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SF2 > Anatomy of the Face > Flashcards

Anatomy of the Face Flashcards

1
Q

Front part of head that in humans extends from forehead to chin and includes mouth, nose, cheeks, and eyes defines what?

A

The face

*ears are not part of the face, it is part of the neck

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2
Q

What are the contents of the face?

A
  1. Bones (facial aspect neuro- & viscerocranium)
  2. Nerves (branches of trigeminal and facial nerve)
  3. Muscles of facial expression
  4. Blood supply (veins, arteries)
  5. Other structures (buccal fat pad, pterygomandibular raphe, parotid gland)
  6. Sinuses
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3
Q

What are the three part of the cranium?

A

Neurocranium: bony case of the brane

Viscerocranium: facial skeleton

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4
Q

The neurocranium includes which part of the skull?

A

Frontal bone

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5
Q

What are the muscles around the mouth?

A

A.Levator labii superioris alaeque nasi

B.Levator labii superioris

C.Zygomaticus minor

D.Zygomaticus major

E.Risorius

F.Depressor anguli oris

G.Depressor labii inferioris

H.Orbicularis oris

Levator anguli oris

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6
Q

What are the 3 muscles of the mouth that originate from the maxilla?

A

A.Levator labii superioris alaeque nasi

B.Levator labii superioris

I.Levator anguli oris

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7
Q

What are the 2 muscles of the mouth that originate from the zygomatic bone?

A

A.Zygomaticus minor

B.Zygomaticus major

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8
Q

What are the muscles of the mouth that originate from the fascia/skin?

A

Fascia

Risorius

Obicularis Oris

Skin

Orbicularis oris

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9
Q

What are the two muscles of the mouth that orignate from the mandible?

A

Depressor anguli oris

depressor labi inferioris

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10
Q

What are the 4 muscles of the mouth that insert into the angle of the mouth?

A

A.Zygomaticus major

B.Risorius

C.Depressor anguli oris

Levator anguli oris

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11
Q

What are the three muscles of the mouth that insert onto the upper lip?

A

A.Levator labii superioris alaeque nasi

B.Levator labii superioris

C.Zygomaticus minor

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12
Q

Where does the depressor labii inferioris inserts where?

A

Lower lip

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13
Q

The orbicularis oris inserts where?

A

surround mouth opening

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14
Q

Levator labii superioris alaeque nasi and levator labii superioris share a function. What is it?

A

Lift upper lip

Additional function of Levator labii superioris alaeque nasi is wing of nose

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15
Q

The Viscerocranium includes what part of the skull?

A

Zygomatic bone

Mandible

Nasal Bone

Maxilla

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16
Q

Which nerve supplies the face?

A

Trigeminal Nerve - CN V

Sensory: face

Facial Nerve - CN VII

Motor: mm of facial expression

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17
Q

The branches of the trigeminal nerve provide sensory innervation on the face. What are the zones and how do they enter the face?

A

Opthalmic Zone - Opthalmic division (V1) and it enters through supraorbital foramen

Maxillary Zone - Maxillary division (V2) and it enters through the infraorbital foramen

Mandibular zone - Madibular branch (V3) and it enter throught he mental foramen

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18
Q

What are the divisions of the CN V1?

A

Supraorbital n.

Supratrochlear n.

Infratrochlear n.

External nasal n.

Lacrimal n.

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19
Q

What are the branches of CN V2?

A

Zygomatico-temporal n.

Sygomaticofacial n.

Infra-orbital n.

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20
Q

What are the branches of CN V3?

A

Auriculotemporal n.

Buccal n. (long buccal n.)

Mental n.

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21
Q

The branches of the trigeminal nerve all originate from one common are. This structure is located in the middle cranial fossa. What is it?

A

Trigeminal Ganglion

V1 then goes through supraorbital fissure

V3 goes through foramen ovale

V2 goes through foramen rotundum

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22
Q

Trigeminal neuralgia is also known as ______.

Describe the cause of this disorder.

A

Tic douloureux

  • Disorder of the sensory root of CNV àDemyelination of axons in the sensory root
  • Caused by pressure of a small aberrant artery (too close) or by pathological process which affects neurons (neuron shed myelin)
  • Most often in middle-aged and elderly persons
  • Frequency of involved branches from trigeminal divisions: V2 > V3 > V1
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23
Q

What are the characteristics of tic douloureux?

A
  • Characterized by sudden attacks of excruciating, lightening like japs of facial pain (can be 15+ min)
  • Pain can be so intense that person winces àhence the common term tic(twitch)
  • Can be initiated by touching face, brushing teeth, shaving, drinking, or chewing
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24
Q

How is tic douloureux treated?

