DOCSLIB.ORG

Surgical Anatomy and Histology of the Levator Palpebrae Superioris Muscle

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Surgical Anatomy and Histology of the Levator Palpebrae Superioris Muscle View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Directory of Open Access Journals Strana 1124 VOJNOSANITETSKI PREGLED Vojnosanit Pregl 2013; 70(12): 1124–1131. UDC: 611.847::617.77-089 ORIGINAL ARTICLE DOI: 10.2298/VSP1312124D Surgical anatomy and histology of the levator palpebrae superioris muscle for blepharoptosis correction Hirurška anatomija i histologija mišiüa podizaþa gornjeg kapka u korekciji blefaroptoze Boban Djordjeviü*, Marijan Novakoviü†‡, Milan Milisavljeviü§, Saša Miliüeviü*, Aleksandar Malikoviü§ *Clinic for Plastic Surgery and Burns, ‡Head Office, Military Medical Academy, Belgrade, Serbia; †Faculty of Medicine of the Military Medical Academy, University of Defense, Belgrade, Serbia; §Institute of Anatomy, Faculty of Medicine, University of Belgrade, Belgrade, Serbia Abstract 1.41 mm on the right, and 40.3 ± 1.63 mm on the left side. In all the cases, the LPS had blood supply from 4 different Background/Aim. The detailed knowledge of the archi- arterial systems: the lacrimal, supratrochlear, and supraorbital tecture of the upper eyelid is very important in numerous artery and muscle branches of the ophthalmic artery. The upper eyelid corrective surgeries. The article deals with the LPS muscle in all the specimens was supplied by the superior detailed anatomy of the major components of the upper lid, medial branch of the oculomotor nerve. The connective tis- which are commonly seen in surgical practice. Methods. sue associated with the LPS muscle contains two transverse This study was conducted on 19 human cadavers (12 adults ligaments: the superior (Whitnall’s) and intermuscular trans- and 7 infants) without pathologic changes in the orbital re- verse ligaments (ITL). The orbital septum in all the speci- gion and eyelids. Anatomic microdissection of the contents mens originated from the arcus marginalis of the frontal of the orbita was performed bilaterally on 12 orbits from 6 bone, and consisted of two layers – the superficial and the unfixed cadavers (3 male and 3 female). Micromorphologic inner layer. In addition, a detailed histological analysis re- investigations of the orbital tissue were performed on 8 en vealed that the upper eyelid’s crease was formed by the con- bloc excised and formalin-fixed orbits of infant cadavers. joined fascia including the fascia of the orbicularis muscle, Specimens were fixed according to the Duvernoy method. the superficial layer of the orbital septum, and the aponeuro- An intra-arterial injection of 5% mixture of melt formalin sis of the LPS muscle, as well as the pretarsal fascia. Conclu- and black ink was administered into the carotid arterial sys- sion. The conducted study provided a valuable morphologi- tem. Using routine fixation, decalcination, dehydration, illu- cal basis for biomechanical and clinical considerations re- mination, impregnation and molding procedures in paraplast, garding blepharoptosis surgery. specimens were prepared for cross-sections. Results. The measurement of the muscle length and diameter in situ in 6 Key words: nonfixed cadavers (12 orbits) showed an average length of oculomotor muscles; blepharoptosis; microdissection; the levator palpbrae superioris (LPS) muscle body of the 42.0 ± oculomotor nerve. Apstrakt orbita kadavera odojÿadi fiksiranih formalinom. Preparati su fiksirani Duvernoy metodom. U karotidni sistem intraarte- Uvod/Cilj. Detaljno poznavanje graĀe gornjeg kapka veo- rijski je ubrizgavana mešavina 5% rastvora formalina i crnog ma je važno za mnogobrojne korektivne hirurške zahvate na tuša. Rutinskom procedurom, koja obuhvata fiksaciju, de- gornjem kapku. Ovaj ÿlanak bavi se detaljnom anatomijom