Connections of the skull bones. Temporomandibular joint. Masticatory muscles, mimic muscles and their innervation. Veronika Němcová, CSc. Connections of the skull bones • Synchondroses cranii • Syndesmoses - suturae cranii, gomphosis • Synostoses • Articulatio temporomandibularis Cartilaginous connections Synchondrosis sphenopetrosa (foramen lacerum) Synchondrosis petrooccipitalis (fissura petrooccipitalis) Synchondrosis Fonticulus Synchondrosis sphenooccipitalis intraoccipitalis mastoideus anterior Symphysis menti Synchondrosis intraoccipitalis posterior Cartilaginous and fibrous connection on the newborn skull Sutura coronalis Sutura squamosa Sutura lambdoidea Sutura sagittalis Sutures newborn Articulatio temporomandibularis complex– discus head: caput mandibulae fossa: fossa mandibularis, tuberculum articulare Articular surfices are covered by fibrous cartilage Movements : depression elevation protraction retraction lateropulsion Ligaments of the temporomandibular joint – lateral aspect Ligamentum laterale - it prevents posterior displacement of the resting condyle Ligamentum stylomandibulare Ligaments of the temporomandibular joint - medial aspect Lig.pterygospinale Lig.sphenomandibulare Lig.stylomandibulare Lig. pterygomandibulare (raphe buccopharyngea) Ligaments of the temporomandibular joint Lig. pterygospinale Lig. stylomandibulare Lig. sphenomandibulare Articulatio temporomandibularis sagittal section (after Frick) Meatus acusticus Discus articularis externus A P Retroarticular plastic pad (Zenker) Caput mandibulae (veins and fatty connective tissue) Position of the caput mandibulae to the external acoustic meatus MR of the temporomandibular joint m-discus C-caput mandibulae E-tuberculum articulare AC-meatus acusticus externus MR of the temporomandibular joint - anterior displacement of the disc Arthrography of the temporomandibular joint Communication of both parts of the joint cavity – rupture of the disc or in eldery Normal Anterior disc displacement Artrocentesis (lavage ) of the temporomandibular joint Temporomandibular joint and m. pterygoideus lateralis m. pterygoideus lat (depression, lateropulsion) Elevation: m.masseter Protraction: mm. pterygoidei m.temporalis m. temporalis m. pterygoideus medialis m. masseter Retraction: m. temporalis m. masseter (newborn) PL T PM M Depression: suprahyoid muscles Lateropulsion: m.pterygoideus med. m.pterygoideus lat. m.pterygoideus lat. Injury of Karel IV. Karel IV. Úraz Karla IV.Normal mandible X-ray picture of the mandible of Karel IV. healed fractures thick corticalis Karel IV. Masticatory muscles • From the first branchial arch • Nerve supplying – mandibular nerve (V/3) • Blood supplying – branches of maxillary artery (pars infratemporalis), • plexus pterygoideus, • Fascia parotideomasseterica temporalis interpterygoidea Fce: elevation - m.masseter, m.temporalis, m.pterygoideus med. protraction - m.pterygoideus lat., m.masseter (superficial fibres) retraction- m.temporalis (posterior part), m.masseter (deep fibres) lateropulsion – m.pterygoiei, unilateral action M.temporalis M.masseter Fossa infratemporalis A.maxillaris N.auriculotemporalis M.pterygoideus V/3 lateralis A.meningea media N.alveolaris inf M.pterygoideus medialis N.lingualis M.pterygoideus lateralis M.buccinator V/3 M.pterygoideus Ductus medialis parotideus M.constrictor pharyngis sup Raphe pterygomandibularis (Raphe buccopharyngea) Frontal section of temporal and infratemporal region Corpus adiposum lingual nerve inferior alveolar nerve A.temporalis superficialis A.auricularis posterior A.occipitalis A.maxillaris A.facialis A.maxillaris Maxillary artery: Pars pterygopalatina Pars pterygoidea Pars mandibularis A.temporalis spf. A.carotis int. A.meningea media A.carotis externa A.alveolaris inf. Maxillary artery Pars pterygopalatina Pars pterygoidea Pars mandibularis A.infraorbitalis R. temporales profundi A.meningea media A.sphenopalatina FSP FOI CP TA AP A.palatina desc. A.masseterica Aa.alveolares Rr.pterygoidei sup.post. A.buccalis A.alveolaris inferior Pterygopalatine fossa – lateral aspect - schema Foramen sphenopalatinum FOI Canalis pterygoideus PrPt Maxilla Maxillary artery branches in the pars pterygopalatina Maxillary artery branches in the pars pterygopalatina Rr. nasales post.lat.