Scalp, Face, Parotid Flashcards

1
Q

What are the 5 layers of the SCALP?

A
  1. Skin
  2. Connective tissue (dense)
  3. Aponurotic layer
  4. Loos connecctive dissue
  5. Pericranium
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2
Q

WHat is the first layer of the scalp?

A

Skin

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3
Q

What is the 2nd layer of the scalp? Describe

A

Dense connective tissue
Lots of blood vessels and nerve endings for cutaneous innervation.
LOTS of bleeding, wounds stay open unless stiching.

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4
Q

What is the 3nd layer of the scalp? Describe

A

Aponuerotic layer
* Thin flat tendonous layer

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5
Q

What is the 4th layer of the scalp? Describe

A

Loose connective tissue
* Not as tight and organized
* Infection spread more easily

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6
Q

What layer of the scalp is loose and therefore alows for the spread of infection more easily?

A

Loose Connective tissue

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7
Q

5th and innermost layer of the scalp. Describe

A

Pericranium
* Basically periosteum
* Sits directly adheared to the bone

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8
Q

An epicranial aponeurousis (thin tendanous sheath over skull)

A

Occipitofrontalis

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9
Q

How many bellys does the Occipitofrontalishave?

A

2 bellys;
occipital & frontal belly

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10
Q

Explain the attachment and innervation of the occipital belly of the occipitofrontalis

A

Attachments:
Occipital bone (superior to nuchal line and mastoid process) and epicranial aponeurosis (galea aponeurotica)

Innervation:
Posterior auricular branch

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11
Q

Explain the *attachment, innervation, and action * of the Frontal belly of the occipitofrontalis

A

Attachments:
To the skin above the eyebrows and the epicranial aponeurosis.

Innervation:
Temporal branch of the facial nerve [VII]

Action:
Move the scalp wrinkle the forehead, and rasie the eyebrows.

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12
Q

What are the 4 main cutaneous innervation of the scalp

(not the sub branches)

A
  1. Opthalmic Nerve V1
  2. Maxillary Nerve V2
  3. Mandibular Nerve V3
  4. Cervical Plexus (post rami)
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13
Q

Cutaneous Innervation of the Scalp

What are the 2 branches of the Opthalmic Nerve V1

A
  1. Supratrochlear n.
  2. Supra-orbital n
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14
Q

Cutaneous Innervation of the Scalp

What is the branch off the Maxillary Nerve V2

A

Zygomaticotemporaln.

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15
Q

Cutaneous Innervation of the Scalp

What is the branch off the Mandibular Nerve V3

A

Auriculotemporaln.

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16
Q

Cutaneous Innervation of the Scalp

What are the cutanous innervation of the posterior scalp an neck?

A

Post rami C2-C4 of the Cervical Plexus

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17
Q

Cutaneous Innervation of the Scalp

What nerves comes of the posterior ramus of C2 and innervates the back of the head?

A

Greater Occipital Nerve

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18
Q

Cutaneous Innervation of the Scalp

What 2 nerves comes off the posterior ramus of C2 C3 and innervates the posterior lateral side of neck and head by the ears and behind?

A
  1. Lesser occipital
  2. Greater auricular
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19
Q

Cutaneous Innervation of the Scalp

What nerves innervates the back of the neck via the posterior ramus of C3?

A

Third occipital N.

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21
Q

Cutaneous Innervation anterior face

Explain the Supratrochlear nerve

A

Branch that comes off V1 and comes up the medial aspect of the forhead

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21
Q

Cutaneous Innervation anterior face

Explain the Supra-orbital N.

A

Branch that comes off V1 and is right above the eye travels up the forhead to superior portion of scalp

more medial

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22
Q

Cutaneous Innervation anterior face

Explain the Zygomaticotemporaln.

A

Branches that come off V2 and are on the lateral aspect of the forhead

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23
Q

Cutaneous Innervation anterior face

Explain the Auriculotemporaln

A

Branch that comes off V3 that come in front of ear, on the side of the temporal bone

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24
Q

What layer does all cutaneous innervation of the scalp run?

A

2nd layer; dense connective tissue

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25
Q

Explain the lymphatic drainage of the scalp

A

No lymph nodes in the scalp
* All drainage occurs via lymphatic vessesl that come down and drain into nodes
* Occipital nodes (back of head), Mastoid nodes (lateral side of head) , Pre-auricular/parotid (side of face), sub mental, sub mandibular.

