SM_02b: Superficial Face and Skull Interior

Question 1

Motor innervation to the face is by the ____

Answer 1

Motor innervation to the face is by the facial nerve (VII, branchiomotor)

Question 2

General sensory supply to the face is by the ____

Answer 2

General sensory supply to the face is by the trigeminal nerve (V)

Question 3

Divisions of the trigeminal nerve are ____, ____, and ____

Answer 3

Divisions of the trigeminal nerve are ophthalmic nerve (V1), maxillary nerve (V2), and mandibular nerve (V3)

Question 4

Sensory innervation of the head below the jaw comes from ____

Answer 4

Sensory innervation of the head below the jaw comes from spinal nerve ventral rami (cervical plexus)

Question 5

Sensory innervation of the back of the head comes from ____ and ____

Answer 5

Sensory innervation of the back of the head comes from spinal nerve dorsal rami and C2 (greater occipital nerve)

Question 6

Sensory innervation of the pharyngeal arch surfaces is due to ____, ____, and ____ because ____

Answer 6

Sensory innervation of the pharyngeal arch surfaces is due to V2, V3, and cervical spinal nerve dermatomes because skin over arches 2-6 does not grow but rather merges with the cervical sinus and disappears

Question 7

Parts of V1 include ____, ____, ____, and ____

Answer 7

Parts of V1 include supraorbital, supratrochlear, lacrimal, and external nasal

Question 8

Parts of V2 include ____, ____, and ____

Answer 8

Parts of V2 include zygomaticotemporal, zygomaticofacial, and infraorbital

Question 9

Parts of V3 include ____, ____, and ____

Answer 9

Parts of V3 include auriculotemporal, buccal, and mental

Question 10

Describe the path of the facial nerve

Answer 10

Facial nerve

1. Exits the stylomastoid foramen of the temporal bone
2. Enters parotid gland
3. Fans out anteriorly to the muscles of facial expression

Question 11

____ is the largest subcutaneous nerve in the body

Answer 11

Facial artery is the largest subcutaneous nerve in the body

(supplies subcutaneous muscles of the face)

Question 12

Facial nerve branches are named by ____, not ____

Answer 12

Facial nerve branches are named by territories, not individual nerves

(temporal, zygomatic, buccal, mandibular, and cervical to platsyma)

Question 13

Describe the major muscles of facial expression

Answer 13

Muscles of facial expression

• Frontalis muscle has broad flat tendon that connects it to occipitalis
• Orbital part of orbicularis oculi: forcefully closes eye, attaches to bone
• Palpebral part of orbicularis oculi: gently closing eye
• Buccinator: wall of oral cavity, Trumpeter’s muscle
• Platsyma allows maximum air in

Question 14

Orbital septum attaching to orbital margin is ____

Answer 14

Orbital septum attaching to orbital margin is barrier to passage of infection from face to orbit

Question 15

Describe the lacrimal gland

Answer 15

Lacrimal gland

• Deep to orbital septum
  Hooks around levator palpebrae superioris tendon
• Has numerous small ducts opening into the superior fornix of conjunctiva

Question 16

Excess lacrimal secretions can end up the nose through the ___

Answer 16

Excess lacrimal secretions can end up the nose through the nasolacrimal duct

Question 17

Layers of the scalp are ____, ____, ____, ____, and ____

Answer 17

Layers of the scalp are skin, subcutaneous fascia, galea aponeurotica, loose conective tissue, periosteum (or pericranium)

Question 18

____, ____, and ____ of the scalp form a tight unit that slides over the ____ because of the loose danger zone where blood/infection can spread

Answer 18

Skin, fascia, and galea aponeurotica of the scalp form a tight unit that slides over the periosteum because of the loose danger zone where blood/infection can spread

Question 19

For the meninges, ____ in the skull acts as ____

Answer 19

For the meninges, dura in the skull acts as periosteum

(there is no epidural space as in the vertebral column)

Question 20

Describe the layers of the meningies in the brain

Answer 20

Layers of meninges in brain

• Dura (gray and yellow): periosteal and meningeal components
• Arachnoid (green): pressed against dura by CSF but not directly attached
• Pia (red): follows all of the contours of the brain

Question 21

Dural sinuses are ____ and all converge on the ____

Answer 21

Dural sinuses are venous channels between the two layers of dura and all converge on the internal jugular vein

