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Connections of the skull bones. Temporomandibular joint. Masticatory muscles, mimic muscles and their innervation.

Veronika Nmcová, CSc.

Connections of the skull bones

· Synchondroses cranii · Syndesmoses - suturae cranii, gomphosis

· Synostoses · Articulatio temporomandibularis

Cartilaginous connections

Synchondrosis sphenopetrosa (foramen lacerum)

Synchondrosis petrooccipitalis (fissura petrooccipitalis)

Synchondrosis Synchondrosis sphenooccipitalis intraoccipitalis anterior

Fonticulus mastoideus

Symphysis menti

Synchondrosis intraoccipitalis posterior

Cartilaginous and fibrous connection on the newborn skull

Sutura squamosa Sutura lambdoidea

Sutura coronalis

Sutura sagittalis

Sutures

newborn

Articulatio temporomandibularis

complex­ discus head: caput mandibulae fossa: fossa mandibularis, tuberculum articulare Articular surfices are covered by fibrous cartilage Movements : depression elevation protraction retraction lateropulsion

Ligaments of the temporomandibular joint ­ lateral aspect

Ligamentum laterale - it prevents posterior displacement of the resting condyle

Ligamentum stylomandibulare

Ligaments of the temporomandibular joint - medial aspect Lig.pterygospinale

Lig.sphenomandibulare

Lig.stylomandibulare

Lig. pterygomandibulare (raphe buccopharyngea)

Ligaments of the temporomandibular joint

Lig. pterygospinale

Lig. stylomandibulare

Lig. sphenomandibulare

Articulatio temporomandibularis sagittal section (after Frick)

Discus articularis Meatus acusticus externus

A

P Retroarticular plastic pad (Zenker) (veins and fatty connective tissue)

Caput mandibulae

Position of the caput mandibulae to the external acoustic meatus

MR of the temporomandibular joint

m-discus C-caput mandibulae E-tuberculum articulare AC-meatus acusticus externus

MR of the temporomandibular joint - anterior displacement of the disc

Arthrography of the temporomandibular joint

Communication of both parts of the joint cavity ­ rupture of the disc or in eldery

Normal

Anterior disc displacement

Artrocentesis (lavage ) of the temporomandibular joint

Temporomandibular joint and m. pterygoideus lateralis

m. pterygoideus lat (depression, lateropulsion)

Elevation: m.masseter m.temporalis m. pterygoideus medialis

Protraction: mm. pterygoidei m. temporalis m. masseter Retraction: m. temporalis m. masseter (newborn)

PL T PM

M

Depression: suprahyoid muscles m.pterygoideus lat.

Lateropulsion: m.pterygoideus med. m.pterygoideus lat.

Injury of Karel IV.

Karel IV.

Normal Úraz Karla IV. mandible

X-ray picture of the mandible of Karel IV.

healed fractures

thick corticalis

Karel IV.

Masticatory muscles

· · · · · From the first branchial arch Nerve supplying ­ mandibular nerve (V/3) Blood supplying ­ branches of maxillary artery (pars infratemporalis), plexus pterygoideus, Fascia parotideomasseterica temporalis interpterygoidea

Fce: elevation - m.masseter, m.temporalis, m.pterygoideus med. protraction - m.pterygoideus lat., m.masseter (superficial fibres) retraction- m.temporalis (posterior part), m.masseter (deep fibres) lateropulsion ­ m.pterygoiei, unilateral action

M.temporalis

M.masseter

Fossa infratemporalis A.maxillaris V/3

N.auriculotemporalis

M.pterygoideus lateralis

A.meningea media N.alveolaris inf M.pterygoideus medialis N.lingualis

M.pterygoideus lateralis

M.buccinator

Ductus parotideus

V/3 M.pterygoideus medialis M.constrictor pharyngis sup Raphe pterygomandibularis (Raphe buccopharyngea)

Frontal section of temporal and infratemporal region

Corpus adiposum

lingual nerve inferior alveolar nerve

A.temporalis superficialis

A.auricularis posterior A.occipitalis

A.maxillaris

A.facialis

A.maxillaris

Maxillary artery: Pars pterygopalatina

Pars pterygoidea

Pars mandibularis

A.temporalis spf. A.carotis int. A.meningea media A.carotis externa A.alveolaris inf.