+septi A.infraorbitalis A.sphenopalatina A.canalis pterygoidei M A.palatina descendens A.alveolares sup.ant. Aa.alveolares sup.post A.palatina major +minor V.temporalis spf. Vv.diploicae V.angularis Plexus pterygoideus V.facialis V.retromandibularis V.jugularis externa V.jugularis interna Nn. temporales profundi N.VII N.auriculotemporalis N.alveolaris inf. N.buccalis R.mylohyoideus N.lingualis n.massetericus Infratemporal fossa - repetition http://anat.lf1.cuni.cz/muzeum/alb3 http://anat.lf1.cuni.cz/muzeum/alb3 Transverse section through the palatine tonsille Section through the neck - C1/2 Spatium parapharyngeum Spatium retropharyngeum Section through the neck - C1/2 ductus parotideus m.buccinator corpus adiposum buccae n.lingualis constrictor pharyngis sup. tonsilla palatina m.masseter a.palatina ascendens n.+vasa alveolaria inf. m. pterygoideus medialis a.pharyngea ascendens SG,SPh a.carotis int., n.X., v. jugularis int. n.IX, n.XII truncus sympaticus a.carotis ext., n.VII, v.retromandibularis nodi lymphatici SH retropharyngei m. digastricus (v.p.) n.XI m.sternocleidomastoideus m.trapezius Section through the neck - C1/2 repetition Section through the neck - C1/2 repetition Mimetic muscles • From the 2. branchial arch • Nerve supplying facial nerve (VII.n) • No fascia • m.buccinator – fascia buccopharyngea Groups: a)muscles of the scalp b) muscles of the auricle c) muscles in the region of eyelids d) muscles of the nasal region e) muscles of the mouth region Galea aponeurotica Mimetic muscles 1 2 3 4 6 5 10 9 11 8 12 7 a) muscles of the scalp 17 b) muscles of the auricle 13 c) muscles in the region of eyelids 14 d) muscles of the nasal region 15 e) muscles of the mouth region 16 Nerve supplying of mimetic muscles - facial nerve (VII.) Porus acusticus int Foramen stylomastoideum Plexus parotideus Regio parotidomasseterica (plexus parotideus) N.auriculotemporalis Vasa temporalia superficialia (V/3) Rr.temporales N.auricularis post. (VII) Rr.zygomatici A.transversa faciei Vasa auricularia post. Ductus parotideus Rr.buccales V.retromandibularis R.marginalis mandibulae N.auricularis magnus (pl.cervicalis) R.colli Duchenne and an assistant faradize the mimetic muscles of a live subject to demonstrate the mechanics of facial expression. M.epicranius, venter frontalis M.depressor anguli oris M occipitofrontalis, venter frontalis M.zygomaticus major M.orbicularis oculi M.zygomaticus major M.corrugator supercilii Peripherial facial nerve palsy Mimetic muscles lateral aspect Mimetic muscles anterior aspect Superfitial face structures – parotid gland is partially removed Superfitial head structures Projection of the important structures on the face surface Face transplantation • Isabelle Dinoire, the world's first face transplant recipient, is beginning to recover much of her facial function Sources • Čihák, Anatomie 1 • Petrovický a spol., Anatomie 1 • Grim, Záklagdy anatomie • Sobotta , Atlas anatomie člověka • Bertolini/Leutert, Atlas der Anatomie des Menschen • Grayś Anatomy • http://en.wikipedia.org/wiki/Guillaume_Benjamin_Amand _Duchenne • http://www.newscientist.com/article/dn8688--face- transplant-recipient-faces-world-press.html • Ramba, Slavné české lebky • Personal archive.