The facial artery is one of the branches of the external carotid artery and supplies blood to the structures of the face.
origin: branch of the external carotid artery a little above the level of the lingual artery, in the carotid triangle of the neck
course: passes deep to the poster...
The facial bones comprise a set of bones that make up the face:
inferior nasal concha
zygoma (zygomatic bone)
Where these bones join each other, sutures occur.
The acanthioparietal or reverse water's view modified Water's view used in trauma. It can be used to assess for facial fractures, as well as for acute sinusitis. Skull radiographs, in general, are rapidly becoming obsolete, being replaced by much more sensitive CT scans.
The facial-cavernous anastomoses are the communications of the facial and deep facial veins with the cavernous sinus.
At the medial canthus of the eye there is a communication with the ophthalmic veins, which drain into the cavernous sinus. Blood from the frontal scalp normally f...
Facial clefts comprise a wide spectrum of pathologies that result from failure of fusion in the facial region during the embryonic/early fetal period. The result is a gap in the fetal face. These clefts can affect the lip, philtrum, alveolus, and hard and soft palate to varying degrees.
Facial fractures are commonly caused by blunt or penetrating trauma at moderate or high levels of force. Such injuries may be sustained during a fall, physical assault, motor vehicle collision, or gunshot wound. The facial bones are thin and relatively fragile making them susceptible to injury.
The facial muscles (also known as the muscles of facial expression or mimetic muscles) enable facial expression and serve as sphincters and dilators of the orifices of the face. These muscles differ from those of other regions in the body as there is no fascia deep to the skin of the face; many ...
The facial nerve is one of the key cranial nerves with a complex and broad range of functions.
Although at first glance it is the motor nerve of facial expression which begins as a trunk and emerges from the parotid gland as five branches (see facial nerve branches mnemonic), it has taste and p...
There are many mnemonics to recall the branches of the facial nerve (superior to inferior) as they exit the anterior border of the parotid gland. Examples include:
Tall Zulus Bear Many Children
Two Zulus Bit My Cat
Two Zebras Bit My Coccyx
Ten Zebras Buggered My Car
To Zanzibar By Motor Car...
Helpful mnemonics for remembering the segments of the facial nerve include:
I Love Going To Makeover Parties 1
I Love Grinning, Then Making Pouts
both grinning and pouting are performed by muscles which are innervated by the facial nerve
I Must Learn To Make (facial) Expressions
Facial palsy refers to the neurological syndrome of facial paralysis. It can result from a broad range of physiological insults to the facial nerve or its central nervous system origins. The most common causes of this is Bell palsy.
While facial palsy refers to the clinical presen...
The facial recess of the petrous temporal bone is a small recess in the posterior wall of the mesotympanum lateral to the pyramidal eminence and stapedius muscle origin. The upper mastoid portion of the facial nerve runs immediately posterior to it, giving it it's name. Medial to the pyramidal e...
The facial vein (previously known as the anterior facial vein) is the continuation of the angular vein and joins the anterior branch of the retromandibular vein to form the common facial vein 1-3.
At the level of the lower margin of the orbit, the angular vein becomes the facial ...
Factitious hyperthyroidism or thyrotoxicosis factitia refers to precipitation of thyrotoxicosis due to exogenous ingestion of thyroid hormone (e.g. levothyroxine). It has been rarely associated with myocardial ischemia 2.
The hypervascularity which is seen wit...
The falciform crest, also known as the crista falciformis, is a horizontal ridge that divides the lateral portion of the internal acoustic meatus (IAM) into superior and inferior portions.
The facial nerve (VII) and superior vestibular nerve (SVN) travel in the superior portion of the...
The Fallopian canal or facial nerve canal refers to a bony canal through which the facial nerve traverses the petrous temporal bone, from the internal acoustic meatus to the stylomastoid foramen. There are three segments of the canal, corresponding to the segments of the facial nerve they contai...
The eponym Fallopian may refer to:
Fallopian canal (facial nerve canal)
Fallopian tube (uterine duct)
Fallopian ligament (inguinal ligament)
History and etymology
It is named after Gabriele Falloppio (also known by his Latin name Fallopius), Italian anatomist (1523-1562).
The false vocal cords (vestibular folds, ventricular folds, ventricular bands) are paired shelf-like structures located within the supraglottic larynx that divide the vestibule above from the ventricle below.
The vestibular ligaments are the ligamentous component of the false vo...
