Head, neck and brain

Skull

from the front

1

Anterior nasal spine
2

Body of mandible
3

Frontal bone
4

Frontal notch
5

Frontal process of maxilla
6

Glabella
7

Greater wing of sphenoid bone
8

Infra-orbital foramen
9

Infra-orbital margin
10

Inferior nasal concha
11

Inferior orbital fissure
12

Lacrimal bone
13

Lesser wing of sphenoid bone
14

Maxilla
15

Mental foramen
16

Mental protuberance
17

Middle nasal concha
18

Nasal bone
19

Nasal septum
20

Nasion
21

Orbit (orbital cavity)
22

Ramus of mandible
23

Superior orbital fissure
24

Supra-orbital foramen
25

Supra-orbital margin
26

Zygomatic bone

The term ‘skull’ includes the mandible, and ‘cranium’ refers to the skull without the mandible.

The calvarium is the vault of the skull (cranial vault or skull-cap) and is the upper part of the cranium that encloses the brain.

The front part of the skull forms the facial skeleton.

The supra-orbital, infra-orbital and mental foramina (24, 8 and 15) lie in approximately the same vertical plane.

Details of individual skull bones are given on pages 18–27 , of the bones of the orbit and nose on page 12 , and of the teeth on pages 13 and 16–19 .

Skull

muscle attachments, from the front

1

Buccinator
2

Corrugator supercilii
3

Depressor anguli oris
4

Depressor labii inferioris
5

Levator anguli oris
6

Levator labii superioris
7

Levator labii superioris alaeque nasi
8

Masseter
9

Mentalis
10

Nasalis
11

Orbicularis oculi
12

Platysma
13

Procerus
14

Temporalis
15

Zygomaticus major
16

Zygomaticus minor

Skull

radiograph, occipitofrontal 15° projection

1

Basi-occiput
2

Body of sphenoid
3

Crista galli
4

Ethmoidal air cells
5

Floor of maxillary sinus (antrum)
6

Foramen rotundum
7

Frontal sinus
8

Greater wing of sphenoid
9

Internal acoustic meatus
10

Lambdoid suture
11

Lateral mass of atlas (first cervical vertebra)
12

Lesser wing of sphenoid
13

Mastoid process
14

Nasal septum

Skull

from the right

1

Anterior lacrimal crest
2

Anterior nasal spine with tympanic ring
3

Body of mandible
4

Condylar process of the mandible
5

Coronal suture
6

Coronoid process of mandible
7

External acoustic meatus of temporal bone
8

External occipital protuberance (inion)
9

Fossa for lacrimal sac
10

Frontal bone
11

Frontal process of maxilla
12

Frontozygomatic suture
13

Glabella
14

Greater wing of sphenoid bone
15

Inferior temporal line
16

Lacrimal bone
17

Lambdoid suture
18

Mastoid process of temporal bone
19

Maxilla
20

Mental foramen
21

Mental protuberance
22

Nasal bone
23

Nasion
24

Occipital bone
25

Orbital plate of ethmoid bone
26

Parietal bone
27

Pituitary fossa (sella turcica) (see Figure A on page 5 )
28

Posterior lacrimal crest
29

Pterion (encircled)
30

Ramus of mandible
31

Squamous part of temporal bone
32

Styloid process of temporal bone
33

Superior temporal line
34

Tympanic part of temporal bone
35

Zygomatic arch
36

Zygomatic bone
37

Zygomatic process of temporal bone

Pterion (29) is not a single point but an area where the frontal (10), parietal (26), squamous part of the temporal (31) and greater wing of the sphenoid bone (14) adjoin one another.

It is an important landmark for the anterior branch of the middle meningeal artery, which underlies this area on the inside of the skull ( page 17 ).

Skull

A

radiograph, lateral projection
B

coloured bones

1

Aponeurosis of occipitofrontalis
2

Dura mater
3

Frontalis muscle (covered by loose areolar tissue)
4

Loose areolar tissue
5

Middle meningeal artery impression on dura mater
6

Parietal branch of the superficial temporal artery
7

Periosteum
8

Skin
9

Subcutaneous tissue
10

Temporal bone
11

Temporal fascia
12

Temporalis muscle

C

scalp dissection

Scalp layers

S, skin; C, connective tissue; A, aponeurosis of occipitofrontalis; L, loose areolar tissue; P, periosteum.

See label list on page 4 for A and B labels

Skull

muscle attachments, from the right

1

Buccinator
2

Corrugator supercilii
3

Depressor anguli oris
4

Depressor labii inferioris
5

Levator anguli oris
6

Levator labii superioris
7

Levator labii superioris alaeque nasi
8

Masseter
9

Nasalis
10

Occipital part of occipitofrontalis
11

Orbicularis oculi
12

Platysma
13

Procerus
14

Sternocleidomastoid
15

Temporalis
16

Temporomandibular joint
17

Zygomaticus major
18

Zygomaticus minor

The bony attachments of the buccinator muscle (1) are to the upper and lower jaws (maxilla and mandible) opposite the three molar teeth. (The teeth are identified on page 13 .)

The upper attachment of temporalis (upper 15) occupies the temporal fossa (the narrow space above the zygomatic arch at the side of the skull). The lower attachment of temporalis (lower 15) extends from the lowest part of the mandibular notch of the mandible, over the coronoid process and down the front of the ramus almost as far as the last molar tooth.

Masseter (8) extends from the zygomatic arch to the lateral side of the ramus of the mandible.

