The First Affiliated Hospital School of Medicine, Zhejiang University Prof. Dr. Gu Xinhua Oral and Maxillofacial Anatomy

The First Affiliated HospitalThe First Affiliated Hospital

School of Medicine, Zhejiang School of Medicine, Zhejiang UniversityUniversity

Prof. Dr. Gu XinhuaProf. Dr. Gu Xinhua

Oral and Maxillofacial Oral and Maxillofacial AnatomyAnatomy

Oral and Maxillofacial Oral and Maxillofacial AnatomyAnatomy

Oral and Maxillofacial Systematic AnatomyOral and Maxillofacial Systematic AnatomyOral and Maxillofacial Systematic AnatomyOral and Maxillofacial Systematic Anatomy

Oral Topographic AnatomyOral Topographic AnatomyOral Topographic AnatomyOral Topographic Anatomy

Maxillofacial Topographic AnatomyMaxillofacial Topographic AnatomyMaxillofacial Topographic AnatomyMaxillofacial Topographic Anatomy

Oral and Maxillofacial Oral and Maxillofacial Systematic AnatomySystematic Anatomy

Key points:1. pillars and processes of maxilla2. weak regions of mandible3. composition of the temporomandibular joint4. muscles of mastication5. How to distinguish the internal and external carotid artery?6. pterygoid plexus7. distribution of trigeminal nerve in oral region8. branches of facial nerve

Oral and Maxillofacial Oral and Maxillofacial Systematic AnatomySystematic Anatomy

BonesBones ：： maxilla and mandible maxilla and mandible BonesBones ：： maxilla and mandible maxilla and mandible

Joints ： temporomandibular joint Joints ： temporomandibular joint

MusclesMuscles ：： muscles of masticationmuscles of masticationMusclesMuscles ：： muscles of masticationmuscles of mastication

VesslesVessles ：： carotid artery and jugular veincarotid artery and jugular veinVesslesVessles ：： carotid artery and jugular veincarotid artery and jugular vein

NervesNerves ：： V VII IX XIIV VII IX XIINervesNerves ：： V VII IX XIIV VII IX XII

Oral and Maxillofacial systematic anatomy

Oral and Maxillofacial systematic anatomy bonebone

There’re totally fourteen bones making up the maxillofacial bony framework.

Single bone: Single bone: mandiblemandible 、、 vomervomer pairing bones: pairing bones: maxillamaxilla 、、 zygomatic boneszygomatic bones、、 palatine bonespalatine bones 、、 inferior inferior nasal conchanasal conchanasal bonesnasal bones 、、 lacrimal lacrimal bonesbones

MaxillaMaxilla

boneboneboneboneOral and Maxillofacial systematic anatomy


maxillamaxillamaxillamaxillabonebone

One bodyOne body （（ four surfacesfour surfaces））Four processesFour processes

One sinusOne sinus

three pairs of three pairs of

pillarspillars



Anterior Anterior surface (facial surface (facial surface)surface)

infraorbital forameninfraorbital foramen

maxillamaxilla口腔颌面部系统解剖口腔颌面部系统解剖 boneboneOral and Maxillofacial systematic anatomy


maxillamaxilla口腔颌面部系统解剖口腔颌面部系统解剖 bonebone

Posterior Posterior surfacesurface

Zygomatico-alveolar Zygomatico-alveolar ridgeridgeMaxillary tuberosity Maxillary tuberosity



Upper surface Upper surface (orbital surface)(orbital surface)

infraorbital grooveinfraorbital groove

maxillamaxilla口腔颌面部系统解剖口腔颌面部系统解剖 boneboneOral and Maxillofacial systematic anatomy


Medial surfaceMedial surface

（（ nasal surfacenasal surface））

maxillamaxillaboneboneOral and Maxillofacial systematic anatomy


maxillamaxillabonebone Four Four processesprocesses

Four Four processesprocesses

Four processesFour processesfrontal processzygomatic processpalatine processalveolar process



maxillary sinusmaxillary sinusThe inferior wall of the maxillary sinus covers the root apexes from the maxillary second premolar to the third molar, and the root apex of the first molar is the nearest to it.

maxillamaxillabonebone One sinusOne sinusOne sinusOne sinusOral and Maxillofacial systematic anatomy


maxillary sinusmaxillary sinus

three pairs of three pairs of pillarspillars

Frontonasal pillarFrontonasal pillar (canine pillar)(canine pillar)

