Head and Face I Flashcards

1
Q

What is the scalp?

A

Skin and connective tissue overlying the scalp.

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2
Q

What does the scalp run to and cover?

A

Anteriorly- supraorbital margin
Posteriorly- superior nuchal line
Laterally- temporalis muscle (temporal fascia) and zygomatic arch

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3
Q

What are the layers of the scalp?

A
Skin
(deep) Connective tissue
Aponeurosis
Loose connective tissue
Periosteal layer of the bone (pericranium)
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4
Q

What is the aponeurosis of the scalp?

A

The aponeuorsis of the occipitalfrontalis muscle.

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5
Q

What arteries provide blood supply to the scalp? (x5)

A

Supratrochlear artery, supraorbital artery, superficial temporal artery, posterior auricular artery, and occipital artery

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6
Q

What nerves provide cutaneous innervation to the scalp? (x7)
Where do they come from?

A

Supratrochlear nerve (V1), supraorbital nerve (V1), zygomaticotemporal nerve (V2), auriculotemporal nerve (V3), lesser occiptial nerve (C2-C3), greater occipital nerve (C2), and teritary (3rd) occiptial nerve (C3)

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7
Q

How many divisions are there of the trigeminal nerve? What are the names of each division?

A

3:
V1= opthalamic
V2= maxillary
V3= mandibular

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8
Q

Of the trigeminal branches, which are sensory (GSA)?

A

All three–however, the mandibular division also has motor fibers.

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9
Q

Which trigeminal branch has both motor and sensory fibers? What type of fibers are they?

A

V3 (mandibular)

Motor= SVE; sensory= GSA

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10
Q

What nerve innervates the muscles of facial expression? What type of fiber are they?

A
CN VII (facial nerve)
SVE
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11
Q

What does CN VII innervate? (SVE fibers)

A

The muscles of facial expression plus 4 (stylohyoid, stapedius, posterior belly digastric, & platysma)

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12
Q

What does CN V innervate? (SVE fibers)

A

The muscles of mastication plus 4 (tensor tympani, tensor veli palatini, anterior belly digastric, & mylohyoid)

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13
Q

True or false:

The SCM and masseter muscles are muscles of facial expression.

A

False

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14
Q

What provides general cutaneous innervation to the face? To the neck?

A
Face= trigeminal nerve (V1, V2, V3)
Neck= dorsal rami of cervical spinal nerves and branches from cervical plexus
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15
Q

What are the cutaneous branches of V1?

A
  • supratrochlear nerve
  • supraoccipital nerve
  • infratrochlear nerve
  • palpebral branch of lacrimal nerve
  • external nasal branch of anterior ethmoidal nerve
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16
Q

What are the cutaneous branches of V2?

A
  • infraorbital nerve
  • zygomaticofacial nerve
  • zygomaticotemporal nerve
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17
Q

What are the cutaneous branches of V3 to the face?

A
  • mental nerve
  • buccal nerve
  • auriculotemporal nerve
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18
Q

What are the cutaneous branches to the neck from the medial branches of the dorsal rami of cervical spinal nerves?

A
  • greater occipital nerve (C2)
  • 3rd occipital nerve (C3)
  • from 4th, 5th, 6th, & 7th nerves in succession below
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19
Q

What are the cutaneous branches of the neck from the cervical plexus?

A
  • lesser occipital nerve (C2)
  • great auricular nerve (C2-C3)
  • transverse cervical nerve (C2-C3)
  • supraclavicular nerves (C3-C4)
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20
Q

Describe the path of CN VII.

A

It takes the longest route through the bony structures of the skull and emerges through the stylomastoid foramen. After it emerges from this foramen, it enters the carotid gland and gives off 5 branches.

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21
Q

What are the five branches of CN VII?

A
Temporal
Zygomatic
Buccal
(Marginal) Mandibular
Cervical
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22
Q

What artery lies deep to the carotid gland?

A

Superficial temporal artery

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23
Q

Describe the branching pattern of the external carotid.

A

It gives off the facial artery, then continues on up the face. Then it gives off the zygomatico-orbital artery and continues as the superficial temporal artery. Then the superficial temporal artery splits into the frontal and parietal arteries.

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24
Q

Describe the branching pattern of the facial artery.

