Nerve Supply of Scalp and Face

Question 1

4 plexuses of spinal nerves

Answer 1

cervical
brachial
sacral
lumbar

Question 2

which spinal nerves supply the back of the scalp?

Answer 2

greater occipital

3rd occipital

Question 3

which spinal nerve supplies the scalp behind the auricle?

Answer 3

lesser occipital

Question 4

which spinal nerve supplies skin over the mandibular angle and front of auricle?

Answer 4

great auricular

Question 5

trigeminal nerve arise from?

Answer 5

pontin portion of brainstem

Question 6

3 divisions of trigeminal nerve?

Answer 6

V1 (ophthalmic)
V2 (maxillary)
V3 (mandibular)

Question 7

ophthalmic supplies—

Answer 7

anterior part of scalp
forehead
upper eyelid
dorsum of nose
**emerges through superior orbital fissure

Question 8

maxillary supplies–

Answer 8

lower eyelid
upper lip
side of nose
upper teeth
**emerges through foramen rotundum

Question 9

mandibular supplies–

Answer 9

cheek
lower teeth
lower lip
chin
temple
**emerges through foramen ovale to supply muscles of mastication

Question 10

cervical nerves are —- to auricle

Answer 10

posterior

Question 11

dorsal rami

Answer 11

C2 greater occipital

C3 3rd occipital

Question 12

ventral rami

Answer 12

(cervical plexus)
C2 lesser occipital
C2-3 great auricular

Question 13

ophthalmic branches into

Answer 13

supratrochlear

supraorbital

Question 14

maxillary branches into

Answer 14

zygomaticotemporal

Question 15

mandibular branches into

Answer 15

auriculotemporal

Question 16

nerve supply of the scalp

Answer 16

(from anterior to posterior)

• supratrochlear
• supraorbital
• zygomaticotemporal
• auriculotemporal
• great auricular
• lesser occipital
• greater occipital
• 3rd occipital

Question 17

erb’s point

Answer 17

where branches go from cervical to skin

Question 18

great auricular nerve (C2-3)

Answer 18

supplies skin over parotid gland and behind the auricle and over the angle of the jaw

Question 19

lesser occipital nerve (C2)

Answer 19

supplies scalp behind and above the ear

Question 20

greater occipital nerve (dorsal ramus of C2)

Answer 20

pierces trapezius lateral to the occipital protuberance and supplies scalp of occipital region up to lambdoid suture

Question 21

3rd occipital nerve (dorsal ramus of C3)

Answer 21

pieces trapezius at midline and supplies scalp of lower occipital and suboccipital region

Question 22

branches of ophthalmic nerve in scalp and face

Answer 22

1. nasociliary
2. frontal
3. lacrimal

Question 23

branches of nasociliary and what they supply

Answer 23

a. infratrochlear–skin over the medial angle of the eye and adjacent parts of the eyelids
b. external nasal–terminal branch of anterior ethmoidal. Supplies the skin over the dorsum of the nose

Question 24

branches of the frontal and what they supply

Answer 24

a. supratrochlear–skin of medial part of upper eye lid

b. supraorbital–skin of middle part of upper eye lid, forehead and scalp up to lambdoid suture

Question 25

what nerves supply the upper eyelid?

Answer 25

supratrochlear, supraorbital, palpebral branch of lacrimal

Question 26

lacrimal gland branches and what they supply

Answer 26

palpebral--skin over later part of upper eyelid

Question 27

lacrimal nerve carries secretomotor fibers to the gland. Where does it come from?

Answer 27

VII | parasympathetic

Question 28

branches of maxillary nerve in scalp and face

Answer 28

1. zygomaticotemporal--> skin over temple 2. zygomaticofacial--> skin over zygoma 3. infraorbital (palpebral, nasal, labial) - palpebral--> lower eye lid - nasal--> side of nose - labial--> upper lip 4. posterior superior alveolar--> upper teeth 5. palatine branches--> hard and soft palate

Question 29

facial nerve goes through---

Answer 29

stylomastoid foramen

Question 30

greater petrosal nerve conveys what type of fibers to what?

Answer 30

parasympathetic fibers to lacrimal, nasal, and palatine branches -responsible for allergies or common cold

Question 31

the pterygoid canal carries--

Answer 31

the vidian nerve

Question 32

V2 turns into V1 through the ----- nerve to get to the ---- gland

Answer 32

v2 goes along zygomatic nerve to turn into v1 to transmit secretomotor fibers to lacrimal gland

Question 33

the pterygoapalatine gland is a part of what nervous system?

Answer 33

parasympathetic nervous system

Question 34

role of V1 and V2 in transmitting secretomotor fibers to lacrimal gland

Answer 34

facial nerve--> PNS secretion--> nasal, lacrimal, palatine, and trigeminal nerve carrying them--> final glandular destination

Question 35

branches of mandibular nerve

Answer 35

1. long buccal--> cheek and mm over buccinators and gum 2. inferior alveolar (mental)--> lower lip, mandibular teeth, mental skin and mm over skin and lower lip 3. auriculotemporal--> auricle and posterior temporal region and TMJ and parotid gland 4. lingual--> anterior 2/3 of tongue (general sensation)

Question 36

upper lip innervated by

Answer 36

V2

Question 37

lower lip innervated by

Answer 37

V3

Question 38

lower eyelid innervated by

Answer 38

V1

Question 39

nose innervated by

Answer 39

V1 and V2

Question 40

what is used for treating wounds of upper lip and maxillary teeth?

Answer 40

infraorbital nerve block

Question 41

what is used when performing surgery on the mandibular teeth?

Answer 41

inferior alveolar nerve block

Question 42

herpes zoster on upper eye and forhead

Answer 42

V1 and V2

Question 43

herpes on upper palate

Answer 43

V2

Question 44

herpes on chin

Answer 44

V3

Question 45

herpes on ear

Answer 45

V3

Question 46

landmarks for occipital nerve block for treatment of cluster headache

Answer 46

lesser occipital N near mastoid process | great occipital N near external protuberance

Question 47

which nerves should be blocked to extract upper tooth?

Answer 47

V2

Question 48

which nerves should be blocked to extract lower tooth?

Answer 48

V3

Question 49

trigeminal neuralgia

Answer 49

stabbing unilateral facial pain triggered by chewing or similar activities - rarely suffer during sleep - more women older than 50 yrs - frequency--comes and goes - time--few seconds to few minutes - location--restricted to one side of face. **V2 is mostly involved one then V3 then V1 - bilateral sensory loss or weakness of facial muscles/jaw

Question 50

idiopathic Trigeminal neuralgia

Answer 50

neurologic examination findings normal

Question 51

secondary trigeminal neuralgia

Answer 51

1. cerebral aneurysms (superior cerebellar artery) 2. tumor (acoustic neuromas, trigeminal neuromas, meningiomas) 3. MS * Brain MRI with and without contrast is critical in diagnosing secondary causes of trigeminal neuralgia

Question 52

treatment of trigeminal neuralgia

Answer 52

1. medical--carbamazepine, Gabapentin-Lamotrigine-baclofen 2. surgical--gamma knife surgery (GKS), microvascular decompression or percutaneous procedures * *surgeon introduces trocar or needle into the ipsilateral foramen ovale. The ganglion is lysed at this location