Scalp and Superficial Face

Question 1

5 layers of the scalp

Answer 1

Skin, Connective tissue, Aponeurosis, Loose connective tissue, Pericranium

Question 2

Clinical relevance of the emissary V

Answer 2

Loose connective tissue just superior can drain into the emissary vein, which can drain into the superior sagittal sinus. This can lead to meningitis.

Question 3

Loose connective tissue can transmit infection to…

Answer 3

scalp, around eye, and nose

Question 4

Describe characteristics of the dense connective tissue in the scalp

Answer 4

Most vascularized, nerves

Question 5

Scalp proper

Answer 5

Skin, connective tissue, aponeurosis

Question 6

Difference between gaping and non-gaping scalp wounds

Answer 6

If the wound cuts coronally through the aponeurosis, muscle will pull and lead to a gaping appearance.

Question 7

Which cranial nerve closes the eye?

Answer 7

Facial nerve

Question 8

What muscle is attached to the aponeurosis of the scalp?

Answer 8

Occipitalis Frontalis Muscle

Question 9

What direction does the neurovasculature of the scalp travel?

Answer 9

Inferior to superior

Question 10

Where is the parotid gland?

Answer 10

Goes from Zygomatic Arch to Inferior Border of Mandible

Question 11

What are the three major structures passing through the Parotid gland?

Answer 11

Facial Nerve (does not innervate gland)

Retromandibular Vein

External Carotid Artery

Question 12

What muscle does the parotid duct dive into?

Answer 12

Buccinator Muscle

Question 13

What is the sensory innervation of the parotid gland?

What is the parasympathetic innervation of the parotid gland?

Answer 13

Sensory: Auricolotemporal Nerve (branch of CN V3) and Great Auricular Nerve

Parasympathetic: CN IX

Question 14

Why would a patient with mumps have pain in the cheek?

Answer 14

Parotid gland is swelling and is constricted by investing layer of deep cervical fascia and cannot expand

Question 15

What part of the orbicularis oculi closes the eye tightly?

Answer 15

Orbital part

Question 16

What part of the orbicularis oculi gently closes the eye?

Answer 16

Palpebral part

Question 17

What cranial nerve closes the eye?

What cranial nerve opens the eye?

Answer 17

Closes: Cranial Nerve VII (Facial)

Opens: Cranial Nerve III (Oculomotor)

Question 18

What is the embryonic origin of the muscles of facial expression?

Answer 18

Pharyngeal Arch 2

Mesoderm

Question 19

What are the four muscles of mastication?

What cranial nerve innervates them all?

Answer 19

Temporalis Muscle
Masseter Muscle
Medial Pterygoid Muscle
Lateral Pterygoid Muscle
*Innervated by Cranial Nerve V3

Question 20

What is the embryonic origin of the muscles of mastication?

Answer 20

Pharyngeal Arch 1

Mesoderm

Question 21

What are the branches of Facial Nerve providing motor innervation?

Answer 21

Posterior Auricular N

Temporal N.

Zygomatic N.

Buccal N.

Mandibular N.

Cervical N.

pA Tiny Zenbra Bit My Cheek

Question 22

Where does the Facial Nerve enter the skull?

Where does the Facial Nerve exit the skull?

Answer 22

Enter: Internal Acoustic Meatus

Exit: Stylomastoid Foramen

Question 23

What branch of Facial Nerve provides sensory information to the anterior 2/3 of the tongue?

Answer 23

Chorda Tympani

Question 24

What branch of Facial N. carries parasympathetic fibers to the submandibular and sublingual salivary glands?

Answer 24

Chorda Tympani

Question 25

What branch of Facial Nerve transmits parasympathetic fibers to the lacrimal gland?

Answer 25

Greater Petrosal Nerve

Question 26

What are some symptoms of Bell's Palsy?