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26
Q

What are the 5 artery/vein systems in the scalp?

A
  1. Supratrochlear
  2. Supra-orbital
  3. Superficial temporal
  4. Posterior Auricular
  5. Occipital
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27
Q

Blood Vessels of the Scalp

Explain the supratrochlear artery/vein

A
  • Comes up anterioly to the scalp from medial upper corner of eye

Branch from opthalmic artery

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28
Q

Blood Vessels of the Scalp

Explain the Supra-orbital artery/vein

A
  • Comes up anterioly to the scalp

Branch from opthalmic artery

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29
Q

Blood Vessels of the Scalp

Explain the superficial temporal artery/vein

A
  • BIG Terminal branches from ex. carotid
  • Comes up (laterally) and across the temporal region to the superior portion of the scalp
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30
Q

Blood Vessels of the Scalp

Explain the posterior auricular artery/vein

A
  • From ext. carotid artery
  • Pass behind ear and up posterior aspect of the scalp
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31
Q

Blood Vessels of the Scalp

Explain the occipital artery/vein

A
  • From ext. carotid artery
  • Pass to the posterior aspect of the scalp.
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32
Q

What 2 arteries of the scalp come off the opthalmic artery (derived from internal carotid artery)

A
  1. Supratrochlear
  2. Supra-orbital
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33
Q

Blood Vessels of the Scalp

What are the 4 main venous drainage of the scalp?

A
  1. Cavernous Sinus
  2. External Jugular v. (superficial)
  3. Deep cervical v.
  4. Vertebral v.
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34
Q

Cutaneous (Sensory) Nerves of theFace

What are the 5 branches of the opthalmic nerve (CN5 V1)

Forehead, uppereyelids, dorsum ofnose

A
  1. Supraorbital
  2. Supratrochlear
  3. Infratrochlear
  4. Lacrimal
  5. External Nasal

Forehead, uppereyelids, dorsum ofnose

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35
Q

Cutaneous (Sensory) Nerves of the Face

Explain the Supraorbital branch

Ophthalmic Nerve (CN V1)

A
  • Above the eye
  • Forhead
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36
Q

Cutaneous (Sensory) Nerves of the Face

Explain the Supratrochlear branch

Ophthalmic Nerve (CN V1)

A
  • Corners of the eye.
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37
Q

Cutaneous (Sensory) Nerves of the Face

Explain the Infratorchlear branch

Ophthalmic Nerve (CN V1)

A
  • Covers medial aspect of the bridge of the nose
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38
Q

Cutaneous (Sensory) Nerves of the Face

Explain the lacrimal branch

Ophthalmic Nerve (CN V1)

A
  • Comes lateral and covers the top edge of the eyelid
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39
Q

Cutaneous (Sensory) Nerves of the Face

Explain the external nasal branch

Ophthalmic Nerve (CN V1)

A
  • comes down through the nose
    Dorsum of the nose (bridge)
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40
Q

Cutaneous (Sensory) Nerves of the Face

Explain where the Opthalmic nerve originates from and where it passes through to leave

A

Originates: Trigeminal ganglion
Exits via: Superior orbital fissue

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41
Q

Cutaneous (Sensory) Nerves of the Face

What are the 2 branches of the maxillary nerve (CN5 V2)

Skin over the uppercheek, lower eyelid,lateral nose, upper lip

A
  1. Zygomaticotemporal
  2. Infraorbital

Skin over the uppercheek, lower eyelid lateral nose, upper lip

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42
Q

Cutaneous (Sensory) Nerves of the Face

Explain the Infra-orbital branch

Maxillary Nerve (CN V2)

A
  • Big branch
  • Spreads out once it exits ganglion
  • Lateral aspect nose
  • Across upper lip
  • Lower eyelid
  • Across zygomatic process (cheek bones) meets zygomaticfacial nerve
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43
Q

Cutaneous (Sensory) Nerves of the Face

Explain the zygomaticotemporal branch

Maxillary Nerve (CN V2)

A
  • comes up the lateral potion of the head
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44
Q

Cutaneous (Sensory) Nerves of the Face

Explain where the Maxillary nerve originates from and where it passes through to leave

A

Originates: Trigeminal ganglion
Exits via: foramen rotundum

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45
Q

Cutaneous (Sensory) Nerves of the Face

What are the 3 branches of the mandibular nerve (CN5 V3)