Familial medullary thyroid carcinoma (FMTC) is a genetic disorder closely related multiple endocrine neoplasia type IIa (MEN2a) and multiple endocrine neoplasia type IIa (MEN2b). It is characterized by the development of medullary thyroid cancer.
FMTC is the result of mutations in the RET (re...
Fatty nodal metaplasia in the neck occurs as a result of chronic inflammation or radiotherapy 3. The normal fatty nodal hilum enlarges, such that the lymph node appears cystic. However, its center is of fatty density. There is no surrounding stranding, and the node otherwise looks normal.
Faulty fetal packing, also known as congenital vault depression, is a congenital concave depression of the skull in a newborn.
Occurs in 1 in 10,000 births 1.
This appearance is due to external compression on the skull from 1,2:
fetal limb or twin
Febrile infection-related epilepsy syndrome (FIRES) is a severe postinfectious neurological disorder that presents with status epilepticus in a previously normal child (or less commonly adult) after a febrile illness.
FIRES has received several names in the literature:
The Fédération Dentaire Internationale or FDI notation system is a commonly used system for the numbering and naming of teeth. The system uses a two number system for the location and naming of each tooth.
The jaw is divided into four quadrants between the central incisors and ...
A fetal goiter is an enlargement of the thyroid gland in utero. It can occur with either hyper- or hypothyroidism (and in isolated cases of euthyroidism 8).
The mechanism depends on whether the underlying cause is hyper- or hypothyroidism.
maternal Graves disease with...
Fibromuscular dysplasia (FMD) is a heterogeneous group of vascular lesions characterized by an idiopathic, non-inflammatory, and non-atherosclerotic angiopathy of small and medium-sized arteries.
The prevalence is unknown 7. It is most common in young women with a female to male r...
First branchial cleft cysts are a type of branchial cleft anomaly. They are uncommon and represent only ~7% of all branchial cleft cysts.
They are usually diagnosed in middle-aged women 3-4.
Their presentation can in the form of 3:
asymptomatic, e.g. inci...
The fissula ante fenestram (FAF), also known as the cochlear cleft, is a small connective tissue-filled cleft located where the tendon of the tensor tympani muscle turns laterally toward the malleus. It is situated immediately anterior to the oval window, and posterior to the cochleariform proce...
The fistula test is used when examining a patient with recurrent vertigo.
A finger is abruptly applied to the external meatus which causes a pulse of air-transmitted pressure. If nystagmus is induced in association with vertigo, it indicates bony destruction within the inner ear e.g. cholesteat...
Floating teeth is the description given to the appearances on imaging of teeth that appear to be floating as a result of alveolar bone destruction around their roots.
They are uncommonly encountered, with a wide differential diagnosis - albeit that the underlying cause ...
The floor of mouth is an oral cavity subsite and is a common location of oral cavity squamous cell carcinoma.
The floor of mouth is a U-shaped space which extends (and includes) from the oral cavity mucosa superiorly, and the mylohyoid muscle sling 2,3.
Florid cemento-osseous dysplasia is a sub type of cemento-osseous dysplasia. It is a rare condition presenting in the jaw refers to a group of fibro-osseous (cemental) exuberant lesions with multi-quadrant involvement.
There maybe an increased female predilection and tends to be ...
Focal calvarial thinning can result from a number of causes. They include:
bilateral thinning of the parietal bones (normal variant) most common
mega cisterna magna
peripherally located tumors (e.g. oligodendroglioma)
Follicular thyroid adenoma is a commonly found benign neoplasm of the thyroid consisting of differentiated follicular cells. It cannot be differentiated from follicular carcinoma on cytologic, sonographic or clinical features alone 1.
Follicular thyroid adenoma is more commonly fo...
Follicular thyroid carcinoma (FTC) is the second most frequent malignancy of the thyroid gland after papillary cancer and accounts for ≈10-20% of all thyroid neoplasms.
It typically occurs in women and in an older age group than papillary (i.e. 40-60 years of age).
The foramen cecum represents a primitive tract between the anterior cranial fossa and the nasal space. It is located along the anterior cranial fossa, anterior to the cribriform plate of the ethmoid bone and posterior to the frontal bone, within the frontoethmoidal suture. It lies at a variable ...
Foramen cecum can refer to a number of different anatomical structures:
foramen cecum (tongue)
foramen cecum (anterior cranial fossa)
The foramen lacerum is a triangular opening located in the middle cranial fossa anterior to the petrous apex, which forms its posterior border. Its anterior border is formed by the body of the sphenoid bone at the junction of greater wing and pterygoid process and medial border is formed by the ...
