Netters Anatomy Flash Cards, Fourth Edition - John T. homeranking.info Ayko Nyush. John F. Kennedy Blvd. Ste Philadelphia, PA NETTER'S. Netter Collection of Medical Illustrations. Search. Advanced Search. Browse Netter Images By Region. The spine · The series of vertebrae forming the axis of . 3D Human Anatomy Software for today's student - Based on the #1 Atlas of Human Anatomy by renowned artist Frank H. Netter.
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homeranking.info tranguergü M; larg-ral FaccI articular antaricr _ |:|ara c atlaS. FaciaI MWSnapgif Atlas of Human Anatomy by Netter. Atlas de Anatomia Humana - homeranking.info - Ebook download as PDF File .pdf) or read book online. 4A Calvaria: Superior View. 4B Calvaria: Inferior View. 5 Cranial Base: Inferior View. 6 Bones of Cranial Base: Superior View. 7 Foramina of Cranial Base.
The muscle fibers blend to attach to the medial surface of the ramus of the mandible, inferior to the mandibular foramen. Lacrimal bone Insertion superior attachment: The somatic component of the peripheral nerves contains both motor and sensory axons. Attaches to the lateral surface of the mastoid process of the temporal bone and the lateral half of the superior nuchal line.
Tenses the soft palate and, by contracting, opens the auditory tube during swallowing and yawning to equalize pressure in the middle ear. This muscle tenses the fibers of the soft palate so that the levator veli palatini muscle can act on them. The tensor not only tenses the soft palate during elevation by the levator veli palatini but also opens the auditory pharyngotympanic, eustachian tube during swallowing and yawning.
This helps equalize the pressure in the middle ear and explains why chewing gum, swallowing, or yawning can relieve the pressure and pain in the middle ear when landing in an airplane.
Uvular muscle 2. Palatopharyngeus muscle 3. Palatoglossus muscle 4. Superior pharyngeal constrictor muscle 5. Pterygomandibular raphe 6. Buccinator muscle Comment: Interdigitating fibers of the levator veli palatini muscle make up most of the soft palate, along with the little uvular muscle. The palatoglossal and palatopharyngeal arches contain small slips of muscle with the same names as the arches beneath their mucosal surfaces.
These thin muscle slips are innervated by the vagus nerve. The palatine tonsil is nestled in the palatine fossa, between these 2 folds. The buccinator muscle lies deep to the oral mucosa of the cheek and helps keep food between the molars. Numerous minor salivary glands populate the mucosa lining the hard palate. If the parasympathetic fibers of the facial nerve are damaged they travel in the lingual nerve of CN V3 , 2 of the 3 major salivary glands will be denervated the submandibular and sublingual glands , as will the numerous minor salivary glands, also supplied by facial parasympathetic nerves.
Consequently, the oral mucosa will appear drier than normal. Superior pharyngeal constrictor muscle Origin: This broad muscle arises from the pterygoid hamulus, pterygomandibular raphe, posterior portion of the mylohyoid line of the mandible, and side of the tongue. The muscles from each side meet and attach to the median raphe of the pharynx and pharyngeal tubercle of the occipital bone.
Constricts the wall of the upper pharynx during swallowing. Pharyngeal plexus of the vagus nerve CN X. The 3 pharyngeal constrictors help move food down the pharynx and into the esophagus. To accomplish this, these muscles contract serially from superior to inferior to move a bolus of food from the oropharynx and laryngopharynx into the proximal esophagus.
The superior constrictor lies largely behind the mandible. While the motor innervation of the pharyngeal constrictors is via the vagus nerve CN X , the sensory innervation of all but the most superior part of the pharynx the constrictor muscles and the mucosa lining the interior of the pharynx is via the glossopharyngeal nerve CN IX. Together, the fibers of CN IX and X form the pharyngeal plexus and function in concert with one another during swallowing. Middle pharyngeal constrictor muscle Origin: Arises from the stylohyoid ligament and the greater and lesser horns of the hyoid bone.
The muscles from both sides wrap around and meet to attach to the median raphe of the pharynx. Constricts the wall of the pharynx during swallowing. The middle pharyngeal constrictor lies largely behind the hyoid bone.
The fibers of the superior and middle pharyngeal constrictors often blend together, but the demarcation point can be seen where the stylopharyngeus muscle intervenes.
Inferior pharyngeal constrictor muscle Origin: Arises from the oblique line of the thyroid cartilage and side of the cricoid cartilage. The 2 inferior pharyngeal constrictor muscles wrap posteriorly to meet and attach to the median raphe of the pharynx. Constricts the wall of the lower pharynx during swallowing. The inferior pharyngeal constrictor lies largely behind the thyroid and cricoid cartilages.
Its lower end is referred to as the cricopharyngeal muscle, which is continuous with the esophageal muscle fibers. Where the inferior constrictor attaches to the cricoid cartilage represents the narrowest portion of the pharynx. Injury to the pharyngeal fibers from CN X can result in difficulty swallowing dysphagia. Stylopharyngeus muscle Origin: Arises from the styloid process of the temporal bone.
Attaches to the posterior and superior margins of the thyroid cartilage. Elevates the pharynx and larynx during swallowing and speaking. Glossopharyngeal nerve CN IX. This muscle passes between the superior and middle pharyngeal constrictors. The stylopharyngeus is 1 of 3 muscles arising from the styloid process of the temporal bone the others are the styloglossus and stylohyoid. Each muscle is innervated by a different cranial nerve and arises from a different embryonic branchial arch.