A

Skull

from behind

1

External occipital protuberance (inion)
2

Highest nuchal line
3

Inferior nuchal line
4

Lambda
5

Lambdoid suture
6

Occipital bone
7

Parietal bone
8

Parietal foramina
9

Sagittal suture
10

Superior nuchal line

See label list below for C and D.

B

Skull

right infratemporal region, obliquely from below

1

Articular tubercle
2

External acoustic meatus
3

Horizontal plate of palatine bone
4

Inferior orbital fissure
5

Infratemporal crest
6

Infratemporal (posterior) surface of maxilla
7

Infratemporal surface of greater wing of sphenoid bone
8

Lateral pterygoid plate
9

Mandibular fossa
10

Mastoid notch
11

Mastoid process
12

Medial pterygoid plate
13

Occipital condyle
14

Occipital groove
15

Pterygoid hamulus
16

Pterygomaxillary fissure and pterygopalatine fossa
17

Pyramidal process of palatine bone
18

Spine of sphenoid bone
19

Styloid process
20

Third maxillary molar tooth
21

Tuberosity of maxilla
22

Vomer
23

Zygomatic arch

A

Skull

from above

1

Bregma
2

Coronal suture
3

Frontal bone
4

Lambda
5

Lambdoid suture
6

Occipital bone
7

Parietal bone
8

Parietal eminence
9

Parietal foramen
10

Sagittal suture

In this skull, the parietal eminences are prominent (A8).

The point where the sagittal suture (A10) meets the coronal suture (A2) is the bregma (A1). At birth, the unossified parts of the frontal and parietal bones in this region form the membranous anterior fontanelle ( page 14 , D1).

The point where the sagittal suture (A10) meets the lambdoid suture (A5) is the lambda (A4). At birth, the unossified parts of the parietal and occipital bones in this region form the membranous posterior fontanelle ( page 14 , C13).

The label A3 in the centre of the frontal bone indicates the line of the frontal suture in the fetal skull ( page 14 , A5). The suture may persist in the adult skull and is sometimes known as the metopic suture.

The arachnoid granulations ( page 62 , B1), through which cerebrospinal fluid drains into the superior sagittal sinus, cause the irregular depressions (B2) on the parts of the frontal and parietal bones (B3 and 7) that overlie the sinus.

B

Skull

internal surface of the cranial vault, central part

1

Coronal suture
2

Depressions for arachnoid granulations
3

Frontal bone
4

Frontal crest
5

Groove for superior sagittal sinus
6

Grooves for middle meningeal vessels
7

Parietal bone
8

Parietal foramina
9

Sagittal suture

Skull

external surface of the base

1

Apex of petrous part of temporal bone
2

Articular tubercle
3

Carotid canal
4

Condylar canal (posterior)
5

Edge of tegmen tympani
6

External acoustic meatus
7

External occipital crest
8

External occipital protuberance
9

Foramen lacerum
10

Foramen magnum
11

Foramen ovale
12

Foramen spinosum
13

Greater palatine foramen
14

Horizontal plate of palatine bone
15

Hypoglossal canal (proximal & distal openings)
16

Incisive fossa
17

Inferior nuchal line
18

Inferior orbital fissure
19

Infratemporal crest of greater wing of sphenoid bone
20

Jugular foramen
21

Lateral pterygoid plate
22

Lesser palatine foramina
23

Mandibular fossa
24

Mastoid foramen
25

Mastoid notch
26

Mastoid process
27

Medial pterygoid plate
28

Median palatine (intermaxillary) suture
29

Occipital condyle
30

Occipital groove
31

Palatine grooves and spines
32

Palatine process of maxilla
33

Pharyngeal canal
34

Petrosquamous fissure
35

Petrotympanic fissure
36

Pharyngeal tubercle
37

Posterior border of vomer
38

Posterior nasal aperture (choana)
39

Posterior nasal spine
40

Pterygoid hamulus
41

Pyramidal process of palatine bone
42

Scaphoid fossa
43

Spine of sphenoid bone
44

Squamotympanic fissure
45

Squamous part of temporal bone
46

Styloid process
47

Stylomastoid foramen
48

Superior nuchal line
49

Transverse palatine (palatomaxillary) suture
50

Tuberosity of maxilla
51

Tympanic part of temporal bone
52

Vomerovaginal canal
53

Zygomatic arch

The palatine processes of the maxilla (32) and the horizontal plate of the palatine bone (14) form the hard palate (roof of the mouth and floor of the nasal cavity).

The carotid canal (3), recognized by its round shape on the inferior surface of the petrous part of the temporal bone, does not pass straight upwards to open into the inside of the skull but takes a right-angled turn forwards and medially within the petrous temporal to open into the back of the foramen lacerum (9).

Skull

muscle attachments, external surface of the base

Green line = capsule attachments of atlanto-occipital and temporomandibular joints

1

Capsule attachment of atlanto-occipital joint
2

Capsule attachment of temporomandibular joint
3

Deep head of medial pterygoid
4

Levator veli palatini
5

Longissimus capitis
6

Longus capitis
7

Masseter
8

Musculus uvulae
9

Occipital part of occipitofrontalis
10

Palatopharyngeus
11

Pharyngeal raphe
12

Posterior belly of digastric
13

Rectus capitis anterior
14

Rectus capitis lateralis
15

Rectus capitis posterior major
16

Rectus capitis posterior minor
17

Semispinalis capitis
18

Splenius capitis
19

Sternocleidomastoid
20

Styloglossus
21

Stylohyoid
22

Stylopharyngeus
23

Superficial head of medial pterygoid
24

Superior constrictor
25

Superior oblique capitis
26

Tensor tympani
27

Tensor veli palatini
28

Trapezius
29

Upper head of lateral pterygoid

The medial pterygoid plate has no pterygoid muscles attached to it. It passes straight backwards, giving origin at its lower end to part of the superior constrictor of the pharynx (24).

