Veins of the Face

The Supratrochlear Vein

• This vessel begins on the forehead from a network of veins connected to the frontal tributaries of the superficial temporal vein.
• It descends near the medial plane with its fellow on the other side.
• These veins diverge near the orbits, each joining a supraorbital vein to form the facial vein near the medial canthus (angle of the eye).

The Supraorbital Vein

• This vessel begins near the zygomatic process of the temporal bone.
• It joins the tributaries of the superficial and middle temporal veins.
• It passes medially and joins the supratrochlear vein to form the facial vein near the medial canthus.

The Facial Vein

• This vein provides the major venous drainage of the face.

• It begins at the medial canthus of the eye by the union of the supraorbital and supratrochlear veins.
• It runs inferoposteriorly through the face, posterior to the facial artery, but takes a more superficial and straighter course than the artery.
• Inferior to the margin of the mandible, the facial vein is joined by the anterior branch of the retromandibular vein.
• The facial veins ends by draining into the internal jugular vein.

The Superficial Temporal Vein

• This vein drains the forehead and scalp and receives tributaries from the veins of the temple and face.
• In the region of the temporomandibular joint, this vein enters the parotid gland.

The Retromandibular Vein

• The union of the superficial temporal and maxillary veins forms this vessel, posterior to the neck of the mandible.
• It descends within the parotid gland, superficial to the external carotid artery but deep to the facial nerve.
• It divides into an anterior branch that unites with the facial vein, and a posterior branch that joins the posterior auricular vein to form the external jugular vein.

The Nasal Mucosa

• Mucosa lines the entire nasal cavities except for the vestibule of the nose.
• The nasal mucosa is firmly bound to the periosteum and perichondrium of the supporting structures of the nose.
• It is continuous with the adjoining cavities to which the nasal cavity communicates (e.g., the nasopharynx and paranasal sinuses).

• The inferior 2/3 of the nasal mucosa is called the respiratory area and air passing over this is warmed and moistened before it passes into the lungs.
• The superior 1/3 is called the olfactory area.

The Olfactory Area of Nasal Mucosa

• This area contains the peripheral organ of smell.
• Sniffing draws air into this area
• Olfactory receptor cells (from the olfactory nerve, CN I, are located in the mucosa of this area in the nose.

Nerves to the Respiratory Area of Nasal Mucosa

• The inferior 2/3 of the nasal mucosa are supplied chiefly by the trigeminal nerve (CN V).

• The mucous membrane of the nasal septum is supplied chiefly by the nasopalatine nerve, a branch of the maxillary nerve (CN V²).
• Its anterior portion is supplied by the anterior ethmoidal nerve (a branch of the nasociliary nerve) which is derived from the ophthalmic nerve (CN V¹).

• The lateral walls of the nasal cavity are supplied by branches of the maxillary nerve (CN V²); the greater palatine nerve, and the anterior ethmoidal nerve.

Arteries of the Nasal Mucosa

• The blood supply of the mucosa of the nasal septum is derived mainly from the maxillary artery.

• The sphenopalatine artery, a branch of the maxillary, supplies most of the blood of the nasal mucosa.
• It enters by the sphenopalatine foramen and sends branches to the posterior regions of the lateral wall and to the nasal septum.

• The greater palatine artery, also a branch of the maxillary, passes through the incisive foramen to supply the nasal septum.

• The anterior and posterior ethmoidal arteries, branches of the ophthalmic artery, supply the anterosuperior part of the mucosa of the lateral wall of the nasal cavity and nasal septum.

• Three branches of the facial artery (superior labial, ascending palatine, and lateral nasal) also supply the anterior parts of the nasal mucosa.

Veins of the Nasal Mucosa

• The veins of the nasal mucosa form a venous network of plexus in the connective tissue of the nasal mucosa.
• Some of the veins open into the sphenopalatine vein and drain to the pterygoid plexus.
• Others join the facial and infraorbital veins.
• Some empty into the ophthalmic veins and drain into the cavernous sinus.

• Long bones (e.g.. femur and humerus)
• Short bones (e.g.. wrist and ankle bones)
• Flat bones (e.g.. ribs)
• Irregular bones (e.g.. vertebrae)

Internal Muscles of the Pharynx

• The internal, chiefly longitudinal muscular layer, consists of 3 muscles: stylopharyngeus, palatopharyngeus, and salpingopharyngeus.
• They all elevate the larynx and pharynx during swallowing and speaking.

The Stylopharyngeus Muscle

• This is a long, thin, conical muscles that descends inferiorly between the external and internal carotid arteries.
• It enters the wall of the pharynx between the superior and middle constrictor muscles.

• Origin: styloid process of temporal bone.
• Insertion: posterior and superior borders of thyroid cartilage with palatopharyngeus muscle.
• Innervation: glossopharyngeal nerve (CN IX).

• It elevates the pharynx and larynx and expands the sides of the pharynx, thereby aiding in pulling the pharyngeal wall over a bolus of food.

The Palatopharyngeus Muscle

• This is a thin muscle and the overlying mucosa form the palatopharyngeal arch.

The Salpingopharyngeus Muscle

• This is a slender muscle that descends in the lateral wall of the pharynx.
• The over lying mucous membrane forms the salpingopharyngeal fold.

• Origin: cartilaginous part of the auditory tube.
• Insertion: blends with palatopharyngeus muscle.
• Innervation: through the pharyngeal plexus.

• It elevates the pharynx and larynx and opens the pharyngeal orifice of the auditory tube during swallowing.

The Articular Capsule

• The capsule of this joint is loose.
• The thin fibrous capsule is attached to the margins of the articular area on the temporal bone and around the neck of the mandible.

-> This bone forms much of the base and posterior aspect of the skull.
-> It has a large opening called the foramen magnum, through which the cranial cavity communicates with the vertebral canal.
-> It is also where the spinal cord becomes continuous with the medulla (oblongata) of the brain stem.
-> The occipital bone is saucer-shaped and can be divided into four parts: a squamous part (squama), a basilar part (basioccipital part), and two lateral parts (condylar parts).
-> These four parts develop separately around the foramen magnum and unite at about the age of 6 years to form one bone.
-> On the inferior surfaces of the lateral parts of the occipital bone are occipital condyles, where the skull articulates with C1 vertebra (the atlas) at the atlanto-occipital joints.
-> The internal aspect of the squamous part of the occipital bone is divided into four fossae: the superior two for the occipital poles of the cerebral hemispheres, and the inferior two, called cerebellar fossae, for the cerebellar hemispheres.