The stylopharyngeus arises embryologically from the 3rd pharyngeal branchial arch and is the only muscle innervated by the glossopharyngeal nerve. A lesion to the motor fibers of CN IX that innervate the stylopharyngeus muscle can cause pain when the patient initiates swallowing. Sternocleidomastoid muscle Origin inferior attachment: This muscle has 2 heads of origin. The sternal head arises from the anterior surface of the manubrium of the sternum.
The clavicular head arises from the superior surface of the medial third of the clavicle. Insertion superior attachment: Attaches to the lateral surface of the mastoid process of the temporal bone and the lateral half of the superior nuchal line.
Tilts the head to 1 side, flexes the neck, and rotates the neck so the face points superiorly to the opposite side. When the muscles of both sides act together, they flex the neck. When the head is fixed, the 2 muscles acting together can help elevate the thorax during forced inspiration.
The sternocleidomastoid SCM is 1 of 2 muscles innervated by the spinal accessory nerve. Although the accessory nerve is classified as a cranial nerve, it does not possess any fibers originating from the brainstem. The SCM is innervated by the accessory nerve CN XI , and this nerve is susceptible to injury where it crosses the posterior cervical triangle between the SCM muscle and the trapezius muscle. CN XI innervates both of these muscles. Torticollis is a contraction of the cervical muscles that presents as a twisting of the neck such that the head is tilted toward the lesioned side ipsilateral and the face away from the lesioned side contralateral.
Commonly, the SCM is affected unilaterally by this congenital fibrous tissue tumor. Sternohyoid muscle Origin: Manubrium of the sternum and medial portion of the clavicle. Body of the hyoid bone. Depresses the hyoid bone after swallowing. C1, C2, and C3 from the ansa cervicalis. The sternohyoid is part of the group of infrahyoid muscles. Swelling within this confined space can be painful and potentially damaging to adjacent structures.
Sternothyroid muscle Origin: Arises from the posterior surface of the manubrium of the sternum. Attaches to the oblique line of the thyroid cartilage. Depresses the larynx after the larynx has been elevated for swallowing. C2 and C3 from the ansa cervicalis. The sternothyroid is part of the group of infrahyoid muscles. Omohyoid muscle Origin: This muscle consists of an inferior and a superior belly.
The inferior belly arises from the superior border of the scapula, near the suprascapular notch. The muscle is attached by a fibrous expansion to the clavicle and forms the superior belly, which inserts into the inferior border of the hyoid bone. Depresses the hyoid bone after the bone has been elevated. Also retracts and steadies the hyoid bone. C1, C2, and C3 by a branch of the ansa cervicalis.
The omohyoid acts with the other infrahyoid muscles to depress the larynx and hyoid bone after these structures have been elevated during swallowing. Thyrohyoid muscle Origin: Arises from the oblique line of the lamina of the thyroid cartilage. Attaches to the inferior border of the body and the greater horn of the hyoid bone. Depresses the hyoid bone and, if the hyoid bone is fixed, draws the thyroid cartilage superiorly.
The thyrohyoid muscle is supplied by fibers of the 1st cervical nerve that happen to travel with the last cranial, or hypoglossal, nerve CN XII. Trauma to the neck may damage the ansa cervicalis C and its branches, leading to paralysis of the infrahyoid and suprahyoid muscles. Because these muscles are critical in the process of swallowing, dysphagia difficulty in swallowing may ensue. Cricothyroid muscle Origin: Arises from the anterolateral part of the cricoid cartilage.
Inserts into the inferior aspect and inferior horn of the thyroid cartilage. Stretches and tenses the vocal folds. External branch of the superior laryngeal nerve of the vagus. This muscle is innervated by the small, external branch of the superior laryngeal nerve of the vagus. Most of the superior laryngeal nerve continues as an internal branch that pierces the thyrohyoid membrane to provide sensory innervation above the vocal folds. This muscle, similar to the other muscles of the larynx, is derived embryologically from the 4th through 6th pharyngeal branchial arches.
All of these laryngeal muscles are innervated by the vagus nerve. Damage on 1 side to the superior laryngeal nerve, a branch of the vagus nerve CN X , will paralyze the ipsilateral cricothyroid muscle.
Consequently, the voice will be affected because the ipsilateral vocal fold cannot be fully stretched and tensed. Additionally, the ipsilateral laryngeal mucosa above the level of the vocal folds will be anesthetized the superior laryngeal nerve is sensory to the laryngeal mucosa above the vocal folds , somewhat compromising the protective gag reflex that would normally keep foreign objects from being aspirated into the larynx.
Stylohyoid muscle Origin: Elevates and retracts the hyoid bone in an action that elongates the floor of the mouth. Facial nerve. The stylohyoid muscle is perforated near its insertion by the tendon of the 2 bellies of the digastric muscle.
The stylohyoid is 1 of the 3 muscles arising from the styloid process, each innervated by a different cranial nerve. The stylohyoid is one of several muscles that help stabilize the hyoid bone, which is important in movements of the tongue and in swallowing.
Digastric muscle Origin: The digastric muscle consists of 2 bellies. The posterior belly is the longest, and it arises from the mastoid notch of the temporal bone. The anterior belly arises from the digastric fossa of the mandible. The 2 bellies end in an intermediate tendon that perforates the stylohyoid muscle and is connected to the body and greater horn of the hyoid bone.
