Anatomy of the Face & Parotid Region - Herring Flashcards by Anna Farrell

5 layers of the scalp

Skin
Connective tissue
Aponeurosis
Loose CT
Periosteum (pericranium)

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contains numerous hair follicles and sweat glands

abundant arterial supply and venous drainage

Skin

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dense, thick subcutaneous layer

highly vascular and well innervated by cutaneous
nerves

Connective Tissue

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sheet of connective tissue between the frontal
and occipital muscle bellies of the occipitofrontalis muscle

fused posteriorly with the periosteum, anchored
laterally with temporal fascia, and not attached to
bone anteriorly

Aponeurosis (epicranial aponeurosis / galea aponeurosis)

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layer of areolar tissue which allows the epicranial aponeurosis to move

potential space in which the spread of blood or infection may occur primarily anteriorly over forehead

Loose connective tissue

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outer fibrous layer of skull which serves as an attachment for muscles of facial expression

Periosteum (pericranium)

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Paired arteries and veins course within the ________
layer between the skin and the aponeurosis

connective tissue

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The vasculature of the scalp is firmly anchored to the connective tissue and
have limited ability to _______

constrict

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The vasculature of the scalp is supplied primarily from branches of the external carotid artery and internal jugular vein: what are the 3 arteries/veins?

Occipital A & V
Posterior auricular A & V
Superficial temporal A & V

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The anterior scalp is supplied by branches of
the internal carotid artery & veins to cavernous sinus: which artery/vein?

Supra-orbital A & V

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What veins connect the scalp veins with the dural venous sinuses creating a potential pathway of scalp infection spread into meninges

Emissary veins

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The anterior scalp is supplied by which CN

CN V1

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What 2 nerves that branch from the facial nerve innervate the anterior scalp

supra-orbital nerve
supratrochlear nerve

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The lateral scalp is supplied/innervated by what 2 CNs

CN V2 and CN V3

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The posterior scalp is mainly supplied by __________ nerve (dorsal ramus
of C2)

greater occipital N

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The posterior scalp is supplied/innervated more inferiorly by _________ of upper cervical spinal nerve

dorsal rami

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The posterior scalp is innervated/supplied in the posterolateral portion by the ___________ (from the cervical plexus)

lesser occipital nerve

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what lobes are involved in facial recognition

temporal lobe and occipital lobe

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The __________ of the temporal lobe is only active when the person looks at faces

fusiform gyrus

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What 3 things are involved in the processing of facial expressions

Temporal lobe (superior temporal gyrus)

frontal lobe

amygdala

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All facial expression muscles are innervated by branches of

CN VII

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Muscles of facial expression can be separated into groups according to where the muscles insert into what 4 places:

Scalp muscles
Periorbital
Nasal muscles
Perioral muscles

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The occipitofrontalis has 2 bellies, what are they

occipital belly

frontal belly

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What common tendon do the occipital and frontal bellies share

epicranial aponeurosis

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Which belly arises from the occipital bone, inserts into epicranial aponeurosis, and retracts scalp

Occipital belly (occipitalis muscle)

Which belly arises from epicranial aponeurosis, inserts into skin and subcutaneous tissue of eyebrows & forehead, and raises eyebrows & wrinkles forehead (horizontal wrinkles)

frontal belly (frontalis muscle)

what muscle closes the eyelids

orbicularis oculi

what muscle draws the eyebrow medially and inferiorly; creates vertical wrinkles

corrugator supercilii

What muscle depresses medial ends of eyebrows; creates horizontal wrinkle(s) between eyebrow

procerus muscle

What muscle flares nostrils

nasalis

What muscle closes mouth (sphincter), compresses the lips against the teeth, & protrudes the lips

Orbicularis oris

What muscle dilates mouth and elevates angle of the mouth (true smiling)

Zygomaticus major

What muscle dilates mouth and elevates the angle of the mouth

Levator anguli oris

What muscle pulls angles of mouth inferiorly

Depressor anguli oris

What muscle presses cheek against teeth (keeps food between occlusal surfaces of teeth)