The lateral pterygoid plate has both pterygoid muscles attached to it: medial and lateral muscles from the medial and lateral surfaces, respectively (3 and 29). The plate becomes twisted slightly laterally because of the constant pull of these muscles which pass backwards and laterally to their attachments to the mandible ( pages 18–19 ).

Skull

internal surface of the base (cranial fossae)

1

Anterior clinoid process
2

Arcuate eminence
3

Carotid groove
4

Clivus
5

Cribriform plate of ethmoid bone
6

Crista galli
7

Diploë
8

Dorsum sellae
9

Foramen caecum
10

Foramen lacerum
11

Foramen magnum
12

Foramen ovale
13

Foramen rotundum
14

Foramen spinosum
15

Frontal crest
16

Frontal sinus
17

Greater wing of sphenoid bone
18

Groove for anterior ethmoidal nerve and vessels
19

Groove for inferior petrosal sinus
20

Groove for sigmoid sinus
21

Groove for superior petrosal sinus
22

Groove for superior sagittal sinus
23

Groove for transverse sinus
24

Grooves for middle meningeal vessels
25

Hiatus and groove for greater petrosal nerve
26

Hiatus and groove for lesser petrosal nerve
27

Hypoglossal canal
28

Internal acoustic meatus
29

Internal occipital protuberance (position of confluence of sinuses)
30

Jugular foramen
31

Jugum of sphenoid bone
32

Lesser wing of sphenoid bone
33

Occipital bone (cerebellar fossa)
34

Optic canal
35

Orbital part of frontal bone
36

Parietal bone (postero-inferior angle only)
37

Petrous part of temporal bone
38

Pituitary fossa (sella turcica)
39

Posterior clinoid process
40

Prechiasmatic groove
41

Squamous part of temporal bone
42

Superior orbital fissure
43

Tegmen tympani
44

Trigeminal impression
45

Tuberculum sellae
46

Venous (emissary) foramen

The anterior cranial fossa (ACF) is limited posteriorly on each side by the free margin of the lesser wing of the sphenoid (32) with its anterior clinoid process (1), and centrally by the anterior margin of the prechiasmatic groove (40).

The middle cranial fossa (MCF) is butterfly-shaped and consists of a central or median part and right and left lateral parts. The central part includes the pituitary fossa (38) on the upper surface of the body of the sphenoid, with the prechiasmatic groove (40) in front and the dorsum sellae (8) with its posterior clinoid processes (39) behind. Each lateral part extends from the posterior border of the lesser wing of the sphenoid (32) to the groove for the superior petrosal sinus (21) on the upper edge of the petrous part of the temporal bone.

The posterior cranial fossa (PCF), whose most obvious feature is the foramen magnum (11), is behind the dorsum sellae (8) and the grooves for the superior petrosal sinuses (21).

For cranial dural attachments and reflections, see pages 59–62 .

A

Skull

bones of the left orbit

1

Anterior ethmoidal foramen
2

Anterior lacrimal crest
3

Body of sphenoid bone, forming medial wall
4

Fossa for lacrimal sac
5

Frontal notch
6

Frontal process of maxilla, forming medial wall
7

Greater wing of sphenoid bone, forming lateral wall
8

Inferior orbital fissure
9

Infra-orbital foramen
10

Infra-orbital groove
11

Lacrimal bone, forming medial wall
12

Lesser wing of sphenoid bone, forming roof
13

Marginal tubercle
14

Maxilla, forming floor
15

Nasolacrimal canal
16

Optic canal
17

Orbital border of zygomatic bone, forming floor
18

Orbital part of frontal bone, forming roof
19

Orbital plate of ethmoid bone, forming medial wall
20

Orbital process of palatine bone, forming floor
21

Posterior ethmoidal foramen
22

Posterior lacrimal crest
23

Superior orbital fissure
24

Supra-orbital foramen
25

Zygomatic bone forming lateral wall
26

Zygomatico-orbital foramen

B

Nasal cavity

lateral wall

In this midline sagittal section of the skull, with the nasal septum removed, the superior and middle nasal conchae have been dissected away to reveal the air cells of the ethmoidal sinus, in particular the ethmoidal bulla (5).

1

Air cells of ethmoidal sinus
2

Clivus
3

Cribriform plate of ethmoid bone
4

Dorsum sellae
5

Ethmoidal bulla
6

Frontal sinus
7

Horizontal plate of palatine bone
8

Incisive canal
9

Inferior meatus
10

Inferior nasal concha
11

Lateral pterygoid plate
12

Left sphenoidal sinus
13

Medial pterygoid plate
14

Nasal bone
15

Nasal spine of frontal bone
16

Opening of maxillary sinus (maxillary antrum)
17

Palatine process of maxilla
18

Perpendicular plate of palatine bone
19

Pituitary fossa (sella turcica)
20

Pterygoid hamulus
21

Right sphenoidal sinus
22

Semilunar hiatus
23

Sphenopalatine foramen
24

Uncinate process of ethmoid bone

The roof of the nasal cavity consists mainly of the cribriform plate of the ethmoid bone (B3) with the body of the sphenoid containing the sphenoidal sinuses (B21 and 12) behind, and the nasal bone (B14) and the nasal spine of the frontal bone (B15) at the front.