Elevates the hyoid bone and, when both muscles act together, helps the lateral pterygoid muscles open the mouth by depressing the mandible. The anterior belly is innervated by the mylohyoid nerve, a branch of the mandibular division of the trigeminal nerve. The posterior belly is innervated by the facial nerve. The 2 bellies of the digastric muscle are unique because they are innervated by different cranial nerves. The digastric muscles are important for opening the mouth symmetrically and are assisted by the lateral pterygoid muscles.
Oblique arytenoid muscles 2. Transverse arytenoid muscles Origin: Arise from the arytenoid cartilages. Attach to the opposite arytenoid cartilage. Close the inlet of the larynx by adducting the arytenoid cartilages. This narrows the rima glottidis, the space between the vocal folds. Recurrent laryngeal nerve of the vagus. Some muscle fibers of the oblique arytenoid continue superiorly as the ary-epiglottic muscle. The vocal folds are controlled by the laryngeal muscles, all of which are innervated by the vagus nerve CN X.
During quiet respiration, the vocal folds are gently abducted to open the rima glottidis space between the folds. In forced inspiration taking a rapid, deep breath , the folds are maximally abducted by the posterior crico-arytenoid muscles, further enlarging the rima glottidis. During phonation, the folds are adducted and tensed to create a reed-like effect similar to a reed instrument , causing vocal fold mucosal vibrations that produce sound that is then modified by the upper airway pharynx, oral cavity, tongue, lips, nose, and paranasal sinuses.
Closure of the rima glottidis occurs when holding your breath or when lifting something heavy the Valsalva maneuver , and the folds are completely adducted. Posterior crico-arytenoid muscle Origin: Arises from the posterior surface of the laminae of the cricoid cartilage. Attaches to the muscular process of the arytenoid cartilage. Abducts the vocal folds and widens the rima glottidis, the space between the vocal folds. Recurrent inferior laryngeal nerve of the vagus. The posterior crico-arytenoid muscles are extremely important because they are the only muscles that abduct the vocal folds.
Damage to the recurrent laryngeal nerve during neck surgery e. This occurs because the posterior crico- arytenoid muscles are the only laryngeal muscles that abduct the vocal folds and keep the rima glottidis open.
Ary-epiglottic part of oblique 4. Thyro-arytenoid muscle arytenoid muscle 5. Lateral crico-arytenoid 2. Posterior crico-arytenoid muscle muscle 6. Vocalis muscle 3. Thyro-epiglottic part of 7.
Vocal ligament thyro-arytenoid muscle 8. Conus elasticus Comment: The muscles of the larynx are small. They act on the laryngeal cartilages. The most superior portion of the conus elasticus is thickened and forms the vocal ligament. The vocal folds themselves contain a small amount of muscle called the vocalis muscle, which is derived from some of the fibers of the thyro-arytenoid muscle. With the exception of the cricothyroid, all the intrinsic muscles of the larynx are innervated by the recurrent laryngeal nerve of the vagus.
All of these muscles are derived embryologically from the 4th through 6th pharyngeal branchial arches. During quiet respiration, the vocal folds are gently abducted to open the rima glottidis. In forced inspiration, the folds are maximally abducted by the posterior crico-arytenoid muscles, further enlarging the rima glottidis.
During phonation, the folds are adducted and tensed to create a reed-like effect, causing vocal fold mucosal vibrations that produce sound that is then modified by the upper airway pharynx, oral cavity, tongue, lips, nose, paranasal sinuses. Closure of the rima glottidis occurs when holding your breath or when lifting something heavy, and the folds are completely adducted. Scalene muscles Origin superior attachment: The anterior scalene arises from the anterior tubercles of the transverse processes of C vertebrae.
The middle and posterior scalenes arise from the posterior tubercles of the transverse processes of C middle and C posterior vertebrae. Insertion inferior attachment: The anterior scalene attaches to the scalene tubercle of the 1st rib. The middle scalene attaches to the superior surface of the 1st rib. The posterior scalene attaches to the external border of the 2nd rib. The anterior and middle scalenes elevate the 1st rib. When that rib is fixed, they also flex the neck forward and laterally and rotate it to the opposite side.
The posterior scalene raises the 2nd rib and flexes and slightly rotates the neck. The anterior scalene is innervated by C ventral rami; the middle scalene, by C ventral rami; and the posterior scalene, by ventral rami of C The scalene muscles are often called lateral vertebral muscles. They form a large portion of the floor of the posterior cervical triangle.
Components of the brachial plexus can be seen emerging between the anterior and middle scalene muscles. The scalene muscles are accessory muscles of respiration and help elevate the first 2 ribs during deep or labored breathing. They are crossed by the accessory nerve CN XI as it passes between the sternocleidomastoid and trapezius muscles. The phrenic nerve C is observed on the anterior surface of the anterior scalene muscle; it courses inferiorly toward the diaphragm, which it innervates.
Trauma to the neck can damage these nerves. Longus capitis muscle 2. Longus colli muscle Origin: The longus capitis arises from the anterior tubercles of the C vertebral transverse processes.
The longus colli arises from the bodies of the T vertebrae, the bodies of the C vertebrae, and transverse processes of the C vertebrae. The longus capitis attaches to the basilar portion of the occipital bone. The colli portion attaches to the anterior tubercle of the atlas C1 , the bodies of the C vertebrae, and transverse processes of the C vertebrae. Both muscles flex the neck, although the longus colli is weak. The longus colli also slightly rotates and laterally bends the neck.
The longus capitis is supplied by the C ventral rami. The longus colli is supplied by the C ventral rami. The longus capitis and longus colli lie in front of the cervical vertebrae and are often called prevertebral muscles. They help other muscles flex the cervical spine. They are encased in a strong fascial sleeve called the prevertebral fascia and do not tolerate swelling well because of this tight enclosure.
