Station 1- Bones

Observe in Plastic Models

1 Skull:
• Frontal bone
• Supraorbital margin
• Glabella
• Nasal bones
• Frontal process of the maxilla
• Infraorbital foramen
• Alveolar process
• Frontal process of zygomatic bone
• Vomer
• Palatine bone and its parts
• Anterior nasal spine
• Inferior concha
• Middle concha
• Lacrimal bone
• Sphenoid bone
• Ethmoid bone
• Superior orbital fissure
• Inferior orbital fissure
• Orbital canal
• Medial pterygoid plate
• Lateral pterygoid plate
• Pterygoid fossa
• Maxillary tubercle
• Temporal fossa
• Zygomatic arch
• Mastoid process and lateral groove
• Superior nuchal line
• External occipital protuberance
• Infratemporal surface
• Crest of greater wing of sphenoid
2 Mandible
• Head
• Neck
• Mandibular notch
• Coronoid process
• Pterygoid fovea
• Ramus
• Angle
• Body
• Mental foramen
• Alveolar process

Anatomy Practical for Head and Neck: Scalp, Face, Mastication, and Neck
Prepared by: Dr. Altayeb Abdalla Ahmed and Dr. Elhady Kheir
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 • Mental protuberance
• Oblique line
• Mandibular foramen
• Lingual
• Mylohyoid line
• Mental spine
• Sublingual fossa
• Submandibular fossa
5 Hyoid Bone: body, lesser cornu, and greater cornu
Observe that it lies at the base of mandible and C3 vertebra
4 Temporomandibular Joint
• What type of joint and why?
• Identify the articular surfaces ((condyle) head of mandible with mandibular fossa and
articular tubercle of temporal bone)
• Ligaments:
o Strong lateral temporomandibular lig.
o Sphenomandibular ligament
o Stylomandibular ligament
• Discuss movements in the Suprameniscal and Inframeniscal compartments

Anatomy Practical for Head and Neck: Scalp, Face, Mastication, and Neck
Prepared by: Dr. Altayeb Abdalla Ahmed and Dr. Elhady Kheir
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 Station 2 Muscles
Observe in Plastic and Plastinated Models
1 Identify the muscles of mastication and discuss their actions and nerve supply
• Temporalis
• Masseter
• Medial pterygoid
• Lateral pterygoid
2 Identify suprahyoids muscles and discuss their actions and nerve supply
• Stylohyoid
• Digastric
• Mylohyoid
• Geniohyoid
3 Identify infrahyoids muscles and discuss their actions and nerve supply
• Omohyoid
• Sternohyoid
• Thyrohyoid
• Sternothyroid
4 Identify the muscles of the facial expression considering their actions and nerve supply:
frontalis, corrugator supercilli, procerus, orbicularis oris, levator labii superior alaeque nasi,
Levator labii superior, zygomaticus major and minor, nasalis (dilator nasalis and compressor
naris), orbicularis oculi,depressor anguli oris, depressor labii inferior oris, risorius, mentalis,
buccinators, and platysma.
5 Identify the layers of the scalp (Skin, connective tissue, galea apponeuritica and occipto-
frontal mucle, loose areolar tissue, and periosteum/ pericranium)
• Discuss movement (the first three layers moves together)
• Discuss blood and nerve supply
• Discuss clinical correlation (incisions, bleeding, infection and spread to intracranial
sinuses, and collections)
6 • Look in cross section of the neck and perceive the deep cervical fascia (Investing,
pretracheal, prevertebral, and carotid).
• Identify structures pass in cross section
• Identify structures in the neck root:
o Apex of lung
o Trachea
o Oeosphagus
o Brachial plexus
o Vagus nerve and recurrent laryngeal
o Sympathetic chain
o Phrenic nerve
o Brachiocephalic trunk
o Common Carotid
o Internal Jugular
o subclavian veins
• Remember that Retropharyngeal & pretracheal spaces infections spread inferiorly to
superior mediastinum.

