Face, Scalp and Parotid Flashcards Preview

MD1 Neuroscience > Face, Scalp and Parotid > Flashcards

Flashcards in Face, Scalp and Parotid Deck (79):
1

What is the extent of the scalp?

From nuchal line to supraorbital margins
Laterally extends down to zygomatic arches

2

What does the nuchal line correspond to?

External posterior protuberance

3

What are the five layers of the scalp?

S - skin
C - connective tissue (dense)
A - aponeurosis
L - loose connective tissue
P - pericranium

4

What does the skin have associated with it?

Hair follicles

5

What is in the dense connective tissue layer?

Fat
Vessels
Nerves

6

What muscle is the aponeurosis of the scalp of?

Occipitofrontalis

7

What are the two bellies of the occipitofrontalis?

Anterior = frontalis
Posterior = occipitalis

8

What does the occipitofrontalis do?

Moves scalp
Frowns forehead

9

Why does a scalp wound deep to the aponeurosis gape?

Opposing pull of two bellies of occipitofrontalis
Also contributes to heavy bleeding

10

Why can you move the upper part of the scalp?

Because of loose connective tissue layer

11

Which layers of the scalp are moved when you "move the scalp"?

Outer three layers that are fused together over bone

12

Why can infection localise in the loose connective tissue of the scalp?

Because of consistency

13

What is under the periosteum/pericranium?

Skull and meninges

14

Which layer of the scalp is the neurovascular layer?

Layer 2

15

Which arteries are in the scalp?

Branches of internal and external carotid arteries

16

Do the branches of the internal and external carotid arteries communicate in the scalp?

Yes, via free and rich anastomoses

17

Why do scalp wounds bleed so heavily?

Because of rich arterial supply

18

Why don't scalp wounds clot easily, and therefore contribute to the heavy bleeding?

Connective tissue septa in layer 2 adhere to margins and hold open cut vessels

19

What is the best treatment to stop bleeding in a scalp wound?

Apply tourniquet around head near wound

20

What is the difference in the layered organisation between the face and scalp?

No layer 4
No aponeurosis - muscles of facial expression instead

21

What is the origin of the muscles of facial expression?

Bone or fascia

22

What is the attachment of the muscles of facial expression?

Skin of face

23

What are the muscles of facial expression arranged around?

Facial orifices
- Eye
- Nasal cavity
- Mouth

24

What is the arrangement of the muscles of facial expression around the orifices?

Surround orifice as sphincter - close
Radiate out linearly from orifice - open

25

What are pharyngeal arches?

Embryological structures each supplied by a cranial nerve

26

Where are the muscles of facial expression derived from?

Second pharyngeal arch

27

Which nerve supplies the muscles of facial expression?

CN VII - facial nerve

28

Which nerve/s supply the sensory information from the skin of the face and scalp anterior to the ears?

CN V - trigeminal nerve

29

What are the three divisions of the trigeminal nerve?

Ophthalmic
Maxillary
Mandibular

30

What region does the ophthalmic nerve innervate?

Eye region including forehead and top of nose

31

What region does the maxillary nerve innervate?

Cheek region
- Cheek
- Upper lip

32

What region does the mandibular region innervate?

Jaw region
- Lower lip
- Jaw

33

Where does mandibular innervation go laterally?

Turns up to go over ear

34

What is the cutaneous innervation to the skin behind the ear?

Articular branch of CN X - vagus nerve

35

What cutaneous innervation does the skin on the back of the head have?

Dorsal rami

36

What is the cutaneous innervation of the C1 dorsal ramus?

None

37

What is the cutaneous innervation of the C2 dorsal ramus?

Back of head

38

What is the cutaneous innervation of the C3 dorsal ramus?

Back of neck - where cervical collar worn

39

What kind of nerve is the mandibular nerve?

Mixed

40

What is the motor innervation of the mandibular nerve?

Muscles of mastication

41

What does the trigeminal ganglion divide into?

Ophthalmic nerve
Maxillary nerve
Mandibular nerve

42

Where is he trigeminal ganglion?

Apex of petrous part of temporal bone - in middle of middle cranial fossa

43

What is the route of the ophthalmic nerve?

Exits skull via superior orbital fissure
Enters orbit
Up forehead

44

What is the route of the maxillary nerve?