Just anterior to the prevertebral fascia, where it covers the bodies of the cervical vertebrae, lies the retropharyngeal space this space is posterior to the buccopharyngeal fascia [the posterior portion of the pretracheal fascia] covering the posterior pharynx and esophagus.
Infections in this vertical space may pass superiorly to the base of the skull or inferiorly into the posterior mediastinum of the thorax. Supra-orbital nerve 2. Infra-orbital nerve 3. Mental nerve 4. Buccal nerve 5. Auriculotemporal nerve 6. Supraclavicular nerves C3, C4 7. Great auricular nerve C2, C3 8. Greater occipital nerve C2 Comment: Cutaneous innervation of the face is by the 3 divisions of the trigeminal nerve CN V.
The ophthalmic division is represented largely by the supra-orbital and supratrochlear nerves. The maxillary division is represented by the infra-orbital and zygomaticotemporal nerves. The mandibular division is represented largely by the mental, buccal, and auriculotemporal nerves.
The skin on the back of the scalp receives cutaneous innervation from the greater occipital nerve dorsal ramus of C2 ; the skin on the back of the neck receives innervation from dorsal rami of cervical nerves.
The 1st cervical nerve C1 has few if any sensory nerve fibers from the skin, so it is usually not shown on dermatome charts. The sensory innervation of the face is via the 3 divisions of CN V. Trauma anywhere along the pathway of the nerve, including that on the face itself e. The innervation of the muscles of facial expression will not be affected unless a laceration also damages the terminal branches of the facial nerve. Main trunk of facial nerve emerging from stylomastoid foramen 2.
Cervical branch 3. Marginal mandibular branch 4. Buccal branches 5. Zygomatic branches 6. Temporal branches Comment: The main trunk of the facial nerve exits through the stylomastoid foramen and, after giving off several small branches, courses through the substance of the parotid gland.
It ends as a plexus of 5 major terminal branches that innervate the muscles of facial expression. The 5 groups of terminal branches are the temporal, zygomatic, buccal, marginal mandibular, and cervical branches. A mnemonic— To Zanzibar By Motor Car named from superior to inferior —might help in remembering the names of these 5 terminal branches.
Facial expression on the affected side is minimal. Often, over time, the symptoms will disappear, but this may take weeks or months to occur. Schema 1. Ciliary ganglion 2. Short ciliary nerves 3. Inferior division of oculomotor nerve 4. Pterygopalatine ganglion 5. Abducent nerve CN VI 6. Ophthalmic nerve CN V1 7. Parasympathetic fibers arise in the brainstem and course with the oculomotor nerve to the ciliary ganglion.
Postganglionic parasympathetics innervate the ciliary muscle which accommodates the lens and the sphincter muscle of the pupil.
Sympathetic fibers that synapse in the superior cervical ganglion send postganglionic fibers to the dilator muscle of the pupil. Sensory innervation to the orbit arises from the ophthalmic division of the trigeminal nerve. Unilateral damage to the oculomotor nerve CN III can paralyze the 4 extra-ocular muscles innervated by this nerve superior, medial, and inferior rectus muscles and inferior oblique muscle and the levator palpebrae superioris muscle of the upper eyelid, causing ophthalmoplegia and ptosis drooping of the eyelid.
Additionally, parasympathetic fibers in CN III will be affected, causing pupillary dilation unopposed sympathetic innervation of the dilator of the pupil and an inability to accommodate the lens for close-up vision on the affected ipsilateral side.
Trochlear nerve IV 2. Ophthalmic nerve V1 3. Optic nerve II 4. Oculomotor nerve III 5. Abducent nerve VI 6. Trigeminal semilunar ganglion 7. Frontal nerve 8. Lacrimal nerve 9. Supra-orbital nerve Comment: The sensory innervation to the orbit arises from the ophthalmic division of the trigeminal nerve.
The major nerves of this division include the nasociliary, frontal, and lacrimal nerves. The sensory nerve cell bodies reside in the trigeminal semilunar ganglion. The motor innervation of the extra-ocular muscles comes from the oculomotor, trochlear, and abducent nerves.
The optic nerve leaves the orbit via the optic canal. In addition to its sensory role and, similar to the other 2 divisions of the trigeminal nerve, this division carries autonomic fibers to the eyeball via its nasociliary nerve and connections to the ciliary ganglion long and short ciliary nerves. Additionally, it carries parasympathetics from the facial nerve CN VII that join the lacrimal branch and innervate the lacrimal glands, which produce tears that moisten the cornea of the eyeball.
Orbital trauma or infections in this confined compartment may affect these important autonomic pathways. Auriculotemporal nerve 2. Chorda tympani nerve 3. Lingual nerve 4. Inferior alveolar nerve cut 5. Nerve to mylohyoid 6. Mental nerve 7. Submandibular ganglion 8. Buccal nerve and buccinator muscle cut 9. Mandibular nerve V3 anterior division and posterior division Comment: The mandibular division of the trigeminal nerve exits the skull through the foramen ovale and divides into sensory and motor components.
This nerve provides motor control to many of the muscles derived from the 1st branchial arch, most notably the muscles of mastication.
The sensory components are represented largely by the auriculotemporal, buccal, lingual, and inferior alveolar nerves. Preganglionic parasympathetic fibers arising from the facial nerve join the lingual nerve via the chorda tympani nerve to synapse in the submandibular ganglion. These postganglionic parasympathetics innervate the sublingual and submandibular salivary glands and the minor salivary glands of the mandibular submucosa.