kalcifikaciju, dehidrataciju, prosvetljavanje, impregnaciju i glavnih struktura gornjeg kapka koji se obiÿno susreýu u hi- kalupljenje u paraplastu, uzorci su pripremani za pravljenje rurškoj praksi. Metode. Studija je sprovedena na 19 ljudskih preseka. Rezultati. Merenje dužine i širine mišiýa na šest kadavera (12 odraslih i 7 odojÿadi) bez patoloških promena svežih kadavera (12 orbita) pokazalo je proseÿnu dužinu tela u orbitalnoj regiji i kapcima. Anatomska mikrodisekcija sa- mišiýa levator palpebrae superioris (LPS) od 42,0 ± 1,41 mm na držaja orbite sprovedena je na 12 orbita, obostrano na 6 desnoj strani, a 40,3 ± 1,63 mm na levoj strani. U svim slu- svežih kadavera odraslih (3 muška i 3 ženska). Mikromor- ÿajevima, LPS je bio vaskularizovan iz ÿetiri razliÿita arterij- fološka ispitivanja struktura orbite izvedena su na 8 en bloc ska sistema: a. lacrimalis, a. supratrochlearis, a. supraorbitalis i mi- Correspondence to: Boban Djordjeviý, Milovana Šaranoviýa 14, 11 000 Belgrade, Serbia. Phone: +381 64 2 096 096. E-mail: [email protected] Volumen 70, Broj 12 VOJNOSANITETSKI PREGLED Strana 1125 šiýnih grana a. ophthalmicae. Mišiý LPS u svim sluÿajevima bicularis oculi, površni sloj orbitalnog septuma, aponeuroza inervisala je gornja medijalna grana n. oculomotoriusa. Usta- mišiýa levator palpebrae superioris i pretarzalna fascija. Zak- novljeno je da je vezivno tkivo povezano sa LPS mišiýem, ljuÿak. Istraživanjem je obezbeĀena važna morfološka os- sastavljeno od dva popreÿna ligamenta: gornjeg (Whit- nova za biomehaniÿka i kliniÿka ispitivanja u hirurgiji ble- nallovog) i intermuskularnog popreÿnog ligamenta (ITL). faroptoza. Orbitalni septum je u svim sluÿajevima polazio od supra- orbitalne ivice ÿeone kosti i sastojao se od dva sloja – po- Kljuÿne reÿi: vršnog i dubokog. Osim toga, detaljna histološka analiza mišiýi, okulomotorni; blefaroptoza; mikrodisekcija; pokazala je da gornji kapaÿni žleb formira fascija mišiýa or- n. oculomotorius. Introduction muscle was dissected to expose the tarsal plate. Microdis- section of the orbital subject was performed using a stereo A wider knowledge of the levator palpebrae superioris magnifying glass (4u). (LPS) muscle and the suspensory fibrous tissue related to the The method of standard dissection of 12 orbits from 6 LPS muscle is essential for the eyelid surgery, especially for formalin fixed cadavers (3 male and 3 female) was per- the blepharoptosis correction. Even though, there are several formed by the combined transcutaneous and transcranial ap- papers providing the description of the eyelid anatomy, anat- proach. Incisions were made on the skin, the orbicularis oculi omic features of the orbicularis oculi and the LPS muscle, muscle was exposed, and a strip of orbicularis oculi muscle there are various anatomical details that are still controver- was turned aside. After the junction of the orbital septum and sial. In particular, the importance of the orbital connective levator aponeurosis was observed, a blunt dissection was car- tissue and the role they play in pathogenesis or the blepha- ried out through the outer layer of the orbital septum, and roptosis treatment are still unclear. continued to the Whitnall’s ligament between the levator In most patients with congenital and acquired blepha- aponeurosis and the inner layer of the orbital septum, which roptosis, palpebral creases are not so distinctive. In addition, covers the posterior surface of the orbital fat. Anderson et al. 1 described an atrophic and dehiscent supe- All the specimens were photographed by a Sony Cyber rior transverse ligament (Whitnall’s ligament-WL 2) in those Shot DCS P8 digital camera. patients. Fink et al. 3 first reported the presence of the con- Micromorphologic investigations of the orbital tissue nective tissue which underlines the LPS muscle, the tissue were performed on 8 en bloc excised and