of 21
8/18/2019 14-Submandibular Region I
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Dr. Ahmed Fathalla Ibrahim
8/18/2019 14-Submandibular Region I
2/21
SUPRAHYOID MUSCLES
DIGASTRIC MUSCLE:• Origin: by 2 bellies:
1.1. Anterior belly: Anterior belly: from ig!s"ri# foss! of
m!nible2.2. Posterior belly:Posterior belly: from m!s"oi no"#$• Inser"ion: bo"$ bellies %ni"e in !n
in"ermei!"e "enon $el by ! fibro%s loo&in"o "$e $yoi bone
• 'er(e s%&&ly:
1.1. Anterior belly: Anterior belly: ner(e "o myelo$yoi
2.2. Posterior belly:Posterior belly: f!#i!l ner(e
8/18/2019 14-Submandibular Region I
3/21
SUPRAHYOID MUSCLES
STYLOHYOID MUSCLE:
• Origin: s"yloi &ro#ess
• Inser"ion: $yoi bone• 'er(e s%&&ly: f!#i!l ner(e
8/18/2019 14-Submandibular Region I
4/21
SUPRAHYOID MUSCLES
MYELOHYOID MUSCLE:
• Origin: myelo$yoi line of m!nible
• Inser"ion: "$e m%s#les on bo"$ siesmee" in ! mei!n r!&$e e)"ening from
sym&$ysis men"i "o $yoi bone
• 'er(e s%&&ly: ner(e "o myelo$yoi
8/18/2019 14-Submandibular Region I
5/21
SUPRAHYOID MUSCLES
GE'IOHYOID MUSCLE:
• Origin: inferior geni!l "%ber#le
• Inser"ion: $yoi bone• 'er(e s%&&ly: (en"r!l r!m%s of C*
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ACTIO'S O+ SUPRAHYOID
MUSCLES
*, +i)!"ion of $yoi bone -!#"ing .i"$infr!$yoi m%s#les/ %ring mo(emen"of "ong%e,
2, De&ression of m!nible "o !ssis"l!"er!l &"erygoi in o&ening of "$emo%"$
0, Ele(!"ion of $yoi bone "o ele(!"e "$efloor of mo%"$ 1 "o im&ro(e "ong%egri&
8/18/2019 14-Submandibular Region I
7/21
ETRI'SIC MUSCLES O+
TO'GUE
STYLOGLOSSUS MUSCLE -MOST
SUPER+ICIAL/:
•Origin: s"yloi &ro#ess• Inser"ion: .$ole leng"$ of sie of
"ong%e
• A#"ion: "$e m%s#les on bo"$ sies r!."$e "ong%e %&.!rs 1 b!#3.!rs
8/18/2019 14-Submandibular Region I
8/21
ETRI'SIC MUSCLES O+
TO'GUE
HYOGLOSSUS MUSCLE:
• Origin: $yoi bone
• Inser"ion: &os"erior $!lf of sie of"ong%e
• A#"ion: "$e m%s#les on bo"$ sies
e&ress "$e "ong%e
8/18/2019 14-Submandibular Region I
9/21
ETRI'SIC MUSCLES O+
TO'GUE
GE'IOGLOSSUS -DEEPEST MUSCLE/:
• Origin: s%&erior geni!l "%ber#le
• Inser"ion: .$ole leng"$ of sie of"ong%e
• A#"ion: "$e m%s#les on bo"$ sies
&ro"r%e "$e "ong%e
8/18/2019 14-Submandibular Region I
10/21
ETRI'SIC MUSCLES O+
TO'GUE
PALATOGLOSSUS:
• Origin: sof" &!l!"e
• Inser"ion: b!#3 of sie of "ong%e• A#"ion: "$e m%s#les on bo"$ sies r!.
"$e "ong%e "o.!rs sof" &!l!"e
8/18/2019 14-Submandibular Region I
11/21
'ER4E SUPPLY O+ ETRI'SIC
MUSCLES O+ TO'GUE
• ALL MUSCLES ARE SUPPLIED 5Y
HYPOGLOSSAL -*2TH CRA'IAL/
'ER4E ECEPT: PALATOGLOSSUS
-5Y CRA'IAL PART O+ ACCESSORY
'ER4E/
8/18/2019 14-Submandibular Region I
12/21
SU5MA'DI5ULAR REGIO'-R!m%s of m!nible is remo(e/
Submandibular Gland
(Superficial part)
Myelohyoid
Hyoglossus Sublingual
gland
Styloglossus
Stylohoid
Digastric
Posterior belly
Hyoid bone Digastric
Anterior belly
M
A
ND
!
"
#
S$
P$
8/18/2019 14-Submandibular Region I
13/21
SU5MA'DI5ULAR REGIO'-S%&erfi#i!l &!r" of s%bm!nib%l!r gl!n is remo(e/
Deep part of submandibular
gland
Myeolohyoid
Hyoglossus
Styloglossus
Sublingual
gland
Hyoid bone Digastric Anterior belly
Digastric
Posterior !elly
S$
P$
M
A
ND
!