Skin anterior to ear,posterior temporalregion

lower cheek,lower lip and chin

A
  1. Auriculotemopral
  2. Buccal
  3. Mental
    Skin anterior to ear,posterior temporalregion, lower cheek,lower lip and chin
46
Q

Cutaneous (Sensory) Nerves of the Face

Explain the Auriculotemporal branch

Mandibular Nerve (CN V3)

A
  • Big nerve
  • Comes up the side of the temporal bone (same as artery)
47
Q

Cutaneous (Sensory) Nerves of the Face

Explain the buccal branch

Mandibular Nerve (CN V3)

A
  • Side of the lower cheek inmouth
48
Q

Cutaneous (Sensory) Nerves of the Face

Explain the mental branch

Mandibular Nerve (CN V3)

A
  • In mandible
  • comes out anteriorly via mental foramen
  • Covers the entire chin
49
Q

Cutaneous (Sensory) Nerves of the Face

Explain where the Mandibular nerve originates from and where it passes through to leave

A

Originates: Trigeminal ganglion
Exits via: foramen ovale

50
Q

Vasculature of the Face

What are the 3 external carotid branches that supply the face?

A
  1. Maxillary artery (ant face, term branch)
  2. Superficial temporal (side of head, term branch)
  3. Facial artery (across mandible onto face)
51
Q

Vasculature of the Face

What are the 4 branches of the facial artery?

A
  1. Inferior labial branch
  2. Superior labial branch
  3. Lateral nasal branch
  4. Angular a.
52
Q

Facial Artery Branch

Explain the inferior labial branch of the facial artery

A
  • Supply the lower lip
53
Q

Facial Artery Branch

Explain the superior labial artery branch of the facial artery

A
  • Supplys the upper lip
54
Q

Facial Artery Branch

Explain the lateral nasal branch of the facial artery

A
  • Supply lateral aspect of nose
55
Q

Facial Artery Branch

Explain the angular branch of the facial artery

A
  • End artery
  • At angle of nose and eye
56
Q

Superficial Temporal Artery Branch

Explain the transverse facial artery branch from the superficial temporal artert

A
  • Comes across cheek and towards the nose
57
Q

Vasculature of Face

Explain the 3 branches off the maxillary artery

**deep, off ext. carotid to medial aspect of face **

A
  1. Infraobital a
  2. Buccal a
  3. Mental a
58
Q

Maxillary artery branch

Explain the infra-orbital artery branch off the maxillary artery

A
  • Under zygomatic arch
  • Exit via Infra-orbital foramen
59
Q

Maxillary artery branch

Explain the buccal artery branch off the maxillary artery

A
  • Come across cheek
  • Supply buccal region
60
Q

Maxillary artery branch

Explain the mental artery branch off the maxillary artery

A
  • Come down interior aspect of the mandible
  • Exits via mental foramen
61
Q

Vasculature of Face

What main artery supplying the face comes of the internal carotid artery?

Comes in through the eye

A

Opthalmic artery

62
Q

Vasculature of Face

What are the5 arterial branches off of the opthalmic artery in the face?

C

A
  1. Zygomaticofacial a.
  2. Zygomaticotemporal a.
  3. Doral nasal a.
  4. Supraorbital a.
  5. Supratrochlear a.
63
Q

Opthalmic Artery Branch

Explain the zygomaticofacial branch off the opthalmic artery

A
  • Comes out lateral aspect of obicularis oculi muscle
64
Q

Opthalmic Artery Branch

Explain the zygomaticotmeporal branch off the opthalmic artery

A
  • Comes out lateral aspect of obicularis oculi muscle
65
Q

Opthalmic Artery Branch

Explain the Dorsal nasal branch off the opthalmic artery

A
  • Comes out over top of the nose.
66
Q

Opthalmic Artery Branch

Explain the Supraorbital branch off the opthalmic artery

A

Above eye, toward superior scalp

67
Q

Opthalmic Artery Branch

Explain the Supratrochlear branch off the opthalmic artery

A

Above eye, toward superior scalp

68
Q

Venous Drainage of Face

Explain what veins connect and go back and emptys into the cavernous sinus

A
  1. Facial Vein
  2. Superior opthalmic vein
    Communicate in medial cornery of the eye
69
Q

What is the significance of the cavernous sinus?