A mnemonic to remember foramen ovale contents is:
O: otic ganglion (inferior)
V: V3 cranial nerve (mandibular division of the trigeminal nerve)
A: accessory meningeal artery
L: lesser petrosal nerve
E: emissary veins
Foramen ovale is an oval shaped opening in the middle cranial fossa located at the posterior base of the greater wing of the sphenoid bone, lateral to the lingula. It transmits the mandibular division of the trigeminal nerve (CN V3), accessory meningeal artery, emissary veins between the caverno...
The foramen rotundum is located in the middle cranial fossa, inferomedial to the superior orbital fissure at the base of greater wing of the sphenoid bone. Its medial border is formed by lateral wall of sphenoid sinus. It runs downwards and laterally in an oblique path and joins the middle crani...
The foramen singulare, also known as the singular foramen, is a small opening at the posteroinferior aspect of the fundus of the internal auditory canal (IAC) 2,3. It carries the singular or posterior ampullary nerve, a branch of the inferior vestibular nerve which carries afferent information f...
The foramen tympanicum (also known as foramen of Huschke) is an anatomical variation in the external acoustic canal (EAC), where a bony defect connects the EAC to the temporomandibular joint (TMJ).
Various studies have reported on the occurrence of a foramen tympanicum in the asym...
The foramen Vesalii, also known as the foramen of Vesalius, sphenoidal emissary foramen, foramen venosus or canaliculus sphenoidal, is a tiny variably present foramen in the greater wing of the sphenoid bone. It transmits a sphenoidal emissary vein linking the pterygoid venous plexus in the infr...
The fossa of Rosenmüller, also known as the posterolateral pharyngeal recess, is the most common site of origin for nasopharyngeal carcinoma.
It is located superior and posterior to the torus tubarius (the posterior projection of the cartilaginous portion of the Eustachian tube) ...
Fourth branchial cleft cysts are very rare, and parallel the course of the recurrent laryngeal nerve. They are most commonly on the left side (80%) and usually form a sinus which extends from the apex of the piriform sinus, as do third branchial cleft sinuses, but passes inferiorly rather than s...
The fovea ethmoidalis is a portion of the ethmoid bone and represents its superior portion (part of the ethmoid roof) which is seen as a continuation of the superior orbital roof to the cribriform plate.
A foveola pharyngica recess is one of the variants of the inferior median clival canal, thought to represent a remnant of the notocord. It represents a blind ending recess in the anteroinferior surface (nasopharyngeal) surface of the clivus 1,2.
Frenulum (plural: frenula) is an anatomical term and refers to a small fold of soft tissue that checks the movement of an anatomical part.
frenulum (ileocecal valve)
frenulum (labia minora)
History and etymology
Frenulum derives from ...
The frontal bone is a skull bone that contributes to the cranial vault. It contributes to form part of the anterior cranial fossa.
The frontal bone has two portions:
vertical portion (squama): has external/internal surfaces
horizontal portion (orbital): has superior/inferior su...
Frontal bossing is a calvarial radiographic feature where the front of the skull appears protruding anteriorly. It is best appreciated on a sagittal or lateral image.
This feature can be seen in many conditions (in alphabetical order):
The frontal bullar cells are a subset of variably present frontal recess cells located above the ethmoid bulla.
They are nearly identical to suprabullar cells. The distinguishing features with the latter are that the frontal bullar cells are located above the frontal ostium and ext...
Frontal cells are anterior ethmoid air cells located along the anterior aspect of the frontal recess. They are a subset of frontal recess cells and are classified into four types according to Kuhn's classification.
They are seen on CT in 20-33% of patients 1.
functional endoscopic si...
The frontal infundibulum is a term that refers to the funnel-shaped inferior narrowing of the frontal sinus. Together with the frontal ostium and frontal recess, it forms the frontal sinus outflow tract.
Frontal intersinus septal cells, also known as interfrontal sinus septal cells, are a subtype of medial frontal recess cells.
The frontal intersinus septal cells lie within the intersinus septum between the frontal sinuses. They usually drain in the medial aspect of the frontal r...
The frontal nerve is the largest and main branch of the ophthalmic division of the trigeminal nerve. It divides off the ophthalmic division just before entering the orbit through the superior orbital fissure outside and superolateral to the tendinous ring, where it lies between the lacrimal nerv...