A

It comes off of the external carotid and then gives off three branches: 1st- superior and inferior labial arteries,
2nd- lateral nasal arteries
3rd- angular arteries

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25
Where are the angular arteries located?
Near the medial corner of the eye.
26
Where does the facial nerve branch off the external carotid?
Near the angle of the ramus of the mandible.
27
What are the three arteries that arise from the opthalmic artery? What does the opthalmic artery come off of?
1) dorsal nasal artery 2) supratrochlear 3) supraorbital The opthalmic comes off the internal carotid artery.
28
What courses across the masseter muscle?
Parotid duct
29
After coursing across the masseter muscle, what does the parotid duct do?
Dives into the buccinator muscle.
30
What type of cervical fascia is loose and irregulary arranged?
Superficial cervical fascia
31
What type of cervical fascia is dense and regularly arranged?
Deep cervical fascia
32
List the five types of deep cervical fascia.
1) Superficial (investing) layer 2) Pretrachial 3) Carotid 4) Prevertebral 5) Pharyngobasilar
33
What does the superficial (investing) layer of deep cervical fascia enclose?
SCM and trapezius
34
What does the superficial (investing) layer of deep cervical fascia attach to? (x3)
Mandible Mastoid process Occiptial bone
35
What does the pretrachial layer of deep cervical fascia enclose?
Larynx, trachea, and thyroid gland
36
What does the carotid sheath enclose? (x4)
Common carotid artery, internal carotid artery, inferior jugular vein,and vagus nerve
37
What does the prevertebral fascia enclose? (x4)
Scalene muscles, prevertebral muscles, posterior neck muscles, and sympathetic trunk.
38
What type of deep cervical fascia is continous with the endothoracic fascia?
Prevertebral
39
What type of deep cervical fascia is continous with the anterior longitudingtional ligament of the thoracic vertebrae?
Prevertebral
40
What type of deep cervical fascia extends laterally as the axillary fascia?
Prevertebral
41
What surrounds the pharynx?
Buccopharyngeal fascia
42
What lies between the pharyngeal constrictor muscles and the muscosal membrane of the pharynx?
Pharyngobasilar fascia
43
Where does the retropharangeal space lie?
Between the prevertebral fascia and buccopharangeal fascia.
44
What is the clinical significance of the retropharyngeal space?
It is a potential space for the spread of infection into the superior mediastinum.
45
What are the boundaries of the posterior triangle of the neck?
Anteriorly- SCM Posteriorly- Trapezius Inferiorly- Clavicle
46
What are the boundaries of the anterior triangle of the neck?
Anteriorly- Mandible Posteriorly- SCM Anterirorly- Midline
47
What divides the posterior triangle of the neck into two triangles?
Inferior belly of the omohyoid muscle
48
What are the two divisions of the posterior triangle of the neck?
Occipital and supraclavicular
49
What creates the roof of the posterior triangle of the neck?
Platysma
50
What creates the floor of the posterior triangle of the neck?
The muscles of the lateral neck: Splenius capitus Levator scapulae Anterior/middle/posterior scalene
51
What are the contents of the posterior triangle of the neck?
``` CN XI (spinal accessory) Roots of brachial plexus Cutaneous nerves of the cervical plexus Suprascapular and transverse cervical artieries External jugular vein ```
52
What artery runs across the supraclavicular triangle?
Supraclavicular
53
What are the suprahyoid muscles?
Digastric (anterior and posterior bellys) Mylohyoid Stylohyoid Geniohyoid
54
What innervates the anterior belly digastric muscle?
SVE fibers of CN V3
55
What innervates the posterior belly digastric muscle?
SVE fibers of CN VII (facial)
56
What innervates the mylohyoid?
CN V3 SVE fibers
57
What innervates the stylohyoid?
SVE fibers of CN VII (facial)
58
What innervates the geniohyoid?
C1 via CN XII
59
What are the infrahyoid muscles?
Sternohyoid Sternothyroid Thyrohyoid Omohyoid (superior and inferior bellies)
60
What innervates the sternohyoid?
Superior root of the ansa cervicalis
61
What innervates the sternothyroid?
Superior root of the ansa cervicalis
62
What innervates the superior belly of the omohyoid?
Superior root of the ansa cervicalis
63
What innervates the inferior belly of the omohyoid?