Trigeminal neuralgia tic douloureux is a neurologic condition characterized by episodes of brief, intense facial pain over 1 of the 3 regions of distribution of CN V.
The etiology is uncertain but could be from vascular compression of the CN V sensory ganglion and usually is triggered by touch and drafts of cool air on the face. Olfactory bulb 2. Lateral internal nasal branch of anterior ethmoidal nerve CN V1 3. Nasopalatine nerve CN V2 5. Nerve vidian of pterygoid canal 6. Deep petrosal nerve 7. Greater petrosal nerve 8. Pterygopalatine ganglion Comment: Vessels of the nasal cavity receive innervation from sympathetic and, to a lesser extent, parasympathetic divisions of the autonomic nervous system.
Sympathetic contributions arise in the deep petrosal nerve as postganglionic fibers that are largely vasomotor in function. Parasympathetic fibers arise in the facial nerve as preganglionics, course to the pterygopalatine ganglion in the greater petrosal and vidian nerves, and synapse in the pterygopalatine ganglion.
Postganglionic fibers pass to the nasal mucosa, the hard and soft palates, and the mucosa of the paranasal sinuses. Facial fractures may involve a fracture of the cribriform plate, which transmits the axons of the olfactory bipolar neurons. As a brain tract, CN I is covered by the 3 meningeal layers and contains cerebrospinal fluid CSF in its subarachnoid space around the olfactory bulb.
A tear of the meninges can cause a leakage of CSF into the nasal cavity and provide a route of infection from the nose to the brain. Nasopalatine nerve septal branch 2. Pterygoid canal behind ganglionic branches connecting maxillary nerve [CN V2] and pterygopalatine ganglion 3.
Maxillary nerve CN V2 4. Infra-orbital nerve 6. Posterior superior alveolar nerve 7. Greater and lesser palatine nerves 8. Lesser and greater palatine arteries 9. Anterior and middle superior alveolar arteries Superficial temporal artery Maxillary artery Descending palatine artery Infra-orbital artery Sphenopalatine artery Comment: Nerves are shown on 1 side and arteries on the other. This region is largely supplied by branches of the maxillary nerve V2 and by arterial branches of the maxillary artery from the external carotid.
The maxillary teeth and gums are supplied by the posterior, middle, and anterior superior alveolar neurovascular bundles. Nerve vidian of pterygoid 6. Superior cervical canal sympathetic ganglion 2. Submandibular ganglion 3. Pterygopalatine ganglion 4.
Otic ganglion 9. Ciliary ganglion 5. Chorda tympani nerve Comment: This schematic shows the 4 parasympathetic ganglia in the head. The ciliary ganglion receives preganglionic parasympathetic fibers from the oculomotor nerve. The otic ganglion receives preganglionic parasympathetic fibers that arise in the glossopharyn- geal nerve.
The pterygopalatine and submandibular ganglia receive preganglionic parasympathetics that originate in the facial nerve. Preganglionic sympathetic fibers arise from the upper thoracic spinal cord levels. They ascend the sympathetic trunk to synapse on postganglionic neurons in the superior cervical ganglion. Postganglionic sympathetic fibers travel on blood vessels or adjacent nerves to reach their targets. These sympathetic postganglionic fibers are largely vasomotor in function.
Its cardinal ipsilateral features are miosis constricted pupil , slight ptosis drooping of the eyelid due to loss of the superior tarsal muscle , anhidrosis loss of sweat gland function , and flushing of the face unopposed vasodilation. Optic nerve CN II 7. Ciliary ganglion 8. Internal carotid nerve and 3. Maxillary nerve CN V2 nerve plexus 4.
Artery and nerve of 9. Accessory nerve CN XI pterygoid canal Internal jugular vein 5. Greater petrosal nerve Internal carotid artery 6. Internal carotid artery Superior cervical ganglion Petrosal part and venous Descending palatine artery plexus Comment: The pathway of the internal carotid artery ICA is tortuous. It enters the skull via the carotid canal in the petrous portion of the temporal bone and then is directed anteromedially and superiorly across the foramen lacerum closed by cartilage.
The ICA then ascends into the cavernous sinus and, just inferior to the anterior clinoid process, makes a degree turn to pass posteriorly to join in the cerebral arterial circle of Willis.
A venous plexus accompanies the ICA from the carotid canal to the cavernous sinus, as does a plexus of postganglionic sympathetic nerve fibers called the deep petrosal nerve from the superior cervical ganglion.
The deep petrosal nerve joins the greater petrosal nerve preganglionic parasympathetic fibers from CN VII to form the nerve of the pterygoid canal vidian nerve. Geniculum of facial nerve site of geniculate ganglion 2. Greater petrosal nerve 3. Cochlear spiral ganglion 4. Chorda tympani nerve 6. Facial canal and nerve 7. Vestibular ganglion Comment: The facial and vestibulocochlear nerves traverse the internal acoustic meatus together.
The facial nerve makes a sharp bend at the level of the geniculate sensory ganglion of the facial nerve before descending and exiting the skull through the stylomastoid foramen. It sends preganglionic parasympathetic fibers to the pterygopalatine ganglion via the greater petrosal nerve and to the submandibular ganglion via the chorda tympani nerve.