A

Blood from face can move back into the skull;

lots of pressure and **cause infection to move back **into the sinus area and surround brain.

69
Q

Venous Drainage of Face

Explain what veins connect and drain into the pterygoid venous plexus before going ot cavernous sinus

A
  1. Facial vein
  2. Deep facial vein

Communicate and drain into pterygoid venous plexus (below cavernous sinus) then drain there.

70
Q

Explain danger triangle of face

A

Creation of pressue ex. via popping pimples can push superficial face infection back via veins into the cavernous sinus and infection can spread to brain.

71
Q

What are 3 main lymphatic drainage nodes of face?

A

1. Submental (chin, lower lip , incisors)
2. Submandibular (Side of nose, cheek, jaw)
3. Pre-auricular/Parotid (Under eye, side of head, parotid gland

72
Q

What artery Follows the same path as the submandibular nodes?

A

Facial artery

73
Q

Muscles of Facial Expression

What are the 2 muscles of the orbital group and what is main idea?

A
  1. Orbicular Oculi
  2. Corrigator Supercilii
    Muscles around eye and center
74
Q

Muscles of Orbital Group

Explain the Orbicular Oculi muscle (parts & function)

A

Closes the eyelid
* Orbital Part; closes eye forcefully; produces wrinkles in forhead.
* Palpebral Part; normal eyelid closure

75
Q

Muscles of Orbital Group

Explain the Corrugator supercillli muscle (parts & function)

A
  • Deeper
  • Angled
  • Draws eyebrow to midline
    angry face
76
Q

Muscles of Facial Expression

What muscle forms verticle wrinkles in bewteen eyebrows when contracted?

A

Corrugator Supercilli muscle

77
Q

Muscles of Facial Expression

What are the 3 muscles of the Nasal group

A
  1. Nasalis
  2. Procerus
  3. Depressor septi Nasi
78
Q

Muscles of Nasal Group

Explain the Nasalis muscle (parts & function)

A

Flare the nares; nostrils
* Transverse Part; compress the nares
* Alar Part; open nares

79
Q

Muscles of Nasal Group

Explain the Procerus muscle (parts & function)

A
  • Btwn brows
  • Draws medial boarder of eyebrown downward
80
Q

Muscles of Nasal Group

Explain the Depressor septi nasi muscle (parts & function)

A
  • Attch to upper septum of nose & top of lip
  • Assit in widening nares
  • Pull nose inferiorly
81
Q

Muscles of Facial Expression

What are the 2 muscles of the Oral group

A
  1. Obucularis oris
  2. Buccinator
82
Q

Oral Group Muscles

Explain the Obicularis oris muscle

A
  • Big circular sphincter muscle
  • Around lips
    Pursing Lips
83
Q

Oral Group Muscles

Explain the Buccinator muscle

A
  • Across lateral side of cheeks
  • Keeps cheeks tight/taut against teeth
  • Aids mastication; prevent food from accumulating btwn teeth and cheeks
  • Assit in forceful expulsion of air from cheeks
84
Q

Muscles of Facial Expression

What are the 3 muscles of the Lower Group Oral Muscles

FROWN!

A
  1. Depressor anguli oris
  2. Depressor labii inferioris
  3. Mentalis
85
Q

Lower Group Oral Muscles

Explain the Depressor anguli oris muscle

A
  • depresses the corners of the mouth
    frowny face
86
Q

Lower group oral muscle

Explain the Depressorlabiiinferioris muscle

A
  • depresses lower lip and moves it laterally
  • Medial aspect of lip
    pouty face, lip flipped down
87
Q

Lower Group Oral Muscles

Explain the mentalis muscle

A
  • raises and protrudes the lower lip
  • wrinkles the skin of the chin
88
Q

Muscles of Facial Expression

What are the 4 muscles of the Upper Group Oral Muscles

A
  1. Risorius
  2. Zygomaticus Major & Minor
  3. Levator labii superioris
  4. Levator anguli oris

SMILE!