The floor of the cavity consists of the palatine process of the maxilla (B17) and the horizontal plate of the palatine bone (B7).

The medial wall is the nasal septum which is formed mainly by two bones – the perpendicular plate of the ethmoid and the vomer – and the septal cartilage.

The lateral wall consists of the medial surface of the maxilla with its large opening (B16), overlapped from above by parts of the ethmoid (B1, 5 and 24) and lacrimal bones, from behind by the perpendicular plate of the palatine (B18), and below by the inferior concha (B10).

C

Skull

Left orbit, individual bones

1

Ethmoid
2

Frontal
3

Lacrimal
4

Mandible
5

Maxilla
6

Nasal
7

Palatine
8

Sphenoid
9

Temporal
10

Zygomatic

D

Permanent teeth

from the left and in front

1

First (central) incisor
2

Second (lateral) incisor
3

Canine
4

First premolar
5

Second premolar
6

First molar
7

Second molar
8

Third molar (wisdom tooth)

The corresponding teeth of the upper and lower jaws have similar names. In clinical dentistry, the teeth are usually identified by the numbers 1–8 (as listed here) rather than by name.

The third molar is sometimes called the wisdom tooth.

Upper and lower jaws

from the left and in front
- E
  
  orthopantomogram in a 6-year-old child
- F
  
  in a 4-year-old child with erupted deciduous teeth and unerupted permanent teeth

1

First (central) incisor of deciduous dentition
2

Second (lateral) incisor of deciduous dentition
3

Canine of deciduous dentition
4

First molar of deciduous dentition
5

Second molar of deciduous dentition
6

First (central) incisor of permanent dentition
7

Second (lateral) incisor of permanent dentition
8

Canine of permanent dentition
9

First premolar of permanent dentition
10

Second premolar of permanent dentition
11

First molar of permanent dentition
12

Second molar of permanent dentition

The deciduous molars occupy the positions of the premolars of the permanent dentition.

G

Edentulous mandible

in old age, from the left

1

Angle
2

Body
3

Mental foramen
4

Ramus

With the loss of teeth, the alveolar bone becomes resorbed, so that the mental foramen (3) and mandibular canal lie near the upper margin of the bone.

The angle (1) between the ramus (4) and body (2) becomes more obtuse, resembling the infantile angle (as in E and F, above).

Skull of a full-term fetus

A

from the front
B

from the left and slightly below
C

from behind
D

from above

1

Anterior fontanelle
2

Coronal suture
3

Elevations over deciduous teeth in body of mandible
4

External acoustic meatus
5

Frontal suture (metopic suture)
6

Frontal tuberosity
7

Half of frontal bone
8

Lambdoid suture
9

Mastoid fontanelle
10

Maxilla
11

Occipital bone
12

Parietal tuberosity
13

Posterior fontanelle
14

Ramus of mandible
15

Sagittal suture
16

Sella turcica
17

Semicircular canals, superior
18

Sphenoidal fontanelle
19

Stylomastoid foramen
20

Symphysis menti
21

Tympanic ring

Fetal skull radiographs

E

frontal projection
F

lateral projection

The face at birth forms a relatively smaller proportion of the cranium than in the adult (about one-eighth compared with one-half) because of the small size of the nasal cavity and maxillary sinuses and the lack of erupted teeth.

The posterior fontanelle (C13, E13) closes about 2 months after birth, the anterior fontanelle (A1, D1, F1) in the second year.

Owing to the lack of the mastoid process (which does not develop until the second year), the stylomastoid foramen (B19) and the emerging facial nerve are relatively near the surface and unprotected.

G

Resin cast of head and neck arteries

full-term fetus, from the left

In this cast of fetal arteries, note in the front of the neck the dense arterial pattern indicating the thyroid gland (G), and above and in front of it the fine vessels outlining the tongue (T).

Skull

A

coloured left half of the skull in sagittal section

A

Superior nasal concha
B

Middle nasal concha
C

Inferior nasal concha
D

Palatine bone

See page 17 for additional label numbers.

NB: The perpendicular plate of the ethmoid has been removed to expose the conchae.

B

cleared specimen from the front, illuminated from behind
C

radiograph of facial bones, occipitofrontal view

Compare with the skull on [CR] .

1

Body of mandible
2

Crista galli
3

Ethmoidal air cells
4

Frontal crest
5

Frontal sinus
6

Greater wing of sphenoid bone
7

Inferior nasal concha
8

Infra-orbital margin
9

Lesser wing of sphenoid bone
10

Mastoid process
11

Maxillary sinus
12

Mental foramen
13

Nasal septum
14

Ramus of mandible
15

Root of lower lateral incisor
16

Root of upper central incisor
17

Superior orbital fissure
18

Supra-orbital margin
19

Zygomatic arch

Skull

left half of the skull in sagittal section

The inside of the left half of the skull is seen from the right, with the bony part of the nasal septum (36 and 45) preserved.