Anatomy Practical for Head and Neck: Scalp, Face, Mastication, and Neck
Prepared by: Dr. Altayeb Abdalla Ahmed and Dr. Elhady Kheir
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 Station 3 Vessels and Nerves
Observe in Plastic and Plastinated Models
1 • Identify the carotid sheath and its contents
• Identify the common carotid artery, external carotid and internal carotid arteries (how
can you differentiate between the last two?)
• Identify the branches of the external carotid artery (superior thyroid, facial and lingual
anteriorly; occipital and posterior auricular posteriorly; and terminal branches:
maxillary and superficial temporal).
• Identify the branches of internal carotid artery in the face (Suratrochlear and
supraorbital)
• Identify the internal and external jugular veins and tributaries.
• Discuss lymph drainage of head and neck and superficial and deep lymph nodes
2 Innervation of the face:
Motor innervation (facial nerve):
• Temporal br. (upper facial muscles)
• Zygomatic br.
• Buccal br.
• Mandibular br.
• Cervial br. (platysma)

Anatomy Practical for Head and Neck: Scalp, Face, Mastication, and Neck
Prepared by: Dr. Altayeb Abdalla Ahmed and Dr. Elhady Kheir
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 Station 4 Neck
Observe in Plastic and Plastinated Models
1 Please trace the extent of the neck: upper: attachment of trapezius & SCM to skull (superior
nuchal line) & inferior border of mandible and lower: manubrium, first rib, clavicle & C7/T1
intervertebral disc.
2 Please identify and discuss the boundaries and contents of following triangles:
• Anterior triangle
o Suprahyoid region
 Submental triangle
 Submandibular or digastric triangle: submandibular gland,
submandibular lymph nodes
o Infrahyoid region
 Carotid triangle: common carotid artery and branches, Internal jugular
vein, and vagus nerve covered by carotid sheath, hypoglossal nerve
(CN XII) and cervical sympathetic trunk
 Muscular triangle: sternothyroid and sternohyoid muscles; thyroid and
parathyroid glands
• Posterior triangle
o Occipital triangle: spinal accessory nerve (CN XI), cutaneous branches of
cervical nerves C2, C3, and C4, and cervical lymph nodes
o Supraclavicular triangle (great supraclavicular fossa): third part of the
subclavian artery and branches

Anatomy Practical for Head and Neck: Scalp, Face, Mastication, and Neck
Prepared by: Dr. Altayeb Abdalla Ahmed and Dr. Elhady Kheir
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 Session 5- Wet Specimen

Anatomy Practical for Head and Neck: Scalp, Face, Mastication, and Neck
Prepared by: Dr. Altayeb Abdalla Ahmed and Dr. Elhady Kheir
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 Station 6 Imaging Anatomy

Anatomy Practical for Head and Neck: Scalp, Face, Mastication, and Neck
Prepared by: Dr. Altayeb Abdalla Ahmed and Dr. Elhady Kheir
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Anatomy Practical for Head and Neck: Scalp, Face, Mastication, and Neck
Prepared by: Dr. Altayeb Abdalla Ahmed and Dr. Elhady Kheir
Reviewed and Approved by: Dr. Altayeb Abdalla Ahmed Page 8
Anatomy Practical for Head and Neck: Scalp, Face, Mastication, and Neck
Prepared by: Dr. Altayeb Abdalla Ahmed and Dr. Elhady Kheir
Reviewed and Approved by: Dr. Altayeb Abdalla Ahmed Page 9
 Station 7- Clinical Anatomy
Fracture of the Anterior Cranial Fossa Bones
Result in:
The cribriform plate of the ethmoid bone
• Epistaxis
• Leakage of cerebrospinal fluid into the nose
(cerebrospinal rhinorrhea).

The orbital plate of the frontal bone

• Hemorrhage beneath the conjunctiva
• Exophthalmos.

