• Cartilage model is covered with perichondrium that is converted to periosteum

• Diaphysis-central shaft
• Epiphysis-located at either end of the diaphysis
• Growth in length of the bone is provided by the emetaphyseal plate located between the epiphyseal cartilage and the diaphysis

• Blood capillaries and the mesenchymal cells infiltrate the spaces left by the destroyed chondrocytes

• Osteoblasts are derived from the undifferentiated cells; form an osseous matrix in the cartilage
• Bone appears at the site where there was cartilage

      Microscopic structure

• Compact bone is found on the exterior of all bones; canceIlous bone is found in the interior
• Surface of compact bone is covered by periosteum that is attached by Sharpey's fibers
• Blood vessels enter the periosteum via Volkmann's canals and then enter the haversian canals that are formed by the canaliculi and lacunae

•  

• Marrow
  • FiIls spaces of spongy bone
  • Contains blood vessels and blood ceIls in various stages of development
  • Types
• Red bone marrow
  • Formation of red blood ceIls (RBCs) and some white blood cells (WBCs) in this location
  • Predominate type of marrow in newborn
  • Found in spongy bone of adults (sternum, ribs, vertebrae, and proximal epiphyses of long bones)
•  Yellow bone marrow
  • Fatty marrow
  • Generally replaces red bone marrow in the adult, except in areas mentioned above
•  
• Ossification is completed as the proximal epiphysis joins with the diaphysis between the twentieth and twenty-fifth year

Nerves of the Face

Innervation of the Muscles of Facial Expression

The Facial Nerve (CN VII)

• The seventh cranial nerve supplies the superficial muscle of the neck (platysma), the muscles of facial expression, the auricular muscles and the scalp muscles.
• CN VII is the sole motor supply to the muscles of facial expression.

• The facial nerve emerges from the skull though the stylomastoid foramen.
• Almost immediately, it enters the parotid gland. It runs superficially in this gland before giving rise to its five terminal branches: temporal, zygomatic, buccal, marginal mandibular, and cervical.
• These nerve emerge from the superior, anterior and inferior margins of the gland and spread out like the abducted digits of the hand to supply the muscles of facial expression.

• The temporal branches of CN VII cross the zygomatic arch to supply all the superficial facial muscles superior to it, including the orbital and forehead muscles.

• The zygomatic branch of CN VII passes transversely over the zygomatic bone to supply the muscles in the zygomatic, orbital and infraorbital regions.

• The buccal branches of CN VII pass horizontally, external to the masseter muscle, to supply the buccinator and the muscles of the upper lip.

• The marginal mandibular branch of CN VII supplies the muscles of the lower lip and chin.

• The cervical branch of CN VII supplies the platysma and the superficial muscles of the neck.

The Medial Wall of the Orbit 

• This wall is paper-thin and is formed by the orbital lamina or lamina papyracea of the ethmoid bone, along with contributions from the frontal, lacrimal, and sphenoid bones (L. papyraceus, "made of papyrus" or parchment paper).

• There is a vertical lacrimal groove in the medial wall, which is formed anteriorly by the maxilla and posteriorly by the lacrimal bone.
• It forms a fossa for the lacrimal sac and the adjacent part of the nasolacrimal duct.

• Along the suture between the ethmoid and frontal bones are two small foramina; the anterior and posterior ethmoidal foramina.
• These transmit nerves and vessels of the same name.

Innervation of the Skin

• Innervation of the skin is mainly through the three branches of the trigeminal nerve (CN V).
• Some skin over the angle of the mandible and anterior and posterior of the auricle is supplied by the great auricular nerve from the cervical plexus.
• Some cutaneous branches of the auricular branch of the facial nerve also supplies skin on both sides of the auricle.

• The trigeminal nerve is the general sensory nerve to the head, particularly the face, and is the motor nerve to the muscles of mastication.

The Ophthalmic Nerve

• This is the superior division of the trigeminal nerve, the smallest of the three branches and is wholly sensory.
• The ophthalmic nerve divides into three branches: the nasociliary, frontal and lacrimal just before entering the orbit through the superior orbital fissure.

• The nasociliary nerve supplies the tip of the nose through the external nasal branch of the anterior ethmoidal nerve.