"
#
8/18/2019 14-Submandibular Region I
14/21
RELATIO'S O+ HYOGLOSSUS-Myelo$yoi 1 ig!s"ri# m%s#les !re remo(e/
Geniohyoid
Genioglossus
"ingual
artery
#%ternal
carotid
artery
"ingual
ner&e
Styloglossus
Stylopharyngeus
Glossopharyngeal
ner&e
Hypoglossal
ner&e
Submandibular
ganglionSubmandibular
duct
Hyoglossus
Stylohyoid
ligament
Deep part of
submandibular
gland
Sublingual
gland
8/18/2019 14-Submandibular Region I
15/21
SU5MA'DI5ULAR REGIO'
*
2
0
8/18/2019 14-Submandibular Region I
16/21
LI'GUAL ARTERY
• 5EGI''I'G: from !n"erior !s&e#" of e)"ern!l#!ro"i !r"ery6 in "$e #!ro"i "ri!ngle6 o&&osi"e "$e"i& of gre!"er #orn% of $yoi bone
• COURSE: $!s ! "or"%o%s #o%rse6 i(ie in"o 0&!r"s:
• FIRST PART: forms ! loo& #rosse by $y&ogloss!lner(e• SECOND PART: r%ns !long %&&er borer of gre!"er
#orn% of $yoi bone6 ee& "o $yogloss%s• TIRD PART: !s#ens !long !n"erior borer of
$yogloss%s 1 r%ns !long "$e %ner s%rf!#e of"ong%e "o re!#$ i"s "i& 1 !n!s"omoses .i"$ !r"eryof o&&osi"e sie
8/18/2019 14-Submandibular Region I
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5RA'CHES O+ LI'GUAL ARTERY
• +ROM +IRST PART: S%&r!$yoi !r"ery: r%ns !long%&&er borer of gre!"er #orn% of $yoi bone6s%&erfi#i!l "o $yogloss%s6 s%&&lying !7!#en"m%s#les
• +ROM SECO'D PART: T.o ors!l ling%!l !r"eries:
s%&&ly ors%m of "ong%e• +ROM THIRD PART: S%bling%!l !r"ery: s%&&lies
s%bling%!l gl!n 1 m%#o%s membr!ne of floor ofmo%"$
• ',5,: 4EI'S CORRESPO'DI'G TO 5RA'CHES O+LI'GUAL ARTERY U'ITE TO +ORM A SI'GLELI'GUAL 4EI' THAT DRAI'S I'TO I'TER'AL8UGULAR 4EI'
8/18/2019 14-Submandibular Region I
18/21
SU5MA'DI5ULAR GA'GLIO'
• I" is ! sm!ll &!r!sym&!"$e"i# g!nglion lyings%&erfi#i!l "o $yogloss%s 1 is #onne#"e "oling%!l ner(e by 2 roo"s -!n"erior 1 &os"erior/
• Origin of fibers: s%&erior s!li(!ry n%#le%s in &ons
•Preg!nglioni# fibers:*, R%ns !long #$or! "ym&!ni br!n#$ of f!#i!l ner(e
2, C$or! "ym&!ni "r!nsmi"s fibers "o ling%!l ner(ebr!n#$ of m!nib%l!r ner(e
0, Ling%!l ner(e "r!nsmi"s fibers "o g!nglion"$ro%g$ &os"erior roo"
8/18/2019 14-Submandibular Region I
19/21
SU5MA'DI5ULAR GA'GLIO'
• Pos"g!nglioni# fibers:
*,*, To s%bm!nib%l!r gl!n:To s%bm!nib%l!r gl!n: fibers !re
is"rib%"e ire#"ly "o "$e gl!n
2,2, To s%bling%!l gl!n:To s%bling%!l gl!n:
• +ibers &!ss !long !n"erior roo" "o
ling%!l ner(e !g!in• Ling%!l ner(e "r!nsmi"s fibers "o
s%bling%!l gl!n
8/18/2019 14-Submandibular Region I
20/21
RELATIO'S O+ HYOGLOSSUS
SUPER+ICIAL -LATERAL/:
• 2 MUSCLES: myelo$yoi6 s"ylogloss%s
• 2 'ER4ES: ling%!l6 $y&ogloss!l• 2 GLA'DS: s%&erfi#i!l 1 ee& &!r"s of
s%bm!nib%l!r gl!ns
• 2 SU5MA'DI5ULAR: %#" 1 g!nglion
8/18/2019 14-Submandibular Region I
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RELATIO'S O+ HYOGLOSSUS
DEEP -MEDIAL/:
• * MUSCLE: geniogloss%s
• * 'ER4E: glosso&$!rynge!l• * 4ESSEL: Ling%!l
• * LIGAME'T: s"ylo$yoi