The vestibulocochlear nerve carries special sensory fibers from the cochlea via the cochlear nerve auditory and from the vestibular apparatus via the vestibular nerve balance. These 2 branches join and leave the inner ear via the internal acoustic meatus to pass to the brain. Vertigo is a symptom involving the peripheral vestibular system or its central nervous system connections and is characterized by the illusion or perception of motion. Geniculate ganglion of 9.
Pharyngeal plexus facial nerve Carotid branch of CN IX 2. Superior cervical ganglion 3. Deep petrosal nerve Vagus nerve 4. Lesser petrosal nerve Jugular foramen 5.
Otic ganglion Glossopharyngeal nerve 6. Auriculotemporal nerve Inferior salivatory nucleus CN V3 7. Parotid gland 8. The glossopharyngeal nerve innervates only 1 muscle stylopharyngeus but receives significant general sensory distribution from the pharynx, posterior third of the tongue, middle ear, and auditory tube. CN IX is the nerve of the 3rd pharyngeal branchial embryonic arch.
The special sense of taste posterior third of the tongue also is conveyed by this nerve. Cardiovascular sensory fibers include those associated with the carotid body chemoreceptor and carotid sinus baroreceptor region adjacent to the common carotid artery bifurcation. Placing a tongue depressor on the posterior third of the tongue elicits a gag reflex, mediated by the sensory fibers of CN IX on the posterior third of the tongue, which then triggers a gag and elevation of the soft palate, mediated largely by the vagus nerve CN X.
Ansa cervicalis Superior root; Inferior root 3. Vagus nerve CN X 4. Phrenic nerve 5. Accessory nerve CN XI 6. Lesser occipital nerve 7. Great auricular nerve Comment: The cervical plexus arises from ventral rami of C It provides motor innervation for many of the muscles of the anterior and lateral compartments of the neck.
This plexus also provides cutaneous innervation to the skin of the neck. Most of the motor contributions to the infrahyoid muscles arise from a nerve loop called the ansa cervicalis C The cervical plexus also gives rise to the first 2 of 3 roots contributing to the phrenic nerve C3, C4, and C5.
The phrenic nerve innervates the abdominal diaphragm. Unilateral trauma to the posterior cervical triangle of the neck may injure the accessory nerve CN XI ipsilateral innervation of the sternocleidomastoid and trapezius muscles , the phrenic nerve C innervates the ipsilateral hemi- diaphragm , or the trunks or cords of the brachial plexus.
The integrity of each of these nerves should be assessed when trauma is evident. Facial artery and vein 2. Retromandibular vein 3. External jugular vein 4. Anterior jugular vein 5. Common carotid artery 6.
Internal jugular vein 7. Superior thyroid artery and vein 8. External carotid artery Comment: Superficial veins of the neck include the external jugular vein and its principal tributaries. The external jugular vein often communicates with the internal jugular vein, which lies deep within the carotid sheath.
The principal arteries of the neck include major branches arising from the subclavian artery thyrocervical and costocervical trunks and several branches arising from the external carotid artery.
Physicians use the internal jugular vein or external jugular on the right side to assess the jugular venous pulse, which provides an indication of the venous pressure in the right atrium of the heart. If the waveform pattern of the pulse is abnormal, it may indicate some pathology associated with right-sided congestive heart failure, a tricuspid valve problem, or some other abnormality. Vertebral artery 6.
Thyrocervical trunk 2. Costocervical trunk 7. Common carotid artery 3. Supreme intercostal artery 8. Transverse cervical artery 4. Internal thoracic artery 9. Inferior thyroid artery 5. Suprascapular artery Comment: The subclavian artery is divided into 3 parts relative to the anterior scalene muscle. The 1st part is medial to the muscle, the 2nd is posterior, and the 3rd is lateral.
Branches of the subclavian include the vertebral and internal thoracic mammary arteries, thyrocervical and costocervical trunks, and dorsal scapular artery. The vertebral artery ascends through the C transverse foramina and enters the foramen magnum. The internal thoracic descends parasternally. The thyrocervical trunk supplies the thyroid gland inferior thyroid , the lower region of the neck transverse cervical , and the dorsal scapular region suprascapular. The costocervical trunk supplies the deep neck deep cervical and several intercostal spaces supreme intercostal.
The dorsal scapular branch is inconstant; it may arise from the transverse cervical artery. The branches of the subclavian artery anastomose with branches of the axillary artery around the shoulder joint, with branches of the thoracic aorta intercostal branches along the rib cage, across the midline of the neck and face via branches from both external carotid arteries, and with the internal carotid arteries and the vertebral branches circle of Willis on the brainstem.
These interconnections are important if the vasculature in 1 region is compromised. Superficial temporal artery 7. Ascending pharyngeal 2. Occipital artery artery 3. Internal carotid artery 8. Lingual artery 4. External carotid artery 9. Facial artery 5. Common carotid artery Posterior auricular artery 6. Superior thyroid artery and Maxillary artery Superior laryngeal branch Comment: The common carotid artery ascends in the neck in the carotid sheath.
At about the level of the superior border of the thyroid cartilage it divides into the internal carotid artery, which passes into the cranium, and the external carotid artery, which supplies more superficial structures lying outside the skull. The external carotid artery gives rise to 8 branches. These 8 branches supply much of the blood to the head outside of the cranium, although several branches also ultimately enter the cranial regions meningeal and auricular branches of the maxillary artery, 1 of the terminal branches of the external carotid.
The branches of the external carotid arteries anastomose across the midline neck superior thyroid arteries and the face to provide collateral circulation should an artery be compromised by occlusion or lacerated in trauma. The small branches of the superficial temporal artery supply the scalp, which bleeds profusely when cut because the small arteries are held open rather than retracted into the subcutaneous tissue by the tough connective tissue lying just beneath the skin epidermis and dermis.
