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HEADANDNECK• Tables

Intrinsic muscles of the eye

Muscle

 

Location

Innervation

Function

Ciliary

1

Muscle fibers in the ciliary body

Parasympathetics from the

Constricts ciliary body, relaxes tension on

 

 

 

oculomotor nerve [III]

lens, lens become more rounded

Sphincter

2

Circularly arranged fibers in the iris

Parasympathetics from the

Constricts pupil

pupillae

 

 

oculomotor nerve [III]

 

Dilator pupillae

3

Radially arranged fibers in the iris

Sympathetics from the superior

Dilates pupil

 

 

 

cervical ganglion (T1)

 

 

 

 

 

 

Muscles of the middle ear

Muscle

 

Origin

Insertion

Innervation

Function

Tensor tympani

1

Cartilaginous part of

Upper part of handle

Branch from mandibular

Contraction pulls handle of

 

 

pharyngotympanic tube, greater

of malleus

nerve [V3]

malleus medially, tensing

 

 

wing of sphenoid, its own bony

 

 

tympanic membrane

 

 

canal

 

 

 

Stapedius

2

Attached to inside of pyramidal

Neck of stapes

Branch of facial nerve [VII]

Contraction pulls stapes

 

 

eminence

 

 

posteriorly, preventing

 

 

 

 

 

excessive oscillation

 

 

 

 

 

 

1

1

 

3

2

2

594

Tables 8

Muscles of mastication

Muscle

Origin

Insertion

Innervation

Function

 

 

 

 

 

Masseter

1 Zygomatic arch and maxillary

 

process of the zygomatic bone

Lateral surface of ramus of mandible

Masseteric nerve from the

Elevation of

anterior trunk of the

mandible

mandibular nerve [V3]

 

Temporalis 2 Bone of temporal fossa and temporal fascia

Coronoid process of mandible and anterior margin of ramus of mandible almost to last molar tooth

Deep temporal nerves

Elevation and

from the anterior trunk of

retraction of

the mandibular nerve [V3]

mandible

Medial

3 Deep head—medial surface of

Medial surface of mandible

Nerve to medial pterygoid

Elevation and

pterygoid

lateral plate of pterygoid process

near angle

from the mandibular nerve

side-to-side

 

and pyramidal process of palatine

 

[V3].

movements of the

 

bone; superficial head—tuberosity

 

 

mandible

 

of the maxilla and pyramidal

 

 

 

 

process of palatine bone

 

 

 

Lateral

4 Upper head—roof of infratemporal

pterygoid

fossa; lower head—lateral surface

 

of lateral plate of the pterygoid

 

process

Capsule of temporomandibular joint in the region of attachment to the articular disc and to the pterygoid fovea on the neck of mandible

Nerve to lateral pterygoid

Protrusion and

directly from the anterior

side-to-side

trunk of the mandibular

movements of the

nerve [V3] or from the

mandible

buccal branch

 

1

2

3

4

595

HEADANDNECK• Tables

Anterior triangle of neck (suprahyoid and infrahyoid muscles)

Muscle

 

Origin

Insertion

Innervation

Function

Stylohyoid

1 Base of styloid process

Lateral area of body of

Facial nerve [VII]

Pulls hyoid bone upward in

 

 

 

hyoid bone

 

a posterosuperior direction

Digastric

2 Digastric fossa on lower

—Anterior belly

inside of mandible

Attachment of tendon between two bellies to body of hyoid bone

Mylohyoid nerve from

Opens mouth by lowering

inferior alveolar branch of

mandible; raises hyoid

mandibular nerve [V3]

bone

—Posterior belly 3 Mastoid notch on medial

Facial nerve [VII]

Pulls hyoid bone upward

side of mastoid process

 

and back

of temporal bone

 

 

Mylohyoid

4 Mylohyoid line on

Body of hyoid bone and

 

mandible

fibers from muscle on

 

 

opposite side

Mylohyoid nerve from inferior alveolar branch of mandibular nerve [V3]

