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Neuro 1 Exam > 8. Superficial Scalp and Face > Flashcards

8. Superficial Scalp and Face Flashcards

1
Q

What are the layers of the scalp?

A

S-C-A-L-P

  1. Skin
  2. Connective tissue (dense)
  3. Aponeurosis
  4. Loose CT
  5. Pericranium
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2
Q

What layers make up the scalp proper?

A

1. Skin

2. CT (dense)

3. Aponeurosis

These layers are intimately connected and move together as a unit.

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3
Q

Describe the SCALP

A
  1. Skin: abundant BV and glands
  2. (dense) CT has alot of neurovasculature.
  3. Aponeurosis serves as the attachement site for muscle bellies converging from the forehead & occiput (occipitofrontalis muscle) & from the temporal bones on each side (temporoparietalis and superior auricular muscles). Structure are. called epicranius and I by the facial N.
  4. Loose CT has potential spaces that. can fill with fluid if there is injury or infection.
  5. Pericranium- forms the external periosteum of the neurocranium
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4
Q

CN: Detached Scalp:

Easy or hard to put on?

A

Detached scalp is v. easy. to put back on because all neurovascularture supply comes from inferior to superior. Thus, you can reconnect them during surgey.

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5
Q

CN: Scalp infection

A
  • Loose CT (layer four) is danger area because pus or blood spreads easily.
  • Can also pass into the cranial cavity through small emissary veins (pass through parietal foramina in calvaria) to reach intracranial structures –
  • Within the eyelids, even a relatively slight injury or inflammation may result in an accumulation of fluid, causing the eyelids to swell
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6
Q

Gaping vs. Non-gaping wounds

A
  • Gaping wounds: caused when you go through the APO
  • Non-gaping wounds: wounds within skin of dense CT (first two layers)
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7
Q

Describe the parotid gland and duct and their relations to nerves, vessels and muscles and its innervation.

type of gland?

Location?

A

Parotid gland is the largest salivary gland: located lateral on the face, anterior and inferior to ear. Extends from temporal bone -> mandible anterior of the ear. It is covered in fascia.

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8
Q

Describe the parotid gland and duct and their relations to nerves, vessels and muscles and its innervation.

Sensory innervation:

Parasympathetic innervation:

A
  1. Sensory innervation: Great auricular N. and auriculotemporal N
  2. Parasympathetic innervation: Glossopharyngeal n. (CN IX) via posterior auricular n. (postsynaptic from otic ganglion).
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9
Q

Describe the parotid gland and duct and their relations to nerves, vessels and muscles.

Parotid duct relation?

Parotic gland relations?

A
  • Parotid duct relation: dives in buccinator M.
  • Parotic gland relations:
    • 1. CN 7 does not innervste it, but passes through it
    • 2. Retromandibular vein
    • 3. External carotid A.
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10
Q

Muscles of facial expression develop from __________.

A

2nd pharyngeal arch

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11
Q

Muscles of facial expression are innervated by:

A
  • Motor innervation: CN VII (facial)
  • Sensory innervation of the face and anteriorsuperior part scalp: mainly CN V (trigeminal N)
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12
Q

List the muscles of facial expression

A
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13
Q

Occipitofrontalis M

Axn:

A

Frontal belly of occipitofrontalis m: lift up eyebrows and wrinkles forehead

Occipital bellow of occipitofrontalis m: retract scalp, increasing effectivness of frontal belly

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14
Q

Orbicularis oculi m.

Axn:

A

Has two parts:

1. Orbital part of the Orbicularis oculi m: close eyelids tightly

  1. Palpebral part of the Orbicularis oculi: close eyelids gently.
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15
Q

Depressor labii inferioris m.

Axn:

A

Depresses lip inferiorly and

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16
Q

Orbicularis oris M.

Axn

A
  • Sphincter around mouth
  • Axn: Keeps mouth close; compresses and protrudes lips when kissing/blowing.
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17
Q

Zyogmaticus Major M

Axn:

A

Elevate labial commissure bilaterally to smile

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18
Q

Buccinator M.

Axn:

A

Cheek muscle.

  1. Presses cheek against molar teeth; works with tongue to keep food between occlusal surfaces and out of oral vestibule; resists distension (when blowing)
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19
Q

Levator anguli oris

Axn:

A

Dilates mouth; widens oral fissure when grinning or grimacing

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20
Q

Risorius M

Axn:

A

Pulls the angle of the mouth laterally.

Contractions of the risorius muscle produce: facial expression of pleasure and laughter.

21
Q

Dilators of mouth

A
  1. Risorius m
  2. Levator labii superioris m
  3. depressor labii inferioris m
22
Q

What m protrudes and elevates lower lip?

A

Mentalis

23
Q

Corrugator supercilii M.

Axn

A

Draws eyebraws medially and inferiorly, creating wrinkles above nose

WORRY

24
Q

What are your muscles of mastication

A
    1. Lateral ptyerygoid m.
    1. Medial pterygoid m.
    1. Masseter m.
    1. Temporalis m.
25
Q

What innervates muscles of mastication?

A

Trigeminal Nerve (CN V3)

Trigeminal nerve is also the sensory nerve for the face.