formalin-fixed orbits that was called the intermuscular transverse ligament (ITL) of infant cadavers with no pathologic changes in the orbital re- by Lukas et al. 4. However, the functional role of these liga- gion and eyelids. An intra-arterial injection of 5% mixture of ments in the LPS muscle is still unclear. melt formalin and black ink was administered in the carotid The aim of this study was to reinvestigate the detailed arterial system, and rinsed out using a saline solution and 4% anatomy of the connective tissues related to the LPS muscle, neutral buffered solution of formaldehyde. The specimens and to establish their role in the suspension and creation of were fixed according to the method of Duvernoy. We used the normal upper eyelid contours in the occidental race. standard technique for the brain removal, and the specific tran- scranial approach. Microdissections (using micro instruments) Methods of injected orbital blood vessels, nerves and muscles were analyzed under the Leica MZ6 stereomicroscope. The anatomic microdissection study and histological All the specimens were photographed by Sony Cyber analysis were conducted on 19 human cadavers (12 adults Shot DCS P8 digital camera. To get more easily visible de- and 7 infants). We used microdissection techniques for the tails, we used the Leica DC 300 digital camera (magnifica- orbits from formalin-unfixed/fixed cadavers, as well as mi- tions 6.3u, 10u and 20u). cromorphologic investigation methods. Histological analysis was carried out on 6 en bloc ex- The anatomic microdissection of the contents of the or- cised and formalin-fixed infant orbits. We used the material bita through the anterior cranial fossa (transcranial approach) from the Anatomic Institute of the Faculty of Medicine, Bel- was performed bilaterally on 12 orbits from six unfixed ca- grade. The aim was to establish the exact micromorphologic davers (3 male and 3 female). The cadavers, aged 42–75 architecture of the upper
Load more

Recommended publications
  • Upper Lid Orbicularis Oculi Muscle Strip and Sequential Brow Suspension with Autologous Fascia Lata Is Beneficial for Selected P
    Eye (2009) 23, 1549–1553 & 2009 Macmillan Publishers Limited All rights reserved 0950-222X/09 $32.00 www.nature.com/eye Upper lid orbicularis B Patil and AJE Foss CLINICAL STUDY oculi muscle strip and sequential brow suspension with autologous fascia lata is beneficial for selected patients with essential blepharospasm Abstract Introduction Purpose Severe cases of blepharospasm Patients with severe blepharospasm, whose resistant to botulinum toxin represent a symptoms are not controlled by botulinum challenging clinical problem. Over the toxin injections, are a difficult management last 10 years, we have adopted a staged problem for whom a number of surgical options surgical management of these cases have been tried. with an initial upper lid orbicularis Two operations, in particular, have been tried; myectomy (combined with myectomy the orbicularis myectomy (or strip) and brow of procerus and corrugator supercilius as suspension. The choice of the procedure appropriate) and then 4–6 months later classically depends upon the clinical a brow suspension with autologous fascia presentation, with all types being offered the Department of lata. The aim of this study was to orbicularis myectomy except for the apraxic (also Ophthalmology, assess the outcome of this staged surgical called the pre-tarsal) type. The proposed Queen’s Medical Centre, approach. aetiology of the apraxic type is considered to Nottingham University, Materials and methods A questionnaire differ and to represent a failure of eyelid opening Nottingham, UK was sent to all patients who had undergone and is clinically characterized by the eyebrows Correspondence: AJE Foss, the procedure and the clinical records going up and not down with the spasms.
