Intrinsic muscles

    all innervated by recurrent laryngeal nerve except cricothyroid: external laryngeal nerve
    adductors of vocal folds: bring folds together at midline

    Transverse and oblique arytenoids: pull arytenoids together
    Lateral cricoartenoids: spin and slide arytenoids up
    only one abductor of vocal folds
    
    Posterior cricoarytenoids—down and up
    adjustors of shape and tension of vocal folds

    Cricothyroid muscle
    
o    superficial to lateral cricoarytenoid
o    tenses vocal folds by tilting thyroid cartilage forward and sliding forward

    Thyroartenoid and vocalis muscles
    
o    vocalis: sometimes treated as medial most fibers of thyroartenoid muscle
o    different fiber directions
    
    lateral: adduct
    medial: change shape of folds
    control voice by bring bringing together different parts of folds

o    as move from epithelium to vocalis muscle, fold becomes stiffer
o    near connections, vocal folds are stiffer
o    vocal fold: complex, multilayered vibrator

• This is the second cranial nerve (CN II) and is the nerve of sight.

The Scalp

• The scalp consists of five layers of soft tissue.
• It extends from the superior nuchal line on the posterior aspect of the skull of the supraorbital margins.
• Laterally, the scalp extends into the temporal fossa to the level of the zygomatic arches.

Layers of the Scalp

• The scalp proper is composed of three fused layers. It is separated from the pericranium by loose connective tissue.
• Because of this potential areolar cleavage plane, the scalp is fairly mobile.
• Each letter of the word "S C A L P" serves as a memory key for one of the layers of the scalp: Skin, Connective Tissue, Aponeurosis Epicranialis, Loose Areolar Tissue and Pericranium.

Layer 1: Skin

• Hair covers the scalp in most people.
• The skin of the scalp is thin, especially in elderly people, except in the occipital region.
• The skin contains many sweat and sebaceous glands and hair follicles.
• The skin of the scalp has an abundant arterial supply and good venous and lymphatic drainage systems.

Layer 2: Connective Tissue

• This is a thick, subcutaneous layer of connective tissue and is richly vascularised and innervated.
• It attaches the skin to the third layer of the scalp.
• Fat is enclosed in lobules between the connective fibres.

Layer 3: Aponeurosis Epicranialis

• This is a strong membranous sheet that covers the superior aspect of the cranium.
• This aponeurosis is the membranous tendon of the fleshy bellies of the epicranius muscle.

• The epicranius muscle consists of four parts: two occipital bellies, occipitalis and two frontal bellies, frontalis that are connected by the epicranial aponeurosis. 

Layer 4: Loose Areolar Tissue

• This is a subaponeurotic layer or areolar or loose connective tissue.
• It is somewhat like a sponge because it contains innumerable potential spaces that are capable of being distended by fluid.
• It is this layer that allows free movement of the scalp proper, composed of layers 1-3.

Layer 5: Pericranium

• This is a dense layer of specialised connective tissue.
• The pericranium is firmly attached to the bones by connective tissue fibres called Sharpey’s fibres, however, they can be fairly easily stripped from the cranial bones of living persons, except where they are continuous with the fibrous tissues of the cranial sutures.

• The six muscles rotate the eyeball in the orbit around three axes (sagittal, horizontal and vertical).
• The action of the muscles can be deduced by their site of insertion on the eyeball.

The Parotid Glands

• The parotid glands are the largest of the three pairs of salivary glands.
• Each gland is wedged between the mandible and the sternocleidomastoid muscle and partly covers them.

• The parotid gland is wrapped with a fibrous capsule (parotid fascia) that is continuous with the deep investing fascia of the neck.

• Viewed superficially, the parotid gland is somewhat triangular in shape.
• Its apex is posterior to the angle of the mandible and its base is along the zygomatic arch.
• The parotid gland overlaps the posterior part of the masseter muscle.

• The parotid duct (Stensen's duct) is about 5 cm long and 5 mm in diameter.
• It passes horizontally from the anterior edge of the gland.
• At the anterior border of the masseter muscle, the parotid duct turns medially and pierces the buccinator muscle.
• It enters the oral cavity opposite the second maxillary molar.

Blood Vessels of the Parotid Gland

• This gland is supplied by branches of the external carotid artery.
• The veins from the parotid gland drains into the retromandibular vein, which enters the internal jugular vein.

Lymphatic Drainage of the Parotid Gland

• The lymph vessels of this gland end in the superficial and deep cervical lymph nodes.

Nerves of the Parotid Gland

• These nerves are derived from the auriculotemporal nerve and from the sympathetic and parasympathetic systems.

• The parasympathetic fibres are derived from the glossopharyngeal nerve (CN IX) through the otic ganglion.
• Stimulation of these fibres produces a thin watery (serous) saliva to flow from the parotid duct.

• The sympathetic fibres are derived from the cervical ganglia through the external carotid plexus.
• Stimulation of these fibres produces a thick mucous saliva.

Tongue 
Appears at 4th week.
Musculature derived from mesoderm of occipital somites.  Precursor muscles cells migrate to region of tongue and are innervated by general sensory efferent fibers of CN XII.
Mucosa derived from anterior endoderm lining arches 1-4; accordingly, innervation depends on arch derivation:
              Mucosa of anterior 2/3 of tongue comes from the first arch -> CN V
              Mucosa of posterior 1/3 of tongue comes from third and forth arch -> CN IX, X
Special taste of anterior 2/3 of tongue comes from CN VII.
Special taste of posterior 1/3 of tongue comes from CN X.
Tongue freed from floor of mouth by extensive degeneration of underlying tissue.  Midline frenulum continues to anchor tongue to floor of mouth.

