anatomy Flashcards
SCALP
Skin Connective Tissue Aponeurosis (galea) Loose CT Periosteum
• Contribute to RSTL (perpendicular to muscles)
Superficial Musculoaponeurotic System (SMAS)
• Rejuvenation such as facelifts relies on redistribution and plication of SMAS • Discrete fibromuscular layer enveloping and interlinking muscles of facial expression
SMAS
Galea aponeurotica of scalp and superficial temporal fascia -
thick SMAS
• It extends from the____ laterally to the ____inferiorly, the ____posteriorly and the___ superiorly
temporalis muscles platysma trapezius frontalis
Cranial Nerve V Trigeminal nerve, 3 branches, primarily___ but motor supply to___
sensory, muscles of mastication
Maxillary (V2) branches
– Infraorbital – Zygomaticotemporal – Zygomaticofacial
Mandibular (V3) – Emerges from–
foramen ovale
Mandibular (V3) branches -
–Mental –Auriculotemporal Damage = Frey’s – Buccal
Frey’s
Auriculotemporal Damage , branch of mental
Danger Zones trigeminal nerve During Surgery -injury to the supraorbital and supratrochlear branches of V1; -resulting in numbness of the___
Superior orbital rim in the mid-pupillary line forehead, upper eyelid, nasal dorsum, and scalp
Ophthalmic (V1)
– Supratrochlear, Infratrochlear – Supraorbital –External nasal, Lacrimal
injury to the infraorbital branch of V2___; lies anterior to the SMAS; resulting in numbness ___
One centimeter below the inferior orbital rim in the mid-pupillary line of the nasal sidewall, cheek, upper lip, and lower eyelid
injury to the mental branch of V3; lies anterior to the SMAS; resulting in numbness of
Mid-mandible below the second premolar ipsilateral lower lip and chin
Trigeminal trophic syndrome causes___
anesthesia, paresthesia, and erosion of the nasal ala (APE);
Trigeminal trophic syndrome results from injury or surgery that damages due to encephalitis or leprosy
CN V at the gasserian ganglion,
may clinically mimic basal cell carcinoma
Trigeminal trophic syndrome
Frey’s syndrome (auriculotemporal syndrome) symptoms: occurs following parotid gland surgery;
pain, vasodilation, and hyperhidrosis of the cheeks when eating (gustatory sweating);
Frey’s syndrome
thought to involve haphazard nerve regeneration whereby parasympathetic fibers rather than sympathetic fibers innervate the sweat glands and blood vessels of the skin
Cranial Nerve VII MNEMONIC To Zanzibar By Motor Car
Temporal Zygomatic Buccal Marginal mandibular Cervical
Cranial Nerve VII Emerges from “ quickly penetrates ___
stylomastoid foramern the parotid gland and bifurcates
Facial nerve, primarily___ sensory to
motor, conchal bowl and anterior tongue,
injury to the temporal branch of VII; causes
inability to raise eyebrow or completely close the eye
temporal branch of VII; danger zone
A rectangular box 2 cm in height extending from the lateral eyebrow to the anterior hairline;
injury to the marginal mandibular branch of VII; lies beneath the SMAS;
results in drooping of the corner of the mouth
marginal mandibular branch of VII;
Mid-mandible 2 cm posterior to the oral commissure
which nerve innervates Frontalis muscle (m.) • Corrugator supercilii m. • Orbicularis ocull m. (upper portion) • Auricular m. (anterior and superior; also known as the temporoparietalis m.)
Temporal Branch
Posterior Auricular Branch
• Occipitalis m. • Auricular m. (posterior)
• Orbicularis oculi m. (lower portion) • Nasalis m. (alar portion) • Procerus m.
Zygomatic Branch
• Upper lip muscles - Levator anguli oris m. - Zygomaticus major m.
Zygomatic Branch
• Buccinator m. (muscle of mastication) • Depressor septi nasi m. • Nasalis m. (tranverse portion)
Buccal Branch
Buccal Branch Upper lip muscles
•- Orbicularis oris m. - Levator anguli oris m.
Buccal Branch supplies -orbicularis oris m - Zygomaticus major and minor m. - Levator labii superioris m. which are
• Lower lip muscles (
- Orbicularis oris m. - Depressor anguli oris m. - Depressor labil inferioris m.