    [Show full text]
  • Blepharoplasty
    Blepharoplasty Bobby Tajudeen Brow position • medial brow as having its medial origin at the level of a vertical line drawn to the nasal alar-facial junction • lateral extent of the brow should reach a point on a line drawn from the nasal alar-facial junction through the lateral canthus of the eye • brow should arch superiorly, well above the supraorbital rim, with the highest point lying at the lateral limbus • Less arched in men • midpupillary line and the inferior brow border should be approximately 2.5 cm. The distance from the superior border of the brow to the anterior hairline should be 5 cm Eyelid aesthetics • The highest point of the upper eyelid is at the medial limbus, and the lowest point of the lower eyelid is at the lateral limbus. • Sharp canthal angles should exist, especially at the lateral canthus. • The upper eyelid orbicularis muscle should be smooth and flat, and the upper eyelid crease should be crisp. The upper lid crease should lie between 8 and 12 mm from the lid margin in the Caucasian patient. • The upper lid margin should cover 1 to 2 mm of the superior limbus, and the lower lid margin should lie at the inferior limbus or 1 mm below the inferior limbus • The lower eyelid should closely appose the globe without any drooping of the lid away from the globe (ectropion) or in toward the globe (entropion) Lid laxity and excess • A pinch test helps determine the degree of excess lid skin that is present. The snap test helps determine the degree of lower lid laxity and is useful in preoperative planning Evaluation •
    [Show full text]
  • Atlas of the Facial Nerve and Related Structures
    Rhoton Yoshioka Atlas of the Facial Nerve Unique Atlas Opens Window and Related Structures Into Facial Nerve Anatomy… Atlas of the Facial Nerve and Related Structures and Related Nerve Facial of the Atlas “His meticulous methods of anatomical dissection and microsurgical techniques helped transform the primitive specialty of neurosurgery into the magnificent surgical discipline that it is today.”— Nobutaka Yoshioka American Association of Neurological Surgeons. Albert L. Rhoton, Jr. Nobutaka Yoshioka, MD, PhD and Albert L. Rhoton, Jr., MD have created an anatomical atlas of astounding precision. An unparalleled teaching tool, this atlas opens a unique window into the anatomical intricacies of complex facial nerves and related structures. An internationally renowned author, educator, brain anatomist, and neurosurgeon, Dr. Rhoton is regarded by colleagues as one of the fathers of modern microscopic neurosurgery. Dr. Yoshioka, an esteemed craniofacial reconstructive surgeon in Japan, mastered this precise dissection technique while undertaking a fellowship at Dr. Rhoton’s microanatomy lab, writing in the preface that within such precision images lies potential for surgical innovation. Special Features • Exquisite color photographs, prepared from carefully dissected latex injected cadavers, reveal anatomy layer by layer with remarkable detail and clarity • An added highlight, 3-D versions of these extraordinary images, are available online in the Thieme MediaCenter • Major sections include intracranial region and skull, upper facial and midfacial region, and lower facial and posterolateral neck region Organized by region, each layered dissection elucidates specific nerves and structures with pinpoint accuracy, providing the clinician with in-depth anatomical insights. Precise clinical explanations accompany each photograph. In tandem, the images and text provide an excellent foundation for understanding the nerves and structures impacted by neurosurgical-related pathologies as well as other conditions and injuries.
