Anatomi Kepala 2017c1

Wendra,dr.,M.
Kes
Wendra/PSKG/Anatomi/2017
 Include:
 Frontal
 Orbital
 Nasal
 Infraorbital
 Zygomatic
 Buccal
 oral
 Tulang Kepala terdiri
atas
 Neurocranium (8 buah),
menutupi rongga otak
(cavum cranii).
 Viscerocranium (14
buah), melindungi jalan
masuk sistem
pernafasan &
pencernaan.
 Bones form the basic underlying structure of the
stomatognathic system.
 Three main bones make up the skeletal portion of the

stomatognathic system- the maxilla, the mandible,
and a portion of the temporal bone of the skull.
 The maxilla and mandible are the bones that hold the
teeth, while the temporal bone is the site of the
mandible’s articulation with the skull.
•Maxilla & mandible are derived
from 1st pharyngeal arch.
Muscles of mastication are

derived from mesoderm of 1st
branchial arch
 The mandible forms the lower part of our face. It is
suspended from the skull by muscles, ligaments and
soft tissues, and doesn’t itself attach bone-to-bone to
the maxilla, but hangs in space.
 U-shaped bone, contains mandibular teeth in alveolar
process.
 Suspended from skull by muscles & ligaments.
 Major structural parts- condyle, coronoid process,
ramus, angle, alveolar process, mental protuberance.
 Composes most of upper part of face &
contains maxillary teeth.
 Fused to skull & hence non-mobile.
 Major intra-oral parts- alveolar process,
palatal process, incisive foramen, mid-palatal
suture, maxillary tuberosity.
 Part of the skull
with which the
mandible articulates.
 Condyle articulates
with concave
mandibular fossa.
 Disebut dengan SUTURA
 Jaringan ikat fibrosa
 Jumlah banyak, wajib hanya 4 sutura :
 Sutura lamdoidea
 Sutura coranaria
 Sutura sagitalis
 Sutura squamosa
 Bayi, Fontanela (ubun 2x) : jaringan ikat antara 2 /
>tulang cranium.
 Fontanela occipitale, sphenoidale, mastoide : 1-2 bln
stlh lahir tutup.
 Fontanela frontale : 2 tahun tutup
 Skin
 Connective
tissue
 Apponeurosis
 Loose conective
tissue
 Pericranium
 Skin
The skin of the scalp is thick and hair bearing and contains numerous
sebaceous glands. As a result, the scalp is a common site for sebaceous
cysts.
 Connective tissue (superficial fascia)

 The superficial fascia ; fibrofatty layer
 connects skin to the underlying aponeurosis
 provides a passageway for nerves and blood vessels.
 Blood vessels are attached to fibrous connective tissue.
 If the vessels are cut, this attachment prevents vasospasm, which
could lead to profuse bleeding after injury.
 Aponeurosis (galea aponeurotica)
 thin, tendinous structure
 insertion site for the occipitofrontalis muscle
 Loose areolar tissue
 Areolar tissue loosely
 connects the epicranial aponeurosis to the pericranium
 allows the superficial 3 layers of the scalp to move over the
pericranium.
 emissary veins traverse this layer, which connects the scalp veins to
the diploic veins and intracranial venous sinuses.
 Pericranium
 The pericranium is the periosteum of the skull
bones. Along the suture lines, the
pericranium becomes continuous with the
endosteum. A subperiosteal hematoma,
therefore, forms in the shape of the skull
bones.
1. Dura mater, epidural , subdural
2. Arachnoidea mater /membran and subarachnoid spaces
/spatium
3. Pia mater
**Dural compartment of the skull :