1

Alveolar process of maxilla
2

Angle of mandible
3

Body of mandible
4

Clivus
5

Coronal suture
6

Crista galli of ethmoid bone
7

Dorsum sellae
8

External occipital protuberance
9

Frontal sinus
10

Groove for mylohyoid nerve
11

Groove for sigmoid sinus
12

Groove for superior petrosal sinus
13

Groove for transverse sinus
14

Grooves for middle meningeal vessels (anterior division)
15

Horizontal plate of palatine bone
16

Hypoglossal canal
17

Incisive canal
18

Internal acoustic meatus in petrous part of temporal bone
19

Internal occipital protuberance
20

Lambdoid suture
21

Lateral pterygoid plate
22

Left sphenoidal sinus
23

Lingula
24

Mandibular foramen
25

Margin of foramen magnum
26

Mastoid (posterior inferior) angle of parietal bone
27

Medial pterygoid plate
28

Mental protuberance
29

Mylohyoid line
30

Nasal bone
31

Occipital bone
32

Occipital condyle
33

Orbital part of frontal bone
34

Palatine process of maxilla
35

Parietal bone
36

Perpendicular plate of ethmoid bone
37

Pituitary fossa (sella turcica)
38

Posterior nasal aperture (choana)
39

Pterion (encircled)
40

Pterygoid hamulus of medial pterygoid plate
41

Ramus of mandible
42

Right sphenoidal sinus
43

Squamous part of frontal bone
44

Squamous part of temporal bone
45

Vomer

The bony part of the nasal septum consists of the vomer (45) and the perpendicular plate of the ethmoid bone (36). The anterior part of the septum consists of the septal cartilage ( pages 60 and 61 ).

In this skull, the sphenoidal sinuses (42 and 22) are large, and the right one (42) has extended to the left of the midline. The pituitary fossa (37) projects down into the left sinus (22).

The grooves for the middle meningeal vessels (14) pass upwards and backwards. The circle (39) marks the region of the pterion, and corresponds to the position shown on the outside of the skull on page 4 .

Mandible

A

from the front
B

from behind
C

from the left and front
D

internal view from the left

1

Alveolar part
2

Angle
3

Anterior border of ramus
4

Base
5

Body
6

Coronoid process
7

Digastric fossa
8

Head
9

Inferior border of ramus
10

Lingula
11

Mandibular foramen
12

Mandibular notch
13

Mental foramen
14

Mental protuberance
15

Mental tubercle
16

Mylohyoid groove
17

Mylohyoid line
18

Neck
19

Oblique line
20

Posterior border of ramus
21

Pterygoid fovea
22

Ramus
23

Sublingual fossa
24

Submandibular fossa
25

Superior and inferior mental spines (genial tubercles)

The head (8) and the neck (18, including the pterygoid fovea, 21) constitute the condyle.

The alveolar part (1) contains the sockets for the roots of the teeth.

The base (4) is the inferior border of the body (5), and becomes continuous with the inferior border (9) of the ramus (22).

Orthopantomogram

Mandible

muscle attachments

A

from the front
B

from behind
C

from the left and front
D

internal view from the left

Green line = capsular attachment of temporomandibular joint; blue line = limit of attachment of the oral mucous membrane; pale green line = ligament attachment

1

Anterior belly of digastric
2

Buccinator
3

Depressor anguli oris
4

Depressor labii inferioris
5

Genioglossus
6

Geniohyoid
7

Lateral pterygoid
8

Masseter
9

Medial pterygoid
10

Mentalis
11

Mylohyoid
12

Platysma
13

Pterygomandibular raphe and superior constrictor
14

Sphenomandibular ligament
15

Stylomandibular ligament
16

Temporalis

The lateral pterygoid (A7) is attached to the pterygoid fovea on the neck of the mandible (and also to the capsule of the temporomandibular joint and the articular disc – see page 42 , A27, A28).

The medial pterygoid (B9, C9) is attached to the medial surface of the angle of the mandible, below the groove for the mylohyoid nerve.

Masseter (C8) is attached to the lateral surface of the ramus.

Temporalis (C16) is attached over the coronoid process, extending back as far as the deepest part of the mandibular notch and downwards over the front of the ramus almost as far as the last molar tooth.

Buccinator (C2) is attached opposite the three molar teeth, at the back reaching the pterygomandibular raphe (C13).

Genioglossus (B5) is attached to the superior mental spine and geniohyoid (B6) to the inferior mental spine.

Mylohyoid (11) is attached to the mylohyoid line.

The attachment of the lateral temporomandibular ligament to the lateral aspect of the neck of the condyle is not shown.

Frontal bone

A

external surface from the front
B

external surface from the left
C

from below
D

internal surface from above and behind (right half not shown; ethmoidal notch is inferior)

