Lecture 5: Scalp & Superficial Face Flashcards

1
Q

What are the layers of the scalp?

A
S- Skin
C - Close, subcutaneous tissue layer 
A - Aponeurotic layer 
L - Loose subaponeurotic layer 
P - Periosteum
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2
Q

Although not usually fatal, scalp lacerations involving the deep portion of what layer tend to bleed profusely?

A

Close, subcutaneous tissue layer

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3
Q

Avulsion injuries of the scalp tend to separate along what layer?

A

Loose subaponeurotic layer

  • This space is opened during surgical approaches to the upper orbits, neurosurgery and in the removal of the cadveric brain
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4
Q

Infections in what layer of the scalp may readily spread via emissary veins to separate along the layer?

A

Loose subaponeurotic layer

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5
Q

What happens with a depressed skull fracture?

A

Separation of the loose subaponeurotic layer causing CSF leakage and a scalp hematoma

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6
Q

The veins that drain the scalp are named the same as the arteries. Scalp veins may drain indirectly into the dural sinuses via ____________ veins. This is an important route for the spread of superficial infections to the brain

A

Emissary veins

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7
Q

What artery runs with the greater occipital nerve?

A

Occipital a

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8
Q

What artery runs with the lesser occipital nerve?

A

Posterior auricular

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9
Q

What artery runs with the auriculotemporal nerve?

A

Superficial temporal artery

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10
Q

_____________________ is a layer of tissue deep to the subcutaneous tissue of the face and neck. Although its fused with the _____________ fascia, its surgically elevated to perform lower face lifts.

A

Superficial muscular aponeurotic system (SMAS); parotid fascia

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11
Q

The SMAS is a layer of tissue deep to the subcutaneous tissue of the face and neck and is surgically elevated to perform lower face lifts. It extends from the ______________ to the ______________ and is continuous with _____________________ and __________

A

Platysma to the galea aponeurotica; continuous with temporoparietal fascia and galea

  • It connects the dermis via vertical septa
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12
Q

The facial nerve is embedded in the __________ gland and courses lateral to the _______________ vein

A

Parotid gland; retromandibular vein

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13
Q

What 3 structures are embedded in the parenchyma of the parotid gland?

A

Facial nerve
Retromandibular vein
External carotid artery

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14
Q

For innervation of the parotid gland, preganglionic parasympathetic fibers originate in the _________________ nucleus, course in the __________________ nerve, _________________ nerve, _______________ plexus, and _____________________ nerve before synapsing in the ____________ ganglion. Postganglionic fibers reach the gland via the ____________________ nerve

A

Inferior salivatory nucleus; glossopharyngeal nerve, tympanic nerve, tympanic plexus, and lesser petrosal nerve; otic ganglion; auriculotemporal nerve

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15
Q

After arising from the __________________ ganglion, Postganglionic sympathetic fibers to the parotid gland travel through the ____________ plexus, ___________________ nerve, ______________ plexus, _______________ nerve, _________ ganglion (no synapse), and ________________ nerve before finally terminating in the parenchyma of the gland

A

superior cervical ganglion; internal carotid plexus, carotico-tympanic nerve, tympanic plexus, lesser petrosal nerve, otic ganglion, auriculotemporal nerve

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16
Q

What is the function of the facial nerve?

A

Motor to muscles of facial expression

Sensory to taste buds on anterior 2/3 tongue

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17
Q

How do you test facial nerve function of a pt?

A

Tell them to raise their eyebrows, close eyes tight, smile and pucker lips

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18
Q

What are the 5 branches of the facial nerve?

A
Temporal 
Zygomatic 
Buccal 
Cervical 
Mandibular/marginal
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19
Q

What does the temporal branch of the facial nerve innervate and what action is this responsible for?

A

Innervates the frontalis muscle -> responsible for raising eyebrows

20
Q

What branch of the facial nerve and muscle is responsible for blinking or winking the eyelids?