• The frontal nerve is the direct continuation of CN V¹ and divides into two branches, the supraorbital and supratrochlear.
• The supratrochlear nerve supplies the middle part of the forehead.
• The supraorbital nerve supplies the lateral part and the front of the scalp.

• The lacrimal nerve, the smallest of the main ophthalmic branches, emerges over the superolateral orbital margin to supply the lacrimal gland and the lateral part of the upper eyelid.

The Maxillary Nerve

• This is the intermediate division of the trigeminal nerve.
• It has three cutaneous branches.

• The infraorbital nerve is the largest terminal branch of the maxillary nerve.
• It passes through the infraorbital foramen and breaks up into branches that supplies the skin on the lateral aspect of the nose, upper lip and lower eyelid.

• The zygomaticofacial nerve, a small branch of the maxillary, emerges from the zygomatic bone from a foramen with the same name.
• It supplies the skin over the zygomatic bone.

• The zygomaticotemporal nerve emerges from the zygomatic bone from foramen of the same name.
• It supplies the skin over the temporal region.

The Mandibular Nerve

• This is the inferior division of the trigeminal nerve.
• Of the three division of the trigeminal nerve, CN V³ is the only one that carries motor fibres (to the muscles of mastication).
• The main sensory branches of the mandibular nerve are the buccal, auriculotemporal, inferior alveolar and lingual nerves.

• The buccal nerve is a small branch of the mandibular that emerges from deep to the ramus of the mandible.
• It supplies the skin of the cheek over the buccinator muscle, the mucous membrane lining the cheek, and the buccal surface of the gingiva.

• The auriculotemporal nerve passes medially to the neck of the mandible and then turns superiorly, posterior to its head and anterior to the auricle. It then crosses over the root of the zygomatic process of the temporal bone, deep to the superficial temporal artery.

• It supplies the auricle, external acoustic meatus, tympanic membrane, and the skin in the temporal region.

• The inferior alveolar nerve is the large terminal branch of the posterior division of the mandibular nerve (the lingual nerve is the other terminal branch).
• It enters the mandible through the mandibular foramen to the mandibular canal. In the canal, it gives branches to the mandibular teeth.
• Opposite the mental foramen, this nerve divides into the mental nerve and the incisive nerve.
• The incisive nerve supplies the incisor teeth, the adjacent gingiva and the mucosa of the lower lip.
• The mental nerve emerges from the mental foramen and supplies the skin of the chin and the skin and mucous membrane of the lower lip and gingiva.

• The lingual nerve is the smaller terminal branch of the mandibular nerve.
• It supplies the general sensory fibres to the anterior two-thirds of the tongue, the floor of the mouth and the gingivae of the mandibular teeth.

Histology

Histology is the study of tissues.

A tissue is a group of cells with similar structure and function plus the extracellular substances located between the cells.

There are four basic types of tissues:

- Epitheliums

- Connective tissue

- Muscle tissue

- Nervous tissue

The Skeleton of the Nose

• The immovable bridge of the nose, the superior bony part of the nose, consists of the nasal bones, the frontal processes of the maxillae, and the nasal part of the frontal bones.

• The movable cartilaginous part consists of five main cartilages and a few smaller ones.
• The U-shaped alar nasal cartilages are free and movable.
• They dilate and constrict the external nares when the muscles acting on the external nose contract.

The Nasal Cavities

• The nasal cavities are entered through the anterior nares or nostrils.
• They open into the nasopharynx through the choanae.

The Roof and Floor of the Nasal Cavity

• The roof is curved and narrow, except at the posterior end.

• The floor is wider than the roof.
• It is formed from the palatine process of the maxilla and the horizontal plate of the palatine bone.

The Walls of the Nasal Cavity

• The medial wall is formed by the nasal septum; it is usually smooth.

• The lateral wall is uneven owing to the three longitudinal, scroll-shaped elevations, called the conchae (L. shells) or turbinates (L. shaped like a top).
• These elevations are called the superior, middle and inferior conchae according to their position.

• The superior and middle conchae are parts of the ethmoid bone, whereas the inferior conchae are separate bones.

• The inferior and middle conchae project medially and inferiorly, producing air passageways called the inferior and middle meatus (L. passage). Note: the plural of "meatus" is the same as the singular.
• The short superior conchae conceal the superior meatus.
• The space posterosuperior to the superior concha is called the sphenoethmoidal recess.