4 - Intro to Skull, Face, Scalp Flashcards
1
Q
Neurocranium
A
cranial bones to protect the brain
2
Q
Viscerocranium
A
facial bones to protect airway
3
Q
Pterion
A
intersection of 4 bones - weaker here.
4
Q
Coronal
A
between frontal & parietal bones
5
Q
Sagittal
A
between 2 parietal bones
6
Q
Squamosal
A
between parietal & temporal
7
Q
Lambdoidal
A
between parietal/temporal & occipital bones
8
Q
Pterion, Lambda, Bregma
A
intersections
9
Q
The joints of the bones of the skull are
A
solid joint with fibrous connections called sutures
10
Q
Sutures are
A
fibrous joints between adjacent bones of the skull linked by a thin layer of connective tissue = sutural ligament
11
Q
3Pterion
A
“H” shaped intersection of coronal suture & squamosal respresenting a 4 bone intersection Frontal Temporal Parietal Sphenoid
12
Q
Vertex
A
most superior point on the cranium
usually ~ midway on the midsagittal suture
13
Q
Bregma
A
intersection of Coronal & Sagittal
14
Q
6 are pairs of face bones are responsible for the
A
bilateral symmetry of the face.
15
Q
Bones of the Face
A
14 - Nasal bones (2) Maxilla bones (2) Zygomatic bones (2) Mandible Lacrimal bones (2) Vomer bone Inferior nasal conchae (2) Palatine bones (2)
16
Q
Boundaries of the Orbit - Frontal bone
A
roof
17
Q
Boundaries of the Orbit- Zygomatic bone
A
lat. wall
18
Q
Boundaries of the Orbit - Maxilla bone
A
floor & part of medial wall
19
Q
Boundaries of the Orbit - Lacrimal & Ethmoid bones
A
rest of medial wall
20
Q
Boundaries of the orbit - Sphenoid bone
A
posterior wall
21
Q
Supraorbital foramen/notch - orbit feature
A
in superciliary arch
22
Q
Optic canal (foramen
A
in medial wall of orbit
23
Q
Superior orbital fissure
A
in medial wall of orbit
24
Q
Inferior orbital fissure
A
in floor of orbit
25
Lacrimal Groove (Nasolacrimal canal)
orbit - communicates with nasal cavity
26
Conchae =
turbinates (other terms)
27
Boundaries of the Nasal Cavity
Nasal bones, Frontal sinus, Ethmoid, Sphenoid sinus = roof
Maxillary bones = floor & lat. Wall
Palatine hoizontal plate = floor
Vomer & perpendicular plate of ethmoid bones = medial wall
Nasal septum = medial wall
28
Nasal Conchae
projections from lat. wall
29
Superior nasal conchae
ethmoid bone
30
Middle nasal conchae
ethmoid bone
31
Inferior nasal conchae
separate bones
32
The nasal cavity is lined by a
nasal mucosal membrane (respiratory epithelium) that we will be looking at in detail later in the histology portion.
33
Features of Maxilla & Mandible - both ahve
alveolar processes = sockets for teeth
34
Features of Maxilla & Mandible - mandible has
mental foramen
35
Features of Maxilla & Mandible - maxillae have
infraorbital foramina
36
Frontal bones have
supraorbital foramina/notches & all 3 foramina line up
37
Features of Mandible
```
Coronoid process
Condyloid (condylar) process (TMJ)
Head, neck, ramus, body & angle
Mandibular notch & foramen
Mylohyoid groove
```
38
Anterior Cranial Fossa
| -cranial vault
hold frontal lobes
39
Middle Cranial Fossa
| -cranial vault
hold temporal lobes
40
Posterior Cranial Fossa
| -cranial vault
hold cerebellum & brainstem
41
Features of Paranasal Sinuses
```
Spaces within skull bones
Make bones lighter
Add resonance to voice
Lined by mucousal membranes
Continuous with nasal cavity
```
42
Paranasal Sinuses
Frontal sinuses
Ethmoid air cells
Sphenoid sinuses
Maxillary sinuses
43
Frontal sinuses - paranasal
In frontal bones (2)
44
Ethmoid air cells - paranasal
More than thisl, just know it is symmetrical. In ethmoid bone (3-13)
45
Sphenoid sinuses - paranasal
In sphenoid bone (2)
46
Maxillary sinuses - paranasal
In maxilla (2)
47
Foramina of Skull allow
vessels & cranial nn. to exit cranial vault
48
Cribriform plate: transmitted structure
Olfactory nerve CN1
49
Optic canal
CN2, opthalmic artery
50
Superior orbital fissure
CN3,4,6, opthalmic (CN V1)
51
Foramen rotundum
Maxillary nerve (V2)
52
Foramen ovale
Mandibular nerve V3
53
Foramen spinosum
middle meningeal a.
