Flashcards in Head and Face I Deck (132):
What is the scalp?
Skin and connective tissue overlying the scalp.
What does the scalp run to and cover?
Anteriorly- supraorbital margin
Posteriorly- superior nuchal line
Laterally- temporalis muscle (temporal fascia) and zygomatic arch
What are the layers of the scalp?
(deep) Connective tissue
Loose connective tissue
Periosteal layer of the bone (pericranium)
What is the aponeurosis of the scalp?
The aponeuorsis of the occipitalfrontalis muscle.
What arteries provide blood supply to the scalp? (x5)
Supratrochlear artery, supraorbital artery, superficial temporal artery, posterior auricular artery, and occipital artery
What nerves provide cutaneous innervation to the scalp? (x7)
Where do they come from?
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)
How many divisions are there of the trigeminal nerve? What are the names of each division?
Of the trigeminal branches, which are sensory (GSA)?
All three--however, the mandibular division also has motor fibers.
Which trigeminal branch has both motor and sensory fibers? What type of fibers are they?
Motor= SVE; sensory= GSA
What nerve innervates the muscles of facial expression? What type of fiber are they?
CN VII (facial nerve)
What does CN VII innervate? (SVE fibers)
The muscles of facial expression plus 4 (stylohyoid, stapedius, posterior belly digastric, & platysma)
What does CN V innervate? (SVE fibers)
The muscles of mastication plus 4 (tensor tympani, tensor veli palatini, anterior belly digastric, & mylohyoid)
True or false:
The SCM and masseter muscles are muscles of facial expression.
What provides general cutaneous innervation to the face? To the neck?
Face= trigeminal nerve (V1, V2, V3)
Neck= dorsal rami of cervical spinal nerves and branches from cervical plexus
What are the cutaneous branches of V1?
-palpebral branch of lacrimal nerve
-external nasal branch of anterior ethmoidal nerve
What are the cutaneous branches of V2?
What are the cutaneous branches of V3 to the face?
What are the cutaneous branches to the neck from the medial branches of the dorsal rami of cervical spinal nerves?
-greater occipital nerve (C2)
-3rd occipital nerve (C3)
-from 4th, 5th, 6th, & 7th nerves in succession below
What are the cutaneous branches of the neck from the cervical plexus?
-lesser occipital nerve (C2)
-great auricular nerve (C2-C3)
-transverse cervical nerve (C2-C3)
-supraclavicular nerves (C3-C4)
Describe the path of CN VII.
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.
What are the five branches of CN VII?
What artery lies deep to the carotid gland?
Superficial temporal artery
Describe the branching pattern of the external carotid.
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.
Describe the branching pattern of the facial artery.
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
Where are the angular arteries located?
Near the medial corner of the eye.
Where does the facial nerve branch off the external carotid?
Near the angle of the ramus of the mandible.
What are the three arteries that arise from the opthalmic artery? What does the opthalmic artery come off of?
1) dorsal nasal artery
The opthalmic comes off the internal carotid artery.
What courses across the masseter muscle?
After coursing across the masseter muscle, what does the parotid duct do?
Dives into the buccinator muscle.
What type of cervical fascia is loose and irregulary arranged?
Superficial cervical fascia
What type of cervical fascia is dense and regularly arranged?
Deep cervical fascia
List the five types of deep cervical fascia.
1)Superficial (investing) layer
What does the superficial (investing) layer of deep cervical fascia enclose?
SCM and trapezius
What does the superficial (investing) layer of deep cervical fascia attach to? (x3)
What does the pretrachial layer of deep cervical fascia enclose?
Larynx, trachea, and thyroid gland
What does the carotid sheath enclose? (x4)
Common carotid artery, internal carotid artery, inferior jugular vein,and vagus nerve
What does the prevertebral fascia enclose? (x4)
Scalene muscles, prevertebral muscles, posterior neck muscles, and sympathetic trunk.
What type of deep cervical fascia is continous with the endothoracic fascia?
What type of deep cervical fascia is continous with the anterior longitudingtional ligament of the thoracic vertebrae?
What type of deep cervical fascia extends laterally as the axillary fascia?
What surrounds the pharynx?
What lies between the pharyngeal constrictor muscles and the muscosal membrane of the pharynx?
Where does the retropharangeal space lie?
Between the prevertebral fascia and buccopharangeal fascia.
What is the clinical significance of the retropharyngeal space?
It is a potential space for the spread of infection into the superior mediastinum.
What are the boundaries of the posterior triangle of the neck?
What are the boundaries of the anterior triangle of the neck?
What divides the posterior triangle of the neck into two triangles?
Inferior belly of the omohyoid muscle
What are the two divisions of the posterior triangle of the neck?
Occipital and supraclavicular
What creates the roof of the posterior triangle of the neck?
What creates the floor of the posterior triangle of the neck?
The muscles of the lateral neck:
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
What artery runs across the supraclavicular triangle?
What are the suprahyoid muscles?
Digastric (anterior and posterior bellys)
What innervates the anterior belly digastric muscle?
SVE fibers of CN V3
What innervates the posterior belly digastric muscle?
SVE fibers of CN VII (facial)
What innervates the mylohyoid?
