Anatomy: Face, Temporal and Infratemporal Fossa

Question 1

What is the scalp?

Answer 1

soft tissue overlaying the skull

Question 2

Layers of the Scalp:

Answer 2

• skin
• connective tissue (dense)
• aponeurosis
• loose connective tissue
• periosteum/pericranium

Question 3

Scalp:

Answer 3

Question 4

Aponeurosis:

Answer 4

• connects two muscle bellies

Question 5

Blood Supply to the Scalp:

Answer 5

• rich vascular supply
• the most vascularised layer is the
  dense connective tissue
• supratrochlear, superficial temporal,
  posterior auricular, occipital

Question 6

Blood Supply to the Scalp:

Answer 6

Question 7

Why do scalp lacerations bleed so profusely?

Answer 7

• aponeurosis when cut perpendicular
  to fibres will bleed more
• results in more gaping

Question 8

The face is defined as

Answer 8

the area of the head between the scalp and the neck

Question 9

Muscle Groups Surrounding the Orifices:

Answer 9

• three groups of muscles
• orbital, oral, nasal

Question 10

Muscles of Facial Expression:

Answer 10

• orbicularis oculi allows closing or
  scrunching of eyes
• orbicularis oris allows pouting
• buccinator allows popping out of
  cheek
• frontalis allows eyebrow movement
• occipitalis connects but not really
  part of the face
• palpebral surrounds eyelids

Question 11

Muscles of Facial Expression:

Answer 11

• procerus and nasalis acts together,
  top allows scrunching, nasalis
  allows/assists side to side
• levator labi superioris is medial to to
  zygomaticus minor
• levator labi superioris alaeque nasi is
  medial to the levator labi superioris
• platysma is very thin
• find functions

Question 12

Muscles of Facial Expression:

Answer 12

Question 13

Muscles of Facial Expression:

Answer 13

Question 14

Parotid Gland:

Answer 14

• largest salivary gland
• located anterior and inferior to the
  ear
• parotid gland secretes into parotid
  duct
• parotid duct:
  
  • horizontally across masseter
    muscle
  • pierces buccal fat pad and
    buccinator muscle
  • drains into the oral
    cavity/vestibule: upper 2nd molar

Question 15

What is shown below?

Answer 15

Parotid gland & duct

Question 16

Surface Anatomy:

Answer 16

Question 17

3 structures that pass through the parotid gland:

Answer 17

• external carotid artery
• retromandibular vein
• facial nerve (motor) branches

Question 18

External Carotid Artery: Branches that pass through the parotid gland:

Answer 18

• posterior auricular artery
• maxillary artery
• superficial temporal artery

Question 19

What is aponeurosis?

Answer 19

flatter connection between tissues than tendons which are more dense

Question 20

Retromandibular Vein: Tributaries that pass through the parotid gland:

Answer 20

• superficial temporal vein
• maxillary vein

Question 21

Parotid Gland Vasculature:

Answer 21

Question 22

Retromandibular vein:

• branches
• drainage

Answer 22

• anterior and posterior branch
• anterior branch connects with the
  facial vein forming the common
  facial vein which drains into the
  internal jugular vein
• posterior branch connects with the
  superior temporal vein and the
  posterior auricular vein and
  eventually drains into the external
  jugular vein

Question 23

Retromandibular Vein:

Answer 23

Question 24

Where does the internal jugular vein lie?

Answer 24

posterior to sternocleidomastoid muscle
difficult to see

common facial vein drains into the internal jugular vein

Question 25

Sensory Innervation to the Face:

Answer 25

- skin - trigeminal nerve

Question 26

Motor Innervation to the Face:

Answer 26

- muscle of facial expression - facial nerve (CNVII)

Question 27

Parasympathetic innervation to the Face:

Answer 27

- parotid gland - glossopharyngeal nerve (CNIX)

Question 28

Label foramen from where trigeminal nerve branches emerge

Answer 28

Question 29

Trigeminal Nerve Journey:

Answer 29

Trigeminal nerve emerges from the lateral surface of the pons and gives off three branches. Ophthalmic branch from the pons passes through the superior orbital fissure to supply the orbit and them comes out of the supraorbital foramen to supply the forehead. Maxillary branch goes through foramen rotundum and exits through the infraorbital foramen Mandibular branch comes out of the foramen ovale and emerges through the *mental foramen* on mandible = sensory

Question 30

Trigeminal Nerve:

Answer 30

Question 31

Trigeminal Nerve:

Answer 31

insert diagram

Question 32

The facial nerve emerges from and exits?

