2 - face and skull Flashcards
(121 cards)
1
Q
sensory function of the trigeminal nerve
A
cutaneous sensation from the face and forehead
2
Q
divisions of the trigeminal nerve
A
V1 - ophthalmic nerve
V2 - maxillary nerve
V3 - mandibular nerve
3
Q
which nerve innervates facial sensataround the frontal bone
A
ophthalmic nerve
4
Q
which nerve innervates facial sensation around the middle part of the face
A
maxillary nerve
5
Q
which nerve innervates facial sensation around the chin and upwards
A
mandibular nerv
6
Q
clinical examination of sensory innervation in the face
A
pinprick and light touch sensations over each region
7
Q
3 groups of important muscles in the head
A
- muscles of facial expression
- muscles of mastication
- extra ocular muscles
8
Q
where do muscles of facial expression insert
A
the skin
9
Q
function of the frontal belly of occipitofrontalis
A
- pulls scalp anteriorly
- wrinkles forehead
- elevates eyebrows
10
Q
function of occipital belly of occupitofrontalis
A
pulls scalp posteriorly
11
Q
function of orbiculares oculi
A
closes eyelids
12
Q
function of orbiculares oris
A
closes the mouth
13
Q
function of buccinator
A
- keeps cheek taught
- resists distension when whistling, sucking and blowing
14
Q
function of platysma
A
tenses the skin of the inferior face and neck
15
Q
function of zygomaticus major
A
draws the corner of the mouth upwards and laterally
16
Q
which nerve innervates the muscles of facial expression
A
facial nerve
17
Q
sensory functions of facial nerve
A
- taste
- part of external acoustic meatus and deeper parts of auricle
18
Q
autonomic functions of facial nerve
A
- secretomotor to all salivary glands except parotid
19
Q
circular muscle acting as a splinter around the eye
A
orbicularis oculi
20
Q
dilators of the eyelid
A
- levator palpebrae superiosis
- superior tarsal
21
Q
what complication would arise due to paralysis of orbiculares oculi?
A
inability to close eyelids tightly
- lower eyelid droops away and sags outwards (ectropion)
- spillage of teards
- drying of conjunctiva
- ulcerations
- secondary infection
22
Q
largest salivary gland
A
parotid gland
23
Q
how does the parotid duct travel
A
transversely across the face
24
Q
where does the parotid duct open into
A
oral cavity near the second upper molar tooth
25
posterior boundary of parotid gland
mastoid process
26
anterior boundary of parotid gland
rams of mandible
27
conditions which result in parotid glands swelling
mumps
| parotid gland stones
28
why is parotid gland stones painful
intense pain when salivating
29
functions of the parotid duct
carries secretions from the parotid gland into the mouth
30
5 terminal branches of the facial nerve
```
temporal division
zygomatic division
buccal division
marginal mandibular division
cervical division
```
31
where does the facial nerve divide
the parotid gland
32
why is the facial nerve vulnerable to damage within the parotid gland
it lies superficially
33
why is surgical removal of the parotid gland difficult
the facial nerve and its branches lie superficial
34
when is the facial nerve at risk
surgery
blunt or penetrating trauma
temporal bone fractures
35
structures which lie within the substance of the parotid gland
- facial nerve and divisions
- retromandibular vein
- external carotid artery and divisions
36
terminal branches of the external carotid artery
maxillary artery
| superficial temporal artery
37
branches of the external carotid artery (in order going up)
- superior thyroid artery
- lingual artery
- facial artery
- maxillary artery
- superficial temporal artery
38
important branch of the maxillary artery
middle meningeal artery
39
what does the middle meningeal artery supply
cranial dura mater
40
route of the middle meningeal artery
under the pterion of the skull
41
what is the pterion
where the frontal bone, temporal bone, parietal bone and sphenoid bone converge on the skull
42
where does the common carotid artery bifurcate
C3-4
43
why is the pterion weak
several bones converge here
44
what type of inter cranial bleeding may result from a fracture to the pterion?
extradural haematoma / extradural haemorrhage
45
how does a fracture to the pterion result in an extradural haemorrhage?
- middle meningeal artery can be damaged
- blood accumulation between the skull and dura matter (subarachnoid bleeding)
- extradural haemorrhage
46
where to palpate for the superficial temporal artery (temporal pulse)
- area anterior to the ear
| - posterosuperior to the temporomandibular joint
47
where to palpate for the anterior branch of the superficial temporal artery (temporal pulse)
- posterior to the zygomatic process of the frontal bone
| - the artery is passing laterally to the temporal fascia
48
where to palpate for the carotid pulse
- lateral to the thyroid cartilage
| - medial to the sternocleidomastoid muscle
49
where to palpate for the facial pulse
adjacent to the anterior margin of the masseter muscle
50
which cranial nerve loops around the internal and external carotid arteries
hypoglossal nerve (CN7)
51
function of hypoglossal nerve
innervates motor functions of the tongue (apart from palatoglossus)
52
eye socket
the orbit
53
how many bones make up the orbit
7
54
main foramina in the orbit
- superior orbital fissure
- interior orbital fissure
- infraorbital foramen
- lacrimal groove
- optic canal
55
bones making up the orbit
- frontal bone
- ethmoid bone
- nasal bone
- maxilla
- zygomatic bone
- sphenoid bone
56
extra-ocular muscles
- superior rectus
- inferior rectus
- medial rectus
- lateral rectus
- superior oblique
- inferior oblique
- levator palpebrae superiosis
57
which nerve are most extraocular muscles innervated by
oculomotor (CN3)
58
which 2 extra-ocular muscles are not innervated by the oculomotor nerve
lateral rectus
| superior oblique
59
what nerve innervates the lateral rectus muscle
abducens nerve (CN6)
60
what nerve innervates the superior oblique muscle
trochlear nerve (CN4)
61
superior rectus muscle
elevates eyeball
62
inferior rectus muscle
depresses eyeball
63
medial rectus muscle
adducts eyeball (pulls the eyeball medially to look towards the midline)
64
lateral rectus muscle
abducts the eyeball (pulls eyeball laterally to look away from the midline)
65
superior oblique muscle
inverts (medially rotates the eyeball)
66
inferior oblique muscle
everts (laterally rotates the eyeball)
67
levator palpebrae superiosis muscle
lifts the eyelids
68
which nerves travel through the orbital fissure
- oculomotor
- trochlear
- abducens
69
which is the only cranial nerve to emerge from the dorsal aspect of the brainstem
trochlear nerve
70
where does the trochlear nerve emerge
the dorsal aspect of the brainstem
71
what is diplopia
double vision
72
how do you examine a patient's eye movements?