    [Show full text]
  • MBB Lab 5: Anatomy of the Face and Ear
    MBB Lab 5: Anatomy of the Face and Ear PowerPoint Handout Review ”The Basics” and ”The Details” for the following cranial nerves in the Cranial Nerve PowerPoint Handout. • Mandibular division trigeminal (CN V3) • Facial nerve (CN VII) Slide Title Slide Number Slide Title Slide Number Blood Supply to Neck, Face, and Scalp: External Carotid Artery Slide3 Parotid Gland Slide 22 Scalp: Layers Slide4 Scalp and Face: Sensory Innervation Slide 23 Scalp: Blood Supply Slide 5 Scalp and Face: Sensory Innervation (Continued) Slide 24 Regions of the Ear Slide 6 Temporomandibular joint Slide 25 External Ear Slide 7 Temporal and Infratemporal Fossae: Introduction Slide 26 Temporal and Infratemporal Fossae: Muscles of Tympanic Membrane Slide 8 Slide 27 Mastication Tympanic Membrane (Continued) Slide 9 Temporal and Infratemporal Fossae: Muscles of Sensory Innervation: Auricle, EAC, and Tympanic Membrane Slide 10 Slide 28 Mastication (Continued) Middle Ear Cavity Slide 11 Summary of Muscles of Mastication Actions Slide 29 Middle Ear Cavity (Continued) Slide 12 Infratemporal Fossae: Mandibular Nerve Slide 30 Mastoid Antrum Slide 13 Inferior Alveolar Nerve Block Slide 31 Eustachian (Pharyngotympanic or Auditory) Tube Slide 14 Palatine Nerve Block Slide 32 Otitis Media Slide 15 Infratemporal Fossae: Maxillary Artery & Pterygoid Plexus Auditory Ossicles Slide 16 Slide 33 Chorda Tympani Nerve and Middle Ear Slide 17 Infratemporal Fossa: Maxillary Artery Slide 34 Superficial Facial Muscles: Muscles of Facial Expression Slide 18 Infratemporal Fossa: Pterygoid Plexus Slide 35 Superficial Facial Muscles: Muscles of Facial Expression Slide 19 Infratemporal Fossa: Otic Ganglion Slide 36 (Continued) Superficial Facial Muscles: Innervation Slide 20 Infratemporal Fossa: Chorda Tympani Nerve Slide 37 Superficial Facial Muscles: Innervation (Continued) Slide 21 Blood Supply to Neck, Face, and Scalp: External Carotid Artery The common carotid artery branches into the internal and external carotid arteries at the level of the superior edge of the thyroid cartilage.
    [Show full text]
  • Anatomy of the Periorbital Region Review Article Anatomia Da Região Periorbital
    RevSurgicalV5N3Inglês_RevistaSurgical&CosmeticDermatol 21/01/14 17:54 Página 245 245 Anatomy of the periorbital region Review article Anatomia da região periorbital Authors: Eliandre Costa Palermo1 ABSTRACT A careful study of the anatomy of the orbit is very important for dermatologists, even for those who do not perform major surgical procedures. This is due to the high complexity of the structures involved in the dermatological procedures performed in this region. A 1 Dermatologist Physician, Lato sensu post- detailed knowledge of facial anatomy is what differentiates a qualified professional— graduate diploma in Dermatologic Surgery from the Faculdade de Medician whether in performing minimally invasive procedures (such as botulinum toxin and der- do ABC - Santo André (SP), Brazil mal fillings) or in conducting excisions of skin lesions—thereby avoiding complications and ensuring the best results, both aesthetically and correctively. The present review article focuses on the anatomy of the orbit and palpebral region and on the important structures related to the execution of dermatological procedures. Keywords: eyelids; anatomy; skin. RESU MO Um estudo cuidadoso da anatomia da órbita é muito importante para os dermatologistas, mesmo para os que não realizam grandes procedimentos cirúrgicos, devido à elevada complexidade de estruturas envolvidas nos procedimentos dermatológicos realizados nesta região. O conhecimento detalhado da anatomia facial é o que diferencia o profissional qualificado, seja na realização de procedimentos mini- mamente invasivos, como toxina botulínica e preenchimentos, seja nas exéreses de lesões dermatoló- Correspondence: Dr. Eliandre Costa Palermo gicas, evitando complicações e assegurando os melhores resultados, tanto estéticos quanto corretivos. Av. São Gualter, 615 Trataremos neste artigo da revisão da anatomia da região órbito-palpebral e das estruturas importan- Cep: 05455 000 Alto de Pinheiros—São tes correlacionadas à realização dos procedimentos dermatológicos.