Zygomatic Zygomatic process pillarprocess pillarPterygoid Pterygoid process pillarprocess pillar

maxillamaxillabonebone three pairs ofthree pairs of pillarspillars

three pairs ofthree pairs of pillarspillars



MandibleMandible

boneboneboneboneOral and Maxillofacial systematic anatomy


The unique bone which is The unique bone which is mobile on the maxillofacial mobile on the maxillofacial regionregion ！！

Body of mandibleBody of mandible

Ramus of mandibleRamus of mandible

angle of mandibleangle of mandible

MandibleMandibleMandibleMandibleOral and Maxillofacial systematic anatomy

Oral and Maxillofacial systematic anatomy bonebonebonebone

The external surface The external surface of the body of of the body of mandiblemandible

Meso-combinationMeso-combination

mental tuberclemental tubercleexternal oblique lineexternal oblique linemental foramenmental foramen

MandibleMandible Body of Body of mandiblemandible

Body of Body of mandiblemandible


Oral and Maxillofacial systematic anatomy bonebonebonebone

The internal surface The internal surface of the body of of the body of mandiblemandible

Mental spinesMental spines

Internal oblique line Internal oblique line (mylohyoid line)(mylohyoid line)

Sublingual fossaSublingual fossa

Digastric fossaDigastric fossa

Submandibular fossaSubmandibular fossa


Oral and Maxillofacial systematic anatomy bonebonebonebone MandibleMandible Body of Body of

mandiblemandible

Body of Body of mandiblemandible

Ramus of mandibleRamus of mandiblecoronoid process

（ muscular process ） Condylar process

(articular process ）simoid notch

(mandibular notch)The internal surface of the ramus of mandble

mandibular foramenmandibular lingulaMandibular canal

Ramus of Ramus of mandiblemandible

Ramus of Ramus of mandiblemandible


Oral and Maxillofacial systematic anatomy bonebonebonebone MandibleMandible

angle of mandible

Internal surface ： pterygoid

tuberosityExternal surface ：masseteric tuberosity

angle of mandible

angle of mandible



The weak regions The weak regions of mandibleof mandible

Meso-combinationMeso-combination

mental foramenmental foramenAngle of mandibleAngle of mandible

neck of condyleneck of condyle

Weak regionWeak regionWeak regionWeak regionOral and Maxillofacial systematic anatomy


Temporomandibular jointTemporomandibular joint

Temporomandibular joint




condylar condylar processprocess

articular fossaarticular fossa

articular disarticular diskk





articular capsulearticular capsule

articular ligamentsarticular ligaments









muscles of masticationmuscles of mastication

musclemuscle muscles of mastication

muscles of mastication



Muscles of Muscles of masticationmastication

massetertemporalismedial pterygoid musclelateral pterygoid muscle


Oral and Maxillofacial systematic anatomy musclemuscle muscles of

mastication

muscles of mastication

MasseterMasseter

Actions:elevates the

mandibleProtrudes the

mandible

massetermassetermassetermasseterOral and Maxillofacial systematic anatomy

Oral and Maxillofacial systematic anatomy musclemuscle

TemporalisTemporalis Actions:elevates the mandibleRetracts the

protruded mandible with its horizontal posterior fibers

Unilateral contraction : mastication

TemporalisTemporalisTemporalisTemporalisOral and Maxillofacial systematic anatomy


Medial pterygoid Medial pterygoid musclemuscle

Actions:elevates the mandible

Medial Medial pterygoidpterygoid

Medial Medial pterygoidpterygoid



Lateral pterygoid muscle

Actions:Bilateral contraction:

initiates mouth opening by protruding the mandible and moving the articular disk forward

Unilateral contraction: tract the mandible to the opposite side during mastication

Lateral Lateral pterygoid pterygoid

Lateral Lateral pterygoid pterygoid



Blood vessel

Blood vessel

blood vesselblood vessel



arteryInternal carotid arteryExternal carotid arteryDistinguish the two arteries （ location 、 branch 、 pulsation ）

veinSuperficial veinDeep vein

Blood vessel

Blood vessel



common carotid artery →Internal carotid artery frontonasal part intra-orbit encephalon