the H test
- have a patient track an object, without moving their head, and move it in the shape of an H
- start in the midline
73
how to measure the function of the oculomotor nerve
- ask the patient to look medially
| - check the upper lid is fully retracted on upward gase
74
how to measure the function of the abducens nerve
ask the patient to look laterally
75
how to measure the function of the trochlear nerve
ask the patient to look medially then downwards
76
ptosis
dropping of upper eyelid / lazy eye
77
ptosis is the malfunction of which muscle?
complete: loss of oculomotor nerve function for levator palpebrae superiosis
partial: loss of sympathetic innervation to the superior tarsal muscle
78
Horner's Syndrome
Any lesion which leads to a loss of sympathetic function in the head
79
clinical presentations of Horner's syndrome
- pupillary constriction
- partial ptosis
- absence of sweating
80
intraocular muscles
- ciliary muscle
- sphincter pupillae muscle
- dilator pupillae muscle
81
which intraocular muscles are supplied by the oculomotor nerve
ciliary
| splinter pupillae
82
ciliary muscle
accommodation of the lens of the eye for near vision
- constricts ciliary body
- relaxes tension on lens
- lens becomes more rounded
83
dilator pupillae muscle
dilates pupil
84
sphincter pupillae muscle
constricts pupil
85
which muscles dilate and constrict the pupil
dilate: dilator pupillae muscle
construct: sphincter pupillae muscle
86
which autonomic ganglion innervates the intraocular muscles
ciliary ganglion:
- ciliary muscle
- sphincter pupillae muscle
superior cervical ganglion:
- dilator pupillae muscle
87
which structures articulate in the temporomandibular joint?
- mandibular fossa of the temporal bone
| - condylar process of the mandible
88
what does the temporomandibular joint permit?
gliding, rotation, elevation and depression of the mandible
89
how are the two articulating surfaces of the TMJ separates?
articular disc of the TMJ
| - this creates the superior and inferior articular cavities
90
how is the temporomandibular joint strengthened
- ligaments
| - articular tubercle
91
TMJ when the mouth opens
protrusion:
| condylar process glides anteriorly to lie directly beneath the articular tubercle
92
how do grinding movements in the jaw occur
if protraction occurs unilaterally
| - condylar process undergoes rotation on the inferior surface of the articular disc
93
muscles of mastication
temporalis
masseter
lateral pterygoid
medial pterygoid
94
superficial muscles of mastication
temporalis
| masseter
95
deep muscles of mastication
medial and lateral pterygoid
96
origin of temporalis muscle
temporal fossa of the skull
97
insertion of temporalis muscle
coronoid process of the mandible
98
origin or the masseter
zygomatic process of the temporal bone
99
insertion of the masseter muscle
external aspect of the ramus and angle of the mandible
100
origin of the lateral pterygoid muscle
external / lateral aspect of the lateral pterygoid plate of the sphenoid bone
101
insertion of the lateral pterygoid muscle
condyloid process of the mandible
102
origin of the medial pterygoid muscle
internal / medial aspect of the lateral pterygoid plate
103
insertion of the medial pterygoid muscle
internal aspect of the ramus and angle of the mandible
104
which nerve innervates the muscles of mastication
mandibular branch of the trigeminal nerve
105
what happens when the medial and lateral pterygoid muscles contract
the mandible moves laterally
106
how does protrusion of the jaw occur
lateral pterydoid assisted by medial pterygoid
107
how does retraction of the jaw occur
- temporalis contracts
- masseter muscle contracts
- digastric muscles contract
108
how does elevation of the jaw occur
- temporalis contracts
- masseter contacts
- medial pterygoid contracts
109
how does depression of the jaw occur
- gravity
| - digastric muscles
110
route of the mandibular branch of the trigeminal nerve
from the brainstem to the face through the foramen oval in the base of the skull
111
consequences of unilateral damage to the mandibular branch of the trigeminal nerve
the jaw will deviate to one side when opened against resistance (deviates towards the paralysed side)
112
which side will the jaw deviate to if there is a lesion on the left mandibular branch of the trigeminal nerve?
left
113
palpebral fissure
the gap between the eyelids
114
origin of platysma
inferior edge of mandible
115
attachments to orbicularis oris
near the midline to the mandible and maxilla
116
route or facial nerve from brainstem out of the skull
brainstem
internal acoustic canal
gives off branches
stylomastoid foramen
117
which structures does the facial artery supply
most superficial structures of the face
118
sensory supply to the face
divisions of the trigeminal nerve
119
dilators of the mouth group of muscles function
opens the mouth
120
why is swelling of the parotid gland painful
because of the toughness of the surrounding fascia and it's position between the mandible and the temporal bone behind
121
which muscle of mastication is fan-shaped?
temporalis