1

Anterior ethmoidal canal (position of groove)
2

Ethmoidal notch
3

Foramen caecum
4

Fossa for lacrimal gland
5

Frontal crest
6

Frontal sinus
7

Frontal tuberosity
8

Glabella
9

Inferior temporal line
10

Nasal spine
11

Orbital part
12

Position of frontal notch or foramen
13

Posterior ethmoidal canal (position of groove)
14

Roof of ethmoidal air cells
15

Sagittal crest
16

Superciliary arch
17

Superior temporal line
18

Supra-orbital margin
19

Supra-orbital notch or foramen
20

Trochlear fovea (or tubercle)
21

Zygomatic process

Right maxilla

A

from the front
B

from the lateral side
C

from the medial side
D

from below
E

from above
F

from behind

1

Alveolar process
2

Anterior lacrimal crest
3

Anterior nasal spine
4

Anterior surface
5

Canine eminence
6

Canine fossa
7

Conchal crest
8

Ethmoidal crest
9

Frontal process
10

Greater palatine canal (position of groove)
11

Incisive canal
12

Incisive fossa
13

Inferior meatus
14

Infra-orbital canal
15

Infra-orbital foramen
16

Infra-orbital groove
17

Infra-orbital margin
18

Infratemporal surface
19

Lacrimal groove
20

Maxillary hiatus and sinus
21

Middle meatus
22

Nasal crest
23

Nasal notch
24

Orbital surface
25

Palatine process
26

Tuberosity
27

Unerupted third molar tooth
28

Zygomatic process

Right lacrimal bone

G

from the lateral (orbital) side
H

from the medial (nasal) side
- 29
  
  Lacrimal groove
- 30
  
  Lacrimal hamulus
- 31
  
  Nasal surface
- 32
  
  Orbital surface
- 33
  
  Posterior lacrimal crest

Right nasal bone

J

from the lateral side
K

from the medial side
- 34
  
  Internal surface and groove for anterior ethmoidal nerve
- 35
  
  Lateral surface

Right palatine bone

A

from the medial side
B

from the lateral side
C

from the front
D

from behind
E

from above
F

from below

1

Conchal crest
2

Ethmoidal crest
3

Greater palatine groove
4

Horizontal plate
5

Lesser palatine canals
6

Maxillary process
7

Nasal crest
8

Orbital process
9

Perpendicular plate
10

Posterior nasal spine
11

Pyramidal process
12

Sphenoidal process
13

Sphenopalatine notch

G

Articulation of the right maxilla and the palatine bone, from the medial side

1

Horizontal plate of palatine
2

Maxillary process of palatine
3

Palatine process of maxilla

Right temporal bone

A

external aspect
B

internal aspect
C

from above
D

from below
E

from the front

1

Aqueduct of vestibule
2

Arcuate eminence
3

Articular tubercle
4

Auditory (eustachian) tube
5

Canal for tensor tympani
6

Canaliculus for tympanic branch of glossopharyngeal nerve
7

Carotid canal
8

Cochlear canaliculus
9

Edge of tegmen tympani
10

External acoustic meatus
11

Groove for middle temporal artery
12

Groove for sigmoid sinus
13

Groove for superior petrosal sinus
14

Grooves for branches of middle meningeal vessels
15

Hiatus and groove for greater petrosal nerve
16

Hiatus and groove for lesser petrosal nerve
17

Internal acoustic meatus
18

Jugular fossa
19

Jugular surface
20

Mandibular fossa
21

Mastoid canaliculus for auricular branch of vagus nerve
22

Mastoid notch
23

Mastoid process
24

Occipital groove
25

Parietal notch
26

Petrosquamous fissure (from above)
27

Petrosquamous fissure (from below)
28

Petrotympanic fissure
29

Petrous part
30

Postglenoid tubercle
31

Sheath of styloid process
32

Squamotympanic fissure
33

Squamous part
34

Styloid process
35

Stylomastoid foramen
36

Subarcuate fossa
37

Suprameatal triangle
38

Tegmen tympani
39

Trigeminal impression on apex of petrous part
40

Tympanic part
41

Zygomatic process

Right parietal bone

A

external surface
B

internal surface

1

Frontal (anterior) border
2

Frontal (antero-superior) angle
3

Furrows for frontal branch of middle meningeal vessels (anterior division)
4

Furrows for parietal branch of middle meningeal vessels (posterior division)
5

Groove for sigmoid sinus at mastoid angle
6

Inferior temporal line
7

Mastoid (postero-inferior) angle
8

Occipital (posterior) border
9

Occipital (postero-superior) angle
10

Parietal foramen
11

Parietal tuberosity
12

Sagittal (superior) border
13

Sphenoidal (antero-inferior) angle
14

Squamosal (inferior) border
15

Superior temporal line

Right zygomatic bone

C

lateral surface
D

from the medial side
E

from behind

1

Frontal process
2

Marginal tubercle
3

Maxillary border
4

Orbital border
5

Orbital surface
6

Temporal border
7

Temporal process
8

Temporal surface
9

Zygomatico-orbital foramen
10

Zygomaticofacial foramen
11

Zygomaticotemporal foramen

The zygomatic process of the temporal bone ( page 4 ) and the temporal process of the zygomatic bone (C7, D7) form the zygomatic arch ( page 4 , 38).

Sphenoid bone

A

from the front
B

from behind
C

from above and behind
D

from below
E

from the left

Vomer

F

from the right
G

from behind

1

Ala of vomer
2

Anterior clinoid process
3

Body with openings of sphenoidal sinuses
4

Carotid groove
5

Cerebral surface of greater wing
6

Dorsum sellae
7

Ethmoidal spine
8

Foramen ovale
9

Foramen rotundum
10

Foramen spinosum
11

Groove for nasopalatine nerve and vessels
12

Infratemporal crest of greater wing
13

Infratemporal surface of greater wing
14

Jugum
15

Lateral pterygoid plate
16

Lesser wing
17

Medial pterygoid plate
18

Optic canal
19

Orbital surface of greater wing
20

Posterior border of vomer
21

Posterior clinoid process
22

Prechiasmatic groove
23

Pterygoid canal
24

Pterygoid hamulus
25

Pterygoid notch
26

Pterygoid process
27

Rostrum
28

Scaphoid fossa
29

Sella turcica (pituitary fossa)
30

Spine
31

Superior orbital fissure
32

Temporal surface of greater wing
33

Tuberculum sellae
34

Vaginal process

Ethmoid bone

A

from above
B

from the left
C

from the front
D

from the left, below and behind

1

Ala of crista galli
2

Anterior ethmoidal groove
3

Cribriform plate
4

Crista galli
5

Ethmoidal bulla
6

Ethmoidal labyrinth (containing ethmoidal air cells)
7

Middle nasal concha
8

Orbital plate
9

Perpendicular plate
10

Posterior ethmoidal groove
11

Superior nasal concha (meatus)
12

Uncinate process

Right inferior nasal concha

E

from the lateral side
F

from the medial side
G

from behind

1

Anterior end
2

Ethmoidal process
3

Lacrimal process
4

Maxillary process
5

Medial surface
6

Posterior end

Maxilla

H

Articulation of right maxilla, palatine bone and inferior nasal concha, from the medial side

