Face and Scalp Flashcards Preview

Sc 23 - Head and neck Neuroanatomy > Face and Scalp > Flashcards

Flashcards in Face and Scalp Deck (37):
1

Bones forming the Facial skeleton

  • (Frontal)
  • (Ethmoid)
  • Nasal
  • Zygomatic
  • Maxilla

2

Only movable facial bone

Mandible

3

Trigeminal Nerve - CN V

3 branches:-

  • Ophthalmic
  • Maxillary 
  • Mandibular

4

Ophthalmic

Vi or V1

Sensory

Passes through the Superior Orbital Fissure

5

Maxillary

Vii or V2

Sensory

Passes through the Foramen Rotundum

6

Mandibular

Viii or V3

Mixed

Passes through Foramen Ovale

7

Cutaneous innervation of the face

Sensory nerves of face enter though a series of foramina: V1 - Supraorbital; Supratrochlear

V2 - Infraorbital

V3 - Mental; Auriculotemporal

 

A image thumb
8

Ophthalmic V1 sensory to:

  • Skin of forehead (most of)
  • Conjunctiva
  • Upper eyelid, bridge of nose
  • Frontal sinus
  • Antero-superior nasla cavity (muscosa)

9

Maxillary V2 sensory to:

Most of skin of cheek, upper lip and all structures deep to them

  • upper teeth 
  • gums 
  • oral aspect of hard and soft palate 
  • maxillary sinus 
  • posterior-inferior nasal cavity

10

Mandibular V3 sensory to:

  • Skin of temple
  • Most of skin over lower jaw

11

Mandibular V3 Motor to:

  • Muscles of Mastication
  • Tensor tympani (dampens down sound i.e. from talking and chewing)
  • Tensor palatini (moves hard palate)
  • Anterior belly of digastric

12

Inferior alveolar branch of Mandibular branch of CN V

  • enters the mandibular bone through the mandibular foramen
  • Used to deliver a Mandibular block
  • Branches off to the teeth as the Inferior Dental Plexus

13

Surgical management of Trigeminal neuralgia

posterior fossa craniotomy (removing a bone flap from the skull) at the confluence of the sigmoid and transverse sinus

Vascual decompression of CN V

14

Facial artery

Branch of the External Carotid Artery

Just above the Linguinal artery, which after a tortuous journey, ends as the Angular Artery at the medial commisure of the eye

15

Transverse Facial Artery

Runs just above the Parotid Duct Branch of the Superficial Temporal Artery

16

Common carotid artery - splits into 2

  • ICA : supplies Brain and the Circle of Willis
  • ECA: supplies the face (external)

17

Facial Vein (anterior facial vein)

Commences at side of root of the nose as a direct continuation of the angular vein

Lies BEHIND the Facial Artery and follows a less tortuous course

Receives blood from the External Palatine vein before:

  1. joining the ant branch of the Retromandibular vein to form the Common Facial Vein
  2. Draining directly into the Internal Jugular Vein

18

Clinical importance of Facial Vein

has a direct connection to the Ophthalmic vein and then to a deep venous sinus within the cranial activity, Cavernous Sinus.

Bacteria can enter the facial vein and gain access to internal cranial structures resulting in infection there

19

Muscles of Facial Expression

  • Epicranius : Frontalis & Occipitalis
  • Orbicularis Oculi 
  • Orbicularis Oris 
  • Buccinator 
  • Zygomaticus 
  • Platysma

20

Epicranius: Frontalis & Occipitalis

  • Origin to Insertion
  • Action

Origin/Insertion:

  • Cranial aponeurosis
  • Eyebrows

Action:

  • Raises the eyebrows

21

Orbicularis Oculi (eye) 

  • Origin to Insertion 
  • Action

Origin to Insertion:

  • Portions of the frontal and maxilla
  • to skin around the eyes

Action:

  • Blinks 
  • Closes eyes

22

Orbicularis Oris (mouth)

  • Origin to Insertion  
  • Action

Origin to Insertion:

  •  Skin around mouth

Action: 

  • Closes and protrudes the lips

23

Buccinator:

  • Origin to Insertion
  • Action

Origin to Insertion:

  • -Mandible/Maxilla to skin around mouth

Action:

  • Flattens cheek against teeth
  • Keeps food in mouth whilst you chew

24

Zygomaticus:

  •  Origin to Insertion
  • Action

Origin to Insertion:

  •  Zygomatic bone to corner of lips

Action:

  • Raises corner of mouth

25

Platysma 

  • Origin to Insertion
  • Action

Origin to Insertion:

  • Fascia of chest
  • To lower border of Mandible

Action: 

  • Draws mouth downward

26

Facial Nerve

CN VII

Mneumonic: Two Zulus Borrowed My Cat

Motor Branches:

  • Temporal
  • Zygomatic
  • Buccal
  • Marginal Mandibular
  • Cervical

27

Facial Nerve

Branchial Motor (special visceral efferent)

Supplies:

  •  THE MUSCLES OF FACIAL EXPRESSION
  • Posterior belly of Digastric muscle
  • Stylohyoid
  • Stapedius

28

Facial Nerve

Visceral Motor (general visceral efferent)

Parasymp innerv of:

  • lacrimal
  • submandibular
  • sublingual glands
  • mucous membranes of the nasopharynx, hard and soft palate

29

Facial Nerve

Special sensory (Special afferent)

TASTE SENSTATION FROM THE ANT 2/3RDS of tongue hard and soft palates

30

Facial Nerve

General Sensory (General somatic afferent)

General sensation from the skin of the concha of the auricle and from a small area behind the ear

31

Bell's Palsy

  • Paralysis of muscles on one side of face
  • Due to swelling of facial nerve (CN VII)
  • Usually develops over 1-3 days
  • Slowly improves/completely goes away in 1-3 months
  • Most ppl with Bell's Palsy completely recover; some are left with weakness on side of face
  • *Most common in adults in the 40s

32

Parotid Gland

  • Tightly enclosed in fascia; swelling is painful = "mumps" 
  • Contains TERMINAL branches of CN VII
  • Parotid duct lies on the Masseter and pierces the Buccinator
  • Duct opens into the oral cavity near the second upper molar tooth
  • External Carotid divides into its terminal branches in the gland (maxillary art. and superficial temporal)

33

SCALP

N.B. also a useful acronym

Scalp is made up of 5 layers:

  • Skin
  • Connective tissue
  • Aponeurosis - occipito-frontalis
  • Loose connective tissue
  • Periosteum

34

Arterial supply of Scalp

  • Superficial Temporal Artery
  • Supraorbital Artery
  • Occipital and Posterior Auricular Arteries

 

These are free anastomoses from side to side.

Vessels run through the dense connective tissue (in the 2nd layer of the scalp)

35

Scalp

Cutaneous Innervation

  • Front - Supraorbital nerve Vi Ophthalmic
  • Side - Auriculotemporal nerve Viii Mandibular
  • Back - Greater Occipital nerve CN II (optic)
  • Side - Lesser Occipital nerve CN II (optic)

36

Panda's Eyes

Loose connective layer of scalp:

  • can allow bacteria/fluid to pass freely from the post. aspect of the scalp into the eyelids in front
  • Trauma in back of head: can result in blood showing up in the eyelids 
  • should make you suspect something going on in the back of the head

37

What is the skin over the angle of the jaw supplied by?

CN II Optic nerve