54
Foramen lacerum
Internal carotid a. (enters cranial vault here)
55
Jugular foramen
IJV, CN9, 10, 11
56
Internal acoustic foramen
CN7, 8
57
Sylomastoid foramen
CN7
58
Hypoglossal canal
CNXII
59
Foramen magnum
vertebral arteries, spinal cord
60
Carotid canal
internal carotid a. (enters skull here)
61
Regions of h and n
Scalp
Orbicularis oculi
orbicularis oris
face
62
Scalp skin
thin except in the occipital region, contains many sweat and sebaceous glands and hair follicles; abundant arterial supply, good venous & lymphatic drainage
63
Scalp connective tissue
forming the think dense, richly vascularized subQ layer, with many cutaneous nerves
64
Scalp aponeurosis
(epicranial aponeurosis), strong tendinous sheet that covers the calvaria, serves as the attachment for the frontal and occipital bellies of the occipitofrontalis muscle and the superior auricular muscle. Together = musculoaponeurotic epicranius.
65
musculoaponeurotic epicranius
epicranial aponeurosis + occipitalfrontalis muscle+ superior auricular muscle
66
Scalp loose connective tissue
sponge-like layer, potential spaces that may distend with fluid as a result of injury or infection. This layer allows free movement of the scalp proper (the first three layers) over the underlying calvaria.
67
pericranium - scalp
dense layer of connective tissue, forms the external periosteum of the neurocranium and is firmly attached. Parts of the pericranium are continuous with the fibrous tissue in the cranial sutures.
68
Scalp - The dense connective tissue tends to
‘hold’ cut vessels open – allowing profuse bleeding
69
Deep wounds into the A layer
gape widely
70
Scalp - Profuse bleeding is due to
vascular anastomoses – vascular connections –
71
Deep wounds gape because of the
muscles attached to the aponeurotic layer: the frontalis and occipitalis mm
72
Clinical Notes: Loose Areolar tissue
“Danger Space” of scalp
73
Loose areolar tissue Infections
spread easily in this layer
74
Loose areolar tissue infections Travel into the
cranial cavity through emissary veins (pass thru the calvaria) to meninges
75
Loose areolar tissue infections Fluid can move
anteriorly into eyelids & root of nose
76
Occipitofrontalis m.
moves scalp back and forward
| occipitalis m. + galea aponeurotica + frontalis m.
77
3 auricularis mm.
protract, elevate & retract ears
78
Muscles of the Scalp & Ears
occipitalis m. + galea aponeurotica + frontalis m.
79
Frontalis elevates
eyebrows and wrinkles skin of forehead; protracts scalp
80
Occipitalis retracts
scalp; increasing effectiveness of frontal belly
81
Mm of facial expression
| - attach to
bone or fascia and act by pulling the skin (insert into skin)
82
mm. of facial expression Also surround the
orifices of the face (mouth, eyes, nose) acting as sphincters and dilators
83
Mm of mastication (how many pairs)
4
84
The face is the
anterior aspect of the head from the forehead to the chin and ear to ear.
85
No deep fascia of the face because
of all the muscle attachments of the muscles of facial expression - loose connective tissue.
