Objectives 3.2 Face/scalp, infratemporal fossa, pterygopalatine fossa

Surface Anatomy

  • External occipital protuberance
  • Mastoid processes
  • Supraorbital margin
  • Nasal bones
  • Alveolar process of the maxillae and mandible
  • Mental protuberance of the mandible
  • Zygomatic bone
  • Zygomatic arch
  • Angle of the mandible

Osteology

  • Pterygomaxillary fissure
  • Sphenopalatine foramen
  • Inferior orbital fissure
  • Temporal fossa
  • Temporomandibular joint
  • Infratemporal fossa
    • Superior- zygomatic arch superficially
    • Lateral- ramus of the mandible
    • Anterior- infratemporal surface of the maxilla
    • Medial- lateral plate of the pterygoid process
    • Roof- greater wing of the sphenoid bone
  • Pterygopalatine fossa:

Muscles of facial expression

  • Orbicularis oculi
    • Orbital part
    • Palpebral part
  • Levator labii superioris
  • Zygomaticus major
  • Zygomaticus minor
  • Risorius
  • Levator anguli oris
  • Buccinator
  • Orbicularis oris
  • Depressor anguli oris
  • Depressor labii inferioris
  • Mentalis
  • Nasalis
  • Corrugator supercilii
  • Platysma
  • Occipitofrontalis (comprised of frontalis and occipitalis mm.)

Muscles of mastication

  • Masseter
  • Temporalis
  • Lateral pterygoid
  • Medial pterygoid

Neurovasculature

  • Facial nerve (CN VII)
    • Temporal branch
    • Zygomatic branch
    • Buccal branch
    • Marginal mandibular branch
    • Cervical branch
    • Posterior auricular branch
    • Chorda tympani
  • Trigeminal nerve (CN V) and Trigeminal ganglion
    • Ophthalmic division (V1)
    • Maxillary division (V2)
    • Mandibular division (V3)
  • Lingual nerve
  • Auriculotemporal nerve
  • Nerve to mylohyoid muscle
  • Facial artery and vein
  • Angular artery and vein
  • Supraorbital nerve, artery, and vein
  • Infraorbital nerve, artery, and vein
  • Supratrochlear nerve, artery, and vein
  • Infratrochlear nerve, artery, and vein
  • Mental nerve, artery, and vein
  • Great auricular nerve
  • Lesser occipital nerve
  • Greater occipital nerve
  • External jugular vein
  • External carotid artery
  • Internal carotid artery
  • Internal jugular vein
  • Retromandibular vein
  • Maxillary artery and vein
  • Inferior alveolar nerve, artery, and vein
  • Deep temporal artery
  • Middle meningeal artery
  • Sphenopalatine artery
  • Greater and lesser palatine arteries
  • Ophthalmic artery
  • Superficial temporal artery and vein
  • Occipital artery and vein
  • Posterior auricular artery and vein
  • Cavernous sinus
  • Pterygoid plexus
  • Pterygopalatine ganglion
  • Otic ganglion
  • Superior and inferior ophthalmic veins
  • Emissary veins

Scalp

  • Skin
  • Connective tissue (adipose and fibrous septa)
  • Aponeurosis
  • Loose areolar connective tissue
  • Pericranium
  • Occipitofrontalis muscle

Parotid Gland

  • Parotid duct and pathway
  • Relationship to neurovasculature

Clinical Correlations

  • Inferior alveolar nerve block
  • Danger Triangle of Face
  • Lymphatic drainage of the face / superficial ring (pericervical collar) of lymph nodes
  • Fracture of neck of mandible and injury to maxillary artery and auriculotemporal nerve
  • Jaw thrust (airway obstruction)
  • Dislocation of the TMJ
  • Paralysis of facial muscles (Bell’s palsy)
  • Trigeminal neuralgia
  • Herpes zoster infection of trigeminal nerve
  • Importance of scalp suturing in relation to the depth of the lesion
  • Parotitis (mumps)
  • Le Forte fractures