Answer 26

Damage done to ipsilateral side ``` Loss of parasympathetic innervation to lacrimal ducts No tear production Loss of innervation to stapedius muscle No protection from loud noises Loss of taste to anterior ⅔ of tongue Lose parasympathetic innvervation to submandibular and sublingual salivary glands Cannot move facial muscles Cannot close eye Loss of general sensory to ear ```

Question 27

If the Facial Nerve was damaged in the Internal Acoustic, what symptoms would be seen?

Answer 27

Loss of all functions of Facial Nerve

Question 28

If the Facial Nerve was damaged at the entrance of the facial canal, what symptoms would we see?

Answer 28

Loss of all functions of Facial Nerve except parasympathetic innervation to lacrimal gland

Question 29

If the Facial Nerve was damaged right before the branch of the Chorda Tympani, what symptoms would we see?

Answer 29

Loss of all functions of Facial Nerve except parasympathetic innervation to lacrimal gland and innervation to stapedius muscle Only will have tear production and protection against loud sounds!

Question 30

If the Facial Nerve was damaged at the stylomastoid foramen, what symptoms would we see?

Answer 30

Symptoms Unilateral flaccid paralysis of facial muscles Loss of sensation around ear Will have tear production, protection against loud sounds, taste to tongue, and salivary production

Question 31

What is the sensory innervation of the bridge of the nose?

Answer 31

Opthalmic V1

Question 32

What is the sensory innervation of the sides of the nose?

Answer 32

Maxillary V2

Question 33

What is the sensory innervation of the upper eyelid?

Answer 33

Opthalmic V1

Question 34

What is the sensory innervation of the lower eyelid?

Answer 34

Maxillary V2

Question 35

What is the sensory innervation of the cornea?

Answer 35

Opthalmic V1

Question 36

What provides cutaneous sensation to the angle of the mandible?

Answer 36

Cervical plexus

Question 37

What provides motor innervation to the Buccinator M.? What provides sensory innervation?

Answer 37

Motor: Buccal branch of Facial N. CN VII Sensory: Buccal Nerve (branch of CN V3)

Question 38

Where do the Supratrochlear and Supraorbital Nerves arise from? What do they innervate?

Answer 38

Ophthalmic Nerve (V1) Sensory innervation to eyelid, forehead, scalp, and vertex

Question 39

What are the branches of the Maxillary Nerve?

Answer 39

Infraorbital Nerve Zygomaticofacial Nerve Zygomaticotemporal Nerve

Question 40

What are the branches of the Mandibular Nerve?

Answer 40

Auriculotemporal Nerve Buccal Nerve Mental Nerve

Question 41

Where does Herpes Zoster normally lie dormant?

Answer 41

Sensory root ganglia/dorsal root ganglia of trigeminal nerve Most common in V1

Question 42

A 50 y/o patient presents with a rash to her forehead and bridge of her nose. She has a history of chicken pox as a child. What nerve has the virus taken the distribution of? Specifically what division?

Answer 42

Trigeminal N V1 (ophthalmic)

Question 43

What is the anastamosis between ICA and ECA on the forehead?

Answer 43

ECA: Superficial Temporal Artery ICA: Supraorbital Artery

Question 44

What two arteries anastomose around the medial part of the eyes and nose?

Answer 44

ICA: Supratrochlear Artery ECA: Angular Artery (continuation of Facial Artery)

Question 45

What two arteries anastomose around the lip?

Answer 45

Superior and Inferior Labial Arteries Both from Facial Artery

Question 46

What do the Occpital Lymph Nodes drain?

Answer 46

Back of Head

Question 47

What do the Mastoid Lymph Nodes drain?

Answer 47

Posterior lateral sides of the head (posterior to ear)

Question 48

What do the Parotid Lymph Nodes drain?

Answer 48

Forehead, lateral face, eyes

Question 49

What do the Submandibular Lymph Nodes drain?

Answer 49

Top lip and lateral lower lips

Question 50

What do the Submental Lymph Nodes drain?

Answer 50

Central lower lip and Chin

Question 51

What lymph nodes drain into deep cervical?

Answer 51

Partoid Submandibular Submental

Question 52

What lymph nodes drain into superficial cervical?

Answer 52

Occipital Mastoid