86
Frontalis m. eye region
raises eyebrow (surprise)
87
Corrugator supercilii m- eye region
draws eyebrow in (frowning)
88
Orbicularis oculi m - eye region
closes eye (winking)
89
Procerus m- nasal region
wrinkles bridge of nose
90
Nasalis m - nasal region
compresses & dilates nostril
91
Levator labii superioris alaeque nasi m - nasal region
dilates nostril
92
Superficial Muscles of the Mouth Region - Orbicularis Oris
closes mouth
93
Superficial Muscles of the Mouth Region - Levator labii superioris
elevates upper lip
94
Superficial Muscles of the Mouth Region - Zygomaticus major/minor
draws mouth up
95
Superficial Muscles of the Mouth Region - Depressor anguli oris
depresses angle of mouth
96
Superficial Muscles of the Mouth Region - Depressor labii inferioris
depresses lower lip
97
Superficial Muscles of the Mouth Region - Risorius
retracts the corner of the mouth
98
Superficial Muscles of the Mouth Region - Mentalis
protrudes lower lip
99
Deep Muscles of the Mouth Region -Buccinator
compresses cheek & assists with mastication
100
Deep Muscles of the Mouth Region - Levator anguli oris
elevates angle of mouth
101
Deep Muscles of the Mouth Region - Depressor labii inferioris
depresses lower lip
102
Muscles of Mastication - Temporalis
elevates & retracts mandible
103
Muscles of Mastication - Masseter
elevates & clenches mandible
104
Muscles of Mastication - Med. Pterygoid
– elevates, protracts & rotates mandible
105
Muscles of Mastication - Lat. Pterygoid
– protrudes & rotates mandible; opens mouth
106
Innervation of Face & Scalp - Trigeminal (CN V)
sensory to the face & scalp
107
Innervation of Face & Scalp - Cervical
sensory to the back of head, ears & jaw
108
Innervation of Face & Scalp - facial CNVII
motor to the mm of facial expression
109
Innervation of Face & Scalp - Mandibular (CN V3)
motor to mm of mastication
110
Innervation of face and scalp - Sensory
Trigeminal (CN V)
-Face & Anterior scalp
Cervical n. (C2,3)
-Jaw, ears, posterior scalp
111
Innervation of face and scalp - Motor
Facial (CN VII)
-Muscles of facial expression
Mandibular (CN V3)
-Muscles of mastication
112
Supraorbital n - Sensory innervation : V1
to central forehead
113
Supratrochlear n - Sensory innervation : V1
to medial forehead
114
Infratrochlear n. - Sensory innervation : V1
to upper nose
115
External nasal n - Sensory innervation : V1
to lower nose
116
Lacrimal n. - Sensory innervation : V1
to lateral brow
117
Sensory innervation : V2 - Zygomaticotemporal n.
to temple
118
Sensory innervation : V2 - Zygomaticofacial n.
– to upper cheek
119
Sensory innervation : V2 - Infraorbital n.
– to maxilla & upper lip
120
Sensory innervation : V3 - Auriculotemporal n. –
to ear & temple
121
Sensory innervation : V3 - Buccal n. –
to lower cheek
122
Sensory innervation : V3 - Mental n.
to chin & lower lip
123
Parotid gland
anterior/inferior to ear
124
Parotid (Stensen’s) duct
transmits saliva from gland
125
Parotid (Stensen’s) duct Crosses
masseter 1-2 cm below zygomatic arch
126
Parotid (stensen's) duct Turns 90° to pierce
buccinator m.
127
Stensen's duct Opens into oral cavity opposite
2nd molar
| Marked by elevated parotid papilla
128
Parotid gland & duct surfaces
Outer surface is irregular
| Inner surface is wedge-shaped
129
Parotid gland & duct enclosed in
Enclosed in a “parotid sheath” of deep cervical fascia
130
Parotid gland - Calculus formation
assoc. with chronic parotiditis (all 3 salivary glands – submandibular*)
131
Salivary fistulas - parotid gland
most close spontaneously but can do duct ligation
132
Neoplasms - parotid gland
85-90% of mixed tumors involve parotid
133
Frey’s syndrome - parotid gland
gustatory swelling
134
Facial n. (CN VII) - parotid gland
passes thru gland
Nerve in danger during parotidectomy
Must ID branches prior to excision of any tumor tissue
Damage results in paralysis of facial mm on affected side
135
CN VII - parotid There is also a branch, prior to entering the parotid gland, that innervates the
posterior belly of the digastric and the stylohyoid muscles
136
CN VII The main trunk then enters the parotid gland and bifurcates into a
superior temporofacial and inferior cervicofacial nerve to give rise to divisions
137
CN VII Temporal division
travels superior to temples
138
Zygomatic CN VII division
travels inferior to arch
139
Buccal cnVII division
medially to buccinator m
140
Marginal Mandibular divisoin CNVII
along inferior mandible
141
Cervical division CNVII
inferiorly to platysma m.
