B. Carotid triangle: Superiorly: Posterior belly of digastric Anteroinferiorly: Superior belly of the omohyoid Posteriorly: Sternomastoid

Roof: Skin, Superficial fascia and investing layer of deep cervical fascia

Floor: Thyrohyoid muscle Hyoglossus Middle constrictor & Inferior constrictor of pharynx

Contents of Carotid triangle: Arteries: Common carotid artery Internal carotid artery External carotid artery

Contents of Carotid triangle: Veins: Internal jugular vein Common facial vein Pharyngeal vein Lingual vein

Contents of Carotid triangle: Nerves: Vagus Spinal accessory nerve Hypoglossal nerve Sympathetic chain Carotid sheath and lymph nodes

D. Muscular triangle: Anterioly: Median line of neck Posterosuperioly: Superior belly of the omohyoid Posteroinferiorly: Sternomastoid muscle

Infrahyoid muscles are chief contents of Contents of Muscular triangle: Infrahyoid muscles are chief contents of muscular triangle

The Scalp

THE SCALP: The soft tissue covering the cranial vault is called as scalp Extent: Anteriorly: Supraorbital margins Posteriorly: External occipital protuberance On each side: Superior temporal lines

Scalp consists of five layers: Skin Close network of subcutaneous tissue Aponeurosis ( galea aponeurotica with epicranius muscle) Loose subaponeurotic tissue Pericranium

1. Skin: It is provided with numerous hair and sebaceous and sweat glands skin Subcutaneous tissue Galea aponeurotica Loose subaponeurotic tissue Pericranium

2. Close network of subcutaneous tissue: It consists of close network of subcutaneous tissue which connects the skin with underlying galea aponeurotica and epicranius muscles skin Subcutaneous tissue Galea aponeurotica Loose subaponeurotic tissue Pericranium

3. Epicranius muscle and its aponeurosis: The Epicranius includes: Occipito-frontalis muscle which consists of Occipital belly behind Frontal belly in front

Galea aponeurotica: It is a fibrous sheet which connects occipitalis and frontalis muscle

4. Loose subaponeurotic tissue: (Dangerous area of scalp) It lies beneath the epicranius muscle and presents a potential space containing emissary veins skin Subcutaneous tissue Galea aponeurotica Loose subaponeurotic tissue Pericranium

5. Pericranium: It is outer periosteum of the skull skin Subcutaneous tissue Galea aponeurotica Loose subaponeurotic tissue Pericranium

Nerve supply: Ten nerves supply the scalp on each side Five in front of the auricle - Four are sensory and one is motor Five behind the auricle –

Nerves in front of auricle: Supra-trochlear (S) Supra-orbital (S) Zygomatico-temporal (S) Temporal branch of facial nerve (M) Auriculo-temporal nerve (S)

Nerves behind the auricle: Posterior branch of great auricular nerve(S) Posterior auricular branch of facial nerve (M) Lesser occipital nerve (S) Greater occipital nerve (S) Third occipital nerve (S)

Arterial supply: Five sets of arteries supply the scalp on each side Three in front of the auricle Two behind the auricle

Arteries in front of the auricle: Supra-trochlear Supra-orbital Ophthalmic artery Superficial temporal External carotid artery

Arteries behind the auricle: Posterior auricular Occipital artery External carotid artery

Venous Drainage: Supra-trochlear Supra-orbital Superficial temporal Posterior auricular Occipital vein

Emissary veins: On each side two sets of emissary veins Parietal - Superior sagittal sinus Mastoid– Sigmoid sinus Emissary vein Sigmoid sinus

Diploic veins: Frontal diploic vein- Supra-orbital vein Occipital diploic vein– Occipital vein Diploic veins

Lymphatic drainage: Anterior part of scalp- Pre-auricular Posterior part of scalp– Post-auricular

FACIAL MUSCLES

Occipitofrontalis muscle Topographically, the muscles are grouped as: 1. Muscle of scalp: Identify the muscle? Occipitofrontalis muscle

3. Auricularis posterior 2. Muscles of the auricle: 2. Auricularis superior Identify the muscles? 3 1 2 3. Auricularis posterior 1. Auricularis anterior

2. Corrugator supercilli 2. Muscles of the eyelids: 2. Corrugator supercilli 2 1 1. Orbucularis oculi Identify the muscles?

1 2 3 4 4. Muscles of the nose: 4. Depressor septi 1. Procerus 2.Compressor naris 2 3 3. Dilator naris 4

3. Levator labii superioris alaequae nasi 4. Levator labii superioris 5. Muscles around the mouth: 2 3. Levator labii superioris alaequae nasi 3 2. Levator anguli oris 4 1 4. Levator labii superioris 1. Orbicularis oris

5 6 7 5. Muscles around the mouth: 5. Zygomaticus minor 6. Zygomaticus major 6 7 7. Risorius

10. Depressor labii angularis 9. Depressor labii inferioris 5. Muscles around the mouth: 10. Depressor labii angularis 10 9 8 9. Depressor labii inferioris 8. Mentalis

6. Muscle of the neck: Platysma 1

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