The frontal ostium is an opening of the frontal sinus below the frontal infundibulum that drains into the frontal recess. Together with the frontal infundibulum and recess, it forms the frontal sinus outflow tract.
The frontal recess is an opening in the inferior aspect of the frontal sinuses that allows drainage of the sinus.
The frontal recess is also known as the nasofrontal duct. However, since it does not have bony walls of its own, it is more appropriately referred to as a recess rather...
Frontal recess cells are anterior ethmoid air cells that pneumatize the frontal recess. Their clinical relevance lies in their potential to obstruct the frontal recess outflow. As such, they should be reported by the radiologist preoperatively, especially in cases of frontal sinusitis.
The frontal sinuses are the paranasal sinuses within the frontal bone. They are lined with mucosa and are most often two in number.
location: anterior frontal bones on either side of the midline behind the brow ridges
blood supply: supratrochlear, supraorbital and anterior ethmoidal a...
Frontal sinus fractures are facial fractures that involve the frontal sinus, either in isolation or more commonly as part of more complex facial fractures. They can result in cosmetic deformity, functional impairment, CSF leak, and/or intracranial infection (e.g. meningitis).
Frontoethmoidal encephaloceles are second only to occipital encephaloceles in terms of frequency, representing approximately 15% of all encephaloceles. They represent meninges or brain tissue herniating through a cranial defect in the anterior cranial fossa and typically result in facial deformi...
The frontoethmoidal suture is a short cranial suture located in the anterior cranial fossa, between the orbital process of frontal and orbital plate of ethmoid bones. It forms part of the medial wall of the orbit.
The anterior and posterior ethmoidal foramina are seen just superior to it, throu...
The frontolacimal suture is the cranial suture between the frontal and lacrimal bones.
The frontomaxillary suture is the site where the nasal process of frontal bone meets the frontal process of the maxilla.
Frontonasal dysplasia, also known as median cleft face syndrome, is a rare disorder characterized by midline defects involving the face, head, and central nervous system.
Frontonasal dysplasia is considered to be a very rare condition, with approximately 100 cases having been repo...
The frontonasal suture is the cranial suture between the frontal bone and the two nasal bones. This suture meets the internasal suture at the nasion.
The frontozygomatic suture, also known as the zygomaticofrontal suture, is between the frontal process of the zygomatic bone and the zygomatic process of the frontal bone.
Functional endoscopic sinus surgery (FESS) is a type of paranasal sinus surgery performed intranasally using a rigid endoscope. Its primary objective is to restore physiological ventilation and mucociliary transport 1.
Paranasal sinus imaging is crucial in preoperative planning and is also incr...
A mnemonic to remember the potential anatomic variants to report on pre-functional endoscopic sinus surgery studies is 1:
C: cribriform plate
L: lamina papyracea
O: Onodi cell
S: sphenoid sinus pneumatization
E: ethmoidal artery (anterior)
ostiomeatal complex nar...
Fungal sinusitis is a collective term referring to a number of entities, which can be divided into two groups, depending on the presence of fungal hyphae within or beyond the mucosa 1:
non-invasive: hyphae do not invade mucosa
allergic fungal sinusitis
sinus fungal mycetoma
invasive: hyphae ...
The galea aponeurotica (also called the Galeal or epicranial aponeurosis or the aponeurosis epicranialis) is a tough fibrous sheet of connective tissue that extends over the cranium, forming the middle (third) layer of the scalp.
Garrington sign is thickening of the periodontal ligament/membrane space of involved teeth in the setting of gnathic osteosarcoma. Symmetrical widening of the space can be seen early in the disease process due to infiltration of tumor cells.
A gene expression classifier (GEC) test is a developing technology in the analysis of indeterminate thyroid nodules, using cells from a fine needle aspiration. The most common commercially available GEC in the United States is known as AFIRMA.
The test is designed to use molecular markers to he...
The genioglossus muscle is a fan-shaped extrinsic muscle of the tongue which makes up the bulk of the tongue.
origin: superior mental spine of the symphysis menti (posterior surface of midline mandible)
insertion: entire tongue mass and body of the hyoid bone
nerve supply: hypoglossa...
The geniohyoid muscle is one of the suprahyoid muscles of the neck that is innervated by the ventral ramus of C1. Geniohyoid draws the hyoid bone up and forward during mastication and assists the opening of the mandible.
origin: inferior mental spine of the mandible also known as the g...