1. Cerebral falx,
2. Cerebellar tentorium –supratentorial space contains
cerebrum , infratentorial space or posterior fossa contains
brainstem and cerebellum.
3. The cerebellar falx.separated cerebelli hemisphere left and
right
 Very vascular
 Due to rich vascularity face blush and blanch
 Wounds of face bleed profusely but heal rapidly
 Facial skin is rich in sebaceous gland and sweat
gland
 Sebaceous gland keep the skin oily but also cause
acne in adult
 Sweat gland regulate body temperature
 Ophthalmic division (CN V.1)
▪ Supratrochlear
▪ Supraorbital
▪ Lacrimal
▪ Infratrochlear
▪ External nasal
 Maxillary nerve (CN V.2)
▪ Infraorbital
▪ Zygomaticofacial and
zygomaticotemporal
 Mandibular nerve (CN V.3)
▪ Auriculotemporal
▪ Buccal nerve
▪ Mental
Skin over the mandibular
angle is supplied by ant.
Div. Of greater auricular
nerve Wendra/PSKG/Anatomi/2017
 Nc. Mesencephalic :
 Sensasi propioseptif dari ocular, facial, dan bulbar
muscles
 Nc. Sensori principalis:
 Sensasi Raba/ Touch dari Wajah, bola mata, seluruh
membrane mukosa di kepala
 Nc. Spinalis
 Sensasi Nyeri dan Suhu dari kulit wajah, bola mata,
membran mukosa di kepala (Sinus, Nasal, oral,
orbita)
Kelompok otot Ekspresi wajah (Nc.VII) Kelompok otot Mastikasi (Nc.V.3
 Medial & lateral pterygoid muscles
 Branches of mandibular nerve
 Otic ganglion
 Chorda tympani
 Maxillary artery
 Pterygoid venous plexus
 Inferior part of temporal muscle
 Type – Synovial Joint
▪ Articulation between mandibular condylar process
and temporal bone
▪ Ginglymoarthrodial joint- allows hinging and gliding
motions.
▪ Articular disc separates the 2 bones
 Concave on both superior and inferior surfaces
allowing for smooth articulation between 2 bones
 Disc injury – locking/catching with opening and
closing of mouth
▪ Mandibular condyle glides forward as mouth opens
 Actions/Purpose:
▪ Speaking
▪ Mastication Wendra/PSKG/Anatomi/2017
 Condyle, articular disc & mandibular fossa
surrounded by soft tissue attachments.
 Attachments aid in structure of joint,
positioning and function of joint
components.
 It consist of ligamentous attachments,
elastic and collagenous connective tissue
attachments and muscle attachment .
 Bands of non-elastic collagenous tissue.
 Function to passively limit range of movement
& protect joint structures.
5 ligaments associated with TMJ
3 functional, 2 accessory
 Functional:
 Collateral (discal) ligaments
 Capsular ligament
 Temporomandibular ligament
 Accessory:
 Sphenomandibular
 Stylomandibular
 2 collateral ligaments- Medial
& lateral.
 Stiff, collagenous connective
tissue.
 Divide TMJ mediolaterally
into superior & inferior joint
cavities.
 Help keep disc positioned on
condyle, allow anterior-
posterior rotational movement.
 Surrounds entire TMJ.
 Runs from neck of
condyle to temporal
bone & articular
eminence, surrounds
mandibular fossa, 360
degrees around.
Functions:
 Prevent
dislocation of
articulating
surfaces.
 Proprioception.
 Contains synovial
lining – produces
synovial fluid.
 Outer Oblique Portion
 articular eminence to neck of
condyle
 limits opening of mouth
 influences nature of opening
movement
 Inner Horizontal Portion
 articular eminence to head of
condyle & disc
 limits posterior movement
 Both are closely related

physically with capsular
ligament
 Sphenomandibular Ligament
 Medial view
 sphenoid bone to lingula.
 non-functional
 Stylomandibular Ligament
 styloid process to angle of
mandible
 limits protrusive
movement
 TMJ is divided into 2
distinct joint cavities by
articular disc and ligaments:
 Superior joint cavity
 Between articular disc &
mandibular fossa
 Responsible for gliding
movements
 Inferior joint cavity
 Space between articular disc &
condyle
 Responsible for hinging
movements
 Joint capsule lined by specialized endothelial
cells- synovial lining.
 Produces synovial fluid, fills both joint
cavities.
Function- lubrication & metabolism.
 2 mechanisms- boundary lubrication &
weeping lubrication.
 Blood supply-
Branches from
superficial temporal and
maxillary arteries. Veins
follows arteries.
 Nerve supply-
Auriculotemporal nerve
and massetric nerve.
 Depression of the mandible: opening mouth
 Elevation of the mandible: closing mouth)
 Protrusion of the chin
 Retraction of the chin
 Lateral movement: grinding and chewing
 Masseter .
 Temporalis.
 Medial pterygoid.
 Lateral pterygoid.
 Hyoid muscles.
 Auxillary oral muscles.
 Depression- Lateral pterygoid (mainly)
Digastric, geniohyoid and mylohoid muscles
help when the mouth is open wide or against
resistance.
 Elevation - Masseter
- Temporalis
- Medial pterygoid (both sides)
 Protrusion – Lateral & medial pterygoids.
 Retraction – Temporalis (post fibers).
 Lateral or side to side movement - Medial &

lateral pterygoids together.
 The muscles of mastication are the primary functional
muscles that perform the majority of mandibular
movements.
 The suprahyoid group contains the muscles responsible
for mouth opening, along with others ,
 The infrahyoids, help to co-ordinate mandibular
function.
 The posterior neck musculature is active in stabilizing
and balancing the head, allowing the other muscles to
work together to perform the many complicated
movements that are possible.
Superficial portion-
 Origin-anterior 2/3rd of zygomatic arch.
 Insertion-coronoid process,ramus and angle of
mandible.
 Function-powerful elevator
Deep portion-
 Origin-medial surface of zygomatic arch
 Insertion-coronoid process,ramus & angle of
mandible.
 Function- elevation & retrusion.
Origin :
 Medial surface of lateral
pterygoid plate.
Insertion :
 Medial surface of the angle
of the mandible.
Function :
 Elevation & protrusion.
Medial pterygoid
Anterior portion-
 Origin : anterior temporal fossa
 Insertion : coronoid process
 Function : elevation Temporalis
Middle portion- muscle
 Origin : Mid temporal fossa
 Function : elevation & retraction
Posterior portion-
 Origin : posterior temporal fossa
 Function : retrusion
Inferior head of lateral pterygoid
 Origin:lateral surface of lateral
pterygoid plate.
 Insertion:neck of condyle.
 Function : protrusion
Superior head of lateral pterygoid

 Origin : infratemporal surface of
greater sphenoid wing.

