Topographical Anatomy of the Head

Skull vault
  • skin
    		•   
  • subcutneous connective tissue
    		• nerves and blood vessels
  • galea aponeurotica
    		•  
  • loose subgalear connective tissue
    		• (enables scalping)
  • pericranium
    		•  
  • lamina externa calvariae
    		• vv. emissariae
  • diploe
    		• vv. diploicae
  • lamina interna calvariae
    		• vv. emissariae, granulationes arachnoideae
  • dura mater cranialis

    • sinus sagittalis superior
  • arachnoidea mater cranialis
    		•  
  • pia mater cranialis
    		•  

    Orbita

  • cranially: pars orbitalis o. frontalis (fovea trochlearis + spina trochlearis, incisura/foramen frontalis/supraorbitalis, fossa glandulae lacrimalis), ala minor o. sphenoidalis (fissura orbitalis sup.)
  • medially: processus frontalis maxillae (fossa sacci lacrimalis), os lacrimale, lamina orbitalis o. ethmoidalis (aoramina ethm.ant. et post.), ala minor o. sphenoidalis

    laterally: facies orbitalis o. zygomatici (foramen zygomaticoorbitale), facies orbitalis alae majoris o. sphenoidalis

  • caudally: facies orbitalis o. zygomatici, facies orbitalis corporis maxillae (sulcus et canalis infraorbitalis, fissura orbitalis inf.), processus orbitalis o. palatini

    • Aditus orbitae → apex orbitae

    Orbita is divided by theoretical planes into 3 levels.

    		upper level (floor is formed by m. levator palpebrae superioris)
  • n. et vasa lacrimalia glandula lacrimalis (pars orbitalis)
  • n. frontalis (
    • » n. supraorbitalis + n. supratrochlearis)
  • vasa supraorbitalia vasa supratrochlearia n. trochlearis m. levator palpabrae superioris (+ m. tarsalis sup.)
  • corpus adiposum orbitae
    •

    middle level (ceiling is formed by m. rectus bulbi sup., floor by theoretical level of n. opticus)

  • mm. recti bulbi (sup.,med., lat.), m. obliquus bulbi sup. n. opticus, vasa centralia retinae n. nasociliaris (» nn. ethmoidales ant. et post., nn. ciliares longi, n. infratrochlearis), r. sup. n. oculomotorii, n. abducens, ggl. ciliare (» nn. ciliares breves) a. ophthalmica (» a. ethmoidalis ant. et post., aa. ciliares posteriores breves et longae., aa. palpebrales med.) plexus ophthalmicus v. ophthalmica sup. gl. lacrimalis (pars palpebralis)
  • corpus adiposum orbitae
    •

    lower level

  • m. rectus bulbi inf.(+ m. tarsalis inf.), m. obliquus bulbi inf. r. inferior n. oculomotorii, n. infraorbitalis, n. zygomaticus (» r. communicans cum n. lacrimali) vasa infraorbitalia v. ophthalmica inf. m. orbitalis saccus lacrimalis
  • corpus adiposum orbitae

    • bulbus oculi (venrtally)

    Anulus tendineus communis (Zinni)
    (Common tendinous ring)

  • tissue cover encycling the canalis opticus and inner and lower part of fissura orbitalis superior
  • origin of eyeball muscles
  • canalis opticus
  • n. opticus
  • a. ophthalmica
  • plexus ophhtalmicus
  • fissura orbitalis superior
  • n. oculomotorius (both branches)
  • n. abducens
  • n. nasociliaris
  • origin of all the mm. recti bulbi

    • Sinus cavernosus

  • venous sinus stretched from fissura orbitalis superior to apex partis petrosi ossis temporalis (width 1cm, length 2 cm)
  • a. carotis interna (+ plexus caroticus internus)
  • n. abducens (mediocaudally)
  • n. oculomotorius, n. trochlearis, n. ophthalmicus (n.
    • V/1), n. maxillaris (n. V/2) (descendentally in the lateral wall)

    Cavitas nasi ossea

    (Bony nasal cavity)

  • cranially: cartilagines nasi laterales, ossa nasalia, pars nasalis o. frontalis, lamina cribrosa o. ethmoidalis, corpus o. sphenoidalis
  • aterally:cartilago alaris major et nasi lateralis, processus frontalis + facies nasalis maxillae, os lacrimale, labyrintus ethmoidalis, lamina perpendicularis o. palatini, lamina medialis processus pterygoidei o. sphenoidalis
  • caudally: palatum durum (processus palatini maxillae (os incisivum), lamina horizontalis o. palatini), palatum molle
  • septum: pars membranacea, pars cartiklaginea (cartilago septi nasi), pars ossea (lamina perpendicularis o. ethmoidalis, vomer)

    • Apertura piriformis → Choanae

    » conchae nasales (sup., med., inf.) divide the space into:

  • meatus nasi superior – recessus sphenoethmoidalis (small concha nas. suprema), apertura sisus sphenoidalis
  • meatus nasi medius – hiatus semilunaris (antrum Highmori), infundibulum ethmoidale, ductus frontonasalis
  • meatus nasi inferior – apertura ductus nasolacrimalis
  • meatus nasi communis - (common part without the conchae at the septum nasi)
  • meatus nasopharyngeus - (common part behind the conchae)

