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BDS1 BAMS histology and head and neck anatomy > clinical anatomy of the face > Flashcards

clinical anatomy of the face Flashcards

1
Q

what is the cranium?

A

the head

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2
Q

what are the two parts of the skeleton of the head?

A
  • neurocranium
  • viscerocranium
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3
Q

what is the neurocranium?

A

bony covering of the brain and meninges (layers surrounding brain and spinal cord)

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4
Q

what is the roof of the neurocranium called?

A

the calvaria

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5
Q

what is the floor of the neurocranium called?

A

cranial base

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6
Q

how many bones make up the neurocranium and what are they called?

A

eight
- one frontal
- one ethmoid
- one sphenoid
- one occipital
- two temporal
- two parietal

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7
Q

what does pneumatised mean?

A

air within the bones

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8
Q

which bones of the cranium are pneumatised?

A

frontal, ethmoid, sphenoid, temporal and maxillary

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9
Q

which bones of the cranium are in the form of paranasal sinuses?

A

frontal, ethmoid, sphenoid and maxillary

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10
Q

what is the connection between the frontal and parietal bones?

A

coronal suture

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11
Q

what is the connection between the parietal and occipital bones?

A

lambdoidal suture

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12
Q

what is the connection between the parietal and temporal bones?

A

squamous suture

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13
Q

skull diagram…

A
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14
Q

what is the ear canal called?

A

external auditory meatus

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15
Q

what does the viscerocranium make up and how many bones is there in it?

A

the facial skeleton- 14 bones

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16
Q

where are the mastoid air cells found?

A

the temporal bone (mastoid is behind the ear)

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17
Q

what is the small bone in the skull where muscles attach onto?

A

styloid process

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18
Q

what is the crash impact barrier part of the skull?

A

zygomatic bone

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19
Q

what is the weakest point of the skull?

A

pterion- where the frontal, parietal, sphenoid and temporal bones meet

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20
Q

what can happen as a result of trauma to the pterion?

A

rupture of the middle menigeal vessels resulting in a extra-dural haemorrhage (lucid interval after injury)

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21
Q

what % of non-verbal communication does our face contribute to?

A

80-90%

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22
Q

what is the orifaces?

A

nose, lips, chin

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23
Q

does the facial skeleton or calvaria take longer to grow?

A

facial skeleton

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24
Q

what is the calvaria?

A

top part of the skull

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25
Q

what are triangles of the neck important for?

A

to identify lumps

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26
Q

regions of head and neck?

A
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27
Q

regions of the face…

A
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28
Q

what are the divisions of the 31 pairs of spinal nerves?

A
  • 8 cervical
  • 12 thoracic
  • 5 lumbar
  • 5 sacral
  • 1 coccygeal
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29
Q

where do the cranial nerves arise from?

A

the brain and brainstem

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30
Q

which nerve supplied sensory innervation to the face?

A

trigeminal

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31
Q

which nerve supplies motor innervation to the muscles of mastication?

A

trigeminal

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32
Q

which nerve supplies the muscles of facial expression?

A

facial

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33
Q

what are the three branches of the trigeminal nerve?

A

ophthalmic Va, maxillary Vb and mandibular Vc

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34
Q

what does the ophthalmic nerve branch of the trigeminal nerve innervate?

A
  • Forehead and scalp
  • Frontal and ethmoidal sinus
  • Upper eyelid and its conjunctiva
  • Cornea
  • Dorsum of the nose
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35
Q

what does the maxillary nerve branch of the trigeminal nerve innervate?

A
  • Lower eyelid and its conjunctiva
  • Cheeks and maxillary sinus
  • Nasal cavity and lateral nose
  • Upper lip
  • Upper molar, incisor and canine teeth and the associated gingiva
  • Superior palate
36
Q

what does the mandibular nerve branch of the trigeminal nerve innervate?

A

Sensory supply:
- Mucous membranes and floor of the oral cavity
- External ear
- Lower lip
- Chin
- Anterior 2/3 of the tongue
- Lower molar, incisor and canine teeth and the associated gingiva
Motor Supply:
- Muscles of mastication; medial pterygoid, lateral pterygoid, masseter, temporalis
- Anterior belly of the digastric muscle and the mylohyoid muscle (these aresuprahyoid muscles)
- Tensor veli palatini
- Tensor tympani”

37
Q

what is HSV?

A

Herpes simplex – virus caused by herpes simplex virus. There are 2 types, Type 1 and Type 2 and around the mouth, Type 1 is more common the mouth and Type 2 around the genitalia.

It could cause a cold sore around the corners of the mouth, affecting the maxillary or mandibular territories.

37
Q

what is VZV?

A

Varicella zoster virus (VZV): Primary varicella zoster infection results in chickenpox and can cause lung and airway disease like bronchitis or pneumonia. When it resolves the virus lays dormant in the ganglia (collection of cell bodies) and can reactivate in 10-20% of people resulting in shingles or herpes zoster.

38
Q

what are the muscles of mastication?

A

masseter, temporalis, pterygoids

39
Q

where is the masseter?

A

zygomatic arch to mandible

40
Q

what is the function of the masseter?

A

elevates the mandible and closes the mouth

41
Q

where is the temporalis?

A

from frontal/parietal bones to coronoid process of mandible

42
Q

what is the function of the temporalis?