    [Show full text]
  • Periorbital Anatomy - an Essential Foundation for Blepharoplasty
    PERIORBITAL ANATOMY - AN ESSENTIAL FOUNDATION FOR BLEPHAROPLASTY William M. Ramsdell, M.D. 102 Westlake Dr, Ste 100 Austin, TX 78746 [email protected] 512-327-7779 Private Practice Periorbital Anatomy - An Essential Foundation for Blepharoplasty ABSTRACT Background Mastery of anatomy is fundamental to all surgeons. The anatomy of the eyelids and periorbital regions is unique. Because the eyes and periorbital areas are so essential to cosmetic appearance, blepharoplasty is a popular procedure. Successful blepharoplasty requires thorough knowledge of anatomical concepts. These concepts continue to evolve. Objective To develop thorough knowledge of the anatomy necessary to perform blepharoplasty. To understand anatomical relationships and age-related anatomical changes based upon physical examination. Conclusion The acquistion of knowledge regarding the structure of periorbital tissues is achievable by cosmetic surgeons dedicated to the best in patient care. Such knowledge results in a mutually beneficial surgical experience for surgeons and patients alike. Periorbital Anatomy - An Essential Foundation for Blepharoplasty PERIORBITAL ANATOMY - AN ESSENTIAL FOUNDATION FOR BLEPHAROPLASTY Comprehensive knowledge of anatomy is fundamental to any successful surgery. The anatomy of the periorbital region is unique. Successful management of this region requires not only a thorough knowledge of basic anatomical elements but also how the aging process affects these structures. The study of anatomy is a dynamic process with development of new insights on an ongoing basis. Our understanding has increased significantly over the past 20 years. This article will address fundamental anatomy of the periorbital region. UPPER EYELID ANATOMY The upper eyelid can be divided into two layers or lamellae. The anterior lamella consists of skin, orbicularis oculi muscle and the orbital septum (Figure 1).
    [Show full text]
  • Understanding the Perioral Anatomy
    2.0 ANCC CE Contact Hours Understanding the Perioral Anatomy Tracey A. Hotta , RN, BScN, CPSN, CANS gently infl ate and cause lip eversion. Injection into Rejuvenation of the perioral region can be very challenging the lateral upper lip border should be done to avoid because of the many factors that affect the appearance the fade-away lip. The client may also require injec- of this area, such as repeated muscle movement caus- tions into the vermillion border to further highlight ing radial lip lines, loss of the maxillary and mandibular or defi ne the lip. The injections may be performed bony support, and decrease and descent of the adipose by linear threading (needle or cannula) or serial tissue causing the formation of “jowls.” Environmental puncture, depending on the preferred technique of issues must also be addressed, such as smoking, sun the provider. damage, and poor dental health. When assessing a client Group 2—Atrophic lips ( Figure 2 ): These clients have for perioral rejuvenation, it is critical that the provider un- atrophic lips, which may be due to aging or genetics, derstands the perioral anatomy so that high-risk areas may and are seeking augmentation to make them look be identifi ed and precautions are taken to prevent serious more youthful. After an assessment and counseling adverse events from occurring. as to the limitations that may be achieved, a treat- ment plan is established. The treatment would begin he lips function to provide the ability to eat, speak, with injection into the wet–dry junction to achieve and express emotion and, as a sensory organ, to desired volume; additional injections may be per- T symbolize sensuality and sexuality.
    [Show full text]
  • Inferior Oblique Muscle of the Eye: Its Fetal Development with Special Reference to Understanding of the Frequent Variants in Adults
    ONLINE FIRST This is a provisional PDF only. Copyedited and fully formatted version will be made available soon. ISSN: 0015-5659 e-ISSN: 1644-3284 Inferior oblique muscle of the eye: its fetal development with special reference to understanding of the frequent variants in adults Authors: Z. W. Jin, S. Umeki, Y. Takeuchi, M. Yamamoto, G. Murakami, S. Abe, J. F. Rodríguez-Vázquez DOI: 10.5603/FM.a2021.0043 Article type: Original article Submitted: 2021-03-13 Accepted: 2021-04-09 Published online: 2021-04-28 This article has been peer reviewed and published immediately upon acceptance. It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited. Articles in "Folia Morphologica" are listed in PubMed. Powered by TCPDF (www.tcpdf.org) Inferior oblique muscle of the eye: its fetal development with special reference to understanding of the frequent variants in adults Z.W. Jin et al., Development of the inferior obliquus Z.W. Jin1, S. Umeki2, Y. Takeuchi2, M. Yamamoto2, G. Murakami2, 3, S. Abe2, J.F. Rodríguez-Vázquez4 1Department of Anatomy, Wuxi School of Medicine, Jiangnan University, Wuxi, China 2Department of Anatomy, Tokyo Dental College, Tokyo, Japan 3Division of Internal Medicine, Cupid Clinic, Iwamizawa, Japan 4Department of Anatomy and Embryology, School of Medicine, Complutense University, Madrid, Spain Address for correspondence: Z.W. Jin, MD, PhD, Department of Anatomy, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Avenue, Wuxi, Jiangsu, 214122, China, tel: +86-510-8519-7079, fax: +86-510-8519-3570, e-mail: [email protected] ABSTRACT To provide better understanding of frequent variations of the inferior oblique (IO) of adult extraocular muscles, we observed sagittal and horizontal histological sections of the eye and orbits from 32 fetuses (approximately 7-34 weeks of gestational age; 24-295 mm of crown-rump length).
