Universitat Internacional de Catalunya - Barcelona

Structure and Function of Head and Neck

• code 07873
• course 1
• term Semester 1
• type FB
• credits 6

Module: Basic biomedical sciences relevant in dentistry

Matter: Anatomy and Physiology

Main language of instruction: Spanish

Other languages of instruction: Catalan, English

If the student is enrolled for the English track then classes for that subject will be taught in the same language.

Head instructor

Dr. Héctor PARELLADA - hparellada@uic.es
Lc. Alexandre GARCIA - alex_g@uic.es

Office hours

Contact person:

Spanish group: Dr. Héctor Parellada. hparellada@uic.es

Ateción Day: Monday from 10 to 12h. by appointment through the mail.

Place: Faculty offices of Anatomy (next to the osteoteca)

English group: Lc. Alex Garcia. alex_g@uic.es.

Ateción Day: Friday from 10 to 12h. by appointment through the mail.

Place: Faculty offices of Anatomy (next to the osteoteca)

The nowledge of the structures of the head and neck and related functions is essential to the practice of dentistry. To chew, to swallow and the phonation, the main functions of the stomatognathic system, involve many musculoskeletal structures. Likewise, their regulation requires complex neuromuscular systems and precise brain control.

For this subject, a basic knowledge of the structures and functions of the human body is required; transmission of nerve impulses and muscle contraction, reflex responses and the integration of functions at different levels will help students to go deeper into the most specific functions of this important anatomical region of the human being.

To provide students with the structural and functional knowledge of the orofacial region needed to assimilate the pathological alterations thereof, which will be explained in subsequent courses.

 Specific Competences 

1. To know the morphology and function of the structures of the head and neck, including their bones, muscles, nerves and vessels.

2. To know the morphology and function of the stomatognathic system, including appropriate specific content in embryology, anatomy and physiology.

3. To understand diagnostic image tests of head and neck anatomical structures and identifying morphological and functional alterations thereof.

• 08 - Knowing how to share information with other healthcare professionals and how to work as part of a team.
• 09 - Understanding the importance of keeping and using patient files in order to subsequently analyse them, while ensuring patient confidentiality is maintained.
• 11 - Understanding the basic biomedical science Dentistry is based on in order to ensure that adequate dental healthcare is provided.
• 12 - Understanding and recognising the structure and normal function of the stomatognathic apparatus, at a molecular, cellular, tissue and organic level, during the various stages of life.
• 19 - Being aware of scientific methods and having the critical ability to evaluate established knowledge and innovative information. Being able to formulate hypotheses, collect and critically evaluate information in order to resolve problems, in accordance with scientific methods.
• 32 - Knowing the biomedical science on which Dentistry is based in order to ensure adequate oral and dental care. This science must include material on: (a). Embryology, anatomy, histology and the physiology of the human body (b). Genetics, Biochemistry, Cell and Molecular Biology and (c). Microbiology and immunology.
• 33 - Knowing the morphology and function of the stomatognathic apparatus, including material on embriology, anatomy, histology and specific physiology

At the end of the semester, the student should be able to identify the bone, muscle, vascular and nervous structures of the head and neck, as well as the functional and specific relationships of each of them in a state of normal health. 