142
Post. Auricular division CNVII
posteriorly to lower ear
143
Injury to CN VII produces
m. paralysis on affected side
144
CN VII N. may be inflamed at
stylomastoid foramen
145
CN VII
Edema & compression of n. in facial canal
146
Bell’s Palsy
most common non-traumatic cause of facial paralysis
| unilateral facial paralysis of sudden onset involving CN VII
147
Buccal Fat Pad
Fat pad located anterior to masseter m.
148
Buccal fat pad Covers up
buccinator m. located medially
149
Buccal fat pad Provides protection for
parotid duct & CN VII (buccal br.)
150
Buccal fat pad Helps give cheeks
fuller appearance
151
Nerves of Buccinator M.
Two buccal nn. Related to buccinator m
152
Buccal br. of Facial n
lateral to masseter m.
| -CN VII : motor to buccinator m.
153
Buccal br. of Trigeminal n.
CN V3 : sensory to buccal mucosa & skin of cheek
154
Note: V3 pierces buccinator m.
it does not supply it
155
Superficial Temporal Artery
Artery – branch of external carotid a.
*Vein – drains to retromandibular v.
*Both run anterior to ear to temporal region
Travel with auriculotemporal n.
156
Superficial temporal vein
Vein – drains to retromandibular v.
157
Transverse Facial Artery & Vein
Branches of superficial temporal vessels
158
Transverse facial artery and vein cross
masseter m. between zygomatic arch & parotid duct
159
Transverse facial artery and vein supply blood to
upper cheek region
| Parotid gland, duct & masseter m.
160
Facial Artery & Vein
Artery is tortuous & anterior to vein
Both cross mandible at anterior border of masseter m.
Facial artery pulse can be palpated here
At angle of mouth: inferior & superior labial branches (to lips)
Continue to medial angle of eye to angular a. & v.
161
Lymphatic drainage of the head & neck: remains
ipsilateral
162
Lymphatic drainage of the head & neck: Medial to
Lateral (neck)
163
Lymphatic drainage of the head & neck: Drains
Inferiorly & generally superficial to deep
164
Lymphatic drainage of the head & neck: Ultimately to the
right lymphatic duct or the Thoracic duct
165
Superficial nodes of the face- Submental nodes
located inferior and posterior to the chin & drain from the medial lower lip to the chin ipsilaterally
166
Superficial nodes of the face - Submandibular nodes
superficial to the gland and inferior to the body of the mandible & drain from the medial corner of the orbit, most of the external nose , the medial part of the cheek, upper lip, and lateral lower lip that follows the course of the facial artery.
167
Superficial nodes of the face - Preauricular and parotid nodes
anteiror to the ear and drain most of the eyelids, part of the external nose, and the lateral cheek
168
Superficial nodes of the face - Jugulodigastric drains the
preauricular and parotid nodes, mastoid nodes, and occipital nodes
169
Superficial nodes of the face - Deep cervical nodes drain the
submandibular nodes
170
Superficial nodes of the face - Juguloomohyoid drains
jugulodigastric, & deep cervical, & submental nodes
171
Bregma =
anterior fontanel
172
lambda =
posterior fontanel
173
Facial exits cranial vault via
EAM
174
Exits cranium via
Sytlomastoid foramen
175
Layers of the Scalp
Skin, connective tissue, aponeurosis, loose connective tissue, pericranium
176
Loose connective tissue =
potential space
177
Emmisary vein foramina
can bring infection from outside of skull to inside
178
Nose muscles in terms of pronounced nose portions will have
varying muscle sizes and shapes in nose.
179
Deep part of masseter
connects to zygomatic arch
180
Connective tissue associated with
temporalis and masseter epimesium fascia continuous with investing layer of deep cervical fascia.
181
Medial pterygoid heads separated by
lower head of lateral pterygoid
182
Parotid stones are painful because
of dense connective tissue - very confined and confining, so if there is any inflammation or swelling, it is painful because it has nowhere to go.