Support and elevation of floor of mouth; elevation of hyoid

Geniohyoid

5 Inferior mental spine on

 

inner surface of mandible

Anterior surface of body of hyoid bone

Branch from anterior ramus of C1 (carried along the hypoglossal nerve

[XII])

Fixed mandible elevates and pulls hyoid bone forward; fixed hyoid bone pulls mandible downward and inward

Sternohyoid

6 Posterior aspect of

Body of hyoid bone medial

 

sternoclavicular joint and

to attachment of omohyoid

 

adjacent manubrium of

muscle

 

sternum

 

Anterior rami of C1 to C3

Depresses hyoid bone

through the ansa

after swallowing

cervicalis

 

Omohyoid

7 Superior border of

 

scapula medial to

 

suprascapular notch

Lower border of body of hyoid bone just lateral to attachment of sternohyoid

Anterior rami of C1 to C3

Depresses and fixes hyoid

through the ansa

bone

cervicalis

 

Thyrohyoid

8 Oblique line on lamina of

 

thyroid cartilage

Greater horn and adjacent aspect of body of hyoid bone

Fibers from anterior ramus of C1 carried along hypoglossal nerve [XII]

Depresses hyoid bone, but when hyoid bone is fixed raises larynx

Sternothyroid

9 Posterior surface of

Oblique line on lamina of

 

manubrium of sternum

thyroid cartilage

Anterior rami of C1 to C3

Draws larynx (thyroid

through the ansa

cartilage) downward

cervicalis

 

596

Tables 8

4 5

 

3

 

1

 

8

2

9

 

6

7

 

597

Tables 8

Subdivisions of the anterior triangle of the neck—a regional approach

Subdivision

Boundaries

Contents

 

 

 

Submental triangle

1

Mandibular symphysis; anterior belly of digastric

(unpaired)

 

muscle; body of hyoid bone

Submental lymph nodes; tributaries forming the anterior jugular vein

Submandibular triangle

2

Lower border of mandible; anterior belly of digastric

(paired)

 

muscle; posterior belly of digastric muscle

Submandibular gland; submandibular lymph nodes; hypoglossal nerve [XII]; mylohyoid nerve; facial artery and vein

Carotid triangle (paired) 3 Posterior belly of digastric muscle; superior belly of omohyoid muscle; anterior border of sternocleidomastoid muscle

Tributaries to common facial vein; cervical branch of facial nerve [VII]; common carotid artery; external and internal carotid arteries; superior thyroid; ascending pharyngeal; lingual, facial, and occipital arteries; internal jugular vein; vagus [X], accessory [XI], and hypoglossal [XII] nerves; superior and inferior roots of ansa cervicalis; transverse cervical nerve

Muscular triangle

4

Midline of neck; superior belly of omohyoid muscle;

(paired)

 

anterior border of sternocleidomastoid muscle

Sternohyoid, omohyoid, sternohyoid, and thyrohyoid muscles; thyroid and parathyroid glands; pharynx

2

3

1

4

599

HEADANDNECK• Tables

Muscles associated with the posterior triangle of the neck

Parentheses indicate possible involvement

Muscle

Origin

Insertion

Innervation

Function

 

 

 

 

 

Sternocleidomastoid

1 Upper part of anterior

Lateral one half of

Accessory nerve [XI] and

—Sternal head

surface of manubrium of

superior nuchal line

branches from anterior

 

sternum

 

rami of C2 to C3 (C4)

Individually, will tilt head toward shoulder on same side rotating head to turn face to opposite side; acting together, draw head forward

—Clavicular head

2 Superior surface of medial

Lateral surface of mastoid

 

 

 

one third of clavicle

process

 

 

Trapezius

3 Superior nuchal line;

Lateral one third of

Motor—accessory nerve

Assists in rotating the

 

external occipital

clavicle; acromion; spine

[XI]; proprioception—C3

scapula during abduction

 

protuberance;

of scapula

and C4

of humerus above

 

ligamentum nuchae;

 

 

horizontal;

 

spinous processes of

 

