or sphenoid sinusitis.

deviated septum______a common condition in which the nasal septum bows to one or the other side of
the nasal cavity rather than being in the midline
cleft palate______a congenital fissure in the roof of the mouth forming a communication between the
nasal passages and the oral cavity. More common in males. Due to the failure of the maxillary
prominence to fuse with the medial nasal prominence (tongue fails to move out of the groove between
these two plates). Repair is usually donein the second year of life.

goiter_____enlargement of the thyroid gland. A goiter is not cancerous. A goiter can be associated with
normal, elevated (hyperthyroidism) or decreased (hypothyroidism) thyroid hormone levels in the blood.

Horner's syndrome_____nerve condition which involves a drooping eyelid (ptosis), constricted pupil
(miosis), enophthalmos and lack of sweating on one side of the face. Often seen in association with
injury (for example neck fracture, penetrating injury) to the cervical sympathetic nerve trunk in the neck
or a Pancoast tumor (tumor of the cupula region) involving both the upper and lower brachial plexus.

laryngectomy______surgical removal of the larynx. Most often performed in cases of laryngeal cancer

quinsy______an extension of a tonsillar infection that leads to a peritonsillar abscess formation behind
and above the tonsil

radical neck dissection______the most commonly performed major operation for head and neck
malignancies, most of which are squamous cell carcinomas. The neck is opened laterally, the majority of
the sternocleidomastoid muscle is removed, as are the regional cervical lymph nodes, the jugular vein,
the spinal accessory nerve, the submaxillary gland and most of the parotid gland. There are several
modifications.

scalenus anticus syndrome______a syndrome in which the nerves and vessels (lower brachial plexus and
subclavian artery) passing between the anterior scalene muscle and a cervical rib are compressed
causing pain over the shoulder and radiating down the arm or over the back of the neck.

submandibular (Wharton's) duct calculus______stone in the submandibular duct

TMJ syndrome/dislocation______TMJ syndrome: Disorder of the temporo-mandibular joint(s) causing

pain usually in front of the ear(s). TMJ Dislocation: Excessive contraction of the lateral pterygoids may
cause the jaw to dislocate anteriorly (pass anterior to the anterior tubercles. This could happen during
yawning or when taking a large bite. Also sideway blows to the chin when the mouth is open dislocates
the TMJ on the side that receives the blow. TMJ dislocation is frequently accompanied by fracture of the
mandible. Posterior dislocation of the TMJ is uncommon due to the resistence by the postglenoid
tubercle and the strong intrinsic lateral or temporomandibular ligament. Care must be taken during
repair in regards to the facial and the auriculotemporal nerve; injury to the auriculotemporal nerve leads
to laxity and instability of the TMJ.

bruxism_____compulsive grinding or clenching of the teeth especially at night

LeForte fractures_____classically described fractures of the face which occur with trauma

LeForte I -______a horizontal fracture through the maxillae just above the maxillary teeth
LeForte II - _______a fracture in which the maxillae are separated from the facial skeleton with the
separated bone being pyramidal in shape and including the palate and maxillary teeth

LeForte III - ______a horizontal fracture in which the entire maxilla and one or more facial bones are
separated from the upper face

subclavian central venous line catheterization______the right subclavian vein is often the point of entry
to the venous system for central line placement to administer parenteral (nutritional) fluids and
medications and to measure central venous pressure. When using the infraclavicular approach, the
physician inserts the needle along the inferior surface of the middle part of the clavicle and moves it
medially toward the jugular notch in the manubrium and along the posterior surface of the clavicle
where the subclavian vein ascends. If the needle is not inserted carefully, it may tear the subclavian vein
and parietal pleura, resulting in hemothorax (bleeding into the pleural cavity). Furthermore, if the needle
goes too far posteriorly, it may enter the subclavian artery. Once the needle is inserted, a soft, flexible
catheter is inserted into the subclavian vein to be used as a guide.

subclavian steal syndrome______aortic arch syndrome, also referred to by many as vertebral-basilar

artery disease, carotid artery occlusive syndrome and subclavian steal syndrome is characterized by a
constellation of signs and symptoms which occur secondary to abnormalities in the major arteries which
extend off of the aortic arch. These abnormalities are structural and most often secondary to the effects
of atherosclerosis, blood clots, trauma or a congenital abnormality. Symptoms of this condition include
various neurologic symptoms, reduction in pulse and changes in blood pressure.

thoracic outlet syndrome______condition due to compromise of blood vessels or nerve fibers between
the armpit (axilla) and base of the neck.

thyroglossal duct cyst ______a thyroglossal cyst is a fluid-filled sac that is present at birth and located
in the midline of the neck. A thyroglossal cyst is a result of incomplete closure of a segment of a tube-like
structure (the thyroglossal duct) that is present, and normally closes, as the embryo develops. A
thyroglossal cyst is also called a thyrolingual cyst.

thyroidectomy______surgery to remove part or all of the thyroid gland. This might be done to remove a
tumor or treat hyperthyroidism or goiter (enlarged thyroid gland). The goal of surgery in hyperthyroidism
is to remove just enough thyroid gland so that a normal amount of thyroid hormone is produced. If too
much thyroid is removed, the patient will produce too little thyroid hormone (hypothyroidism) and need
treatment to return the thyroid status to normal (euthyroid). The complications of surgery can include
vocal cord paralysis (if the recurrent laryngeal n. is cut) and accidental removal of the parathyroid glands
(located behind the thyroid gland), resulting in low calcium levels (the parathyroid glands regulate
calcium).
tonsillectomy______surgical removal of the palatine tonsils. Lingual tonsils are also taken. Indications
include airway obstruction or recurrent tonsillitis. Complete recovery is in two weeks. Adults have a
significantly longer period of recovery and a much higher complication rate than children.

tonsillitis_____inflammation of the palatine tonsil

torticollis______a wry neck, a contracted state of the cervical muscles, producing twisting of the neck
and an unnatural position of the head. (Latin, tortus = twisted + collum = neck)

tracheostomy______The surgical creation of an artificial airway in the trachea (windpipe) on the anterior
surface of the neck.

Virchow's node_____also called a signal node. An enlarged supraclavicular lymph node, usually on the
left side, which is often the first sign of an abdominal tumor (such as stomach cancer).

Zenker's diverticulum______herniation of the mucosa of the laryngopharynx or esophagus through a

defect in the wall of the muscular portion. The location is usually in the lowest portion of the
laryngopharynx or upper one-third of the esophagus.

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