A

elevates the mandible and closes the mouth
ALSO
retracts the mandible

43
Q

what is the function of the lateral pterygoids?

A

Both left and right acting at the same time will result in protraction of the mandible. When one acts on its own it results in deviation of the mandible to the opposite side. ONLY ONE WHICH OPENS MOUTH

44
Q

what is the function of the medial pterygoids?

A

elevate mandible and close the mouth

45
Q

how would you test the muscles of mastication clinically?

A

ask patient to clench jaw tightly

46
Q

how many muscles are in the face?

A

43

47
Q

what nerve supplies the facial muscles?

A

facial nerve VII

48
Q

what is different about the facial muscles?

A

they are attached to the bone/fascia (tissue) then to the skin directly
- this allows for facial expression

49
Q

what are the muscles around the lips and mouth important for?

A

clear speech

50
Q

what are the muscles of the mouth/cheeks?

A
  • elevators, retractors, evertors (pout) of upper lip
  • depressors, retractors, evertors of lower lip
  • obicularis oris
  • buccinator
51
Q

where is the obicularis oris?

A

around the mouth
- originates from the maxilla and cheek muscles and inserts into the lips

52
Q

which muscle is involved in pursing of the lips?

A

obicularis oris

53
Q

what nerve supplies the obicularis oris?

A

buccal branch of the facial nerve

54
Q

where is the buccinator muscle?

A

cheek
- originates from the maxilla and mandible and extends down to blend with the obicularis oris and skin of the lips

55
Q

what is the function of the buccinator muscle?

A

pulls in cheeks, pushing food into middle of the oral cavity

56
Q

what nerve supplies the buccinator muscle?

A

buccal branch of the facial nerve

57
Q

what is the muscle which moves the eye?

A

obicularis oculi

58
Q

what are the two parts of the obicularis oculi?

A

orbital (strong thicker closing part) and palpedral (in eyelids- soft closing eg blinking)

59
Q

what muscle allows some people to move their ears?

A

auricular muscles

60
Q

what are the three major structures which pass through the parotid gland?

A
  • external carotid artery
  • retromandibular vein
  • facial nerve
61
Q

what enters the oral cavity opposite the second upper molar?

A

parotid duct

62
Q

what causes mumps?

A

a paramyxovirus
- it can cause swelling of the parotid gland, and lymph nodes, including those inside the parotid gland
- swellings are painful and give a hamster appearance, and are sore as they stretch the fascia (connective tissue) which surrounds the parotid gland

63
Q

what can mumps cause?

A

deafness, infertility and meningitis
- it is usually a self limiting condition and clears itself, and analgesia and bed rest are the only supportive treatments available

64
Q

what is bell’s palsy?

A

complete paralysis one ONE SIDE only
- most common cranial neuropathy
- diagnosed only if no specific cause is identified
- due to swelling of facial nerve through the stylomastoid foramen

65
Q

what are available treatments for bell’s palsy?

A

prednisolone (steroid)
acyclovir

66
Q

what are the 5 main branches of the facial nerve?

A
  • temporal
  • zygomatic
  • buccal
  • marginal mandibular
  • cervical
67
Q

what does the temporal branch of the facial nerve innervate?

A

the frontalis, orbicularis oculi and corrugator supercilli

68
Q

what does the zygomatic branch of the facial nerve innervate?

A

orbicularis ocui

69
Q

what does the buccal branch of the facial nerve innervate?

A

orbicularis oris , buccinator and zygomaticus muscles

70
Q

what does the marginal mandibular branch of the facial nerve innervate?

A

mentalis muscle

71
Q

what does the cervical branch of the facial nerve innervate?

A

the platysma

72
Q

what is the risk of removing the parotid gland (tumour)?

A

the facial nerve branches could be cut

73
Q

what does ectomy mean?

A

surgical removal

74
Q

what are the two ways of doing a parotidectomy?

A

anterograde or retrograde

75
Q

what is an aterograde parotidectomy?

A

identifying main trunk of facial nerve and tracing out smaller branches PREFFERED

76
Q

what is a retrograde parotidectomy?

A

identifying smaller branches of facial nerve and tracing them back to the main trunk

77
Q

what should be done before operating need parotid gland?

A
  • mark mandible angle
  • mark neck
78
Q

what is likely to be done during an operation which could potentially damage the facial nerve?

A

the great auricular nerve

79
Q

what does facial reanimation treatment depend on?

A
  • level of injury
  • duration of paralysis ( before 12 months)
80
Q

what are the types of facial reanimation?

A
  • immediate/ early reconstruction
  • intermediate reconstruction
  • late reconstuction
81
Q

which facial reconstructions are dynamic?

A

(bring back movement)
early and intermediate

82
Q

what is a static facial reconstruction?

A

(late)
bring back facial symmetry

83
Q

what is a hypoglossal facial anastomosis (joining up again)?

A

joins CN XII and CN VII if CN VII stops working
- used for patients with intermediate length paralysis
- side to end anastomosis is most popular

84
Q

what does the hypoglossal nerve innervate?

A

tongue muscles

85
Q

where is skin taken from for static facial reanimation?

A

thigh- fascia lata (attached to corner of mouth)

BDS1 BAMS histology and head and neck anatomy (12 decks)

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