 

upper fibers—elevate,

 

vertebrae CVII to TXII

 

 

middle fibers—adduct,

 

 

 

 

lower fibers—depress

 

 

 

 

scapula

Splenius capitis

4 Lower half of ligamentum

 

nuchae; spinous

 

processes of vertebrae

 

CVII to TIV

Mastoid process, skull

Posterior rami of middle

Together, draw head

below lateral one third of

cervical nerves

backward; individually,

superior nuchal line

 

draw and rotate head to

 

 

one side (turn face to

 

 

same side)

Levator scapulae

5

Transverse processes of

Upper part of medial

C3, C4; and dorsal

Elevates scapula

 

 

CI to CIV

border of scapula

scapular nerve (C4, C5)

 

Posterior scalene

6

Posterior tubercles of

Upper surface of rib II

Anterior rami of C5 to C7

Elevation of rib II

 

 

transverse processes of

 

 

 

 

 

vertebrae CIV to CVI

 

 

 

Middle scalene

7

Transverse processes of

Upper surface of rib I

Anterior rami of C3 to C7

Elevation of rib I

 

 

vertebrae CII to CVII

posterior to the groove for

 

 

 

 

 

the subclavian artery

 

 

Anterior scalene

8

Anterior tubercles of the

Scalene tubercle and

Anterior rami of C4 to C7

Elevation of rib I

 

 

transverse processes of

upper surface of rib I

 

 

 

 

vertebrae CIII to CVI

 

 

 

Omohyoid

9 Superior border of

 

scapula medial to

 

scapular notch

Inferior border of body of

Ansa cervicalis; anterior

Depress the hyoid bone

hyoid bone

rami of C1 to C3

 

600

Tables 8

3

4

 

5

1

 

2

7 6

9 8

601

HEADANDNECK• Tables

Prevertebral and lateral muscles

Muscle

 

Origin

Insertion

Innervation

Function

Rectus capitis

1

Anterior surface of lateral

Inferior surface of basilar

Branches from anterior rami

Flexes head at

anterior

 

part of atlas and its

part of occipital bone

of C1, C2

atlanto-occipital joint

 

 

transverse process

 

 

 

Rectus capitis

2

Superior surface of

Inferior surface of jugular

Branches from anterior rami

Flexes head laterally to

lateralis

 

transverse process of atlas

process of occipital bone

of C1, C2

same side

Longus colli

3

Anterior tubercles of

Tubercle of anterior arch of

Branches from anterior rami

Flexes neck anteriorly

—Superior

 

transverse processes of

atlas

of C2 to C6

and laterally and slight

oblique part

 

vertebrae CIII to CV

 

 

rotation to opposite side

—Inferior

4 Anterior surface of bodies of

oblique part

vertebrae TI, TII, and maybe

 

TIII

Anterior tubercles of transverse processes of vertebrae CV and CVI

—Vertical part

5

Anterior surface of bodies of

Anterior surface of bodies of

 

 

 

TI to TIII and CV to CVII

vertebrae CII to CIV

 

Longus capitis

6

Tendinous slips to

Inferior surface of basilar

Branches from anterior rami Flexes the head

 

 

transverse processes of

part of occipital bone

of C1 to C3

 

 

vertebrae CIII to CVI

 

 

2

6

1

3

5

4

602

Tables 8

Constrictor muscles of the pharynx

Muscle

 

Posterior attachment

Anterior attachment

Innervation

Function

Superior constrictor

1

Pharyngeal raphe

Pterygomandibular raphe

Vagus nerve [X]

Constriction of pharynx

 

 

 

and adjacent bone on the

 

 

 

 

 

mandible and pterygoid

 

 

 

 

 

hamulus

 

 

Middle constrictor

2

Pharyngeal raphe

Upper margin of greater horn

Vagus nerve [X]

Constriction of pharynx

 

 

 

of hyoid bone and adjacent

 

 

 

 

 

margins of lesser horn and

 

 

 

 

 

stylohyoid ligament

 

 