Sphenopalatine artery 2. Posterior superior alveolar artery 3. Descending palatine artery in pterygopalatine fossa 4. Inferior alveolar artery 5. Middle meningeal artery 6.
Deep temporal arteries and nerves Comment: The maxillary artery is 1 of the 2 terminal branches of the external carotid artery. It passes superficially or deeply to the lateral pterygoid muscle and courses medially in the infratemporal fossa.
Descriptively, it is divided into 3 parts. The 1st retromandibular portion of this artery gives rise to branches supplying the tympanic cavity and membrane, dura, mandibular teeth and gums, ear, and chin. The 2nd pterygoid portion supplies the muscles of mastication and the buccinator. The 3rd pterygopalatine part supplies the maxillary teeth and gums, portions of the face, orbit, palate, auditory tube, superior pharynx, paranasal sinuses, and nasal cavity.
Many of these small nasal arteries and arterioles are branches of the maxillary artery and facial artery lateral nasal and septal branches. Internal carotid artery 2. Buccal artery 7. Facial artery 3.
External carotid artery 8. Maxillary artery 4. Superior thyroid artery 9. Superficial temporal artery 5. Common carotid artery Comment: Arteries of the oral and pharyngeal regions arise princi- pally from branches of the external carotid artery. The external carotid gives rise to 8 branches: The maxillary artery contributes many branches to the infratemporal region, nasal cavities, and muscles of mastication.
Descriptively, the maxillary artery is divided into 3 parts some of its branches are shown in this figure. Anastomoses among the branches of the facial and maxillary arteries are common and provide some collateral circulation to the face if 1 artery is compromised.
Pterygoid plexus 2. Superior laryngeal vein 3. Middle thyroid vein 4. Inferior thyroid veins 5. Subclavian vein 6. Common trunk for facial, retromandibular, and lingual veins 8. External jugular vein cut 9.
Retromandibular vein Superficial temporal vein and artery Comment: Veins of the facial, oral, and pharyngeal regions are largely tributaries that ultimately collect in the internal jugular vein. In the infratemporal region, a pterygoid plexus of veins communicates with the cavernous sinus and veins of the orbit and oral cavity. Many of the veins of this region have the same names as their corresponding arteries. Key veins are as follows: The retromandibular vein receives tributaries from the temporal and infratemporal regions pterygoid plexus , nasal cavity, pharynx, and oral cavity.
The internal jugular vein drains the brain, face, thyroid gland, and neck. The external jugular vein drains the superficial neck, lower neck and shoulder, and upper back often communicates with the retromandibular vein. These veins generally do not possess valves and therefore provide avenues for the spread of infection throughout the head and neck region. The pterygoid plexus of veins has connections with the ophthalmic veins and to the cavernous sinus via these veins , facial veins, and superficial temporal veins and their small tributaries, which also pass through the skull as emissary veins to drain into the dural venous sinuses.
Anterior communicating artery 2. Anterior cerebral artery 3. Internal carotid artery 4. Middle cerebral artery 5. Posterior communicating artery 6. Posterior cerebral artery 7. Superior cerebellar artery 8. Basilar artery 9. Anterior inferior cerebellar artery Vertebral artery cut Posterior inferior cerebellar artery Comment: Branches of the internal carotid and vertebral arteries supply the brain.
After entering the foramen magnum, the 2 vertebral arteries join to form the basilar artery. The latter continues forward on the anterior aspect of the brainstem, and its branches anastomose with the branches of the internal carotid artery to form the cerebral arterial circle of Willis dashed line.
The anterior circulation to the brain encompasses the anterior and middle cerebral arteries. The posterior circulation encompasses the vertebrobasilar system and the posterior cerebral artery. Generally, the arteries supplying the brain are end arteries, with insufficient anastomotic connections to compensate for occlusion of an artery. The most common cause of subarachnoid hemorrhage bleeding into the subarachnoid space is the rupture of a saccular, or berry, aneurysm of one of the arteries of the cerebral and brainstem circulation.
Inferior sagittal sinus 2. Anterior and Posterior intercavernous sinuses 3. Sigmoid sinus 4. Transverse sinus 5. Occipital sinus 6. Confluence of sinuses 7. Superior sagittal sinus 8. Straight sinus 9. The dural venous sinuses form between the periosteal endosteal and meningeal layers of the dura mater. The superficial and deep regions of the brain are drained by the superior sagittal and inferior sagittal venous sinuses. Most of the venous blood from the brain collects in these dural venous sinuses and ultimately drains into the internal jugular veins.
Infections can gain access to these dural venous sinuses and spread to other regions of the head. Embeds 0 No embeds.
No notes for slide. Netter atlas de neuroanatomia 1. Netter, MD John A. Hansen, PhD Bruce M. Koeppen, MD, PhD 2.
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Printed in U. Foreword Frank Netter: Frank H. Viewing these pictures again prompts reflection on Dr. Netter was born in in New York City.
During his student years, Dr. He continued illustrating as a sideline after establishing a surgical practice in , but ultimately opted to give up his practice in favor of a full-time commitment to art. This year partnership resulted in the production of the extraordinary collection of medical art so familiar to physicians and other medical professionals worldwide.
When Dr. As a student of Dr. In that respect each plate is more of an intellectual than an artistic or aesthetic exercise. It is easy to appreciate the aesthetic qualities of Dr.
