21.5 Anat: Face, scalp, parotid

Question 1

What are the 5 layers of the scalp?

Answer 1

S: Skin/hair
C: CT (dense, fat/nerves/vessles)
A: Aponeurotic layer
L: Loose CT
P: Pericranium

Question 2

What are the muscles of the scalp? What is the clinical significance?

Answer 2

Frontalis (aponeurosis), occipitalis

Scalp wounds gape (and bleed due to rich anastamoses)

Question 3

What is the clinical significance of the loose connective tissue layer of the scalp?

Answer 3

Spiderweb appearance- an infection can localise and spread through here

Question 4

What is the skin of face and scalp innervated by (anterior to the ears)?

Answer 4

Trigeminal nerve (ophthalmic, maxillary and mandibular divisions)

Question 5

Where do the divisions of the trigeminal nerve exit?

Answer 5

V1 (ophth): SOF
V2 (maxil): foramen rotundum
V3 (mand): foramen ovale

Question 6

What is the blood supply to the medial forehead?

Answer 6

From internal carotid (via ophthalmic)

Question 7

What is the blood supply to the rest of the face (other than the middle forehead)?

What does this also supply?

Answer 7

From external carotid: facial artery supplies bulk (tortuous course)

Lateral head

Question 8

What is the major venous drainage of the face? Where does it run compared to the artery?

Answer 8

Facial vein (more posteriorly/superficially and straighter than the A)

Question 9

How can infections spread from a skin lesion on the reverse triangle area on the face?

What is this called?

Answer 9

Via the facial vein because of the connections to the cavernous sinus (into the cranial cavity)

Thrombophlebitis

Question 10

What is the lymphatic drainage of the scalp?

Answer 10

To the ring of nodes around level of base of the skull

-Occipital, mastoid/pre-auricular

From the superficial ring they drain into deep cervical nodes

Question 11

What sits behind the parotid gland? (clincial signficiance-beware while operating)

Answer 11

Facial nerve trunk (from stylomastoid)

Question 12

What happens in mumps to the gland in the face?

Answer 12

The parotid gland is wrapped in fascia and becomes inflamed

Question 13

Where is the parotid duct opening?

Answer 13

Near second upper molar

Question 14

What is the motor supply to the muscles of facial expression? Where does it exit via?

Answer 14

VII-facial nerve

Exits via stylomastoid foramen

Question 15

What are the branches of the facial nerve? (from superior to inferior)

Answer 15

Temporal
Zygomatic
Buccal
Mandibular
Cervical

Question 16

What vein is formed within the parotid gland? What is it formed by the union of?

Answer 16

Retromandibular (by the union of superificial temporal and maxillary vein)

Question 17

Where does the external carotid artery divide into its terminal branches?

Answer 17

In the parotid gland (into the superficial temporal and maxillary arteries)

Question 18

What artery gives off the middle meningeal? Where does it enter?

Answer 18

Maxillary artery

It enters through foramen spinosum into skull

Question 19

What occurs in Bell’s palsy?

Answer 19

Paralysis of muscles of facial expression due to facial nerve damage