• 1.04 - Know the organization of our immune system: molecules, cells and organs
• 1.07 - Know the structure and function of support and movement systems; skeletal and muscular system, different bones and muscle groups that form the axial and appendicular skeleton.
• 1.08 - Identify and describe the morphological and functional characteristics of the different joints of the human body
• 1.09 - - Know the structure and function of communication and control systems, nervous system and endocrine
• 1.10 - Know the structure and function of the organs and systems involved in maintaining the homeostasis of the human body. Circulatory, respiratory, digestive and urinary apparatus.
• 1.11 - Identify in the corpse the different structures, organs, apparatus and systems in of the human body
• 1.12 - Solve clinical problems from deductions made with the basic knowledge of anatomy and physiology of the human body
• 1.13 - Identify using image techniques, structures of different topographical regions of the human body
• 1.14 - Understand and describe the embryological origin of the structures of head and neck
• 1.15 - Know the structure and function of support and movement of the head and neck systems. Bones of the skull and face. Head Musculature: muscles of facial expression, masticatory, supra and infrahyoid. Neck muscles
• 1.16 - Know the structure and function of the temporomandibular joint
• 1.17 - Know the distribution of vascularization of the head and neck
• 1.18 - Know the distribution of cranial nerves and clinical examination
• 1.19 - Solve clinical problems from deductions made from the basic knowledge of anatomy and physiology of the head and neck
• 1.20 - Identify using image techniques, structures of different topographical regions of the head and neck
• 1.21 - Understand and describe the embryological origin of oral and maxillofacial structures. The origin and the eruption of the dentition in humans
• 1.29 - Identify using image techniques, structures of the different topographical regions of the oral cavity and teeth in particular
• 1.30 - Understand the basic bio-medical sciences on which dentistry is based to ensure proper oral-dental care.
• 1.31 - - Understand and recognize the structure and normal function of the stomatognatic apparatus at a molecular and cellular level
• 1.33 - Will know better the scientific method and will have critical capacity to assess the established knowledge and new information
• 1.35 - Will manage better than at the beginning of the subject, contemporary information technologies
• 1.37 - Will value as necessary the knowledge throughout life
• 1.38 - Will start to understand the biochemical behavior of the essential bio-materials for dental practice

1. LECTURES: 

UNIT 1: The skull:

- General features. Osteology of the skull

· Neurocranium: occipital, sphenoid, temporal, parietal, frontal and ethmoid bones.

· Viscerocranium: maxillar, palatin, zygomatic, nasal and lacrimal bones, cornetes, vomer and mandible.

· Sutures of the cranium.

· Cavities of the cranium: Cranial cavity. Orbital cavity. Temporal and infratemporal fossae. Pterygopalatine fossa. Nasal cavities and paranasal sinuses.

· Hyoid bone.

- Architectural analysis of the cranium. Overview. Cephalometrics and craneometrics. Growth of the cranium and face.

- Bone physiology. Functions of bone. Hystological types. Blood and nerve supply. Bone formation and resorption. Types of ossification. Bone growth. Role of bone in homeostasis. Bone remodelling: factors. Fracture and bone repair. Role of bone in calcium homeostasis.

UNIT 2: Muscles of the head and neck:

- General characteristics. Types of function and properties of muscle tissue. Skeletal muscle tissue: macroscopic and microscopic anatomy. Contraction and relaxation of skeletal muscle fibres. Muscle metabolism. Control of muscle tension. Types of muscle fibre.

- Masticatory muscles

Supramandibular muscles. Suprahyoid inframandibular muscles. Infrahyoid muscles. Functional neuroanatomy and physiology of the masticatory system.

- Muscles of facial expression

Superficial neck muscles. Mouth and nose muscles. Eyelid and eyebrow muscles. Ear and scalp muscles.

UNIT 3: Clinical anatomy of the temporomandibular joint:

- General characteristics. Cranial component. Mandibular component. Joint disk. Capsule and joint ligaments. Vascularisation and innervation. Dynamics of the joint: forces, postures and movements. Lubrication and maintenance.

UNIT 4: Oral cavity and oropharyngeal system:

- Oral cavity.

- Limits and relationships. The teeth.

- The tongue.

- Development. Tongue musculature: intrinsic and extrinsic.

- Soft palate and Pharynx.

- Musculature. Vegetative and sensory innervation. Motor innervation of the pharynx and oesophagus. Swallowing.

- Larynx.

- Development. Pharyngeal skeleton. External configuration and internal musculature. Vegetative and motor innervation. Phonation.

- Salivary glands: parotid, submandibular and sublingual. Location, relationships. Salivary secretion. Formation of saliva. Neurohumoral regulation of salivary secretion. Composition of saliva. Functions of saliva in oral health.