26
Q

What pharyngeal arch do muscles of mastication come from?

A

1st pharyngeal arch

27
Q

What other muscles are innervated by trigeminal N?

A

1. Myelohyoid M (V3)

2. Anterior belly of digastric M (V3)

3. Tensor tympani m and tensor veli palantini m. (V3)

28
Q

Facial nerve is associated with the derivatives of the _____ pharyngeal arch.

A

2nd

29
Q

Actions of facial nerve (CN VII)

A

Has a motor root and sensory root

  • Motor: Innervates the muscles of facial expression via
    • Temporal branch
    • Zygomatic branch
    • Buccal branch
    • Mandibular branch
    • Cervical branch
  • Motor to [posterior belly. of digastric m. and stylohyoid m.]
  • Sensory:
    • Taste for the anterior 2/3 of tongue via chorda tympani
    • Sends parasympathetic fibers to [lacrimal gland, submandibular and sublingual salivary glands]
    • General sensory around concha of ear
30
Q

Mneumonic for facial nerve branches.

A

pA TINY ZEBRA BIT MY COCK

  • 1. Posterior auricular
  • 1. Temporal branch
  • 2. Zygomatic branch
  • 3. Buccal branch
  • 4. Mandibular branch
  • 5. Cervical branch
31
Q

Parasympathetic fibers to lacrimal gland travel with?

Parasympathetic fibers to submandibular and sublingual gland travel with?

A

1. Greater petrousal N.

2. Chordi tympani

32
Q

Bell’s Palsy

A

• Unilateral facial nerve paralysis

Cannot blink, pucker lips, keep food in mouth while chewing (drooling

33
Q

What are the actions of trigeminal nerve (CN 5)?

A

Motor and sensory root:

  • 1. Motor: for muscles of mastication via V3 (mandibular nerve)
  • 2. Sensory: sensory to to the face
34
Q

Branches of Trigeminal N (CN V)

A
  1. Opthalamic nerve (CN V1); branches into
  • Supratrochlear N: sensation to cornea -> upper eyelid-> forehead -> vertex of scalp
  • Supraorbital N: sensation to foreheard-> scalp -> vertex of scalp
  • External nasal branch of anterior ethmoidal N: bridge and tip of nose
  1. Maxillary nerve (CN V2) -> cheek, upper lip, side of nose, lower eye lid, temporal area
  • Infraoribital N
  • zygomaticifacial n.
  • zygomaticotmeporal n
  1. Mandibular (CN V3); sensory and motor
  • Mental N. -> chin
  • Buccal N. -> sensory
  • Auriculotemporal
35
Q

What innervates Dura?

A

CN V (trigeminal)

36
Q

What is herpes Zoster?

A

Shingle; chicken pox

In ppl who had CP without vaccination, virus is dormant in sensory ganglia.

Herpes zoster can follow trigeminal N dermatomes almost precisely (esp V1)

37
Q

Trigeminal Neuralgia aka tic douloureux

A

Sensory disorder of CN V;

Sudden attacks of pain often due to compresion of V2 and V3.

38
Q

Describe the course and major branches of the blood supply to the superficial face. Evaluate anastomoses of the face and determine supply and distribution.

A

Major BV:

Off of external carotid A.

    1. Facial A. and V.
      * Give of
      • inferior labial A.
      • Superior labial A.
      • Angular A.
    1. Superficial temporal A.
    1. Transverse facial A and V (located in front of ear)
    1. Infraorbital A (branch of maxillary A).

Off of internal carotid A.

    1. Supraorbital A and V
    1. Supratrochlear A and V.
39
Q

Why is plastic surgery. so easy. on. face?

A

FACE/SCALP LOVES ANASTOMSING! Brain and tongue do not.

  • Lipsd: Facial A. branches into superior and inferior labial A.
  • Supraorbital from ICA and superficial temporal A from ECA anastomose
  • Eyes: Angular A from ECA anastomose with supraorbital A from ICA.
40
Q

Face drains via:

A

external jugular vein

41
Q

Are there LN in scalp?

A

No lymph nodes in the scalp, &

only located in the parotid/buccal region of the face

42
Q

Lymphatic drainage of the face is made up of what two groups of LN?

A
  1. Superficial ring (pericervical collar) LN
  2. Deep cervical LN
43
Q

Lymph drains into the superficial ring (pericervical collar) of lymph nodes located where?

A

1. Submental

2. Submandibular

3. Parotid

4. Mastoid

5. Occipital

44
Q

Superficial ring of LN drain into where?

A

Deep cervical LN:

  1. Jugulo-digastric (upper deep cervicals)
  2. Jugulo-omohyoid (lower deep cervicals)
45
Q

• Lymph from the lateral part of face, scalp, & eyelids → ___________

A

→ superficial parotid lymph nodes

46
Q

• Lymph from the upper lip & lateral lower lip → ___________

A

submandibular lymph nodes

47
Q

• Lymph from the chin & central lower lip →_________

A

submental lymph nodes

48
Q

• Lymph from the sides and posterior to ear →_________

A

mastoid LN

49
Q

• Lymph from the back of head and neck →_________

A

occipital LN

Neuro 1 Exam (24 decks)

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