A

•Medical or surgical treatment to reduce pain (e.g., avulsion or cutting of nerve branches at foramina) – minimal invasive procedure.

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25
Q

Widespread anesthesia involving the

  • Corresponding anterior half of scalp
  • Face,except area around angle of mandible (this is the cranial auricular nerve that comes from the cervicalplexus), cornea, and conjunctiva
  • Mucous membranes of mouth, nose, and anterior part of tongue

Is caused by what?

A

Lesion of the entire trigeminal nerve

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26
Q

Lesion to the motor part of the trigeminal nerve affects which part of the head?

A

Paralysis of muscles of mastication and tensor veli palatini

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27
Q

Clinical Herpes Zoster is caused by what?

Describe it’s characteristics.

A

Also known as Shingles!

it is caused by infection of trigeminal ganglion (infection may produce a lesion in the cranial ganglia)

Characteristics

•eruption of groups of vesicles following the course of the affected nerve

Ganglion infection occurs in 20% of cases

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28
Q

Which branch of the trigeminal nerve is often affected by Herpes Zoster (Shingles)?

A

Opthalmic n. (V1)

Often affects the cornea -> painful corneal ulceration and subsequent scarring of cornea

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29
Q

The facial nerve exits the skull through the stylomastoid foramen and gives off two initial branches. What are they?

A

Posterior: Posterior auricular nerve (VII) - not part of the face

Anterior - transveres parotid gland and divides into 5 main branches (deep to skin) - this is know as the parotid plexus

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30
Q

What are the branches of the facial nerve?

A
  • T–Temporal
  • Z– Zygomatic
  • B– Buccal
  • M– Marginal mandibular
  • C– Cervical (innervates platysma muscle)

“Two Zebras Bit My Cat”

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31
Q

Condition in which muscles of facial expression on one side of the face becomes weak or paralyzed is known as?

A

Facial Palsy - Bell’s Palsy

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32
Q

What is the characteristic of Bell’s Palsy?

A

•It affects only one side of the face at a time, causing it to droop or become stiff on that side

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33
Q

How does Bell’s Palsy occur?

A
  • It’s caused by some kind of trauma to the facial nerve (CNVII)
  • Seems to occur more often in people who have diabetes or are recovering from viral infections (e.g., herpes simplex 1 virus).
  • Most of the time, symptoms are only temporary.
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34
Q

Infection with Borreliaburgdorferi via tick bites can cause ______?

A

Lyme Disease

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35
Q

Of pts affected with Lyme diseas, 10% develop ______ _______, with 25% of the patients presenting with _______ _________.

A

Facial paralysis (paralysis of muscles of facial expression)

Bilateral Palsy

36
Q

In this image the muscles that are X’ed out are what?

A

Not muscle of facial expression

37
Q

This muscle originates from the fascia overlying pectoralis major and deltoid muscles and inserts into the inferior border of mandible and skin over lower face. What is it?

A

Platysma

ONLY muscle of facial expression over the neck region

38
Q

What are the actions and innervation of the Platysma?

A

Action:

  • depresses corners of mouth
  • depression of mandible
  • tenses skin of neck (shaving)
  • expands neck during heavy breathing

Innervation: cervical branch of facial nerve

39
Q

The frontalis and occipitalis together create the?

A

Epicranius

40
Q

Fronatalis

Origin

Insertion

Innervation

A

Origin: galeaaponeurotica/ epicranialaponeurosis

Insertion: skin of eyebrows

Innervation: temporal branches of

41
Q

Occipitalis

Origin

Inseriton

Innervation

A

Origin: superior nuchal line

Insertion: galeaaponeurotica

Innervation: posterior auricular branch/nerve

42
Q

What is the function of the Epicranius?

A

Elevates eyebrows and wrinkles forehead. Pulls scalp back and forth

43
Q

Orbicularis Oculi

Origin

Insertion

Action

Innervation

A

Origin: medial palpebral ligament

Insertion

  • orbital part: skin of lateral cheek (part that runs over bone)
  • palpebral part: lateral palpebral ligament (runs on eyelid, no bone)

Action: closes the eyelids; protects eye

Innervation: temporal (above fissure) & zygomatic branches (below fissure)

44
Q

Procerus

Origin

Insertion

Action

Innervation

A

Origin: nasal bone

Insertion:skin between the eyebrows

Action: depresses the medial corners of the eyebrows

Innervation: temporal branch

45
Q

What is the common function of the Zygomatic major and zygomatic minor?

