Temporal and Infratemporal Fossae 1 and 2
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Middle Cranial Fossa Sphenoidal Region Dural Arteriovenous Fistulas: Anatomic and Treatment Considerations
ORIGINAL RESEARCH INTERVENTIONAL Middle Cranial Fossa Sphenoidal Region Dural Arteriovenous Fistulas: Anatomic and Treatment Considerations Z.-S. Shi, J. Ziegler, L. Feng, N.R. Gonzalez, S. Tateshima, R. Jahan, N.A. Martin, F. Vin˜uela, and G.R. Duckwiler ABSTRACT BACKGROUND AND PURPOSE: DAVFs rarely involve the sphenoid wings and middle cranial fossa. We characterize the angiographic findings, treatment, and outcome of DAVFs within the sphenoid wings. MATERIALS AND METHODS: We reviewed the clinical and radiologic data of 11 patients with DAVFs within the sphenoid wing that were treated with an endovascular or with a combined endovascular and surgical approach. RESULTS: Nine patients presented with ocular symptoms and 1 patient had a temporal parenchymal hematoma. Angiograms showed that 5 DAVFs were located on the lesser wing of sphenoid bone, whereas the other 6 were on the greater wing of the sphenoid bone. Multiple branches of the ICA and ECA supplied the lesions in 7 patients. Four patients had cortical venous reflux and 7 patients had varices. Eight patients were treated with transarterial embolization using liquid embolic agents, while 3 patients were treated with transvenous embo- lization with coils or in combination with Onyx. Surgical disconnection of the cortical veins was performed in 2 patients with incompletely occluded DAVFs. Anatomic cure was achieved in all patients. Eight patients had angiographic and clinical follow-up and none had recurrence of their lesions. CONCLUSIONS: DAVFs may occur within the dura of the sphenoid wings and may often have a presentation similar to cavernous sinus DAVFs, but because of potential associations with the cerebral venous system, may pose a risk for intracranial hemorrhage. -
Innervation of the Temporomandibular Joint Can Be Discussed It Is Necessary First to Describe Its Embryology, Gfoss Anatomy and Microscopic Appe¿Ìrance
à8.ì 'R? INNERVATION OF THE TEMPOROMAI\DIBULAR J AN EXPERIMENTAL AMMAL MODEL USING AUSTRALIAN MERINO STIEEP ABDOLGHAFAR TAHMASEBI-SARVESTANI' B. Sc, M. Sc Thesis submitted for the degree of DOCTOR OF PHILOSOPHY In The Department of Anatomical Sciences The University of Adelaide (Faculty of Medicine)' Adelaide, South Australia, 5005 April, L997 tfüs tñesisis [elicatelø nl wtfe Aggñleñ ø¡tlour g4.arzi"e tfr.re e c friûfren Ía fiera ñ, fo zic ñ atú fi l-1 ACKNOWLEDGMENTS I am greatly indebted to my supervisors Dr. Ray Tedman and Professor Alastair Goss who first inrroduced me to this freld of study and providing me with the opportunity to carry out this work. I wish to thank them for their constant interest and guidance throughout the course of this study. I am also indebted to the scholarship committee of the Shiraz Medical Science University and Ministry of Health and Medical Education, Iran for gânting me a 4 year scholarship to study at the Universiry of Adelaide. I thank professor Goss and the Japanese Surgical Research team for their expertise in surgical animal models, and Professor July Polak and Dr Mika Hukkanen, Royal postgraduate Medical School London University for their expertise in immunohistochemistry and for providing some of the antisera used in the neuropeptide studies. I would also like to thank Professor Ian Gibbins, Department of Anatomy and Histology of the Flinders Medical Centre for, without the use of his laboratories, materials, and expertise, the double and triple labelling parts of the immunocytochemical work would not have occurred. I also orwe many thanks to Susan Matthew, a senior laboratory officer for her skilful technical assistance in double and triple immunocytochemistry. -
Extracranial Course of Cranial Nerves