Genioplasty or in more simple terms chin augmentation refers to a surgical procedure performed to improve facial balance and/or rejuvenate the lower facial third - mandible. An osseous genioplasty refers to surgery which is performed by creating an osteotomy and then mobilizing an inferior segme...
A geographic skull is a radiographic appearance which is seen in eosinophilic granuloma (EG) and characterized by destructive lytic bone lesions, the edges of which may be bevelled, scalloped or confluent.
Gillespie syndrome is a rare genetic condition presenting as a mydriasis, secondary to an omnipresent partial aniridia. The abnormal iris is bilateral, with a highly-specific scalloped inner margin, due to hypoplasia of the central constrictor pupillae fibers. Associated features include an unch...
The glabella is the smooth midline bony prominence between the supraciliary arches of the frontal bone, representing the most anterior part of the forehead when standing erect and look straight ahead. The metopic suture traverses the glabella, between the two frontal bones. Just below it is the ...
The globes or simply, the eyes are paired spherical sensory organs, located anteriorly on the face within the orbits, which house the visual apparatus.
The globe is suspended by the bulbar sheath in the anterior third of the bony orbit.
Each globe is an approxim...
Globe rupture is an ophthalmologic emergency. A ruptured globe or an open-globe injury must be assessed in any patient who has suffered orbital trauma because open-globe injuries are a major cause of blindness.
In a blunt trauma, ruptures are most common at the insertions of the intraocular mus...
Globus pharyngeus is the subjective feeling of a lump in the throat which can have a variety of causes. In modern practice globus is often evaluated by flexible nasoendoscopy in the first instance since many patients present to otolaryngology services. If no cause is identified or if nasoendosco...
Glomus jugulare paraganglioma is a paraganglioma of the head and neck that is confined to the jugular fossa. While it is a rare tumor, it is the most common of the jugular fossa tumors.
The relative prevalence of glomus jugulare with respect to other head and neck paraganglioma va...
Glomus jugulotympanicum paraganglioma is a glomus jugulare paraganglioma that has spread superiorly to involve the middle ear cavity. The term can also be used clinically when a suspected glomus tympanicum paraganglioma involves the hypotympanum as its inferior extent cannot be established clini...
Glomus tympanicum paragangliomas (chemodectomas) are the most common middle ear tumor.
There is a female predominance (M:F = 1:3); presentation is most common when patients are more than 40 years old 1,2.
May be incidental but symptomatic masses produce p...
Glomus vagale tumors are glomus tumors that occur along the path of the vagus nerve (CN X). They are a subset of extra-adrenal neuroendocrine tumors that are derived from the nonchromaffin paraganglion cells.
Typically presents as a painless mass behind the carotid arter...
The glossopharyngeal nerve is the ninth (IX) of the twelve pairs of cranial nerves. It exits the brainstem out from the sides of the upper medulla, just rostral to the vagus nerve and has sensory, motor, and autonomic components.
The sensory ganglion cells lie in the supe...
Glossopharyngeal neuralgia is due to irritation of the glossopharyngeal nerve and presents with repeated episodes of severe pain in the tongue, throat, ear, and tonsils, which can last from a few seconds to a few minutes. It is far less common than trigeminal neuralgia.
The glottis is an anatomic subsite of the larynx, between the supraglottis and subglottis.
The glottic larynx includes the true vocal cords, where they come together at the anterior commissure, and where they meet the laryngeal cartilages at the interarytenoid region or posterio...
Goiter (rarely thyromegaly) refers to enlargement of the thyroid gland. It can occur from multiple conditions. Clearly the absence of thyroid enlargement does not preclude significant thyroid pathology.
The definition of a goiter depends on age and sex; below are the upper limits of normal for ...
Goldenhar syndrome (also known as oculo-auriculo-vertebral spectrum (OAVS), Goldenhar-Gorlin syndrome or facio-auriculo-vertebral dysplasia) is a complex congenital anomaly characterized by abnormalities of the ears, eyes and vertebrae.
The estimated incidence is at 1 in 3000-500...
Gorlin-Goltz syndrome, also known as the basal cell nevus syndrome, is a rare phakomatosis characterized by multiple odontogenic keratocysts (KOT), multiple basal cell carcinomas (BCC), and other abnormalities.
The condition is thought to occur in ~1 in 60,000 live births while 0....
Gradenigo syndrome consists of the triad of:
abducens nerve palsy, secondary to involvement of the nerve as it passes through Dorello canal
retro-orbital pain, or pain in the cutaneous distribution of the frontal and maxillary divisions of the trigeminal nerve, due to extensi...