Buccinator

What muscle is important in muscles in infants to maintain suckling during feeding

Buccinator

What muscle retracts (elevates) upper lip only and dilates mouth

Levator labii superioris

What muscle dilates mouth & raises upper lip only

zygomaticus major

What muscle depresses lower lip only

depressor labii inferioris

What muscle elevates and protrudes lower lip (pouting) and assists orbicularis oris in clearing food from mandibular labial vestibule

Mentalis

What muscle can become hypertrophied due to malocclusions

Mentalis

What muscle tenses skin over neck and lower face and assists with depression of the mandible against resistance

Platysma

What nerve block is when the needle pierces mucosa superior to the 2nd premolar and advances toward the infra-orbital foramen

Infra-orbital nerve block

What nerve block is when the needle pierces the mucosa inferior to the 2nd premolar and advances toward the mental foramen

Mental nerve block

What nerve block is when the needle pierces the mucosa lateral to the pterygomandibular raphe

Inferior alveolar nerve block

When CN is for the motor innervation to the muscles of facial expression (somatic motor)

CN VII

Which CN is for the sensory innervation to the face that is supplied by the three divisions of the trigeminal nerve (somatic sensory)

CN V

Somatic motor fibers of CN VII emerge through ________________ to innervate muscles of facial expression

stylomastoid foramen

CN VII passes through the parotid gland but ________ innervate it

does NOT

the facial nerve divides into 2 main trunks, what are they

Temporofacial trunk Cervicofacial trunk

Temporal and zygomatic branches arise from the __________ trunk

temporofacial

(marginal) mandibular and cervical branches arise from _________ trunk

cervicofacial

Buccal branch can arise from _______ trunk

either

What branch supplies the supraorbital muscles: frontalis, corrugator supercilii, procerus, superior aspect of orbicularis oculi

temporal branch

What branch supplies inferior aspect of orbicularis oculi, zygomaticus major, zygomaticus minor, levator labii superioris, and nasalis muscles

Zygomatic branch

What branch innervates buccinator, levator anguli oris, and superior aspect of orbicularis oris

Buccal branch

What branch supplies muscles of lower lip: mentalis, depressor labii inferioris, depressor anguli oris, inferior aspect of orbicularis oris

(Marginal) Mandibular Branch

What branch supplies the platysma muscle

Cervical branch

The facial nerve also gives off two other branches as it emerges from stylomastoid foramen, what are they

posterior auricular branch nerve to the posterior belly of digastric muscle

what branch travels posterior to the ear to supply occipitalis muscle and muscles around auricle

Posterior auricular branch

What nerve supplies the posterior belly of digastric & stylohyoid muscles (pharyngeal arch 2 muscles)

Nerve to the posterior belly of digastric muscle

All cutaneous sensory supply to face via branches of trigeminal nerve (CN V) except for over the angle of _________ (great auricular nerve)

mandible

What CN supplies bridge of nose, brow ridge, forehead and much of the anterior scalp

CN V1

What nerve passes through supra-orbital notch/foramen to supply upper eyelid and much of forehead and anterior scalp

Supra-orbital nerve

What nerve passes superior to trochlea of superior oblique muscle to supply the middle of the forehead

Supratrochlear nerve

What nerve passes inferior to trochlea of superior oblique muscle to supply the root (bridge) of nose

Infratrochlear nerve

What CN supplies alar of nose, upper lip and cheek, portion of temporal region

CN V2

What nerve passes through infra-orbital foramen to supply the lower eyelid and upper lip, medial cheek region

Infra-orbital nerve

What nerve passes through zygomaticofacial foramen to supply the lateral cheek

Zygomaticofacial nerve

What CN supplies lower lip and jaw and a portion of the temporal region

CN V3

What nerve passes through zygomaticotemporal foramen to supply part of temporal region

