9. Scalp and Superficial Face (Keim) Flashcards
What are the five branches of the facial nerve?
Temporal
Zygomatic
Buccal
Mandibular
Cervical
“To Zanzibar By Motor Car”
What are the sensory branches of the maxillary division of the trigeminal nerve?
Infraorbital
Zygomaticofacial
Zygomaticotemporal
Why do scalp wounds bleed profusely?
Because the dense connective tissue layer holds arteries open when wounded.
What cranial nerve closes your eye?
What cranial nerve opens your eye?
Closes: VII
Opens: III
What are the sensory branches of the opthalmic division of the trigeminal nerve?
Supraorbital
Supratrochlear
Palpebral branch of the lacrimal nerve
Infratrochlear nerve
External nasal branch of the anterior ethmoidal.
What cranial nerve supplies the muscles of mastication?
Mandibular branch of the trigeminal nerve V3.
What are the functions of the sensory root of the facial nerve?
With which structures do each of these fibers travel?
Taste to the anterior 2/3 of the tongue.
Parasympathetics to the lacrimal gland, submandibular gland, and sublingual salivary gland (not parotid).
The fibers supplying taste to the anterior 2/3 of the tongue, as well as the parasympathetic fibers to the submandibular and sublingual salivary glands all run with the chorda tympani.
Parasympathetic fibers to the lacrimal ducts run with the greater petrosal.
Name the following anastomoses:
What layer of the scalp can spread infection quickly to the entire head?
The loose connective tissue layer.
What nerves provide innervation to these areas?
What are the sensory branches of the mandibular division of the trigeminal nerve?
Mental nerve
Buccal nerve
Auriculotemporal nerve
Name the lymph nodes of the superficial ring of the head and face.
What areas do each serve?
Occipital - back of the head.
Mastoid - sides of the head and posterior ear.
Parotid - lateral side of the face and forehead and eye.
Submandibular - top lip and lateral lower lip.
Submental - chin and central lower lip.
What nerves innervate the parotid gland, both for secretions and for sensory information?
Sensory: Great auricular and auriculotemporal
Secretions: Parasympathetics from CN IX
What facial muscles are innervated by the trigeminal nerve?
Temporalis
Masseter
Medial and Lateral pterygoid
Mylohyoid (via the nerve to the mylohyoid)
Anterior belly of the digastric
Tensor tympani
Tensor vili palantini
What three structures pass through the parotid gland?
The retromandibular vein.
The external carotid A.
The facial nerve.
Where is the parotid gland located?
From the mandible to the ear, just anterior to the ear.
Where can the parotid duct be found?
Diving into the buccinator muscle.
Facial Nerve Lesions
At the internal acoustic meatus?
In the Facial Canal between Stapedius N. and Chorda Tympani?
Bell’s Palsy, No tears, Loud Sounds, No Taste, unilateral gland issues
Tears and Sound okay, No taste, Muscular Issues (Bell’s)
Herepes Zoster
Shingles likes to follow sensory ganglion
Will follow distriubtion of nerve that is infected
What are the two anastomoses of the face we should know?
Superficial temoral A. with supraorbital A.
Angular A. (from facial) with Supratrochlear A.
What carries preganglionic parasympathetics?
What carries postganglionic parasympathetics?
3, 7, 9, 10
Trigeminal
What happens if an infection gets into the loose CT of the scalp?
Can get into the emissary vein and into the dural sinuses and oh no now you have meningitis
Weird but why are descalped-scalps easy to reattach with minimal deficits?
Because the neurovascular supplies fruns inferior to superior
Do have to reattach each little vessel. Note to self, do not become a vascular surgeon
U shape in surgeries helps make reattaching easier
If you cut thru the scalp aponeurosis, will you have a gaping head wound or non-gaping?
Gaping.
Scalp Sensation
V1-middle head
V2- anterolateral head
V3-middle lateral head
C2-3-posterior/lateral head
Posterior rami C2-3-posterior head
Facial lymphatic drainage
submental-lower lip, chin, floor of mouth, tip of tongue
submandibular-gingiva, teeth, lateral lower lip, upper lip
parotid-anteiror ear, upper face/scalp
mastoid-posterior/lateral scalp
occipital-posterior scalp and neck
top three drain into deep cervical (near IJV)
bottom two drain into superficial cervical (near EJV)
Eventually, everything drains into deep cervical.