    • Fossa temporalis

  • laterally: arcus zygomaticus, fascia temporalis
  • cranially: linea temporalis superior
  • ventrally: facies temporalis o. zygomatici
  • caudally: crista infratemporalis o. sphenoidalis
  • medially: squama o. temporalis, facies temporalis alae majoris o. sphenoidalis
  • pterion (punctum Sylvii) – four sutures meet here
  • m. temporalis
  • nn. temporales (←n. V/3) (medially of the m. temporalis)
  • aa. temporales prof. (ant. et post.)
  • a. temporalis media (pierces the fascia)
  • r. zygomaticotemporalis n. zygomatici (←n.V/2)
  • (s mall branch of a. lacrimalis)
  • corpus adiposum buccae /Bichati/ - processus temporalis

    • Fossa infratemporalis

  • cranially: facies infratemporalis alae majoris o. sphenoidalis (foramen ovale + spinosum), squama o. temporalis
  • ventrally: facies infratemporalis maxillae (tuber maxillae)
  • dorsally:opens in spatium prestyloideum
  • medially: lamina laterally: proc. pterygoidei o. sphenoidalis, proc. pyramidalis o. palatini
  • laterally: ramus mandibulae
  • cranially: fissura orbitalis inf., fissura pterygomaxillaris
  • m. temporalis
  • a. maxillaris + its branches (pars mandibularis + pterygoidea)
  • plexus pterygoideus (medially of m. temporalis and laterally of m. pterygoideus lat.) + its tributaries
  • m. pterygoideus med. and lat., ggl. oticum + n. petrosus minor, n. mandibularis (n. V/3) + its branches, chorda tympani (medially)
  • foramen mandibulae – n. alveolaris inf (←n. V/3) + vasa alveolaria inf. (laterally)
  • lymph vessels
  • corpus adiposum buccae /Bichati/ - processus temporalis

    • Fossa pterygopalatina

  • cranially: facies maxillaris alae majoris o. sphenoidalis
  • ventrally: facies infratemporalis maxillae (fissura orbitalis inferior)
  • medially: lamina perpendicularis o. palatini (foramen sphenopalatinum)
  • dorsally: proc. pterygoideus (canalis pterygoideus + palatovaginalis)
  • laterally: fissura pterygomaxillaris
  • caudally: canalis palatinus major
  • ggl. pterygopalatinum (+ n. canalis pterygoidei)
  • n. maxillaris + its branches
  • a. maxillaris + its branches (pars pterygopalatina)
  • tributaries to plexus pterygoideus

    • Spatium pterygomandibulare

  • medially: lateral surface of m. pterygoideus med.
  • laterally: medial surface of ramus mandibulae
  • dorsally: glandula parotis
  • n. et vasa alveolaria inferiora
  • n. lingualis (ventromedially) + chorda tympani

    • Spatium prestyloideum

  • cranially: basis cranii (facies infratemporalis o. sphenoidalis, squama o. temporalis)
  • dorsally: septum styloideum
  • ventrally: opens to fossa infratemporalis
  • laterally: medial surface of m. pterygoideus med.
  • medially: pharyngeal wall, fascia buccopharyngea
  • caudally: opens to the area of trigonum caroticum at the level of venter post. m. digastrici
  • a. palatina ascendens
  • a. carotis ext. (divides into a. maxillaris + a. temporalis superficialis at the level of collum mandibulae)
  • glandula parotis, v. retromandibularis, branches of n. facialis (lat. border)

    • Spatium retrostyloideum

  • cranially: basis cranii (pars petrosa o. temporalis)
  • ventrally: septum styloideum
  • dorsally: lamina prevertebralis fascie cervicalis
  • medially: opens to spatium retropharyngeum
  • laterally: medial surface of m. sternocleidomastoideus
  • caudally: opens to the area of trigonum caroticum at the level of venter post. m. digastrici
  • a. carotis int.
  • v. jugularis int.
  • n. glossopharyngeus, n. vagus (+ plexus pharyngeus, n. laryxngeus sup.) , n. accessorius, n. hypoglossus, ansa cervicalis profunda
  • vasa pharyngea ascendenta, plexus (venosus) pharyngeus et vv. pharyngeae
  • plexus caroticus internus (+ n. petrosus profundus)
  • truncus sympathicus (v lamina prevertebralis fasciae cervicalis) + ganglion cervicale superius

    • Spatium retropharyngeum

  • cranially: skull base (basis o. occipitalis)
  • ventrally: posterior pharyngeal wall
  • dorsally: lamina prevertebralis fasciae cervicalis (and m. longus colli et capitis behind it)
  • laterally: opens to spatium retrostyloideum
  • caudally: opens to the space behind the esophageus downwards up to mediastinum superius
  • loose connective tissue
  • plexus pharyngeus
  • nodi lymphoidei retropharyngeales (two nodes at the level of C2 frequetly)
  • rr. pharyngeales a. pharyngeae ascendentis, vv. pharyngeae a plexus (venosus) pharyngeus

    • Septum styloideum

    stretches dorsolaterally covered with lamina pretrachealis fasciae cervicalis

  • m. stylopharyngeus
  • m. styloglossus
  • processus styloideus (lig. stylohyoideum)
  • m. stylohyoideus
  • venter post. m. digastrici
  • m. sternocleidomastoideus

    •