89
Q

Upper Group Oral Muscles

Explain the Risorius muscle

A
  • Corners of mouth laterally & upward
  • Contraction= pull up corner of mouth laterally superiorly
90
Q

Upper Group Oral Muscles

Explain the Zygomaticus Major/Minor muscle

A
  • Attach to zygomatic arch
  • Minor(medial on lip ) Major (lateral on lip)
  • Raise corners of mouth & help smile
91
Q

Upper Group Oral Muscles

Explain the Levatro Labii superiorus muscle

A
  • Next to nose from eye and down to upper lip
  • Raise upper lip
  • Creates nasiolabial furrow when smile
92
Q

Upper Group Oral Muscles

Explain the Levator anguli oris muscle

A
  • Deepest
  • More to angel of mouth
  • Help increase furrow, elevates angle of mouth
93
Q

What 2 muscles of the upper oral muscles form the nasolabial furrow?

A
  1. Levatro labii superioris
  2. Levator anguli Oris
94
Q

Explain the 3 auricular muscles

A
  1. Anterior (pull ear up and forward)
  2. Superior (elevate ear)
  3. Posterior (pull ear back and up)
95
Q

Where is the parotid gland located?

largest salivary gland

A
  • Anterior to the ear
  • across angel of the mandible
  • superficial to the massater muscle.
96
Q

From parotid gland, runs ~1cm below zygomatic arch, pierces buccinator m. and opens inside the cheek near 2nd maxillary molar allow salivary secretions into the mouth.

A

Parotid Duct

97
Q

The
* retromandibular vein
* external carotid arterys
* Facial Nerve CN7
* Transverse facial artery/vein
* Superfical & deep parotid nodes
do what witht the parotid gland?

A

Run through it!

98
Q

What supplys parasympathetic innervation to the parotid gland?

A

GLossopharyngeal CN 9

General Visceral Efferent

99
Q

Explain the path of the parasympathetic signals from the glossopharyngeal nerve CN9 to the parotid gland.

6 Steps

A
  1. CN 9 exits jugular foramen
  2. Tympanic br. comes off, re-enters skull via tymanic canaliculus
  3. Into tympanic cavity (inner ear), on promontory of medial wall, helps form tympanic plexus
  4. **Tympanic br. **Exits as lesser petrosal n. via hiatus on ant. petrous ridge
  5. Exits cranium again via foramen ovale (usually)
  6. Presynaptic fibers synapse in Otic Ganglion and **Post ganglion Visceral efferent **hitchhike on Auriculotemporal n. (V3) to parotid gland
100
Q

How does the parotid gladn recieve sympathetic innervation?

A

postganglionic sympathetics from superior cervical ganglion form external carotid plexus on ECA (vasomotor)

101
Q

What is the vasculature of the parotid gland? A/V

A

A= 1. Posterior auricular a./superficial temporal a. (ECA)
V= 2. Retromandibular v.

102
Q

What are the 5 main branches of the facial nevre CN 7

branches in the parotid gland

A
  1. Temporal
  2. Zygomatic
  3. Buccal
  4. Marginal Mandibular
  5. Cervical

Ten Zebras Bit My Coat (hand on face)

103
Q

What do the facial nerve do?

A

Innervate the skeletal muscle of the face!
Damage= loose ability to move muscle in face

104
Q

Upper –Temporofacial (Facial Nerve branches)

What are the 2 upper temporofacial branches of the facial nerve? + functions

A
  1. Temporal (up to temporal bone)
  2. Zygomatic (come acorss zygomatic bone)
105
Q

Upper –Cervicofacial (Facial Nerve branches)

What are the 3 lower cervicofacial branches of the facial nerve? + functions

A
  1. Bucal (across cheek)
  2. Marginal Mandibular (across mandible)
  3. Cervical (upper neck)
106
Q

Other Facial Nerve Branches

what are the 2 other posterior branches of the facial nerve?

A
  1. Posterior auricular (behind ear)
  2. Digastric (behind digastric msucle)
107
Q

What muscle not working?

Eyelid droop

A

Orbital group loose fxn

108
Q

What muscle not working?

Mouth droop

A

Upper group of oral muscles loose fxn

109
Q

What muscle not working?

Unable to close eyelids

A

Obicularis Oculi

(cant close eye)

110
Q

What muscle not working?

Food/Saliva falls out of mouth, Chewing is inefficient

A

Buccinator

111
Q

Symptoms of what?

Eyelid droop
Mouth droop
Unable to close eyelids
Food/saliva falls out of mouth
Chewing is inefficient
Atrophy of facial expression muscles
Facial muscle asymmetry
Sounds may appear louder

A

Bell’s palsy