Marginal Mandibular Branch • Lower lip muscles
Mentalis m. Risorius m. Platysma m. (upper portion)
Marginal Mandibular Branch
• Platysma m.
Cervical Branch
branches of facial nerve most at risk during surgery ___ because ____
• The temporal and marginal mandibular rami.
• Undermine ____ where? to avoid injury to the temporal branch
in the superficial fat above the SMAS
The marginal mandibular nerve lies beneath the platysma muscle; it is most at risk from injury___
along the jawline.
• Nerve for Conchal bowl -
Vagus nerve
eyelid ectropion and inability to close eyelid
Damage zygomatic branch
damage to buccal branch
Inability to smile -•
The nerves innervate the facial muscles deeply at their undersurfaces, except for the
buccinator, which is innervated at its superficial surface
greater auricular nerve
Innervation of post ear
Sensory Nerves of the Neck and Posterior Scalp GLOTS
Great Auricular (C2, C3), Lesser Occipital (C2), Greater Occipital (C2), Transverse Cervical (C2, C3), Supraclavicular (C3, C4)
cervical plexus supplies the
to the lateral neck and posterior scalp is from
sensory innervation to the lower neck, clavicle, and shoulder
• C3, C4 (supraclavicular)
sensory innervation to the anterior portion of the neck
• C2, C3 (transverse cervical)
sensory innervation to the occipital scalp
C2 (greater occipital)
sensory innervation to the scalp posterior to the ear and the superior portion of the posterior auricle
• C2 (lesser occipital) supplies
sensory innervation to the skin overlying the parotid, the lower anterior ear, the lower posterior ear, and the mastoid process
C2, C3 (great auricular)
Danger Zones 1.) Approximately 6.5 cm below the external auditory canal along the posterior border of the sternocleidomastoid muscle;
injury to the great auricular nerve (C2, C3); lies posterior to the SMAS
great auricular nerve (C2, C3);
results in numbness of the inferior two-thirds of the ear and the adjacent cheek and neck
location greater auricular, lesser occipital, spinal accessory nerves
Erb’s point near the mid-posterior sternocleidomastoid muscle
Spinal Accessory Nerve • Injury results in the inability to
elevate the shoulder on the affected side, winged scapula,inability to initiate arm abduction
Innervates the posteriolateral sole the
Sural Nerve
• Innervates anteromedial sole
Posterior Tibial Nerve
Deep Peroneal Nerve
Innervates the great toe and toe cleft between 1st and 2nd toes
Innervates the dorsum of the foot
Superficial Peroneal Nerve
____supplies eyelids, upper nose, nasal dorsum, forehead, scalp via___ branch
ICA , ophthalmic
____supplies rest of face
• ECA
The __major arteries supplying the face:
six
Facial:
Angular artery anastomoses with dorsal nasal branch of ophthalmic artery in periocular region
Superficial temporal: Comes off the ECA, and palpable at the____ branches into:
superior pole of the parotid gland; transverse facial and frontal arteries
Maxillary: Comes off the ___ branches into the
ECA infraorbital, buccal, and inferior alveolar (mental) arteries
Posterior auricular: Off the Occipital:
ECA
Ophthalmic: Comes off the___ branches into the _____ anastomoses with the _______ specifically, the angular artery anastomosis with_____
ICA, supraorbital, supratrochlear, palpebral, dorsal nasal, and lacrimal arteries; ECA, the dorsal nasal branch
Innervates the dorsum of the foot
Superficial Peroneal Nerve
____supplies eyelids, upper nose, nasal dorsum, forehead, scalp via___ branch
ICA , ophthalmic
____supplies rest of face
• ECA
The __major arteries supplying the face:
six
Facial:
Angular artery anastomoses with dorsal nasal branch of ophthalmic artery in periocular region
Superficial temporal: Comes off the ECA, and palpable at the____ branches into:
superior pole of the parotid gland; transverse facial and frontal arteries
Maxillary: Comes off the ___ branches into the
ECA infraorbital, buccal, and inferior alveolar (mental) arteries
Posterior auricular: Off the Occipital:
ECA
Ophthalmic: Comes off the___ branches into the _____ anastomoses with the _______ specifically, the angular artery anastomosis with_____
ICA, supraorbital, supratrochlear, palpebral, dorsal nasal, and lacrimal arteries; ECA, the dorsal nasal branch
Facial veins lack valves • Drain into
cavernous sinus
sensory innervation foot