• Nasal Fractures
Most common facial fractures. Because of :
• Prominence of the nose
• Bones & cartilages are lined with
mucoperiosteum and overlying by skin.

• Facial trauma:
Key facts
• 85% of facial injuries are from assault, often
with alcohol/drugs involved; the remaining from
falls, sports, road accidents, Industrial injuries.
• 20% have associated head injury, 2%
cervical spine injury.
• Fracture incidence: nose > zygoma > mandible
> maxilla. Pan facial fractures indicate high
energy impact or multiple blows.

Anatomy Practical for Head and Neck: Scalp, Face, Mastication, and Neck
Prepared by: Dr. Altayeb Abdalla Ahmed and Dr. Elhady Kheir
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Fractures of the Zygoma or Zygomatic Arch
• Fractured by a blow to the side of the face.

Subgaleal Hemorrhage:
Patients can develop raccoon eyes
Causes of Raccoon

• Scalp laceration
• Trauma of the eyes
• Fracture of the anterior cranial fossa

Forceps Delivery may cause Facial Nerve

Damaged. Justify that?

Injury of the facial nerve:

• Lower motor neuron – Bell’s palsy (half
of the face is paralyzed.
• Upper motor neuron- Facial palsy but
forehead is saved

Anatomy Practical for Head and Neck: Scalp, Face, Mastication, and Neck
Prepared by: Dr. Altayeb Abdalla Ahmed and Dr. Elhady Kheir
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• Fractures of the Mandible
Traumatic impact is transmitted around the ring,
causing a single fracture or multiple fractures of
the mandible, often far removed from the point
of impact.

If you find a fracture in one side you need to

exclude that there is no fracture in the other side

• Dislocation of the Temporomandibular Joint

Occurs when the mandible is depressed. In this
movement, the head of the mandible and the articular
disc both move forward until they reach the summit
of the articular tubercle.
Reduction of the dislocation is easily achieved by
• Pressing the gloved thumbs downward on
the lower molar teeth.
• Pushing the jaw backward.
(The downward pressure overcomes the tension
of the temporalis and masseter muscles, and the
backward pressure overcomes the spasm of the
lateral pterygoid muscles).

Bone changes with age and resorption

Anatomy Practical for Head and Neck: Scalp, Face, Mastication, and Neck
Prepared by: Dr. Altayeb Abdalla Ahmed and Dr. Elhady Kheir
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• Various forms of cleft lip.

• Central venous line:

A central line is inserted in the apex of the
triangular interval between the clavicle and the
clavicular and sternal heads of the
sternocleidomastoid muscle into the internal
jugular vein through which the catheter is
threaded into the superior vena cava.
• Carotid sinus syncope:
Is a temporary loss of consciousness or fainting
caused by diminished cerebral blood flow?
Discuss that.

• Congenital Torticollis
Excessive stretching of the sternocleidomastoid
muscle during a difficult labor. Later this
becomes invaded by fibrous tissue, which
contracts and shortens the muscle. Result in:
• The mastoid process is thus pulled down
toward the sternoclavicular joint of the same
side,
• Cervical spine is flexed
• Face looks upward to the opposite side.
• Asymmetrical growth changes occur in the
face.
• Cervical vertebrae may become wedge
shaped.

Dangerous area of face- infections from face

mainly from upper lip & nose can go to
cavernous sinus through ophthalmic vein and
deep facial vein to cavernous sinus (thrombosis)

Anatomy Practical for Head and Neck: Scalp, Face, Mastication, and Neck
Prepared by: Dr. Altayeb Abdalla Ahmed and Dr. Elhady Kheir
Reviewed and Approved by: Dr. Altayeb Abdalla Ahmed Page 13
 Station 8- Revision station

Put out all models from previous session

Anatomy Practical for Head and Neck: Scalp, Face, Mastication, and Neck
Prepared by: Dr. Altayeb Abdalla Ahmed and Dr. Elhady Kheir
Reviewed and Approved by: Dr. Altayeb Abdalla Ahmed Page 14