Question 22

Dural sinuses drain ___ and connect with ___

Answer 22

Dural sinuses drain blood from the brain and connect with veins of the scalp

Question 23

Superior sagittal sinus receives all ____ via ____

Answer 23

Superior sagittal sinus receives all CSF via tufts of arachnoid (arachnoid granulations) extending into the sinus

Question 24

Epidural bleeding is ____ from the ____

Answer 24

Epidural bleeding is arterial from the middle meningeal artery

Question 25

Subdural bleeding is ____ from \_\_\_\_

Answer 25

Subdural bleeding is venous from cerebral veins at the superior sagittal sinus

Question 26

Subarachnoid bleeding will be ____ if from the \_\_\_\_

Answer 26

Subarachnoid bleeding will be arterial if from the cerebral arteries (e.g. from ruptured aneurysms)

Question 27

Epidural blood between the ____ and ____ peels the dura away from bone, giving a ____ shape

Answer 27

Epidural blood between the dura and bone peels the dura away from bone, giving a convex towards the brain shape

Question 28

Subdural blood between the ____ and ____ separates the two layers, leading to an ____ shape

Answer 28

Subdural blood between the dura and arachnoid separates the two layers, leading to an irregular shape

Question 29

Blood is ____ between the ____ and \_\_\_\_

Answer 29

Blood is epidural between the dura and bone (blood contained by dura to give it a convex shape towards the brain)

Question 30

Blood is ____ between the ____ and \_\_\_\_

Answer 30

Blood is subdural between the dura and arachnoid (blood spreads more easily and has a more irregular profile)

Question 31

Describe the types of bleeding in this picture

Answer 31

* Subarachnoid blood: in CSF between arachnoid and pia, follows contour of brain * Subdural bleeding: between dura and arachnoid * Intracerebral bleeding: such as from ruptured aneurysm * Epidural bleeding: between bone and dura

Question 32

Paranasal air sinuses are ____ and function to ____ and \_\_\_\_

Answer 32

Paranasal air sinuses are mucous-lined air spaces within the frontal, maxillary, ethmoid and sphenoid bones and function to lighten the bones and communicate with the nasal cavity to resonate the voice

Question 33

Describe the flow sequences of the dural sinuses

Answer 33

Flow sequences of the dural sinuses * Superior sagittal sinus -\> transverse sinus -\> sigmoid sinus -\> internal jugular vein * Inferior sagittal sinus (joining great cerebral vein) -\> straight sinus -\> transverse sinus etc * Ophthalmic veins and veins from deep in the brain -\> cavernous sinus -\> superior and inferior petrosal sinuses -\> beginning and end of the sigmoid sinuses

Question 34

\_\_\_\_ and ____ pass through the cavernous sinus, which flanks the \_\_\_\_

Answer 34

Nerves to orbit / V2 and internal carotid artery pass through the cavernous sinus, which flanks the body of the sphenoid (sella turcica)

Question 35

Cranial nerve I exits the skull at the \_\_\_\_

Answer 35

Cranial nerve I exits the skull at the cribriform plate / ethmoid

Question 36

Cranial nerve II exits the skull at the \_\_\_\_

Answer 36

Cranial nerve II exits the skull at the optic canal / sphenoid

Question 37

Cranial nerves III, IV, V1, and VI exit the skull at the \_\_\_\_

Answer 37

Cranial nerves III, IV, V1, and VI exit the skull at the superior orbital fissure

Question 38

Cranial nerve V2 exits the skull at the \_\_\_\_

Answer 38

Cranial nerve V2 exits the skull at the foramen rotundum

Question 39

Cranial nerve V3 exits the skull at the \_\_\_\_

Answer 39

Cranial nerve V3 exits the skull at the foramen ovale

Question 40

\_\_\_ exits the skull at the foramen spinosum

Answer 40

Middle meningeal artery exits the skull at the foramen spinosum

Question 41

Cranial nerves VII and VIII exit the skull at the \_\_\_\_

Answer 41

Cranial nerves VII and VIII exit the skull at the internal acoustic meatus

Question 42

Cranial nerves IX, X, and Xi exit the skull at the \_\_\_\_

Answer 42

Cranial nerves IX, X, and Xi exit the skull at the jugular canal

Question 43

Cranial nerve XII exits the skull at the \_\_\_\_

Answer 43

Cranial nerve XII exits the skull at the hypoglossal canal

Question 44

Cranial nerves pierce dura in ____ place compared to where they pierce bone

Answer 44

Cranial nerves pierce dura in a different place compared to where they pierce bone