UNIT 5: Blood vessels of the head and neck:

- Overview. External carotid artery: anterior, posterior and medial branches. Terminal branches. Internal carotid artery.

- Veins of the head and neck. Superficial veins and deep and posterior veins.

UNIT 6: The encephalon and the cranial nerves:

- Introduction. 

- Anatomy of encephalic structures. Brain stem. Cerebelum. Diencephalon. Brain.

- Cranial nerves. Modalities and functions.

· I cranial nerve: Olfactory nerve. Anatomy of the olfactory nerve, olfactory receptors.  Olfactory channels. Projections of the olfactory bulb and cortical projections

· II cranial nerve: Optical nerve. Anatomy of the optical nerve and the visual channel. Anatomy of the retina. Photoreceptors. Visual phototransduction.  Visual fields. The photomotor reflex.

· III cranial nerve: oculomotor nerve. Anatomy of the oculomotor nerve. Somatic motor and visceral parasympathetic components. Pupil light response.

· IV cranial nerve: trochlear nerve. Anatomy of the trochlear nerve. Eye movements – mediated by the fourth nerve.

· V cranial nerve: trigeminal nerve. Anatomy of the trigeminal nerve.  Afferent sensory component. Sensory nuclei.  Central channels: Tactile discrimination, pain and temperature. Detailed description of the three divisions. Terminal branches. Brachial motor component. Peripheral nerves.

· VI cranial nerve: abducens nerve. Anatomy and function of the abducens nerve.

· VII cranial nerve: facial nerve. Anatomy of the facial nerve. Nuclei and intracranial course. General and special sensory components. Brachial motor component.  Visceral motor component.

· VIII cranial nerve: vestibulocochlear nerve Anatomy of the vestibulocochlear nerve. Vestibular component. Vestibular nuclear complex. Cochlear component. Action potentials of sensory neurons. Central channels.

· IX cranial nerve: glossopharyngeal nerve. Anatomy of the glossopharyngeal nerve. General sensory component. Visceral sensory component. Special sensory component. Brachial motor component. Visceral motor component.

· X cranial nerve: vagus nerve.Anatomy of the vagus nerve. Course. General sensory component. Visceral sensory component. Special sensory component. Brachial motor component. Visceral motor component.

· XI cranial nerve: accessory nerve.Anatomy of the accessory nerve.

· XII cranial nerve: hypoglossal nerve.Anatomy of the hypoglossal nerve. Brachial motor component.

UNIT 7:Anatomophysiology of pain. Anatomical basis of local anaesthesia:

- The sensation of pain. Nociceptors.  Pain conduction channels. Types of pain. Modulation of pain. Central excitation effect. Orofacial pain.

- The anatomical basis for the administration of local anaesthesia in dentistry. Bone structures. Distribution of nerve branches for the dental plexus. Maxillar branches. Mandibular branches. Vascular structures.

2. PRACTICAL SESSIONS:

Area 1: OSTEOTECA

- Practical sessions 1 to 7:

• OSTEOLOGY OF THE CRANIUM
•  TMJ

-Practical sessions 8 and 9:

• MUSCLES OF THE HEAD AND NECK
• ORAL CAVITY AND OROPHARYNGEAL SYSTEM

- Practical sessions 10 and 11:

• VASCULARISATION OF THE HEAD AND NECK

- Practical sessions 12 to 14:

• ENCEPHALON AND SPINAL CORD
• INNERVATION OF HEAD AND NECK
• SENSORY ORGANS. Vision and hearing

Area 2: DISSECTION ROOM:

- Practical sessions 1 to 4:

• MUSCLES OF THE HEAD AND NECK

- Practical sessions 5 to 8:

• ORAL CAVITY AND OROPHARYNGEAL SYSTEM

- Practical sessions 9 to 13:

• VASCULARISATION OF THE HEAD AND NECK
• INNERVATION OF HEAD AND NECK

- Practical sessions 14 and 15:

• SENSORY ORGANS. Vision and hearing

1. Theoric content in the form of master classes (clinical case methodology is included, where appropriate). It is offered to all students and makes up 60% of the total.