1

Anterior end of inferior nasal concha
2

Ethmoidal process of inferior nasal concha
3

Frontal process of maxilla
4

Horizontal plate of palatine
5

Lacrimal process of inferior nasal concha
6

Palatine process of maxilla
7

Perpendicular plate of palatine
8

Posterior end of inferior nasal concha

Occipital bone

A

external surface from below
B

internal surface
C

external surface from the right and below
D

bones of the base of the skull

orange, occipital; red, temporal; blue, sphenoid

1

Basilar part
2

Cerebellar fossa
3

Cerebral fossa
4

Condylar fossa (and condylar canal in B and C)
5

Condyle
6

External occipital crest
7

External occipital protuberance
8

Foramen magnum
9

Groove for inferior petrosal sinus
10

Groove for sigmoid sinus
11

Groove for superior sagittal sinus
12

Groove for transverse sinus
13

Highest nuchal line
14

Hypoglossal canal
15

Inferior nuchal line
16

Internal occipital crest
17

Internal occipital protuberance
18

Jugular notch
19

Jugular process
20

Jugular tubercle
21

Lambdoid margin
22

Lateral angle
23

Lateral part
24

Mastoid margin
25

Pharyngeal tubercle
26

Squamous part
27

Superior angle
28

Superior nuchal line

Neck

surface markings of the front and right side

1

Accessory nerve emerging from sternocleidomastoid
2

Accessory nerve passing under anterior border of trapezius
3

Angle of mandible
4

Anterior border of masseter and facial artery
5

Anterior jugular vein
6

Arch of cricoid cartilage
7

Body of hyoid bone
8

Clavicle
9

Clavicular head of sternocleidomastoid
10

Deltoid
11

External jugular vein
12

Hypoglossal nerve
13

Inferior belly of omohyoid
14

Infraclavicular fossa and cephalic vein
15

Internal laryngeal nerve
16

Isthmus of thyroid gland
17

Jugular notch and trachea
18

Laryngeal prominence (Adam’s apple)
19

Lowest part of parotid gland
20

Mastoid process
21

Pectoralis major
22

Site for palpation of common carotid artery
23

Sternal head of sternocleidomastoid
24

Sternoclavicular joint and union of internal jugular and subclavian veins to form brachiocephalic vein
25

Sternocleidomastoid
26

Submandibular gland
27

Tip of greater horn of hyoid bone
28

Tip of transverse process of atlas
29

Upper trunk of brachial plexus
30

Vocal cord position

The pulsation of the common carotid artery (22, opposite page, 8) can be felt by backward pressure in the angle between the lower anterior border of sternocleidomastoid and the side of the larynx and trachea.

The cricoid cartilage (6) is about 5 cm (2 in) above the jugular notch of the manubrium of the sternum (17).

The lower end of the internal jugular vein lies behind the interval between the sternal (23) and clavicular (9) heads of sternocleidomastoid (when viewed from the front), just above the point where it joins the subclavian vein to form the brachiocephalic vein (24).

The trunks of the brachial plexus (29) can be felt as a cord-like structure in the lower part of the posterior triangle.

Side of the neck

right side, deep dissection

The lingual nerve (27) lies superficial to hyoglossus (17) and at this level is a flattened band rather than a typical round nerve, with the deep part of the submandibular gland (10) below it. The nerve crosses underneath the submandibular duct (51), lying first lateral to the duct and then medial to it.

The thyrohyoid membrane (60) is pierced by the internal laryngeal nerve (23) and the superior laryngeal artery (55).

Apart from supplying muscles of the tongue, the hypoglossal nerve (19) gives branches to geniohyoid (14) and thyrohyoid (59) and forms the upper root of the ansa cervicalis (62). These three branches consist of the fibres from the first cervical nerve that have joined the hypoglossal nerve higher in the neck; they are not derived from the hypoglossal nucleus. The C1 fibres in the upper root of the ansa contribute to the supply of sternohyoid (45) and omohyoid (21, 54).