Inferior root of the ansa cervicalis
64
What innervates the thryohyoid?
C1 via CN XII
65
What muscle is split by the tendon of the digastric muscle?
Stylohyoid
66
Into how many triangles is the anterior triangle of the neck divided into?
Five--submental, submandibular, carotid, and muscular triangles.
67
What does the anterior belly of the digastric muscle divide the anteior neck triangle into?
Submental and submandibular triangles
68
What does the posterior belly of the digastrtic muscle divide the anterior neck triangle into?
Submandibular and carotid triangles
69
What does the superior omohyoid muscle divide the anterior neck triangle into?
Muscular and carotid triangles.
70
What is the other name for the muscular triangle?
Omotrachial triangle
71
What anterior neck triangle is the only unpaired triangle?
Submental
72
What bounds the submental triangle? The floor?
Bounded by: midline, anterior belly digastric, & hyoid | Floor: mylohyoid and median fibrous raphe
73
What are the contents of the submental triangle?
Lymph nodes
74
What is sometimes referred to as the digastric traingle?
The submandibular triangle
75
What are the borders of the submandibular triangle? Roof? Floor?
``` Borders= anterior digastric, stylohyoid, & mandible Roof= platysma & investing layer of deep cervical fascia Floor= mylohyoid, hypoglossus, and middle pharyngeal constrictor muscle ```
76
What are the contents of the submandibular triangle?
Submandibular gland Hypoglossal nerve Nerve to the mylohyoid Facial and Submental arteries
77
What is the carotid triangle of the neck bounded by? Floor?
Bounded by= posterior belly digastric, superior omohyoid, and SCM Floor= scalene and middle and inferior pharyngeal constrictor muscles
78
What are the contents of the carotid triangle?
``` Common, internal, external carotid arteries Carotid sinus, vagus, accessory, and hypoglossal nerve branches of cervical plexus internal jugular vein ```
79
What is found within the carotid sheath?
Common carotid artery Internal jugular vein Vagus nerve
80
What nerve courses across the top of the carotid triangle?
Hypoglossal
81
What nerve courses through the submandibular triangle of the neck before going deep to the mylohyoid?
Hypoglossal nerve
82
What important things in the respiratory reflex are located within the carotid sinus?
Chemoreceptors
83
What is the muscular triangle of the neck bounded by?
Superior omohyoid, SCM, and midline
84
What are the contents of the muscular triangle of the neck?
Infrahyoid muscle | Thyroid and parathyroid glands
85
What does C1 from the cervical plexus "hitchhike" on?
The hypoglossal cranial nerve
86
What is the loop formed by C1, C2, and C3?
Ansa cervicalis
87
How many roots are there to the ansa cervicalis? What are their names and cord levels?
``` Superior root (descending hypoglossi)- C1-C2 Inferior root (descending cervicalis)- C2-C3 ```
88
What muscles does the superior root of the ansa cervicalis supply?
Sternohyoid, sternothryoid, and superior belly of the omohyoid
89
What muscle does the inferior root of the ansa cervicalis supply?
Inferior belly of the omohyoid
90
In the cervical plexus, what two muscles does C1 supply?
Geniohyoid and thryoidhyoid
91
What are the cutaneous nerves from the cervical plexus?
``` Lesser occiptial (C2) Great auricular (C2-C3) Transverse cervical (C2-C3) Supraclavicular (C3-C4) ```
92
What are the cord levels of the phrenic nerve? What does it innervate?
C3, C4, C5--diaphragm
93
What are the three major branches of the subclavian artery?
Vertebral Thyrocervical trunk Costocervical trunk
94
What are the branches of the thryocervical trunk off of the subclavian?
Suprascapular Transverse cervical (superficial and deep branches) Inferior thyroid Ascending cervical
95
What are the two branches of the costocervical trunk off of the subclavian?
Deep cervical | Supreme intercostal
96
What is the other artery that branches off the subclavian and travels on either side of the sternum?
Internal thoracic (mamillary) artery
97
What is torticollis?
A flexion deformity that results in shortness of the SCM muscle.
98
What causes torticollis?
Lesion of CN XI (spinal accessory)
99
Where does V3 exit the skull?
Foramen ovale
100
Where does V2 exit the skull?
Foramen rotunda
101
Where does V1 exit the skull?