A

Temporal and zygomatic branches; obicularis oculi m

21
Q

What does the zygomatic branch alone of the facial nerve innervate and what action is this responsible for?

A

Innervates the zygomatic major m -> responsible for smiling

22
Q

What does the buccal branch of the facial nerve innervate and what action is this responsible for?

A

Innervates the orbicularis oris m -> responsible for puckering the lips

23
Q

What does the cervical branch of the facial nerve innervate and what action is this responsible for?

A

Innervates the platysma m -> responsible for flaring the neck

24
Q

What are clinical signs of damage to the temporal/zygomatic branches of the facial nerve affecting the orbicularis oculi m?

A

Drooping of the lower eyelid
Spoiling of tears
Corneal drying

25
Q

What are the clinical signs of damage to the buccal branch of the facial nerve?

A

Drooling of saliva from the corner of the mouth

26
Q

What are clinical signs of damage to the cervical branch of the facial nerve?

A

Flaring of the anterior neck

27
Q

What branches of the facial nerve are considered part of the temporofacial division?

A

Temporal
Zygomatic
Superior buccal

28
Q

What branches of the facial nerve are considered part of the cervicofacial division?

A

Inferior buccal
Mandibular or marginal
Cervical

29
Q

What action is the mandibular/marginal branch of the facial nerve responsible for?

A

Frowning

30
Q

What is Bell’s Palsy?

A

Damage of branches of the facial nerve causing drooping of the lower eyelid (ectropion), spilling of tears from the eyes (epiphora), drying of cornea, inability to wink or raise the eyebrows, unequal smile, drooling from corner of mouth, hyperacusis

31
Q

What are the 4 branches of the face artery?

A

Inferior and superior labial
Lateral nasal
Angular

32
Q

Define ectropion and epiphora

A

Ectropion = drooping of the lower lid

Epiphora = spilling of tears from the eye

33
Q

What is the terminal branch of the inferior alveolar artery?

A

Mental artery

34
Q

What are the terminal branches of the ophthalmic artery?

A

Supraorbital a and supratrochlear a

35
Q

What are the 3 divisions of the trigeminal nerve?

A

Ophthalmic
Maxillary
Mandibular

36
Q

What is the function of the trigeminal nerve?

A

Motor to muscles of mastication (SVE)

Sensory to face (GSA)

37
Q

Supraorbital and supratrochlear veins drain into the ____________ vein

A

Angular vein

38
Q

The infraorbital vein and mental vein drain into the ____________ plexus

A

Pterygoid

39
Q

What is the function of the supraorbital nerve (branch of trigeminal)?

A

Supplies the skin of the lateral aspect of the forehead and scalp

40
Q

What is the function of the supratrochlear nerve (branch of trigeminal)?

A

Supplies the skin of the medial aspect of the forehead and scalp

41
Q

What nerves comprise the maxillary division of the trigeminal nerve?

A

Infraorbital nerve

Zygomaticofacial nerve

42
Q

What is the function of the infraorbital nerve (branch of trigeminal)?

A

Supplies the skin of the antero-superior cheek region

43
Q

What is the function of the zygomatcofacial nerve (branch of trigeminal)?

A

Supplies the skin of the malar prominence

44
Q

What is the function of the auriculotemporal nerve (branch of trigeminal)?

A

Supplies the skin of the temporal region

45
Q

What is the function of the buccinator/buccal branch of the trigeminal nerve?

A

Supplies the mucous membrane and skin of the inner cheek

**The buccinator nerve does NOT innervate the buccinator muscle

46
Q

What is the function of the mental nerve (branch of trigeminal)?

A

Supplies the skin of the chin region

47
Q

What is trigeminal neuralgia (Tic Douloureux)?

A

An intractable pain of the face usually associated with one or more of the sensory dermatomes of the trigeminal nerve. The pain may be due to abnormal seizure-like activity in the trigeminal sensory nucleus, which may be triggered by stimulation of one of its sensory branches