→External carotid artery →superior thyroid artery →lingual artery →facial artery (external

maxillary artery) →maxillary artery (internal

maxillary artery ) →superficial temporal

artery

arteryarteryarteryarteryBlood vessel

Blood vessel



Distinguish internal and Distinguish internal and external carotid arteryexternal carotid arterylocationlocation ：： the internal is at the post-lateral side of the external first and then at its post-intra side branchbranch ：： the internal has no branch at the cervical partPulsation: Pulsation: external maxillary artery and superficial temporal artery have no pulsation when blocking the external carotid artery

arteryartery distinguishingdistinguishingBlood vessel

Blood vessel



superficial vein at oral superficial vein at oral maxillo-facial regionmaxillo-facial region

facial veinsuperficial temporal vein

deep vein at oral maxillo-deep vein at oral maxillo-facial regionfacial region

pterygoid plexusmaxillary veinretromandibular veincommon facial vein

veinveinveinveinBlood vessel

Blood vessel



pterygoid plexus:

Is a venous network situated behind the mandibular ramus between the muscles of mastication. It has extensive connections with the adjacent veins which are clinically important because they may allow infectious organisms to enter the cranial cavity.

veinveinveinveinBlood vessel

Blood vessel



nervesnervesnervesnerves

nervesnerves



olfactory nerveoptic nerveoculomotor nervetrochlear nerveV.trigeminal nerve －branch 、 distributionabducent nerveVII.facial nerve －branch 、 distributionvestibulocochlear nerveIX.glossopharyngeal nerve － distributionvagus nerveaccessory nerveXII.hypoglossal nerve－ distribution

Cranial nervesCranial nerves



nervesnervesnervesnerves

trigeminal nerve



Prin

cipal sen

sory P

rincip

al sensory

nu

cleus

nu

cleus

（（to

uch

-pre

ssure

se

nsa

tion

））

spin

al nu

cleus

spin

al nu

cleus

（（p

ain an

d

pain

and

tem

peratu

re tem

peratu

re sen

sationsen

sation

））

Motor n

ucleu

sM

otor nu

cleus

（（m

otoe rootm

otoe root

））

Trigeminal ganglionTrigeminal ganglion

Op

hth

almic n

erveO

ph

thalm

ic nerve

（（sen

sory nerve

sensory n

erve

））

Maxillary n

erve M

axillary nerve

（（sen

sory nerve

sensory n

erve

）） Man

dib

ular

Man

dib

ular

nerve

nerve

（（m

ixed n

ervem

ixed n

erve

））

trigeminal nerve

trigeminal nerve


Oral and Maxillofacial systematic anatomy Cranial

nervesCranial nerves

lacrimal gland

eyeballeyeball

eyelideyelid

skin of foreheadskin of forehead

nasal mucosanasal mucosa

OphthalmOphthalmic ic divisiondivision




trigeminal nerve

trigeminal nerve

nervus meningeus medius— cerebral nervus meningeus medius— cerebral dura materdura materzygomatic nervezygomatic nerve—skin of the cheek —skin of the cheek and tempus and tempus

sphenopalatine nerve—mucosa of the sphenopalatine nerve—mucosa of the nose and palatenose and palate

Posterior superior alveolar nerve— Posterior superior alveolar nerve— distoside distoside

Middile superior alveolar nerve— Middile superior alveolar nerve— mesial sidemesial side

Anterior superior alveolar nerve—Anterior superior alveolar nerve—

infraorbital nerveinfraorbital nerve—facial section—facial section

MaxillaMaxillaryry nervenerve

Middle Middle cranial cranial sectiosectio

nn

PterygopalPterygopalatine atine fossa fossa sectionsection

Orbital Orbital sectisectionon




trigeminal nerve

trigeminal nerve

Facial sectio

n

nervesnervesnervesnervesOral and Maxillofacial systematic anatomy


Maxillary nerve

trigeminal nerve

trigeminal nerve

nervus spinosus─nervus spinosus─cerebral dura matercerebral dura matermedial pterygoid nerrvemedial pterygoid nerrve──medial pterygoidmedial pterygoid

deep temproal ngervesdeep temproal ngerves──temporalistemporalismasseteric nervemasseteric nerve──massetermasseterlateral pterygoid nervelateral pterygoid nerve──lateral pterygoidlateral pterygoidbuccal nervebuccal nerve──skin and mucosa of the skin and mucosa of the posterior tooth’s buccal sideposterior tooth’s buccal side

auriculotemporal nerve

lingual nerve

temporomandibular jointtemporomandibular jointexternal acoustic meatusexternal acoustic meatusexternal acoustic meatusexternal acoustic meatusSkin of temporal regionSkin of temporal region