Extracranial course of cranial nerves Oculomotor, Trochlear, Abducent, Trigeminal, Facial and Accessory nerves Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology Dr. Heba Kalbouneh Brainstem Mid brain Pons Medulla Pons Inferior view Facial nerve Anatomically, the course of the facial nerve can be divided into two parts: Motor: Innervates the muscles of facial Intracranial – the course of the nerve through expression, the posterior belly of the the cranial cavity, and the cranium itself. digastric, the stylohyoid and the stapedius Extracranial – the course of the nerve outside muscles. the cranium, through the face and neck. General Sensory: A small area around the concha of the auricle, EAM Special Sensory: Provides special taste sensation to the anterior 2/3 of the tongue. Parasympathetic: Supplies many of the glands of the head and neck, including: 1- Submandibular and sublingual salivary glands (via the submandibular ganglion/ chorda tympani) 2- Nasal, palatine and pharyngeal mucous glands (via the pterygopalatine ganglion/ greater petrosal) 3- Lacrimal glands (via the pterygopalatine ganglion/ greater petrosal) Dr. Heba Kalbouneh Intracranial course The nerve arises in the pons. It begins as two roots; a large motor root, and a small sensory root The two roots travel through the internal acoustic meatus. Pons Here, they are in very close proximity to the inner ear. 7th (motor) 8th Note: The part of the facial nerve that runs between the motor root of facial and vestibulocochlear nerve is sometimes Kalbouneh known as the nervus intermedius It contains the sensory and parasympathetic Heba fibers of the facial nerve Dr. Dr. Still within the temporal bone, the roots leave the internal acoustic meatus, and enter into the facial canal. -
The Mandibular Nerve - Vc Or VIII by Prof
The Mandibular Nerve - Vc or VIII by Prof. Dr. Imran Qureshi The Mandibular nerve is the third and largest division of the trigeminal nerve. It is a mixed nerve. Its sensory root emerges from the posterior region of the semilunar ganglion and is joined by the motor root of the trigeminal nerve. These two nerve bundles leave the cranial cavity through the foramen ovale and unite immediately to form the trunk of the mixed mandibular nerve that passes into the infratemporal fossa. Here, it runs anterior to the middle meningeal artery and is sandwiched between the superior head of the lateral pterygoid and tensor veli palatini muscles. After a short course during which a meningeal branch to the dura mater, and the nerve to part of the medial pterygoid muscle (and the tensor tympani and tensor veli palatini muscles) are given off, the mandibular trunk divides into a smaller anterior and a larger posterior division. The anterior division receives most of the fibres from the motor root and distributes them to the other muscles of mastication i.e. the lateral pterygoid, medial pterygoid, temporalis and masseter muscles. The nerve to masseter and two deep temporal nerves (anterior and posterior) pass laterally above the medial pterygoid. The nerve to the masseter continues outward through the mandibular notch, while the deep temporal nerves turn upward deep to temporalis for its supply. The sensory fibres that it receives are distributed as the buccal nerve. The 1 | P a g e buccal nerve passes between the medial and lateral pterygoids and passes downward and forward to emerge from under cover of the masseter with the buccal artery. -
Head & Neck Muscle Table
Robert Frysztak, PhD. Structure of the Human Body Loyola University Chicago Stritch School of Medicine HEAD‐NECK MUSCLE TABLE PROXIMAL ATTACHMENT DISTAL ATTACHMENT MUSCLE INNERVATION MAIN ACTIONS BLOOD SUPPLY MUSCLE GROUP (ORIGIN) (INSERTION) Anterior floor of orbit lateral to Oculomotor nerve (CN III), inferior Abducts, elevates, and laterally Inferior oblique Lateral sclera deep to lateral rectus Ophthalmic artery Extra‐ocular nasolacrimal canal division rotates eyeball Inferior aspect of eyeball, posterior to Oculomotor nerve (CN III), inferior Depresses, adducts, and laterally Inferior rectus Common tendinous ring Ophthalmic artery Extra‐ocular corneoscleral junction division rotates eyeball Lateral aspect of eyeball, posterior to Lateral rectus Common tendinous ring Abducent nerve (CN VI) Abducts eyeball Ophthalmic artery Extra‐ocular corneoscleral junction Medial aspect of eyeball, posterior to Oculomotor nerve (CN III), inferior Medial rectus Common tendinous ring Adducts eyeball Ophthalmic artery Extra‐ocular corneoscleral junction division Passes through trochlea, attaches to Body of sphenoid (above optic foramen), Abducts, depresses, and medially Superior oblique superior sclera between superior and Trochlear nerve (CN IV) Ophthalmic artery Extra‐ocular medial to origin of superior rectus rotates eyeball lateral recti Superior aspect of eyeball, posterior to Oculomotor nerve (CN III), superior Elevates, adducts, and medially Superior rectus Common tendinous ring Ophthalmic artery Extra‐ocular the corneoscleral junction division -