CN V3 SVE fibers
What innervates the stylohyoid?
SVE fibers of CN VII (facial)
What innervates the geniohyoid?
C1 via CN XII
What are the infrahyoid muscles?
Omohyoid (superior and inferior bellies)
What innervates the sternohyoid?
Superior root of the ansa cervicalis
What innervates the sternothyroid?
Superior root of the ansa cervicalis
What innervates the superior belly of the omohyoid?
Superior root of the ansa cervicalis
What innervates the inferior belly of the omohyoid?
Inferior root of the ansa cervicalis
What innervates the thryohyoid?
C1 via CN XII
What muscle is split by the tendon of the digastric muscle?
Into how many triangles is the anterior triangle of the neck divided into?
Five--submental, submandibular, carotid, and muscular triangles.
What does the anterior belly of the digastric muscle divide the anteior neck triangle into?
Submental and submandibular triangles
What does the posterior belly of the digastrtic muscle divide the anterior neck triangle into?
Submandibular and carotid triangles
What does the superior omohyoid muscle divide the anterior neck triangle into?
Muscular and carotid triangles.
What is the other name for the muscular triangle?
What anterior neck triangle is the only unpaired triangle?
What bounds the submental triangle? The floor?
Bounded by: midline, anterior belly digastric, & hyoid
Floor: mylohyoid and median fibrous raphe
What are the contents of the submental triangle?
What is sometimes referred to as the digastric traingle?
The submandibular triangle
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
What are the contents of the submandibular triangle?
Nerve to the mylohyoid
Facial and Submental arteries
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
What are the contents of the carotid triangle?
Common, internal, external carotid arteries
vagus, accessory, and hypoglossal nerve
branches of cervical plexus
internal jugular vein
What is found within the carotid sheath?
Common carotid artery
Internal jugular vein
What nerve courses across the top of the carotid triangle?
What nerve courses through the submandibular triangle of the neck before going deep to the mylohyoid?
What important things in the respiratory reflex are located within the carotid sinus?
What is the muscular triangle of the neck bounded by?
Superior omohyoid, SCM, and midline
What are the contents of the muscular triangle of the neck?
Thyroid and parathyroid glands
What does C1 from the cervical plexus "hitchhike" on?
The hypoglossal cranial nerve
What is the loop formed by C1, C2, and C3?
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
What muscles does the superior root of the ansa cervicalis supply?
Sternohyoid, sternothryoid, and superior belly of the omohyoid
What muscle does the inferior root of the ansa cervicalis supply?
Inferior belly of the omohyoid
In the cervical plexus, what two muscles does C1 supply?
Geniohyoid and thryoidhyoid
What are the cutaneous nerves from the cervical plexus?
Lesser occiptial (C2)
Great auricular (C2-C3)
Transverse cervical (C2-C3)
What are the cord levels of the phrenic nerve? What does it innervate?
C3, C4, C5--diaphragm
What are the three major branches of the subclavian artery?
What are the branches of the thryocervical trunk off of the subclavian?
Transverse cervical (superficial and deep branches)
What are the two branches of the costocervical trunk off of the subclavian?
What is the other artery that branches off the subclavian and travels on either side of the sternum?
Internal thoracic (mamillary) artery
What is torticollis?
A flexion deformity that results in shortness of the SCM muscle.
What causes torticollis?
Lesion of CN XI (spinal accessory)
Where does V3 exit the skull?
Where does V2 exit the skull?
Where does V1 exit the skull?
Superior orbital fissure
Where does CN VII exit the skull?
It first enters the internal auditory meatus and then exits through the stylomastoid foramen
What does Bell's palsy involve?
Inflammation of CN VII
What virus has been shown to be a cause of Bell's palsy?
Herpes simplex virus
What foramen in the skull allows for passage into the lateral nasal cavity?
What are the four muscles of mastication?
What innervates the muscles of mastication?
SVE fibers from CN VII
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
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
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
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
Which of the muscles of mastication have two heads?
Medial and lateral ptygeroids
What is the pterygomandibular raphe?
A shiny white tendon at the edge of the buccinator muscle
What seperates the buccinator muscle and the superior pharayngeal constrictor muscles?
Where is the sphenomandibular ligament located?
Anterior to the mandibular foramen
What is the TMJ joint?
An articulation between the condyloid process of the mandible and the mandibular fossa of the temporal bone
What type of joint is the TMJ?
Condyloid (and synovial)
What types of motion occur at the TMJ?
Gliding (protrusion/retrusion/side to side)
What ligament reinforces the fibrous capsule of the TMJ laterally?
How many synovial membranes are in the TMJ joint?
What muscle attaches to the articular disc of the TMJ?
What provides innervation to the TMJ joint?
GSA fibers from the auriculotemopral nerve (V3)--it provides propriception and pain
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
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
What are the three divisions of the maxillary artery?
What are the branches of the mandibular portion of the maxillary artery?
What are the branches of the ptygeroid portion of the maxillary artery?
masseteric, medial ptygeroid, lateral ptygeroid, buccal, and deep temporal
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
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
What stimulates more saliva to be produced?
Parasympathetic nervous system
What inhibits the production of saliva?
Sympathetic nervous system