Lingual gum of the mandibleLingual gum of the mandibleTwe-thirds mucosa of the fore tongueTwe-thirds mucosa of the fore tongueMucosa of the oral floorMucosa of the oral floorsublingual glandsublingual gland

inferior alveolar nerve

Gum of the mandibleGum of the mandibleMylohyoidMylohyoidanterior belly of digastricanterior belly of digastric

Fore

-trun

k o

f Fore

-trun

k o

f th

e

the

man

dib

ula

r m

an

dib

ula

r n

erv

en

erv

e

Meta

-trun

k o

f the

Meta

-trun

k o

f the

man

dib

ula

r m

an

dib

ula

r n

erv

en

erv

e




trigeminal nerve

trigeminal nerve

Man

dib

ula

r n

erv

e

Motor branches: for the muscles of mastication

Sensory branches: Buccal nerveAuriculotemporal nerveLingual nerveInferior alveolar nerve




trigeminal nerve

trigeminal nerve

Mandibular nerve

nervesnervesnervesnervesOral and Maxillofacial systematic anatomy


Mandibular nerve

8 7 6 5 4 8 7 6 5 4 3 2 13 2 1 1 2 31 2 3 4 54 5 66 7 87 8

8 7 6 5 4 3 2 18 7 6 5 4 3 2 1 1 2 3 4 1 2 3 4 5 6 7 85 6 7 8

Cranial nervesCranial nervesOral and Maxillofacial

systematic anatomy


trigeminal nerve

trigeminal nerve

PmA

Palatal/lingual

Lingual n.Buccal n./Mental

n.

/Inferior alveolar n.

L-B/teeth

Nasopalatine n.

anter. pala.n

.

Distribution of n. in oral region

nervenervenervenerve

Facial nerveFacial nerve



Motor fiberMotor fiber ：： mainly dominate the muscles of facial mainly dominate the muscles of facial expressionexpression

submaxillary gland, sublingual glandsubmaxillary gland, sublingual glandlacrimal glandlacrimal gland 、、 mucosal glands of the mucosal glands of the nasal cavity and palatenasal cavity and palate

Taste fiberTaste fiber ：： taste bud of the anterior twe-thirds of the taste bud of the anterior twe-thirds of the tonguetongue

Facial Facial nervenerve


ParasympatheParasympathetic fibertic fiber ：：




nervenervenervenerve Facial nerveFacial nerveOral and Maxillofacial systematic anatomy


Tem

poral facial trun

kT

emp

oral facial trunk

Cervicofacial

Cervicofacial

trunk

trunk

temporal branchestemporal branches

zygomatic brancheszygomatic branches

buccal branchesbuccal branches

marginal marginal mandibular branchmandibular branch

cervical branchcervical branch

Com

men

trun

k o

f the fa

cia

l n

erv

e

muscular branchesmuscular branches











Central paralysis and peripheral paralysis

Central paralysisCentral paralysisLoss of the upper neurpns, in this case

on the left side.presents clinically with paralysis of the contralateral muscles of the facial expression in the lower half of the face , while the contralateral forehead and extra-ocular muscles remain functional. Thus, the corner of the mouth sags on the right (contralateral) side, but the patient can still wrinkle the forehead and close the eyes on both sides. Speech articulation is impaired.






Peripheral paralysisPeripheral paralysis (Loss of the lower neurpns, in this

case on the right side).is characterized by complete paralysis of the ipsilateral muscles. The patient cannot wrinkle the forehead, the corner of the mouth sags, articulation is impaired, and the eyelid cannot be fully closed. A Bell phenomenon is present (the eyeball turns upward and outward, exposing the sclera, when the patient attempts to close the eyelids), and the eyelids closure reflex is abolished. Depending on the site of the lesion, additional deficits may be present such as decreased lacrimation and salivation or loss of taste sensation in the anterior two-thirds of the tongue.






glossopharyngeal nerve (mixed nerve)(mixed nerve)