Inferior constrictor

3

Pharyngeal raphe

Cricoid cartilage, oblique line

Vagus nerve [X]

Constriction of pharynx

 

 

 

of thyroid cartilage, and a

 

 

 

 

 

ligament that spans between

 

 

 

 

 

these attachments and

 

 

 

 

 

crosses the cricothyroid

 

 

 

 

 

muscle

 

 

 

 

 

 

 

 

1

2

3

603

HEADANDNECK• Tables

Longitudinal muscles of the pharynx

Muscle

 

Origin

Insertion

Innervation

Function

Stylopharyngeus

1

Medial side of base of

Pharyngeal wall

Glossopharyngeal

Elevation of the pharynx

 

 

styloid process

 

nerve [IX]

 

Salpingopharyngeus

2

Inferior aspect of

Pharyngeal wall

Vagus nerve [X]

Elevation of the pharynx

 

 

pharyngeal end of

 

 

 

 

 

pharyngotympanic tube

 

 

 

Palatopharyngeus

3

Upper surface of

Pharyngeal wall

Vagus nerve [X]

Elevation of the pharynx;

 

 

palatine aponeurosis

 

 

closure of the oropharyngeal

 

 

 

 

 

isthmus

 

 

 

 

 

 

Intrinsic muscles of the larynx

Muscle

 

Origin

Insertion

Innervation

Function

Cricothyroid

1

Anterolateral aspect of

Oblique part—inferior horn

External branch of

Forward and downward

 

 

arch of cricoid cartilage

of the thyroid cartilage;

superior laryngeal

rotation of the thyroid cartilage

 

 

 

straight part—inferior

nerve from the vagus

at the cricothyroid joint

 

 

 

margin of thyroid cartilage

nerve [X]

 

Posterior crico-

2

Oval depression on

Posterior surface of

Recurrent laryngeal

Abduction and external

arytenoid

 

posterior surface of

muscular process of

branch of the vagus

rotation of the arytenoid

 

 

lamina of cricoid

arytenoid cartilage

nerve [X]

cartilage. The posterior

 

 

cartilage

 

 

crico-arytenoid muscles are

 

 

 

 

 

the primary abductors of the

 

 

 

 

 

vocal folds. In other words,

 

 

 

 

 

they are the primary openers

 

 

 

 

 

of the rima glottidis.

Lateral crico-

3

Superior surface of arch

Anterior surface of

Recurrent laryngeal

Internal rotation of the

arytenoid

 

of cricoid cartilage

muscular process of

branch of the vagus

arytenoid cartilage and

 

 

 

arytenoid cartilage

nerve [X]

adduction of vocal folds

Transverse arytenoid

4

Lateral border of

Lateral border of posterior

Recurrent laryngeal

Adduction of arytenoid

 

 

posterior surface of

surface of opposite

branch of the vagus

cartilages

 

 

arytenoid cartilage

arytenoid cartilage

nerve [X]

 

Oblique arytenoid

5

Posterior surface of

Posterior surface of apex

Recurrent laryngeal

Sphincter of the laryngeal inlet

 

 

muscular process of

of adjacent arytenoid

branch of the vagus

 

 

 

arytenoid cartilage

cartilage; extends into

nerve [X]

 

 

 

 

ary-epiglottic fold

 

 

Thyro-arytenoid

6

Thyroid angle and

Anterolateral surface of

Recurrent laryngeal

Sphincter of vestibule and of

 

 

adjacent cricothyroid

arytenoid cartilage;

branch of the vagus

laryngeal inlet

 

 

ligament

some fibers continue in

nerve [X]

 

 

 

 

ary-epiglottic folds to the

 

 

 

 

 

lateral margin of the

 

 

 

 

 

epiglottis

 

 

Vocalis

7

Lateral surface of vocal

Vocal ligament and thyroid

Recurrent laryngeal

Adjusts tension in vocal folds

 

 

process of arytenoid

angle

branch of the vagus

 

 

 

cartilage

 

nerve [X]

 

 

 

 

 

 

 

604

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