Answer 32

- emerges from the pons and passes through the internal acoustic meatus - sensory branches through external meatus? - motor part exits through the stylomastoid foramen (behind the ear), passes through parotid gland and branches off)

Question 33

Name 3 branches of the facial nerve.

Answer 33

- Chordae Tympani (parasymp and special sensory) - Greater Tetrosal (parasymp) - Motor Root

Question 34

Name the 5 branches of the motor root of the facial nerve.

Answer 34

- temporal - zygomatic - buccal - marginal mandibular - cervical

Question 35

Facial Nerve: Motor Root: Branches:

Answer 35

after exiting stylomastoid foramen, splits into five branches

Question 36

Can you identify the branches of the facial nerve?

Answer 36

insert diagram

Question 37

Bell's Palsy:

Answer 37

- compression of the facial nerve as it passes through the facial canal - injury, swelling, or ischaemia - most common cause of unilateral facial paralysis

Question 38

Bell's Palsy:

Answer 38

Question 39

Glossopharyngeal Nerve:

Answer 39

- general sensory fibres - motor fibres - parasympathetic and special sensory fibres - provides the parotid gland with parasympathetic supply

Question 40

Glossopharyngeal:

Answer 40

insert diagram

Question 41

What effect will innervation of the facial nerve have upon the parotid gland?

Answer 41

Parasympathetic innervation hence will increase secretion/activity of the gland

Question 42

Answer 42

insert

Question 43

Blood Supply to the Face:

Answer 43

ascending pharyngeal not seen on diagram but travels deep toward pharynx occipital runs behind the ear toward back of head maxillary branch is very deep superficial temporal runs upwards temples SALFOPMS

Question 44

Pulse Points:

Answer 44

Question 45

Answer 45

drainage journey: danger triangle = drainage of superior ophthalmic vein and facial vein into cavernous sinuses = risk of infection

Question 46

Muscles of Mastication:

Answer 46

- responsible for chewing - causes movements at TMJ (temporomandibular joint( - temporalis, masseter, lateral pterygoid, medial pterygoid

Question 47

Temporomandibular Joint:

Answer 47

- formed by the articulation of the mandible with the temporal bone - has both hinge and glid movements - synovial joint - BUT has atypical features: extracapsular ligaments, fibrocartilage articular surfaces (not hyaline), articular disc divides into upper and lower parts - complete....

Question 48

TMJ:

Answer 48

Question 49

Temporalis: - function - location - size - attaches***

Answer 49

- elevation and retraction of the jaw - superficial - one of the biggest

Question 50

Masseter: - function - location - size - attaches***

Answer 50

- elevation and protrusion - superficial - one of the biggest

Question 51

Muscles of Mastication:

Answer 51

Question 52

Lateral Pterygoid: - function - attaches to - location - attaches

Answer 52

- depression and protrusion - attaches to the

Question 53

Muscles of Mastication:

Answer 53

Question 54

Infratemporal Fossa:

Answer 54

- wedge-shaped - lateral aspect - inferior to temporal fossa - deeper than temporal

Question 55

Temporal Fossa:

Answer 55

- fan shaped depression - lateral aspect - not as deep as infratemporal fossa

Question 56

Infratemporal Fossa: Contents:

Answer 56

Question 57

Answer 57

Question 58

Maxillary Artery:

Answer 58

insert diagram - branches of the external carotid artery - 1st part is behind the bony neck of mandible - 2nd part is near lateral pterygoid muscle - 3rd part is in the pterygopalatine fossa

Question 59

Branches of the Maxillary Artery:

Answer 59

middle meningeal artery enters skull through foramen spinosum and supplies the meninges Inferior alveolar artery supplies lower teeth buccal supplies the upper teeth temporal branch runs under the zygomatic bone to supply deeper areas

Question 60

Mandibular Nerve V3 Branches:

Answer 60

motor branch = masseter branch, lateral pterygoid, deep temporal nerves sensory branches = buccal, inferior alveolar, lingual chorda tympani follows lingual nerve into oral cavity chorda tympani carries special sensory and parasympathetic fibres from the facial nerve (sensation to tongue)