A

Smile (Zmile)

Zygomatic major lift the lips at the angle of the mouth and the zygomatic minor lifts the upper lip

46
Q

What is the common function of the Depressor anguli oris and depressor labii inferioris?

A

Depresses angle of mouth (anguli oris) and lower lip (Labii inferioris)

47
Q

What is the function of the Risorius m.?

A

subtle retraction of angle of mouth

48
Q

What is the function of the Orbicularis oris?

A

Constictor!

Closes mouth (kissing and eating)

49
Q

What is the function of the levator anguli oris?

A

lift angles of mouth

50
Q

Out of all the muscles of the mouth how many are used for laughing and how many for frowning?

A

22 for a full laugh

6 for frowning

51
Q

Most the muscle (except one) surrounding the mouth are innervated by the buccal branch of the facial nerve. What are they?

A

Levator labii superioris alaeque nasi

Levator labii superioris

Zygomaticus minor

Risorius

Orbicularis oris

Levator anguli oris

Depressor anguli oris

Zygomatic major

(As you can see the only muscle not included is the depressor labi inferioris)

52
Q

Of the muscle surrounding the mouth, three muscles recieve innervation outside of the bucal branch of the facial n? What are they?

A

Zygomatic and buccal branches supply the Zygomatic major

Marginal mandibular and buccal branches supply the depressor angular oris

The marginal mandibular branch supplies the depressor labii inferioris

53
Q

Mentalis

Origin

Insertion

Nerve

Actions

A
  • Origin: anterior mandible
  • Insertion: skin of chin
  • Nerve: mandibular branch of facial nerve
  • Actions: elevates and wrinkles skin of chin, protrudes lower lip
54
Q

Buccinator

Origin

Insertion

Action

Innervation

A

Origin

  • pterygomandibularraphe
  • maxilla lateral to molar teeth
  • mandible

Insertion:

  • angle of mouth
  • lateral portion of both lips

Action:

  • pulls the corner of mouth laterally
  • presses the cheek against the teeth

Innervation:buccal branches of facial n.

IMPORTANT IN MASTICATION (but not innervated by the buccal nerve from V3)

55
Q

Image shows the vessels of the head

A
56
Q

Slide 31????

A

Listen again

57
Q

What is the cavernosus sinus?

A

Communicates with veins of the face through 2 routes

  1. Veins that pass through superior orbial fissue
  2. Veins that pass through foramen ovale/foramen of Vesalius
58
Q

T/F

The flow of the veins can be reversed?

A

True

Pterygoid plexus has valves and can act as a suction pump (this occurs during yawning)

59
Q

What is the flow of veins in the faces?

A

Opthalmic veins darin into the Cavernous Sinus

inferior opthalmic v. also drains into pterygpid plexus

infraorbital vein drains into pterygoid plexus

Deep facial vein drains into facial vein which then heads toward jugular vein

60
Q

What is the danger zone?

A

Possible infection between angular and deep facial veins

  • Dangerous area is triangle bounded by lines from root of nose to angle of mouth
  • Venous drainage from this area (face and orbit) communicate with cavernous sinus via superior & inferior ophthalmic veins and deep facial vein (via pterygoid plexus)
  • Risk of spread of infection -> can lead to sinus thrombosis
61
Q

What is the content of the cavernous sinus?

A

TOM of CAT

T: Trochlear nerve

O: Opthalmic nerve

M: Maxillary nerve

O: Occulomotor nerve

C: Cavernous Part ofo Internal Carotid artery

A: Abducens Nerve

T: Trigeminal nerve

INFECTION TO THIS AREA IS DANGEROUS

62
Q

An infection leading to a blood clot caused by the complication of an infection in the paranasal or central face sinuses can lead to what?

A

Thrombosis of the Cavernosus SInus

63
Q

What are the symptoms of Thromboss of the Cavernous Sinus?

A

Fatigue

Seizure

Vomiting

Impaired vision

Boil on the face

Drooping eyelid

high temp

Sinusitis - an infection in the skull

Severe pain or numbness in the face

Infection in eyes - redness, swellin or irritation around the eyes

64
Q

What are the branches of the extenal carotid artery?

A

Some Anatomists Like Freaking Out Poor Medical Students (inferior to superior)

  • S: superior thyroid artery
  • A: ascending pharyngeal artery
  • L: lingual artery

•F: facial artery

  • O: occipital artery
  • P: posterior auricular artery

•M: maxillary artery - behind the angle of the mandible

•S: superficial temporal artery - behind the angle of the mandible

65
Q

What are the branches of the facial artery?