This intellectual process requires thorough under- standing of the topic, as Dr. Netter wrote: It is the planning, the conception, the determination of point of view and the approach which will best clarify the subject which takes the most effort.
In pursuit of this principle Dr. Netter often integrates pertinent basic and clinical science ele- ments in his anatomic interpretations. Although he was chided for this heresy by a prominent European anatomy professor, many generations of students training to be physicians rather than anatomists have appreciated Dr.
The integration of physiology and clinical medicine with anatomy has led Dr. Netter to another, more subtle, choice in his art. Many texts and atlases published during the period of Dr. The value of Dr. John A. Craig, MD Austin, Texas 4. This volume brings together two distinct but related aspects of the work of Frank H. Netter, MD, and associated artists. Netter is best known as the creator of the Atlas of Human Anatomy, a comprehensive textbook of gross anatomy that has become the standard atlas for students of the subject.
In the pages ofClinical Symposia, a series of mono- graphs published over a period of more than 50 years, and inThe Netter Collection of Medical Illustrations, this premier medical artist created superb illustrations of biological and physiological processes, disease pathology, clinical presentations, and medical procedures.
We hope that readers will find Dr. Part 1 Neuroanatomy Cerebrum—Medial Views. Inferior Views. Frontal View and Section. Lateral and Medial Views. General Topography. Cross Sections. Verification of this finding awaits further investigation. Anterior parietal postcentral sulcal artery also occurs as separate anterior parietal and postcentral sulcal arteries Lateral protrusion at disc level L4—5 affects L5 spinal nerve, not L4 spinal nerve.
Schema Olfactory bulb cells: Schema Overlapping visual fields Projection on left retina Choroid Choroid Periphery Macula Projection on right retina Central darker circle represents macular zone Lighter shades represent monocular fields Each quadrant a different color Projection on right dorsal lateral geniculate nucleus Optic nerves II Optic chiasm Optic tracts Projection on left dorsal lateral geniculate nucleus Lateral geniculate bodies Optic radiation Optic radiation Calcarine sulcus Calcarine sulcus Projection on left occipital lobe Projection on right occipital lobe Structure of retina: Schema Afferent fibers Geniculum of facial nerve site of geniculate ganglion Facial canal Greater petrosal nerve Cochlear spiral ganglion Vestibular nerve Cochlear nerve Tympanic cavity Chorda tympani nerve Motor root of facial nerve and intermediate nerve Vestibulocochlear nerve VIII Medulla oblongata cross section Internal acoustic meatus Medial Superior Inferior Lateral Vestibular nuclei diagrammatic Anterior Posterior Cochlear nuclei Inferior cerebellar peduncle to cerebellum Vestibular ganglion Inferior division Superior division Saccule Ampulla of posterior semicircular duct Utricle Ampulla of superior semicircular duct Ampulla of lateral semicircular duct of vestibular nerve Head of malleus Incus Schema Intrinsic muscles of tongue Superior longitudinal Transverse and vertical Inferior longitudinal Styloglossus muscle Meningeal branch Hypoglossal nucleus Occipital condyle Inferior ganglion of vagus nerve Hypoglossal nerve XII in hypoglossal canal Ventral rami of C1, 2, 3 form ansa cervicalis of cervical plexus Superior cervical sympathetic ganglion Superior root of ansa cervicalis Internal carotid artery Inferior root of ansa cervicalis Ansa cervicalis Internal jugular vein Common carotid artery Sternothyroid muscle Sternohyoid muscle Omohyoid muscle superior belly Genioglossus muscle Geniohyoid muscle Hyoglossus muscle Thyrohyoid muscle Omohyoid muscle inferior belly Efferent fibers Afferent fibers Only muscles innervated by ulnar nerve shown Articular branches not shown Articular branch Part 2 Neurophysiology Organization of the Brain: Cell Types.
Morphology of Synapses. Neuromuscular Junction. Visceral Efferent Endings.
Inhibitory Mechanisms. Chemical Synaptic Transmission. Temporal and Spatial Summation. Circulation of CSF. Ventral Rami. Membranes and Nerve Roots. Cholinergic and Adrenergic Synapses.
Afferent Pathways. Efferent Pathways. Pacinian Corpuscle. Visual Pathway. Vestibulospinal Tracts. In general, the frontal lobe processes motor, visual, speech, and personality modalities. The parietal lobe processes sensory information; the temporal lobe, auditory and memory modalities; and the occipital lobe, vision. The cerebellum coordinates smooth motor activities and processes muscle position.
The brainstem medulla, pons, midbrain conveys motor and sensory information and mediates important autonomic functions. The spinal cord receives sensory input from the body and conveys somatic and autonomic motor information to peripheral targets muscles, viscera.
Cell Types Red: Motor neuron Sensory neuron Interneuron Glial and neurilemmal cells and myelin Multipolar pyramidal cell of cerebral motor cortex Astrocyte Multipolar somatic motor cell of nuclei of cranial nn. Multipolar cell of lower brain motor centers Oligodendrocyte Corticospinal pyramidal fiber Axodendritic ending Axosomatic ending Axoaxonic ending Multipolar somatic motor cell of anterior horn of spinal cord Collateral Renshaw interneuron feedback Myelinated somatic motor fiber of spinal nerve Myelin sheath Motor endplate with Schwann cell cap Striated voluntary muscle Striated somatic muscle Motor endplate Interneurons Interneuron Astrocyte Bipolar cell of cranial n.
Unipolar cell of sensory ganglia of cranial nn.