Superior orbital fissure
102
Where does CN VII exit the skull?
It first enters the internal auditory meatus and then exits through the stylomastoid foramen
103
What does Bell's palsy involve?
Inflammation of CN VII
104
What virus has been shown to be a cause of Bell's palsy?
Herpes simplex virus
105
What foramen in the skull allows for passage into the lateral nasal cavity?
Sphenopalatine foramen
106
What are the four muscles of mastication?
Masseter Temporalis Medial ptygeroid Lateral ptygeroid
107
What innervates the muscles of mastication?
SVE fibers from CN VII
108
What is the origin of the masseter muscle? Insertion? Action?
O: zygomatic bone/arch I: angle of mandible and outer surface of ramus A: elevates (closes jaw) and assists in protrusion
109
What is the origin of the temporalis muscle? Insertion? Action?
O: temproal fossa/ deep temporal fossa I: coronoid process of mandible (and anterior border of mandible) A: elevates (closes jaw) and posterior fibers retract mandible
110
What is the origin of the lateral ptygeroid muscle? Insertion? Action?
O: lateral surface of the lateral ptygeroid plate & greater wing of sphneoid I: (superior head)- articular disc of TMJ (inferior head)- condyloid process of mandible A: (bilaterally)- protrusion and depression (unilaterally)-lateral protrusion
111
What is the origin of the medial ptygeroid muscle? Insertion? Action?
O: (superficial head)- medial surface of lateral ptygeroid plate & palatine bone (inferior head)- palatine bone & tuberosity of maxilla I: mandibular angle and inner surface of ramus A: (bilaterally)- elevation (unilaterally)- protrusion and grinding
112
Which of the muscles of mastication have two heads?
Medial and lateral ptygeroids
113
What is the pterygomandibular raphe?
A shiny white tendon at the edge of the buccinator muscle
114
What seperates the buccinator muscle and the superior pharayngeal constrictor muscles?
Pterygomandibular raphe
115
Where is the sphenomandibular ligament located?
Anterior to the mandibular foramen
116
What is the TMJ joint?
An articulation between the condyloid process of the mandible and the mandibular fossa of the temporal bone
117
What type of joint is the TMJ?
Condyloid (and synovial)
118
What types of motion occur at the TMJ?
Hinge (elevation-closing/depression-opening) | Gliding (protrusion/retrusion/side to side)
119
What ligament reinforces the fibrous capsule of the TMJ laterally?
Lateral ligament
120
How many synovial membranes are in the TMJ joint?
2
121
What muscle attaches to the articular disc of the TMJ?
Lateral ptygeroid
122
What provides innervation to the TMJ joint?
GSA fibers from the auriculotemopral nerve (V3)--it provides propriception and pain
123
What are the boundaries of the infratemporal fossa?
``` Anteriorly= posterior aspect of maxilla Posteriorly= mastoid and styloid processes Superiorly= greater wing of the sphenoid bone Inferiorly= medial ptygeroid muscle Laterally= ramus of the mandible Medially= lateral ptygeroid plate ```
124
What are the contents of the infratemporal fossa?
Temporalis muscle, medial/lateral ptygeroid muscles, maxillary artery, V3 nerve, lingular nerve, chorda tympani nerve, and otic ganglia
125
What are the three divisions of the maxillary artery?
1-mandibular 2-ptygeroid 3-ptygeropalatine
126
What are the branches of the mandibular portion of the maxillary artery?
``` deep auricular anterior tympanic middle mengineal accessory meningeal inferior alveolar ```
127
What are the branches of the ptygeroid portion of the maxillary artery?
masseteric, medial ptygeroid, lateral ptygeroid, buccal, and deep temporal
128
What are the branches of the ptygeropalatine portion of the maxillary artery?
descending palatine, posterior superior alveolar, sphenopalatine, artery to the ptygeroid canal, pharangeal artery, annd the infraorbital artery
129
What innervates the parotid gland?
Preganglionic GVE fibers of CN IX (glossopharangeal) via the lesser petrosal nerve to the otic ganglia ans post ganglionic fibers that "hitchike" on the auriculotemporal nerve
130
What stimulates more saliva to be produced?
Parasympathetic nervous system
131
What inhibits the production of saliva?
Sympathetic nervous system
132
What does the lesser petrosal nerve do?
Carrys preganglionic GVE fibers to the otic ganglia