Exits skull via foramen rotundum
Onto cheek

45

What is the route of the mandibular nerve?

Exits skull via foramen ovale
Onto jaw

46

What area of the scalp does the ophthalmic branch of the internal carotid supply?

Central forehead via branches winding out of orbit

47

What are the two major branches of the internal carotid on the central forehead?

Medial = supratrochlear arteries
Lateral = supraorbital arteries

48

What is the main artery of the face?

Facial artery

49

What artery is the facial artery a branch of?

External carotid artery

50

What is the route of the facial artery?

Winds around inferior border of mandible and onto face
Heads to inferior border of eye
Tortuous course across cheek to inner corner of eye
Branches to
- Lower lip
- Upper lip
- Cheek
- Nose
Anastomoses with internal carotid branches at eye

51

What is the route of the superficial temporal artery?

Passes up and over zygomatic arch
Supplies anterior and lateral part of scalp

52

What are the branches of the external carotid artery supplying the face and scalp?

Facial artery
Superficial temporal artery
External auricular artery
Occipital artery

53

What areas do the external auricular and occipital arteries supply?

Behind ear

54

Which branches of the external carotid artery are accompanied by veins?

All

55

What is the main venous drainage of the face?

Facial vein

56

Where is the facial vein, and what is its shape?

Behind facial artery
Straighter than facial artery

57

How do the tissues of the face drain into the cavernous sinus?

Via emissary veins
Directly through facial bones

58

Can infections from the face spread into the brain and meninges and cause encephalitis and meningitis?

Yes, because facial tissues drain into cavernous sinus

59

Which lymph nodes drain the face and scalp?

Those in ring around base of scalp
- Submental anteriorly
- Submandibular more posteriorly and laterally
- Pre-auricular and parotid near ear
- Mastoid
- Occipital
Move into deep cervical nodes

60

What is the parotid gland?

Salivary gland

61

Where is the parotid gland?

Below zygomatic arch
Above angle of mandible
In front of ear
Behind massoter muscle
Superficial to styloid process

62

What is the parotid gland wrapped in?

Parotid fascia

63

What happens when the parotid gland is infected, as happens on mumps, for example?

Gland swells
Fascia doesn't
Causes intense pain

64

How does the parotid gland deliver saliva to the mouth?

Via duct
- Comes forward from anterior border of gland
- Across massoter muscle
- Reaches anterior border and pierces buccinator muscles
- Enters oral cavity near second molar

65

What are the structures inside the parotid gland, from superficial to deep?

Facial nerve
Retromandibular vein
External carotid artery

66

How does the facial nerve exit the skull?

Via stylomastoid foramen, in between styloid and mastoid processes at base of skull

67

Which motor nerve innervates the occipitalis bell of the occipitofrontalis muscle?

Facial nerve branch

68

What else does the facial nerve innervate, that isn't a muscle of facial expression?

Posterior belly of digastric and stylohyoid muscles

69

Where does the facial nerve enter the parotid gland?

Posteromedial surface

70

What does the facial nerve do inside the parotid gland?

Creates plexus within substance of gland

71

What is the name of the plexiform arrangement of the facial nerve within the parotid gland?

Pes anserinus

72

What are the five branches of the facial nerve, from superior to inferior?

Tall - temporal
Zulus - zygomatic
Bear - buccal
Many - mandibular
Children - cervical

73

What do the branches of the facial nerve innervate?

Muscles of facial expression

74

Where does the retro mandibular vein run?

Behind mandible

75

What forms the retromandibular nerve?

Union of superficial temporal and maxillary veins

76

What does the external carotid artery divide into after entering the parotid gland?

Superficial temporal artery
Maxillary artery
Given off within substance of gland

77

What is a very important branch of the maxillary artery?

Medial meningeal artery

78

What is the risk of performing surgery near the parotid gland?

Damaging facial nerve
Damage supply of muscles of facial expression in that side

79

What is Bell's palsy?

Affects branches of facial nerve
Unknown aetiology - possible previous viral infection
Happens overnight
Characteristics
- Drooping eyelid
- Flattening of nasolabial fold
- A little drooling
Treatment
- High dose steroids
- Can recover in weeks-months-years, but sometimes never

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