Diagrams of the Nerves of the Human Body
DIAGRAMS OF THE NERVES OF THE HUMAN BODY; EXHIBITING THEIR ORIGIN, DIVISIONS, AND CONNECTIONS, WITH THEIR DISTRIBUTION TO THE VARIOUS REGIONS OF THE CUTANEOUS SURFACE AND TO ALL THE MUSCLES. BY WILLIAM HENRY FLOWER, FELLOW OF THE ROYAL SOCIETY; FELLOW OF THE ROYAL COLLEGE OF SURGEONS. SECOND AMERICAN FROM THE SECOND ENGLISH EDITION. EDITED, WITH ADDITIONS, BY WILLIAM W. KEEN, M.D., LECTURER ON ANATOMY AND OPERATIVE SURGERY IN THE PHILADELPHIA SCHOOL OF ANATOMY; LECTURER ON PATHOLOGICAL ANATOMY IN THE JEFFERSON MEDICAL COLLEGE, FELLOW OF THE COLLEGE OF PHYSICIANS, Ac. PHILADELPHIA : TURNER HAMILTON, BOOKSELLER AND STATIONER, 106 S. TENTH STREET. 1874. Entered according to the Act of Congress, in the year 1874, by TURNER HAMILTON, in the Office of the Librarian of Congress. All rights reserved. EDITOR’S PREFACE TO THE FIRST AMERICAN EDITION. The signal benefit derived from these diagrams as illustrations in teaching, and their great convenience for ready reference in practice, have led to their republication, reduced to one-fourth the size of the originals. The Editor has made some additions where greater detail seemed desirable, has grouped the spinal nerves in their plexuses, and has added to the text a synopsis of the various sympathetic ganglia. His alterations have been very slight, and limited almost exclusively to the mechanical arrangement, e.g. in the mode of bifurcation of the brachial plexus. 1729 Chestnut Street, Philadelphia, January 1, 1874. PREFACE TO THE SECOND EDITION. These diagrams were originally published in 1860. They were designed by the author while engaged in teaching anatomy at the Medical School attached to the Middlesex Hospital. -
Computed Tomography of the Buccomasseteric Region: 1
605 Computed Tomography of the Buccomasseteric Region: 1. Anatomy Ira F. Braun 1 The differential diagnosis to consider in a patient presenting with a buccomasseteric James C. Hoffman, Jr. 1 region mass is rather lengthy. Precise preoperative localization of the mass and a determination of its extent and, it is hoped, histology will provide a most useful guide to the head and neck surgeon operating in this anatomically complex region. Part 1 of this article describes the computed tomographic anatomy of this region, while part 2 discusses pathologic changes. The clinical value of computed tomography as an imaging method for this region is emphasized. The differential diagnosis to consider in a patient with a mass in the buccomas seteric region, which may either be developmental, inflammatory, or neoplastic, comprises a rather lengthy list. The anatomic complexity of this region, defined arbitrarily by the soft tissue and bony structures including and surrounding the masseter muscle, excluding the parotid gland, makes the accurate anatomic diagnosis of masses in this region imperative if severe functional and cosmetic defects or even death are to be avoided during treatment. An initial crucial clinical pathoanatomic distinction is to classify the mass as extra- or intraparotid. Batsakis [1] recommends that every mass localized to the cheek region be considered a parotid tumor until proven otherwise. Precise clinical localization, however, is often exceedingly difficult. Obviously, further diagnosis and subsequent therapy is greatly facilitated once this differentiation is made. Computed tomography (CT), with its superior spatial and contrast resolution, has been shown to be an effective imaging method for the evaluation of disorders of the head and neck. -
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. -
Physiologic Factors for Dental Anesthesia Injections