    [Show full text]
  • FIPAT-TA2-Part-2.Pdf
    TERMINOLOGIA ANATOMICA Second Edition (2.06) International Anatomical Terminology FIPAT The Federative International Programme for Anatomical Terminology A programme of the International Federation of Associations of Anatomists (IFAA) TA2, PART II Contents: Systemata musculoskeletalia Musculoskeletal systems Caput II: Ossa Chapter 2: Bones Caput III: Juncturae Chapter 3: Joints Caput IV: Systema musculare Chapter 4: Muscular system Bibliographic Reference Citation: FIPAT. Terminologia Anatomica. 2nd ed. FIPAT.library.dal.ca. Federative International Programme for Anatomical Terminology, 2019 Published pending approval by the General Assembly at the next Congress of IFAA (2019) Creative Commons License: The publication of Terminologia Anatomica is under a Creative Commons Attribution-NoDerivatives 4.0 International (CC BY-ND 4.0) license The individual terms in this terminology are within the public domain. Statements about terms being part of this international standard terminology should use the above bibliographic reference to cite this terminology. The unaltered PDF files of this terminology may be freely copied and distributed by users. IFAA member societies are authorized to publish translations of this terminology. Authors of other works that might be considered derivative should write to the Chair of FIPAT for permission to publish a derivative work. Caput II: OSSA Chapter 2: BONES Latin term Latin synonym UK English US English English synonym Other 351 Systemata Musculoskeletal Musculoskeletal musculoskeletalia systems systems
    [Show full text]
  • Muscles-Of-The-Head
    ANATOMY ANATOMY HEAD HEAD AREAS BONES MUSCLES NERVES ORGANS JOINTS VESSELS OTHER • Scalp • Skull • The Tongue • Sympatheti • The Ear • TMJ • Arterial • Lacrimal • Pterygopal • Bony Orbit • Facial c • The Eye Supply Gland atine Fossa • Sphenoid Expression Innervation • Nose and • Venous • Eyelids • Infratempo Bone • Extraocular • Parasympat Sinuses Drainage • Teeth ral Fossa • Ethmoid • Mastication hetic • Salivary • Lymphatics • Palate • Cranial Bone Innervation Glands Fossae • Temporal • Ophthalmic • Oral Cavity Bone Nerve • Mandible • Mandibular Nerve • Nasal Skeleton • Maxillary Nerve • Cranial Foramina Contents 1 Orbital Group • 1.1 Clinical Relevance: Paralysis to the Orbital THE MUSCLES Muscles OF FACIAL • 2 Nasal Group • 3 Oral Group EXPRESSION • 3.1 Clinical Relevance: Paralysis to the Oral Muscles HEAD Muscle of Facial Expression • The muscles of facial expression are located in the Subcutaneous tissue, originating from bone or fascia, and inserting onto the skin. By contracting, the muscles pull on the skin and exert their effects. They are THE MUSCLES the only group of muscles that insert into skin. • These muscles have a common embryonic origin – The OF FACIAL 2nd pharyngeal arch. They migrate from the arch, taking their nerve supply with them. As such, all the muscles EXPRESSION of facial expression are innervated by the Facial Nerve. • The facial muscles can broadly be split into three groups; orbital, nasal and oral. Muscles of Facial Expression Muscle Of facial Expression Orbicularis Oculi Muscle of Facial Expression Orbicularis Oculi Orbital Group • The orbital group of facial muscles contains two muscles associated with the eye socket. These muscles control the movements of the eyelids, important in protecting the cornea from damage. They are both innervated by the facial nerve.