Motor fiber:Motor fiber: Parasympathetic fiberParasympathetic fiber ：： secretion of parotid glandsecretion of parotid glandSensory fiber:

pharyngeal mucous pharyngeal mucous membrane, membrane,

carotid sinus,carotid sinus, carotid body,carotid body,

one-third mucosa of the one-third mucosa of the post tongue,post tongue,palatine tonsil palatine tonsil Taste fiber: Taste fiber: one-third of one-third of the post tonguethe post tongue

Glossopharyngeal nerve

Glossopharyngeal nerve




Hypoglossal Hypoglossal nerve nerve

(motor nerve)(motor nerve)

intrinsic and intrinsic and extrinsic muscles extrinsic muscles of the tongueof the tongue

Hypoglossal Hypoglossal nervenerve

Hypoglossal Hypoglossal nervenerve




L-1

local anatomy of the oral local anatomy of the oral cavitycavity

Key points1. features of the soft tissue of the hard palatefeatures of the soft tissue of the hard palate

2. papillae and their functions of the tongue 2. papillae and their functions of the tongue

3. lymphatic drainage of the tongue3. lymphatic drainage of the tongue

local anatomy of the oral local anatomy of the oral cavitycavity

Boundary of the oral cavityBoundary of the oral cavityBoundary of the oral cavityBoundary of the oral cavity

Anatomy of the lipAnatomy of the lipAnatomy of the lipAnatomy of the lip

Anatomy of the tongueAnatomy of the tongueAnatomy of the tongueAnatomy of the tongue

Anatomy of the hypoglossal areaAnatomy of the hypoglossal areaAnatomy of the hypoglossal areaAnatomy of the hypoglossal area

Surface markerSurface markerSurface markerSurface marker

Anatomy of the cheekAnatomy of the cheekAnatomy of the cheekAnatomy of the cheek

Anatomy of the palateAnatomy of the palateAnatomy of the palateAnatomy of the palate

Anatomy of the dentitionAnatomy of the dentitionAnatomy of the dentitionAnatomy of the dentition

Boundary of the oral Boundary of the oral cavitycavityLips are the anterior wallLips are the anterior wallFauces is the posterior Fauces is the posterior

erathemerathemPalate is the upper boundPalate is the upper boundOral floor is the lower bound Oral floor is the lower bound The dental arches with the The dental arches with the

alveolar processes of the alveolar processes of the maxilla and mandible maxilla and mandible subdivide the oral cavity subdivide the oral cavity into oral vestibule and oral into oral vestibule and oral cavity proper.cavity proper.

local anatomy of the oral cavity


Boundary of the oral cavity

Boundary of the oral cavity

oral vestibular groovefrenulum of the upper and lower lipbuccal frenumopening of the Stensen's duct—Parotid glandretromolar area Pterygonmandibular foldlingual frenulum

Surface Surface markermarker




lipslips

Anatomy ofAnatomy of the lipsthe lips




boundaryboundary ：： basis nasi is the upper basis nasi is the upper

boundbound mentolabial sulcus is the mentolabial sulcus is the

lower boundlower bound labial sulccus is the labial sulccus is the

lateral boundlateral bound anatomic landmark ：：

angle of mouthangle of mouth vermilion vermilion vermilion bordervermilion border labial archlabial arch labial peaklabial peak vermilion tuberclevermilion tubercle nasal columellanasal columella philtrumphiltrum 、、 philtrum philtrum

ridgeridge 、、 philtrun philtrun incisureincisure









cheekscheeks

Anatomy of Anatomy of the cheeksthe cheeks




boundary inferior margin of the

zygomatic bone is the upper bound

inferior border of mandible is the lower bound

anterior border of masseter is its posterior border

layer skin hypodermis ： buccal pad,

vascular nerve Buccinator ， fascia

buccinator submucosa ： contain

mucous gland mucosa ： have thw

opening of the Stensen's duct





palatepalate

Anatomy ofAnatomy of the palatethe palate




Anatomic landmark

Palatine rapheIncisive papillaPalatine foldsHard palate Greater palatine foramenPterygoid hamulusFoveola palatina





Feature of the soft Feature of the soft tissue of the hard tissue of the hard palatepalate

submucosasubmucosa ：： there are no glands in the anterior part ， and a lot of mucous glands in the posterior part.Periosteum adhere to mucosa and submucosa more tightly than to bone surfaceMucoperiosteum is not easy to move,and can tolerate scrape and masticatory pressure





