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Chapter 8 Head and Neck

解剖學科
鄭授德

本教材之圖片取自於
Gray’s Anatomy for Students, 4th ed., 2020, by Drake, Vogl, and Mitchell
Ref:
https://www.youtube.com/watch?v=cUnIgkZ10KY
https://www.youtube.com/watch?v=weJ-eaDRIGs
https://www.youtube.com/watch?v=We2QFap4qyU
Conceptual overview
• Head
– Major
• Cranial cavity
• Ears
• Orbits
• Nasal cavities
• Oral cavity
Conceptual overview
• GENERAL DESCRIPTION
– Others
• Infratemporal fossa
• Pterygopalatine fossa
• Face
• Scalp
Conceptual overview
• Neck
– Boundary
• Sup. – inferior margin of
mandible, posterior aspect of
skull, posterior openings of
nasal and oral cavities
• Inf. – top of sternum, clavicle,
acromion
• Post. – line between
acromion and spinous
process of CVII vertebra,
base of the neck
Conceptual overview
• Neck
– Compartments
• Vertebral compartment
• Visceral compartment
– Larynx
– Pharynx
• Vascular compartments
• Larynx and pharynx
– associated with digestive and respiratory tracts
FUNCTIONS of H & N
• Protection
• Contains upper parts of respiratory and
digestive tracts
• Communication
• Positioning the head
• Connects the upper and lower respiratory
and digestive tracts
Respiratory tract: Nasal cavities Larynx – Trachea
Pharynx
Digestive tract: Oral cavity Esophagus
COMPONENT PARTS
• Skull
– Sutures
– Fontanelles
– Synovial joints
• (1 TMJ+2 mid ear)*2
• Cervical vertebrae
• Hyoid bone
• Soft palate
• Muscles
RELATIONSHIP TO OTHER REGIONS
• Thorax
• Upper limbs
KEY FEATURES
• Vertebral levels CIII/IV and CV/VI
• Airway in the neck

X
X
Pre. parasym. nerve fibers in CN III, VII, IX, X
• Cranial nerves Post. parasym. nerve cell bodies in gang.
• Cervical nerves
*

C3,4,5 keep you alive.


• Functional separation of the digestive and
respiratory passages

baby
• Triangles of the neck
SKULL
• Anterior view
– Frontal bone
• Superciliary arches, glabella
• Supraorbital foramen (or notch)
• Zygomatic process of frontal bone
– Zygomatic and nasal bones
• Frontonasal suture, nasion
• Frontal process of maxilla
• Piriform aperture
• Nasal crest
• Anterior nasal spine
• Inferior nasal concha
SKULL
• Anterior view
– Maxillae
• Zygomatic process of maxilla
• Frontal process of maxilla
• Body of maxilla
• Infraorbital foramen
• Alveolar process
– Mandible
• Body of mandible
• Base
– mental protuberance
– mental tubercle
– mental foramen
– oblique line
• Alveolar part
• Ramus of mandible
• Angle of mandible
SKULL
• Lateral view
– Lateral portion of the calvaria
– Temporal bone
– Visible part of the facial skeleton
– Mandible
SKULL Lateral view
– Lateral portion of the calvaria
• Coronal suture
• Lambdoid suture
• Sphenoparietal suture
• Pterion
P
(Fracture of skull at here F
causes extradural hematoma.) S T

• Occipitomastoid suture
SKULL Lateral view
– Temporal bone
• Squamous part
• Zygomatic process
– forms zygomatic arch with
temporal process of
zygomatic bone
• Tympanic part F
– external acoustic opening Z
– external acoustic meatus ZT
• Mastoid part
– parietomastoid suture
– occipitomastoid suture
– mastoid process
– styloid process
顳骨顴突
SKULL Lateral view
– Visible part of the facial skeleton
• Nasal bone
• Maxilla
– alveolar process
– frontal process
– zygomatic process
• Zygomatic bone
– prominence of cheek
– inferior rim of orbit
– frontal process
– temporal process
– Zygomaticofacial foramen
– Zygomaticotemporal foramen
SKULL Lateral view
– Mandible
• Body
– mental protuberance
– teeth on the alveolar part
– mental foramen
• Angle
• Ramus
– condylar process
– coronoid process
SKULL Posterior view
– Occipital bone
• Squamous part
– lambdoid suture with parietal bone
– external occipital protuberane
– superior nuchal lines
– inferior nuchal lines
– external occipital crest
– Temporal bone
• Mastoid notch
SKULL Superior view
– Calva
– Coronal suture
– Sagittal suture
– Lambdoid suture
– Bregma
– Lambda
– Parietal foramina
– Diploë
SKULL Inferior view
– Anterior part
– Middle part
– Posterior part
SKULL Inferior view
– Anterior part
• Alveolar processes of maxillae • Greater palatine foramina
• Hard palate intermaxillary suture • Lesser palatine foramina
• Palatomaxillary suture • Posterior nasal spine
• Incisive fossa
SKULL Inferior view
– Middle part
• Vomer • Sphenoid
– part of nasal septum – Body
– Pterygoid processes:
» Medial plate – with pterygoid humulus, form
scaphoid fossa, opening of pterygoid canal
» Pterygoid fossa
» Lateral pterygoid plate
– Greater wing:
» Foramen ovale
» Foramen spinosum
– Middle part
SKULL Inferior view
• Occipital bone • Temporal bone
– basilar part – foramen lacerum
– foramen magnum – carotid canal
– pharyngeal tubercle – pharyngotympanic tube (auditory tube)
– mandibular fossa
– articular tubercle
SKULL Inferior– Lateral
view
part
– Posterior part
» occipital condyles
• Occipital bone
» condylar fossa
– Squamous part:
» condylar canal
» external occipital crest
» hypoglossal canal
» inferior nuchal line
» jugular foramen
– Basilar part
SKULL Inferior view
– Posterior part
• Temporal bone
– Mastoid process
– Styloid process
– Stylomastoid foramen
學習要領

• 未來職業面對的是失能的病患,
• 應當以此為念學習基礎醫學科目
• 行經之路徑,或許繁雜累贅,
• 但是對於臨床運用上及第一階段國考試題上
(臨床題型占30%以上)均甚為重要

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