 Insertion : articular capsule,disc
& neck of condyle.

 Function : protractor of disc in
conjuntion with elevator muscles
Mandibular
division of
trigeminal nerve
Blood supply to
muscles of mastication-
Maxillary
Artery
 Exocrine gland
 Collectively produce and secrete saliva.
 a fluid that assists in the initial activities of

digestion
 Secreted daily ranges between 1.0 and 1.5 L.
 Most is produced during mealtime, but
 Smaller amounts are produced continuously to
ensure that the oral cavity remains moist.
 Three pairs of large,
multicellular salivary
glands:
 parotid glands
 submandibular glands
 sublingual glands
 Largest salivary glands.
 Each parotid gland is located anterior and inferior to the ear,
partially overlying the masseter muscle.
 Produce about 25–30% of the saliva, which is conducted
through the parotid duct to the oral cavity.
 Duct is opening into maxilary 2nd mollar
 Inferior to the body of the mandible.
 Produce most of the saliva (about 60–70%).
 A duct opens from each gland through a papilla in the floor
of the mouth on the lateral sides of the lingual frenulum.
 Inferior to the tongue and internal to the oral cavity mucosa.
 Each gland extends multiple tiny sublingual ducts that open
onto the inferior surface of the oral cavity, posterior to the
submandibular duct papilla.
 Contribute only about 3–5% of the total saliva.
 An accessory digestive organ that is formed from
skeletal muscle and covered with lightly keratinized
stratified squamous epithelium.
 Helps compress the partially digested materials
against the palate to turn these materials into a
bolus › a globular mass of partially digested
material
 Performs important functions in swallowing.
 Skeletal muscles move the tongue.
Anterior two-third
 Apex
 Body (corpus)
 Dorsal
 Floor
Posterior third
 Root (radix)
Posterior third Anterior two-third
General sensory Glossopharyngeal nerve Lingual nerve (CN V3)

(CN IX)
Taste Glossopharyngeal nerve Chorda tympani (CN VII),

(CN IX) (also vallate via lingual nerve
papillae)
Motor Hypoglossal, pharyngeal Hypoglossal nerve (CN XII)

plexus (palatoglossus) (CN
XII, XI via CN X)
Muscles of Expression:
Action Origin
Muscle Insertion Innervation
Buccinator Depresses the Alveolar process Angle of mouth Facial
cheeks of maxilla and
mandible
Depressor Draws angle of Oblique line of Angle of mouth Facial

Anguli Oris mouth mandible
downward
Depressor Labii Lowers the Oblique line of Lower lip Facial

Inferioris mouth mandible
Digastric Opens mouth Inferior border Superior aspect Trigeminal
of mandible of hyoid bone
Geniohyoid Opens mouth Median ridge of Body of hyoid Ansa Cervicalis
mandible bone
Levator Anguli Raises each side Just superior to Angle of mouth Facial
Oris of mouth canine teeth
Muscles of Expression:
Action Origin
Muscle Insertion Innervation
Mentalis Elevates the Incisive fossa of Point of the Facial
skin of the chin the mandible mandible
Mylohyoid Opens the Inferior border Superior aspect Trigeminal
mouth of the mandible of hyoid bone
Orbicularis Oris “Puckers” the Originates off of Skin Facial
lips the muscles surrounding the
surrounding the lips
mouth
Procerus Wrinkles the Lower portion Lower portion Facial

nose of the nasal of the forehead
bone; Lateral between the
nasal cartilage eyebrow
Temporalis Aids in biting Temporal fossa Coronoid Trigeminal

process and
ramus of
mandible
Zygomaticus Smiling Zygomatic bone Angle of mouth Facial

Major

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Wendra,dr.,M.

 Three main bones make up the skeletal portion of the

Muscles of mastication are

 Connective tissue (superficial fascia)

**Dural compartment of the skull :

 Both are closely related

 Retraction – Temporalis (post fibers).

 Lateral or side to side movement - Medial &

Superior head of lateral pterygoid

greater sphenoid wing.

& neck of condyle.

conjuntion with elevator muscles

 a fluid that assists in the initial activities of

General sensory Glossopharyngeal nerve Lingual nerve (CN V3)

Taste Glossopharyngeal nerve Chorda tympani (CN VII),

Motor Hypoglossal, pharyngeal Hypoglossal nerve (CN XII)

Depressor Draws angle of Oblique line of Angle of mouth Facial

Depressor Labii Lowers the Oblique line of Lower lip Facial

Procerus Wrinkles the Lower portion Lower portion Facial

Temporalis Aids in biting Temporal fossa Coronoid Trigeminal

Zygomaticus Smiling Zygomatic bone Angle of mouth Facial

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