Clinical Anatomy of the Face Flashcards
What are the 2 parts of the cranium?
- Neurocranium
- Viscerocranium
What is the neurocranium?
- bony covering of the brain and meninges
What is the roof of the neurocranium called?
Calavaria
What is the floor of the neurocranium called?
Cranial base
What are the 8 bones of the neurocranium?
Frontal Ethmoid Sphenoid Occipital Temporal (x2) Parietal (x2)
What is included in the Viscerocranium?
The 14 facial bones
Frontal, temporal, sphenoid and ethmoid bones are pneumatised. What does this mean?
They have air in them
When does resorption of alveolar bone occur?
When a tooth is taken out and affects the bone around the other teeth
What are the boundaries of the anterior aspect of the head?
- From the forehead to the chin
- From ear to ear
What takes longer to grow: the Calavaria or the facial skeleton?
The facial skeleton
What are the 12 cranial nerves?
- Olfactory
- Optic
- Oculomotor
- Trochlear
- Trigeminal
- Abducens
- Facial
- Vestibulocochlear
- Glossopharyngeal
- Vagus
- Spinal accessory
- Hypoglossal
What does the motor branch of the trigeminal nerve innervate?
The muscles of mastication
What are the 3 sensory branches of the trigeminal nerve?
- Ophthalmic
- Maxillary
- Mandibular
What is the clinical test of the muscles of mastication?
- Ask patient to close eyes and say yes every time the feel you touching their face - testing sensation of the trigeminal nerve
- Also ask patient to clench teeth and relax in 2 areas
How many muscles are there in the face?
43 muscles in total
Muscles in the face are arranged around the orifices. What does this mean?
They are arranged around the holes of the face
What are the muscles in the face attached to?
Bone or facia then to skin - this is what allows facial expression
Which nerve are the muscles of the face supplied by?
The facial nerve
What do the muscles of the upper lip do?
- Elevate
- Retract
- Evert (pull things forward)
What do muscles of the lower lip do?
- Depress
- Retract
- Evert (pull things forward)
What is the circular muscle around the mouth?
Orbicularis oris
What is the main muscle of facial expression in the cheek?
Buccinator
If the orbicularis oris muscle is not completely intact in a patient why does this need to be operated on?
As the patient will be unable to eat or speak
What is the function of the buccinator muscle and what medical condition can affect this muscle?
- Function: push food and fluid back into the centre of the oral cavity AND muscle in charge of pushing out cheek
- this gets affected when people have a stroke
What is the palpebral part of the orbicularis oculi muscle?
Tiny muscles in eyelid - while asleep they are continuously contracted
What is the orbital part of the orbicularis oculi muscle?
Goes around eye - allows you to scrunch up eyes (protective mechanism)
What is facial palsy/paralysis?
Weakness/paralysis of the face
What is a parotidectomy?
Removal of parts or all of the parotid gland
What is facial reanimation?
How to bring peoples face back to life again - bringing function back to the face
What is Bell’s palsy?
- Facial paralysis on one side of the face: forehead, cheek and chin
- If it is a stroke it does not include the forehead
What is the most common facial neuropathy?
Bell’s palsy
- Diagnosed only if no specific cause can be identified
What is Bell’s palsy caused by?
- Controversial: don’t know why people get it - no known cause, sometimes it just happens
- Herpes simplex virus may be linked
What is Prednisolone?
- Synthetic steroid used to reduce swelling
- Can be used for Bell’s palsy
What is Acyclovir?
- Medication to treat the herpes simplex virus
- Can be used for Bell’s palsy
Where do parotid pathologies occur?
Extra-temporal portion of the facial nerve
What % of all head and neck tumours occur on the extra temporal portion of the facial nerve?
3%
What percentage of head and neck tumours (not inside the brain) are in the parotid gland?
75%-85%
What percentage of tumours in the head and neck are benign?
70%-80%
What does treatment of facial reanimation depend on?
- The level of injury
- The duration of paralysis
What are the 3 levels of facial reconstruction in terms of time duration?
- Immediate/early reconstruction (dynamic)
- Intermediate reconstruction (dynamic)
- Late reconstruction (static)
What is an anastomosis?
The connection of 2 things that are usually diverging
What is a hypoglossal - facial anastomosis used for?
- Patients with intermediate duration length facial paralysis
- Not used in long standing facial paralysis (because nerve and muscle will of died)
- Side-to-end anastomosis most popular
What does static facial reanimation use?
Autogenous fascia Lata (fibrous tissue of the thigh)