A
  • Submental a.: arises at lower body of mandible; supplies skin of chin and lower lip
  • Inferior labial a.: arises near angle of mouth, runs medially in lower lip, anastomosis with fellow of opposite site
  • Superior labial a.: runs medially in upper lip and gives branches of to septum and ala of nose
  • Angular a.: termination of facial artery, supplies area around eye
66
Q

The superficial temporal artery is the terminal of the carotid artery?

What is the path of the artery?

A
  • Ascends in front of ear (palpable) to supply temporal and anterior portion of scalp
  • Transverse facial artery runs above parotid duct to supply the cheek region
67
Q

The maxillary artery give of many branches. What are thr three branches we need to know currently?

A
  1. Infra-orbital: enters the face through the infra-orbital foramen and suplies the lower eyelid, upper lip and the area between these structures
  2. Buccal artery: enters the face on the superficial surface of the buccinator muscle and supplies structures in this area
  3. Mental artery: enters the face through the mental foramen and supplie the chin
68
Q

What is the origin of the supra orbital a?

A

Arises from the opthalmic a. which arises from the internal carotid a.

69
Q

What is the origin of the infra-orbital a.?

A

Arises from the maxillary a. (3rd part) which ariss from external carotid artery

70
Q

What is the buccal fat pad?

A

•One of many encapsulated fat pads in the cheek (above buccinator and can extend to temporal region)

71
Q

What is a common cosmetic facial surgery uprocedure that is performed to slim the cheeks or face?

A

Buccal fat pad reduction

72
Q

Why is the buccal fat pad used in surgery for cingenital and aquired defects that occur in the maxillofacial area

A

The buccal fat pad flap is a simple and reliable flap for the treatment of many of these defects because of its rich blood supply and location, which is close to the location of various intraoral defects.

73
Q

What is the Pterygomandibular raphe?

A

From mouth to oropharynx: orbicularis oris, buccinator, superior pharyngeal constrictor

•Sphincter to oropharynx (keep food between teeth

* this is piered during a inferior alveolar nerve block to reach the linguak n. (V3) and inferior alveolar n. (V3)

74
Q

Whhich gland is the largest of the 3 paired salivary glands?

A

Parotid gland

  • Irregular shaped àparotid bed: anterio-inferior of external acoustic meatus
  • Wedged between ramus of mandible and mastoid process
  • Fatty tissue between lobes: flexibility of gland to accommodate motion of mandible
75
Q

What are the structures that are embedded in parotid gland?

A

Facial nerve plexus, retromandibular vein, and external carotid artery

Structures are encolsed within tough facial capsule, know as the Parotid Sheet

Lymph nodes are located on the sheet and within gland

76
Q

What is the path of the parotid duct?

A
  • Parotid duct passes horizontally from anterior edge of gland
  • At anterior border of masseter, the duct runs medially, pierces the buccinator, and enters oral cavity through small orifice opposite of 2nd maxillary tooth
77
Q

What is a Parotidectomy?

A

Sugical Excision of the parotid gland

80% of Salivary gland tumors in the parotid gland, most the time they are benign.

Procedure is done to preserve the facial plexus

78
Q

Small air-filled spaces located within bones surrounding the nose

This is known as?

A

Paranasal sinused

79
Q

How do the paranasal sinuses develop?

A

develop from invaginations of nasal cavity that extend into bones: 2 during fetal development, 2 postnatally

80
Q

In an adult, what are 4 paired paranasal sinuses?

A

Maxillary sinuses

Ethmoid sinuses

Frontal sinuses

Sphenoid sinuses

81
Q

Why is the paranasal sinuses so important?

A
  • Sinuses shape/reshape face through enlargement of air filled space
  • Keep weight of head low while growing
82
Q

Describe the Maxillary sinus?

A

It develops in the 3rd fetal month

Invagination of nasal sac that expands within the maxillary bone

83
Q

Describe the Ethmoid sinuses?

A

Develop in the 5th fetal month

Invagination of middle meatus of nasal passages (spaces underlying middle nasal concha) grow into ethmoid bone

84
Q

Describe the Sphenoid sinuses?

A

Developes in the 5 postnatal month

extensions of ethmoid sinuses into sphenoid sinuses

85
Q

Describe the frontal sinuses?

A

Develops in the 5-6th postnatal year

Each frontal sinus consist of two independent spaces that develop from different sources.

  • 1 forms by expansion of ethmoid sinus into frontal bone
  • 1 develops from independent invagination of middle meatus of nasal passages
86
Q

What is sinusitis?

A
  • Inflammation of membranes lining the paranasal sinuses
  • Can be caused by infection or other health problem
  • Symptoms include facial pain and nasal discharge

SF2 (14 decks)

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