Muscle of the soft Muscle of the soft palatepalate

tensor veli palatinilevator veli palatinipalatoglossuspalatopharyngeusuvular muscle





tonguetongue

Anatomy ofAnatomy of the tonguethe tongue




The V-shaped The V-shaped terminal sulcus terminal sulcus divides tongue divides tongue to an anterior to an anterior two-thirds two-thirds (boby) and a (boby) and a posterior one-posterior one-third (root)third (root)

tonguetonguetonguetonguelocal anatomy of the oral cavity




Body of tongue has four Body of tongue has four kinds of papillakinds of papillafiliform papilla-filiform papilla-

sensitive sensitive to tactile to tactile stimulistimuli

fungiform papilla-fungiform papilla-mechanical/thermal mechanical/thermal receptors,taste budsreceptors,taste buds

vallate papilla-vallate papilla- abundant taste budsabundant taste buds

foliate papilla-foliate papilla- taste taste budsbuds

TongueTongueTongueTonguelocal anatomy of the oral cavity




Root of tongue:Root of tongue:

no papillano papilla ，， a lot of a lot of nodosity lymphatic nodosity lymphatic tissue called tissue called lingual tonsil.lingual tonsil.





muscles:muscles: extrinsic:4 musclesextrinsic:4 muscles

intrinsic:intrinsic:

superior longitudinal m.superior longitudinal m.

inferior –inferior –

transverse m.transverse m.

vertical m.vertical m.





apex of tongue lymphatic vessel

submental lymph nodes

nodi lymphaticus juguloomohyoideus

ante- lateral tongue

Submaxillary L.N

lymphonodi cervicales profundi craniales

center of tongue

lymphonodi cervicales profundi craniales

submaxillary L.N

part cross to opposite side

posterior tongue lymphonodi cervicales profundi craniales

Lymphatic Lymphatic drainagedrainage

Lymphatic Lymphatic drainagedrainage





lingual frenulumfimbriated foldsublingual

carunclesublingual fold

Lingual Lingual abdomenabdomenLingual Lingual

abdomenabdomenlocal anatomy of the oral cavity




dentitiondentition

Anatomy ofAnatomy of the dentitionthe dentition








Permanent Permanent teethteeth

Deciduous Deciduous teethteeth













hypoglossal areahypoglossal area

Anatomy of the Anatomy of the hypoglossal areahypoglossal area




Under the tongue and mucous membrane of oral floor

Beyond the Mylohyoid and hyoglossus

Go ahead to reach the medial surface of the body of mandible

Root of tongue is the post wall

Genioglossus and geniohyoid divide it into two halves

Anatomic landmark

Anatomic landmark





Sublingual gland and the deep part of the submandibular gland

Submandibular duct and lingual nerve

Hypoglossal nerve and its accompanying vein

Sublingual artery

contentscontentslocal anatomy of the oral cavity




Local anatomy of the maxillofacial Local anatomy of the maxillofacial regionregion

Key points

1. features of the soft tissue in the maxillofacial region

2. deep region of lateral face

3. communication between the cellulite spaces

Local anatomy of the maxillofacial Local anatomy of the maxillofacial regionregion

Surface markerSurface markerSurface markerSurface marker

Parotideomasseteric Parotideomasseteric regionregionParotideomasseteric Parotideomasseteric regionregion

Cellulite spacesCellulite spacesCellulite spacesCellulite spaces

Feature of the soft tissueFeature of the soft tissueFeature of the soft tissueFeature of the soft tissue

Deep layer of the lateral facial regionDeep layer of the lateral facial regionDeep layer of the lateral facial regionDeep layer of the lateral facial region

nasal columella Base of the nose Nasofacial sulcus Labiofacial sulcus menton infraorbital foramen surface projection of the

Stensen's duct the position of the facial

nerve efferens stylomastoid foramen

Local anatomy of the maxillofacial region




Skin is thin and soft and has wrinkle whose strike is regular.

Subcutaneous tissue is curmbly.

Abundant of sebaceous glands, hair follicle and sweat gland

Blood vessels are intensive, and blood is plentiful.