    [Show full text]
  • Anatomy of the Corrugator Supercilii Muscle
    ORIGINAL ARTICLE Anatomy of the Corrugator Supercilii Muscle Jung I. Park, MD, PhD; Todd M. Hoagland, PhD; Min S. Park, MD Objective: To define the anatomy of the corrugator Results: The origin of the CSM has a wide base, span- supercilii muscle (CSM). ning across 0.6 cm from the midline and the supraor- bital notch/foramen. The area of the muscle origin mea- Design: Cadaver dissections following a preset approach. sured 0.98ϫ2.52 cm on the right side and 1.04ϫ2.35 cm on the left side. The lateral extent of the CSM inser- Setting: Anatomy laboratory at a medical school. tion measured 4.27 and 4.50 cm from the midline on the right and left sides, respectively. Method: Sixteen sides of 8 preserved cadaver heads were dissected. Inferiorly based trapdoor-type flaps were de- Conclusions: The CSM originates as 3 or 4 thin, rect- veloped in the subgaleal plane. The bone origins of the angular, panellike muscle groups occupying a wide area CSM were first identified. The muscles were then fol- across 0.6 cm from the midline and the supraorbital notch/ lowed to their insertions. The origin and outline of the foramen. The muscle groups travel parallel to one an- muscles were plotted on the face of the cadaver. Follow- other in an oblique course without distinguishable ob- ing the measurements, we transferred the configuration lique or transverse components. of the CSM to the image of a computer-manipulated face of a model. Arch Facial Plast Surg. 2003;5:412-415 NTRODUCTION OF the endo- the middle and the lateral third of the eye- scopic forehead lift procedure brow.
    [Show full text]
  • Electrophysiological Investigations of Cephalic Tetanus
    J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.36.2.296 on 1 April 1973. Downloaded from Journal of Neurology, Neurosurgery, and Psychiatry, 1973, 36, 296-301 Electrophysiological investigations of cephalic tetanus RICARDO GARCIA-MULLIN AND ROBERT B. DAROFF From the Department of Neurology, University of Miami School of Medicine, Jackson Memorial Hospital, and the Neurology Service, Veterans Administration Hospital, Miami, Florida, U.S.A. SUMMARY Electrophysiological studies of a patient with cephalic tetanus, manifested by trismus and unilateral facial palsy, revealed that the trismus resulted from strictly unilateral masseter spasm which stopped during sleep, a normal silent period in the involved masseter muscles, initially pro- longed distal latency of the paretic orbicularis muscles, and abnormal continuous muscle activity in the paretic facial muscles which stopped during sleep and after facial nerve block. We conclude that the facial paralysis was probably secondary to peripheral nerve dysfunction and the continuous muscle potentials represented enhanced activity of the nucleus. An intensity spectrum of the inhibi- tory defect in tetanus is postulated. Protected by copyright. Cephalic tetanus is defined as a form of the affected (Park, 1970). The neurophysiological disease in which trismus is accompanied by mechanism underlying the cranial nerve palsies paralytic involvement of one or more cranial has been an enigmatic feature in a disorder nerves (Bagratuni, 1952). The tetanus may be otherwise characterized by spasms secondary to generalized or local, with trismus in the latter abnormally enhanced motoneuronal activity constituting the sole manifestation of spasm. The (Brooks, Curtis, and Eccles, 1957). We are causative injury is usually on the head or face herein reporting a patient with cephalic tetanus and the ipsilateral facial nerve is most commonly who demonstrated a unique type of constant FIG.
    [Show full text]