Zygomaticotemporal nerve

What nerve is a terminal branch of the inferior alveolar nerve which passes through the mental foramen to supply the chin and lower lip

Mental nerve

What nerve passes through infratemporal fossa to supply the skin of the lower cheek, mucosa of much of the mandibular oral vestibule, and mandibular molar buccal gingiva

Long buccal nerve

What nerve passes laterally through the infratemporal fossa posterior to the TMJ to supply the skin anterior to the auricle of the ear and to much of the temple region

Auriclotemporal nerve

What nerve do PostGPS fibers from the otic ganglion follow (“hitch-a-ride” to the parotid gland)

auriculotemporal nerve AKA V3

Arterial supply tot he face is primarily from branches of __________

external carotid artery

Minor blood supply contributions to medial forehead and bridge of nose from branches of ___________ (from orbit via ophthalmic artery)

internal carotid artery

What artery branches from the external carotid artery at the level of the posterior belly of the digastric muscle, passes deep to the submandibular gland, and curls over the inferior margin of mandible anteromedial to masseter muscle to supply most of the face

Facial artery

What artery branches from facial artery inferior to the modiolus to supply the lower lip

Inferior labial artery

What artery branches from facial artery superior to the modiolus to supply the upper lip

Superior labial artery

What artery is the terminal portion of facial artery (name change at the angle of the nose) continues superior course along ala and then up to the bridge of nose

Angular artery

What artery is the terminal branch of the external carotid artery continues superiorly anterior to the auricle to give off numerous branches to lateral and superior scalp

Superficial temporal artery

What artery is a branch of the superficial temporal artery which courses inferior to zygomatic arch to supply cheek region and lateral face

Transverse facial artery

What artery travels with the supra-orbital nerve through supra-orbital foramen/notch to emerge onto the forehead

Supra-orbital artery

What artery travels with the supratrochlear nerve superior to the trochlea to emerge onto the middle of the forehead

Supratrochlear artery

What artery travels with the infratrochlear nerve inferior to the trochea to emerge onto the root or bridge of the nose

Dorsal nasal artery

Veins of the face lack _______

valves

Veins of the face typically flow _________ into neck to the internal jugular veins

inferiorly

Regarding veins of the face, some venous blood can enter deep face or orbit (via ophthalmic veins) and flow into ________ (Danger Triangle)

cavernous sinus

what vein collects most of the venous blood from the face

facial vein

What vein along the nose communicates with the cavernous sinus via ophthalmic veins

angular vein

What vein communicates with the pterygoid venous plexus via the deep facial vein

facial vein

what vein is formed by union of superficial temporal vein and maxillary vein

retromandibular vein

What vein drains most of infratemporal fossa and lateral scalp

retromandibular vein

The retromandibular vein divides inferiorly into an anterior and posterior division: the anterior division unites with the common facial vein to drain into the _________ (variable)

internal jugular vein

The retromandibular vein divides inferiorly into an anterior and posterior division: the posterior division unites with the posterior auricular vein to form the ________

external jugular vein

what is the largest salivary gland

parotid gland

What 3 structures pass through the parotid gland:

branches of CN VII external carotid artery retromandibular vein

Sensory innervation to parotid sheath supplied by ________________(branch of the cervical plexus)

great auricular nerve

The parotid gland hasp arasympathetic innervation from which CN

CN IX

the parotid gland has preganglionic parasympathetic cell bodies in the __________

inferior salivary nucleus

What nerve has preganglionic parasympathetic fibers via tympanic plexus of CN IX) exits the middle ear, travels along the floor of the middle cranial fossa to the foramen ovale, and synapses at otic ganglion (postganglionic parasympathetic cell bodies; near CN V3 at the foramen ovale)

lesser petrosal nerve

PostGPS fibers hitch a ride on CN ________ and exit it as it passes by the parotid gland

The parotid gland has PostGS cell bodies located in the _________

superior cervical ganglion

PostGS fibers travel to the parotid gland on the

external carotid artery