ARE YOU NUMB YET? THE ANATOMY OF LOCAL ANESTHESIA PART 2: TECHNIQUES PHYSIOLOGIC FACTORS FOR DENTAL ANESTHESIA Alan W. Budenz, MS, DDS, MBA INJECTIONS Dept. of Biomedical Sciences and Vice Chair of Diagnostic Sciences & Services, Dept. of Dental Practice University of the Pacific, Arthur A. Dugoni School of Dentistry San Francisco, California Success versus Failure [email protected] Failed Anesthetic: Measuring the Problem Physiology of Anesthetic Agents One of every three patients is not properly numb when the dentist or hygienist is ready to start (or actually starts) a dental procedure. How do we assess anesthesia? Is this “failed anesthetic”? 60% Question the patient Soft tissue only 50% * Probe the area 46% Average 40% 42% 41% Failure 38% Rate is Cold test 30% 29% Pulpal tissue 31% Electric pulp tester 20% 19% 20% 17% 15% How is anesthetic success defined in studies? 10% Frequency Frequency Anesthetic Failedof Ideal: 2 consecutive 80/80 readings with EPT within 15 0% IAN Blocks - 15 min. after injection Maxillary infiltrations - 10 min. after injection minutes of injection (and sustained for 60 mins) Delayed pulpal onset: occurs in the mandible of 19 – 27% Slide courtesy Dr. Mic Falkel of patients (even though soft tissue is numb) Delayed over 30 minutes in 8% Nusstein J et al. The challenges of successful * Average failure rate reported across 38 published studies mandibular anesthesia, Inside Dentistry, May 2008 Physiology of Anesthetic Agents Blocks versus Infiltrations Onset of anesthesia: Advantages of infiltrations 1. Dependent upon anesthetic agent 1. Faster onset Concentration 2. Diffusion to the site Simple Lipid solubility 3. -
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. -
The Relationship of the Fronto-Temporal Branches of The
Neurosurg Rev DOI 10.1007/s10143-006-0053-5 REVIEW The relationship of the fronto-temporal branches of the facial nerve to the fascias of the temporal region: a literature review applied to practical anatomical dissection Niklaus Krayenbühl & Gustavo Rassier Isolan & Ahmad Hafez & M. Gazi Yaşargil Received: 26 June 2006 /Revised: 13 September 2006 /Accepted: 14 September 2006 # Springer-Verlag 2006 Abstract The understanding of the course of the facial anterior cranial fossa lesions with wider exposures, includ- nerve and its relationship to the different connective tissue ing partial removal or mobilization of the orbit or the layers in the temporal area is paramount to preserving this zygomatic arch made protection of the fronto-temporal nerve during surgery. But the use of different nomencla- branches of the facial nerve a bigger issue [3–5, 12, 29, 47, tures for anatomical structures such as for the different 55]. Moreover, the advances in plastic, reconstructive and fascial layers or fat pads in the temporal region as well as maxillofacial surgery have improved the understanding of the difference in description of the course of the fronto- the relationship between the different fascial layers and the temporal branches of the facial nerve in relationship to the nerves in the temporal region [2, 9, 20, 21, 45, 53, 56]. fascial layers can lead to confusion. Therefore we have A clear understanding of the course of the facial nerve reviewed the literature about this topic and tried to apply and its relationship to the different galeal-fascial layers is the information to practical anatomical dissection. paramount to preserve this nerve during surgery. -
With Autopsy Guide and Clinical Notes with Autopsy G Uide with and Clinicalnotes Autopsy Anatomy Topographical
učební texty Univerzity Karlovy v Praze UIDE AND CLINICALNOTES TOPOGRAPHICAL WITH AUTOPSY G WITH AUTOPSY Jiří Valenta ANATOMYPavel Fiala WITH AUTOPSY GUIDE AND CLINICAL NOTES TOPOGRAPHICAL ANATOMY ANATOMY TOPOGRAPHICAL Jiří Valenta, Pavel Fiala Pavel Valenta, Jiří KAROLINUM U k á z k a k n i h y z i n t e r n e t o v é h o k n i h k u p e c t v í w w w . k o s m a s . c z , U I D : K O S 1 9 5 7 3 9 Topographical Anatomy with Autopsy Guide and Clinical Notes prof. MUDr. Jiří Valenta, DrSc. doc. RNDr. Pavel Fiala, CSc. Reviewers: prof. MUDr. Libor Páč, CSc. prof. MUDr. Zbyněk Vobořil, DrSc. Published by Charles University in Prague, Karolinum Press as a teaching text for the Faculty of Medicine in Pilsen Prague 2013 Typeset by DTP Karolinum Press Second edition © Charles University in Prague, 2013 Illustrations © Pavel Fiala, 2013 Text © Jiří Valenta, Pavel Fiala, 2013 The text has not been revised by the publisher ISBN 978-80-246-2210-1 ISBN 978-80-246-2646-8 (online : pdf) Ukázka knihy z internetového knihkupectví www.kosmas.cz Charles University in Prague Karolinum Press 2014 http://www.cupress.cuni.cz U k á z k a k n i h y z i n t e r n e t o v é h o k n i h k u p e c t v í w w w . k o s m a s . c z , U I D : K O S 1 9 5 7 3 9 U k á z k a k n i h y z i n t e r n e t o v é h o k n i h k u p e c t v í w w w .