6: Scalp And Superficial Face

Question 1

Five layers of the scalp

Answer 1

1. Skin
2. Dense CT
3. Aponeurosis
4. Loose Areolar CT
5. Pericranium / periosteum

Question 2

Three major sources of cutaneous innervation to the face and scalp

Answer 2

1. CN V
2. spinal nerve C2
3. spinal nerve C3

Question 3

Three nerves from V1 that supply cutaneous face and scalp

Answer 3

1. Supraorbital N
2. Supratrochlear N
3. Infratrochlear N

Question 4

Three spinal nerves that supply cutaneous face and scalp

Answer 4

1. Greater auricular N (anterior rami C2)
2. Lesser occipital N (anterior rami C3)
3. Greater occipital N (posterior rami C2)

Question 5

Three nerve from V2 that supply cutaneous face and scalp

Answer 5

1. Infraorbital N
2. Zygomaticofacial N
3. Zygomaticotemporal N

Question 6

Three nerves from V3 that supply cutaneous face and scalp

Answer 6

1. Mental N
2. Buccal N
3. Auriculotemporal N

Question 7

Deep vs superficial scalp lac

Answer 7

Superficial: superficial to aponeurosis, does not gape
Deep: through aponeurosis, forms gaping wound

Question 8

What muscle causes deep scalp lacs to gape

Answer 8

Occipitofrontalis M pulls on it

Question 9

Why do scalp lacs bleed profusely?

Answer 9

CT of scalp tends to hold cut vessels open

Question 10

How can scalp infections spread into cranium

Answer 10

Via small emissary veins (anastomoses between intra and extracranial N’s)

Question 11

Two branches of the internal carotid that supply the face and scalp

Answer 11

Supraorbital A, supratrochlear A

Question 12

What is unique about muscles of facial expression?

Answer 12

Often insert on skin, not bones

Question 13

Four major groups of muscles of facial expression

Answer 13

Mouth, nose, eyes, forehead

Question 14

Surprise/fright muscle

Answer 14

Epicranius M

Question 15

What is the epicranius M

Answer 15

Occipitofrontalis M, a combo of frontalis M + occipitalis M

Question 16

Muscle for closing eyelids

Answer 16

Orbicularis oculi

Question 17

Muscle for lifting upper lip

Answer 17

Levator labii superioris

Question 18

Two muscles that depress the lower lip

Answer 18

1. Depressor labii inferioris

2. Depressor anguli oris

Question 19

Muscle to close the mouth / pout

Answer 19

Orbicularis oris

Question 20

Three muscles for smiling and laughing

Answer 20

1. Zygomaticus major
2. Zygomaticus minor
3. Levator anguli oris

Question 21

Muscle holding cheek close to teeth

Answer 21

Buccinator

Question 22

Two muscles for kissing

Answer 22

1. Buccinator

2. Orbicularis oris

Question 23

Motor innervation to all muscles of facial expression **

Answer 23

CN 7

Question 24

Bell’s Palsy cause

Answer 24

Facial nerve injury

Question 25

Bell’s Palsy symptoms

Answer 25

Muscle weakness/paralysis, inability to close eyelids, prone to corneal ulceration

Question 26

Mechanism of Botox injection

Answer 26

Botulinum toxin inhibits Ach release -> blocks NMJ transmission

Question 27

Uses for Botox

Answer 27

Eye disorders, migraines, muscle spasms, cosmetics

Question 28

What happens if herpes zoster affects CN V

Answer 28

Usually V1 affected, can cause cornea ulceration

Question 29

Level of thyroid

Answer 29

C5-T1

Question 30

Isthmus of thyroid

Answer 30

Unites lobe overlying trachea at 2nd/3rd rings

Question 31

Dense CT attached to thyroid

Answer 31

Attaches thyroid to cricoid cartilage + superior tracheal rings

Question 32

Blood supply to thyroid and where these three arteries arise from

Answer 32

1. Superior thyroid A (from external carotid)
2. Inferior thyroid A (from thyrocervical trunk)
3. Thyroid ima A (variably present from brachiocephalic trunk)

Question 33

Parathyroids in relation to thyroid

Answer 33

Posterior to thyroid