2. Practical content in the laboratory; it is offered in groups (two groups). Practical sessions take place in two venues:

• In the Osteoteca – tutored self-learning using anatomical models. 
• In the Dissection room – identification of structures on cadaveric specimens. 

Final evaluation of the subject comprises a final exam consisting of two independent examinations:

1. Practical examination: identification of bone, muscle, vascular and nervous structures on cadavers and orofacial structures on X-ray radiographs. The examination is passed with at least 50% of the total points. A passing mark in the practical examination is required in order to sit the theoretical examination.

 2. Theoretical examination: multiple choice questions (one point per correct answer and penalisation for incorrect answers; one point will be subtracted for every five wrong answers).  The examination is passed with at least 50% of the total points (after subtracting points for errors).

Both exams make up 80% of the final mark, with the following contributions: 60% for the theoretical examination and 20% for the practical examination. Both examinations must be passed in order to pass the course. The work completed in the practical sessions may improve the mark of exams by a maximum of 20%.

Attendance of practical sessions is compulsory. Unexcused absences to more than three sessions will preclude the student from sitting the examination and therefore from passing the subject. 

Basic recommended texts:

· Anatomía de la Cabeza para odontólogos. Velayos JL, Santana HD. 4th edition. Medica Panamericana: Buenos Aires;  Madrid: 2007

· Netter. Anatomía de la cabeza y cuello para odontólogos. Norton NS. Netter FH.  Elsevier- Masson Barcelona. 25th ed. 2015.

· Nervios Craneales. En la salud y la enfermedad. Wilson-Pauwels L, Akeson EJ, Stewart PA, Spacey SD. 3th ed. Medica Panamericana: Buenos Aires; Madrid: 2015.

Atlas:

· Atlas de Anatomía Humana. Sobotta Becher. Tomo I. 23 Ed. Medica Panamericana: Buenos Aires;  Madrid: 2012

· Prometeus. Atlas de Anatomía. Tomo 3 cabeza y Neuroanatomia.  Schünke M,Schulte, Schumacher U. Medica Panamericana: Buenos Aires;  Madrid: 2013

· Atlas  de Anatomía Humana. Estudio fotográfico del Cuerpo humano. Rohen JW, Lütjen-Drecoll, Yokochi C. 8ª ed. Elsevier. Barcelona. 2015.

· Anatomía Humana. Texto y  Atlas en color. Gosling JA, Harris PF, Humpherson JR, Whitmore I, Willan PTL.  2 Ed. Tomo 2. (Ch. 7: Cabeza y cuello). Mosby/ Doyma Libros. Madrid: 1994.

Others:

· Principios de Anatomía y Fisiología. Tortora GJ, Derrickson B. 15th ed. Medica Panamericana: Buenos Aires;  Madrid: 2018

· Anatomía y Fisiología. Thibodeau-Patton Ed. Elsevier-Mosby. 8th edition 2013

· Tratamiento de Oclusión y afecciones temporomadibulares. Okeson JP.  7th ed.  Harcourt Mosby. Madrid 2014.

· Anatomia Oral.  Sicher/ Du Brul. Du Brul E LL. Doyma  Barcelona: 1988

Teaching material:

· Fichas de Autoevaluación. Netter Anatomía. Cabeza y cuello. Hansen JT, Netter FH. 2nd ed. Elsevier- Masson Barcelona. 2015.

· Laminas Mudas. Prometeus. Texto y Atlas de Anatomía. Tomo 3 cabeza y Neuroanatomia.  Schünke M,Schulte, Schumacher U. Medica.  Panamericana: Buenos Aires;  Madrid: 2018

E: exam date | R: revision date | 1: first session | 2: second session:

• E1 07/01/2019 08:00h A08
• E1 07/01/2019 08:00h A22
• E1 07/01/2019 08:00h A21
• R1 21/01/2019 13:00h A11
• E2 17/06/2019 08:00h A02
• R2 01/07/2019 10:30h A16