Thyroid Gland

Develops as in growth of mucosal epithelium located in the midline of the tongue (at foramen cecum).  It descends along front of pharyngeal gut, but remains connected to tongue by thyrooglossal duct, which is obliterated later in development.  Thyroid gland descends to a point just caudal to laryngeal cartilages. 

Facial structures (general)

a) medial nasal prominence forms midline of nose, philtrum and primary palate
b) lateral nasal prominence forms alae of nose
c) maxillary prominence forms cheek region and lateral lip
d) clefts can form at inter-prominence fusion lines

Nose

At the time of anterior neural tube closure, mesenchyme around forebrain, frontonasal prominence (FNP), has smooth rounded extended contour.  Nasal placodes (thickening of surface ectoderm to become peripheral neural tissue) develop on frontolateral aspects of FNP.  Mesenchyme swells around nasal placode producing a medial and lateral nasal prominence (nasomedial and nasolateral processes).  These nasal prominences form the nose.

Mouth 

Stomadeum (primitive oral cavity) forms between frontonasal prominence and first pharyngeal arch.  The first pharyngeal arch forms the dorsal maxillary prominence and ventral mandibular prominence.  The maxillary prominence will merge with medial nasal prominences, pushing them closer to cause fusion.  Fused medial nasal prominences will form midline of nose and midline of upper lip (philtrum) and primary palate (first 4 teeth).

Nasolacrimal structures

Maxillary and lateral nasal prominences are separated by deep furrow, the nasolacrimal groove.  Ectoderm in floor of groove forms epithelial cord, which detaches from overlying ectoderm.  The epithelial cord canalizes to form the nasolacrimal duct.  The upper end of the duct widens to form the lacrimal sac.  After detachment of the cord, the maxillary and lateral nasal prominences merge with each other, resulting in the formation of a nasolacrimal duct that runs from the medial corner of the eye to the inferior meatus of the nasal cavity.  
The maxillary prominences enlarge to form the cheeks and maxillae.
The lateral nasal prominences form the alae of the nose.

Secondary (hard) palate

Main part of definitive palate formed by two palatine shelves derived from intraoral bilateral extensions of the maxillary prominences.  These appear at the 6th week.  They are directed obliquely downward on each side of the tongue; they move down when mandible gets bigger.  
At the seventh week, they ascend to attain a horizontal position, then fuse to form the secondary palate.  At the time the palatine shelves fuse, the nasal septum (an outgrowth of median tissue of the frontonasal prominence) grows down and joins the cephalic aspect of the newly formed palate
Anteriorly, shelves fuse with triangular primary palate.  The incisive foramen marks the midline between the primary and secondary palate.

External Ear

The auricle is derived from 6 auricular hillocks (mesenchymal proliferations) along the dorsal aspect of arches 1 (top of ear) and 2 (bottom of ear).  These fuse to form the definitive auricle.  At the mandible grows, the ear is pushed upward and backward from its initial horizontal position on the neck.
The EAM is derived from the 1st pharyngeal arch.  
The eardrum (tympanic membrane) is composed of 3 layers of cells: 1) ectodermal epithelial lining of bottom of EAM; 2) endodermal epithelium lining of tympanic cavity; 3) intermediate layer of connective tissue.
The eardrum is composed of multiple cell layers because it represents the first pharyngeal membrane, and thus lies at the junction of the first pharyngeal pouch and cleft.

Middle Ear

The middle ear consists of an auditory tube (from the 1st pharyngeal pouch, along with tympanic cavity) and the ossicles (from pharyngeal arches 1 and 2 cartilage).  
The first arch cartilage forms the malleus and incus.  The tensor tympani (muscle of the malleus) is derived from the fourth somitomere (associated with the first arch) and is therefore innervated by CN V.
The second arch cartilage forms the stapes.  The stapedius (muscles of the stapes) is derived from the sixth somitomere (associated with the second arch) and is therefore innervated by CN VII.
The ossicles are initially embedded in mesenchyme, but in the 8th month, the mesenchyme degenerates and an endodermal epithelial lining of the tympanic cavity envelops the ossicles and connects them to the wall of the cavity in a mesentery-like fashion.

Inner Ear

The inner ear is derived thickening of surface ectoderm on both sides of the hindbrain (otic placodes).  The placodes invaginate to form otic vesicles (otocytes).  The vesicles then divide into ventral and dorsal components.
The ventral component forms the saccule and cochlear duct.
The dorsal component forms the utricle and semicircular canals and endolymphatic duct.

Cochlear Duct

Derived from an outgrowth of the saccule during the 6th week.  The outgrowth penetrates the surrounding mesenchyme in a spiral fashion.  The surrounding mesenchyme forms the cartilage and undergoes vacuolization.
The scala vestibule and scale tympani form and surround the cochlear duct.  They are filled with periplymp to receive mechanical vibrations of ossicles. The mechanical stimuli activates sensory (ciliary) cells in the cochlear duct.  

Semicircular canals

The utricle is initially three flattened outpocketings, which lose the central core.  From this three semicircular canals are forms, each at 90 degree angles from one another.  Sensory cells arise in the ampulla at one end of each canal, in the utricle and saccule.