Maxillary artery

Pars pterygopalatina Pars pterygoidea Pars mandibularis A.meningea media A.infraorbitalis R. temporales profundi A.sphenopalatina FSP FOI CP

TA A.palatina desc. Aa.alveolares sup.post. A.masseterica Rr.pterygoidei A.buccalis

AP

A.alveolaris inferior

Pterygopalatine fossa ­ lateral aspect - schema

Foramen sphenopalatinum FOI Canalis pterygoideus

PrPt Maxilla

Maxillary artery branches in the pars pterygopalatina

Maxillary artery branches in the pars pterygopalatina

A.infraorbitalis Rr. nasales post.lat.+septi A.sphenopalatina A.canalis pterygoidei M

A.alveolares sup.ant. Aa.alveolares sup.post

A.palatina descendens

A.palatina major +minor

V.temporalis spf.

Vv.diploicae V.angularis Plexus pterygoideus V.facialis V.retromandibularis V.jugularis externa V.jugularis interna

Nn. temporales profundi

N.VII N.auriculotemporalis N.alveolaris inf. N.buccalis R.mylohyoideus N.lingualis

n.massetericus

Infratemporal fossa - repetition

http://anat.lf1.cuni.cz/muzeum/alb3

http://anat.lf1.cuni.cz/muzeum/alb3

Transverse section through the palatine tonsille

Section through the neck - C1/2 Spatium parapharyngeum Spatium retropharyngeum

Section through the neck - C1/2 m.buccinator constrictor pharyngis sup. tonsilla palatina a.palatina ascendens a.pharyngea ascendens a.carotis int., n.X., v. jugularis int. truncus sympaticus nodi lymphatici retropharyngei

ductus parotideus corpus adiposum buccae n.lingualis m.masseter n.+vasa alveolaria inf. m. pterygoideus medialis SG,SPh n.IX, n.XII a.carotis ext., n.VII, v.retromandibularis SH m. digastricus (v.p.) n.XI m.sternocleidomastoideus m.trapezius

Section through the neck - C1/2 repetition

Section through the neck - C1/2 repetition

Mimetic muscles

· From the 2. branchial arch · Nerve supplying facial nerve (VII.n) · No fascia · m.buccinator ­ fascia buccopharyngea Groups: a)muscles of the scalp b) muscles of the auricle c) muscles in the region of eyelids d) muscles of the nasal region e) muscles of the mouth region

Galea aponeurotica

Mimetic muscles

1 2 3 6 9 11 8 7 a) muscles of the scalp b) muscles of the auricle c) muscles in the region of eyelids d) muscles of the nasal region e) muscles of the mouth region 13 16 14 15 12 17 5 10 4

Nerve supplying of mimetic muscles facial nerve (VII.)

Porus acusticus int

Foramen stylomastoideum

Plexus parotideus

Regio parotidomasseterica (plexus parotideus)

N.auriculotemporalis Vasa temporalia superficialia (V/3) Rr.temporales N.auricularis post. (VII) Vasa auricularia post. Rr.zygomatici A.transversa faciei Ductus parotideus

Rr.buccales V.retromandibularis N.auricularis magnus (pl.cervicalis) R.marginalis mandibulae R.colli

Duchenne and an assistant faradize the mimetic muscles of a live subject to demonstrate the mechanics of facial expression.

M.epicranius, venter frontalis

M.depressor anguli oris

M occipitofrontalis, venter frontalis

M.zygomaticus major

M.orbicularis oculi

M.zygomaticus major

M.corrugator supercilii

Peripherial facial nerve palsy

Mimetic muscles lateral aspect

Mimetic muscles anterior aspect

Superfitial face structures ­ parotid gland is partially removed

Superfitial head structures

Projection of the important structures on the face surface

Face transplantation

· Isabelle Dinoire, the world's first face transplant recipient, is beginning to recover much of her facial function

Sources

· · · · · · · Cihák, Anatomie 1 Petrovický a spol., Anatomie 1 Grim, Záklagdy anatomie Sobotta , Atlas anatomie clovka Bertolini/Leutert, Atlas der Anatomie des Menschen Gray Anatomy http://en.wikipedia.org/wiki/Guillaume_Benjamin_Amand _Duchenne · http://www.newscientist.com/article/dn8688--facetransplant-recipient-faces-world-press.html · Ramba, Slavné ceské lebky · Personal archive

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Microsoft PowerPoint - Connections on the skull bones. Temporomandibular joint. Masticatory muscles, mimic muscles and their innervation..ppt

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