Expression muscles

Feature of theFeature of the soft tissuesoft tissue

Feature of theFeature of the soft tissuesoft tissue



parotideomasseteric parotideomasseteric regionregion

parotideomasseteric regionparotideomasseteric regionLocal anatomy of the maxillofacial region


Prozone-- exterior edge Prozone-- exterior edge of masseterof masseter

Postzone--Postzone--sternocleidomastoidsternocleidomastoid 、、 mmastoid process and astoid process and exterior edge of the exterior edge of the posterior belly of posterior belly of digastric muscledigastric muscle

Upper bound -- Upper bound -- zygomatic arch and zygomatic arch and external acoustic meatusexternal acoustic meatus

Lower bound--inferior Lower bound--inferior border of mandibleborder of mandible

boundaryboundaryboundaryboundaryLocal anatomy of the maxillofacial region


Parotideomasseteric region


contentscontentscontentscontents

parotid gland and its contents

perpendicular teamsuperficial temporal artery and veinauriculotemporal nervevena facialis posteriorexternal carotid artery

Lateropulsion teamFacial nerveMaxillary artery and veintransverse facial artery

masseter





Deep region of lateral Deep region of lateral

faceface

Deep region ofDeep region oflateral facelateral face




Prozone-- the posterior surface of the maxilla.

Postzone--the parotid gland sheath.

Extra-zone--the ramus of mandible.

Intra-zone-- the lamina lateralis processus pterygoidei.

equal to the range of pteryomandibular space and temporal space

boundaryboundaryboundaryboundaryLocal anatomy of the maxillofacial region




Pterygoid plexus ：located between the temporalis and lateral pterygoid M., also between the medial and lateral pterygoid M.Maxillary artery ： go along the deep part of the neck of condyleMandibular nerve and its branchesLateral pterygoid M.

contentscontentscontentscontentsLocal anatomy of the maxillofacial region




Cellulite spacesCellulite spaces

Cellulite Cellulite spacesspaces




Infraorbital Infraorbital spacespace

Infraorbital Infraorbital spacespace

boundaryboundary ：：Upper bound is Upper bound is infraorbital margininfraorbital marginLower bound is Lower bound is processus alveolaris processus alveolaris maxillaemaxillaeExtra-bound is Extra-bound is zygomaticuszygomaticusIntra-bound is nasal Intra-bound is nasal lateral marginlateral marginBottom is the Bottom is the anterior wall of the anterior wall of the maxillamaxilla





Buccal Buccal spacespace

Buccal Buccal spacespace

BoudaryBoudary ：：Between the Between the buccinator and the buccinator and the massetermasseter

Prozone is the Prozone is the anterior ledge of the anterior ledge of the massetermasseter

Postzone is the Postzone is the anterior ledge of anterior ledge of ramus and ramus and temporalistemporalis



CelluliteCellulite spacesspaces


Masseteric Masseteric spacespace

Masseteric Masseteric spacespace

Boundary Boundary ：：Between the masseterBetween the masseter and and ramusramus

Prozone is the mucosa of the Prozone is the mucosa of the retromolar area retromolar area

Postzone is the parotid glandPostzone is the parotid gland





PterygomandibularPterygomandibular spacespace

PterygomandibularPterygomandibular spacespace

Boundary Boundary ：：Between the ramus of mandible and Between the ramus of mandible and the medial pterygoidthe medial pterygoid

Prozone is the temporalis and Prozone is the temporalis and buccinator buccinator

Postzone is the parotid glandPostzone is the parotid gland

Upper bound is the inferior margin of Upper bound is the inferior margin of the lateral pterygoidthe lateral pterygoid

Lower bound is the point which the Lower bound is the point which the medial pterygoid attaches to the medial pterygoid attaches to the ramusramus





InfratemporalInfratemporal spacespace

InfratemporalInfratemporal spacespace

Boungary Boungary ：：Prozone is the posterior surface of the maxillaProzone is the posterior surface of the maxillaPostzone is the styloid process and many Postzone is the styloid process and many muscles which attach to styloid processmuscles which attach to styloid processIntra-bound is lamina lateralis processus Intra-bound is lamina lateralis processus pterygoideipterygoideiExtra-bound is upper part of the ramus and Extra-bound is upper part of the ramus and zygomatic archzygomatic archUpper bound is the infratemporal surface and Upper bound is the infratemporal surface and infratemporal crest of the great wing of infratemporal crest of the great wing of sphenoid bonesphenoid boneLower bound is the inferior margin of lateral Lower bound is the inferior margin of lateral pterygoidpterygoid