1

Accessory nerve
2

Anterior belly of digastric and nerve
3

Ascending palatine artery
4

Auriculotemporal nerve
5

Buccinator
6

Capsule of temporomandibular joint
7

Cervical nerves to trapezius
8

Common carotid artery
9

Deep lingual artery
10

Deep part of submandibular gland
11

External carotid artery
12

External laryngeal nerve
13

Facial artery
14

Geniohyoid
15

Glossopharyngeal nerve
16

Great auricular nerve
17

Hyoglossus
18

Hyoid bone
19

Hypoglossal nerve
20

Inferior alveolar nerve
21

Inferior belly of omohyoid
22

Internal jugular vein
23

Internal laryngeal nerve
24

Lateral lobe of thyroid gland
25

Lesser occipital nerve
26

Levator scapulae
27

Lingual nerve
28

Linguofacial trunk
29

Lower root of ansa cervicalis
30

Middle thyroid vein
31

Molar salivary glands
32

Mylohyoid and nerve
33

Nerve to mylohyoid
34

Occipital artery
35

Parotid duct
36

Posterior auricular artery
37

Posterior belly of digastric
38

Ramus of mandible
39

Roots of phrenic nerve
40

Scalenus anterior
41

Scalenus medius
42

Splenius capitis
43

Sternocleidomastoid (cut)
44

Sternocleidomastoid branch of occipital artery
45

Sternohyoid
46

Sternothyroid
47

Styloglossus
48

Stylohyoid
49

Stylohyoid ligament
50

Sublingual gland
51

Submandibular duct
52

Superficial (transverse) cervical artery
53

Superficial temporal artery
54

Superior belly of omohyoid
55

Superior laryngeal artery
56

Superior thyroid artery
57

Superior thyroid vein
58

Temporalis
59

Thyrohyoid and nerve
60

Thyrohyoid membrane
61

Trapezius
62

Upper root of ansa cervicalis
63

Vagus nerve
64

Ventral ramus of fifth cervical nerve
65

Zygomatic arch

Front of the neck

deeper dissection

Axial CT neck

1

Accessory nerve
2

Brachial plexus (roots)
3

Cervical nerves to trapezius
4

Clavicle
5

Common carotid artery
6

Cricothyroid
7

Digastric, anterior belly
8

External carotid artery
9

Facial artery
10

Facial vein
11

Great auricular nerve
12

Hyoid bone, body
13

Inferior thyroid vein
14

Internal jugular vein
15

Laryngeal prominence
16

Mandible
17

Mylohyoid, anomalous fibres
18

Omohyoid, inferior belly (cut)
19

Omohyoid, superior belly (cut)
20

Parotid gland
21

Pectoralis major
22

Phrenic nerve
23

Platysma
24

Right brachiocephalic vein
25

Right subclavian vein
26

Scalenus anterior
27

Scalenus medius
28

Sternocleidomastoid, clavicular head
29

Sternocleidomastoid, sternal head
30

Sternohyoid (cut)
31

Subclavian artery
32

Subclavius
33

Submandibular gland
34

Superior laryngeal artery
35

Superior thyroid artery
36

Superior thyroid vein
37

Supraclavicular nerve
38

Suprascapular artery
39

Suprascapular vein
40

Tendon of scalenus anterior
41

Thyrohyoid
42

Thyroid gland, lateral lobe
43

Trapezius
44

Vagus nerve

On the right hand side, the clavicle (4) has been cut and reflected inferiorly to reveal the underlying subclavius (32). Dotted line is the level of axial CT (shown on the right).

Right side of the neck

1

Accessory nerve
2

Ansa cervicalis
3

Common carotid artery
4

Dorsal scapular nerve
5

External carotid artery
6

External laryngeal nerve
7

Facial artery
8

Facial vein
9

Fourth cervical nerve ventral rami
10

Great auricular nerve
11

Greater horn of hyoid bone
12

Hyoid bone
13

Hypoglossal nerve
14

Inferior belly of omohyoid
15

Inferior constrictor of pharynx
16

Inferior root of ansa cervicalis
17

Inferior thyroid artery
18

Internal carotid artery
19

Internal jugular vein (double at upper end)
20

Internal laryngeal nerve penetrating thyrohyoid membrane
21

Lesser occipital nerve
22

Levator scapulae
23

Lingual artery
24

Lingual vein
25

Marginal mandibular branch of facial nerve
26

Omohyoid tendon
27

Phrenic nerve
28

Posterior belly of digastric
29

Scalenus anterior
30

Scalenus medius
31

Second cervical nerve ventral rami
32

Sternocleidomastoid (cut)
33

Sternohyoid
34

Sternothyroid
35

Stylohyoid
36

Subclavian vein
37

Submental artery
38

Transverse cervical artery (superficial)
39

Superior belly of omohyoid
40

Superior laryngeal artery
41

Superior root of ansa cervicalis
42

Superior thyroid artery
43

Suprahyoid artery on hyoglossus
44

Suprascapular artery
45

Suprascapular nerve
46

Third cervical nerve ventral rami
47

The right lymphatic duct
48

Thyrocervical trunk
49

Thyrohyoid muscle and nerve to thyrohyoid
50

Upper trunk of brachial plexus
51

Vena comitans of hypoglossal nerve

Tags: Abrahams' and McMinn's Clinical Atlas of Human Anatomy

Nov 8, 2019 | Posted by drzezo in GENERAL & FAMILY MEDICINE | Comments Off

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Head, neck and brain

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Skull

A

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A

Skull

B

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Skull

Skull

A

Skull

B

Nasal cavity

C

Skull

D

Permanent teeth

Upper and lower jaws

G

Edentulous mandible

Skull of a full-term fetus

Fetal skull radiographs

G

Resin cast of head and neck arteries

Skull

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Mandible

Mandible

Frontal bone

Right maxilla

Right lacrimal bone

Right nasal bone

Right palatine bone

Right temporal bone

Right parietal bone

Right zygomatic bone

Sphenoid bone

Vomer

Ethmoid bone

Right inferior nasal concha

Maxilla

Occipital bone

Neck

Side of the neck

Front of the neck

Right side of the neck

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