Temporal Temporal spacespace

Temporal Temporal spacespace

Boundary Boundary ：：Located at the temporal regionLocated at the temporal region

To To have zygomatic arch and have zygomatic arch and infratemporal crest as the infratemporal crest as the boundary to the infratemporal boundary to the infratemporal space space

To be divided into superficial To be divided into superficial temporal space and deep temporal space and deep temporal spacetemporal space





Parapharyngeal Parapharyngeal spacespace

Parapharyngeal Parapharyngeal spacespace

Boundary Boundary ：：Located between the medial pterygoid, Located between the medial pterygoid, deep lobe of the parotid gland and the deep lobe of the parotid gland and the lateral pharyngeal walllateral pharyngeal wallUpper to base of skull Upper to base of skull Lower bound is the hyoid bone planeLower bound is the hyoid bone planeProzone is ligamentum Prozone is ligamentum pterygomandibularepterygomandibularePostzone is lateral side of the fascia Postzone is lateral side of the fascia colli profundacolli profundaStyloid process and the muscles which Styloid process and the muscles which attach to it divide the space into attach to it divide the space into anterior parapharyngeal space and anterior parapharyngeal space and posterior parapharyngeal spaceposterior parapharyngeal space


Local anatomy of the maxillofacial region Cellulite spacesCellulite spacesCellulite spacesCellulite spaces

PterygopalatinePterygopalatine spacespace

PterygopalatinePterygopalatine spacespace

Boundary Boundary ：：Prozone is the maxillaProzone is the maxillaPostzone is the pterygoid Postzone is the pterygoid

process of sphenoid boneprocess of sphenoid boneUpper bound is the greater wing Upper bound is the greater wing

of sphenoid boneof sphenoid boneOutside bound is the vertical Outside bound is the vertical

plate of palatine boneplate of palatine bone





communication between the cellulite communication between the cellulite spacesspaces

submental space

infratemporal space

Pterygomandibular space

parotid spaces

pterygopalatine spaces

Cranium cavity

temporal

space buccal space

infra

orb

ital

sp

ace

Masseteric space

sublingual space

parapharyngeal space

ParaParaviscera space

Genioglossus space

pretracheal spacemedias

tinum

retro

esop

ha

geal

sp

ace

Retro

ph

ary

ng

eal

sp

ace

SubmandibSubmandibular spaceular space

Local anatomy of the Local anatomy of the cervical cervical partpart

Submandibular regionSubmandibular regionSubmandibular regionSubmandibular region

Cervical section of the tracheaCervical section of the tracheaCervical section of the tracheaCervical section of the trachea

Local anatomy of the Local anatomy of the cervical cervical partpart

Key points:1. Submandibular region

2. Cervical section of the trachea

submandibular trianglesubmandibular triangle

Local anatomy of the cervical part


submandibular triangle


Boundary ：upper bound --the inferior border of mandibleAnte-lower bound -- the anterior belly of digastricPost-lower bound -- the posterior belly of digastric Its basic floor -- constituded of mylohyoid, hyoglossus, superior constrictor of pharynx and so on.





Contents ： Submandibular

gland submandibular

lymph nodes external maxillary

artery vena facialis

anterio lingual nerve

Wharton duct hypoglossal nerve





Cervical section of the Cervical section of the tracheatrachea





Layer :Layer :((from superficial to deepfrom superficial to deep)) ** skinskin* superficial fascia* superficial fascia* * superficial layer of superficial layer of the deep fascia of the deep fascia of neckneck* * middle layer of the middle layer of the deep fascia of neckdeep fascia of neck

Cervical section of the trachea

Cervical section of the tracheaLocal anatomy of

the cervical part


adjacent ：linea alba

cervicalisthyroid glandcommon

carotid arteryEsophagusrecurrent

laryngeal nerve





[email protected]

Arrangement of Lab. or clinical study

Group 1&4 -1st Aff Hospital, Ward of Oral-Maxillofacial Surg, 7th floor Building 3 Chief Tutor: Prof Liu Jianhua 13588890251

Group 2&5 -2nd Aff Hospital, Ward of Oral-Maxillofacial Surg, Ground floor Building 1 Chief Tutor: Dr. Liu Yanming 15967157676

Group3&6-divided into 3a,6a(1st),3b,6b(2nd) Nov.16(Wed),13:15-14:50

Documents

The First Affiliated Hospital School of Medicine, Zhejiang University Prof. Dr. Gu Xinhua Oral and Maxillofacial Anatomy