Clinical Anatomy of the Face

Question 1

What are the 2 parts of the cranium?

Answer 1

• Neurocranium

- Viscerocranium

Question 2

What is the neurocranium?

Answer 2

• bony covering of the brain and meninges

Question 3

What is the roof of the neurocranium called?

Answer 3

Calavaria

Question 4

What is the floor of the neurocranium called?

Answer 4

Cranial base

Question 5

What are the 8 bones of the neurocranium?

Answer 5

Frontal 
Ethmoid 
Sphenoid 
Occipital 
Temporal (x2)
Parietal (x2)

Question 6

What is included in the Viscerocranium?

Answer 6

The 14 facial bones

Question 7

Frontal, temporal, sphenoid and ethmoid bones are pneumatised. What does this mean?

Answer 7

They have air in them

Question 8

When does resorption of alveolar bone occur?

Answer 8

When a tooth is taken out and affects the bone around the other teeth

Question 9

What are the boundaries of the anterior aspect of the head?

Answer 9

• From the forehead to the chin

- From ear to ear

Question 10

What takes longer to grow: the Calavaria or the facial skeleton?

Answer 10

The facial skeleton

Question 11

What are the 12 cranial nerves?

Answer 11

1. Olfactory
2. Optic
3. Oculomotor
4. Trochlear
5. Trigeminal
6. Abducens
7. Facial
8. Vestibulocochlear
9. Glossopharyngeal
10. Vagus
11. Spinal accessory
12. Hypoglossal

Question 12

What does the motor branch of the trigeminal nerve innervate?

Answer 12

The muscles of mastication

Question 13

What are the 3 sensory branches of the trigeminal nerve?

Answer 13

• Ophthalmic
• Maxillary
• Mandibular

Question 14

What is the clinical test of the muscles of mastication?

Answer 14

• 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

Question 15

How many muscles are there in the face?

Answer 15

43 muscles in total

Question 16

Muscles in the face are arranged around the orifices. What does this mean?

Answer 16

They are arranged around the holes of the face

Question 17

What are the muscles in the face attached to?

Answer 17

Bone or facia then to skin - this is what allows facial expression

Question 18

Which nerve are the muscles of the face supplied by?

Answer 18

The facial nerve

Question 19

What do the muscles of the upper lip do?

Answer 19

• Elevate
• Retract
• Evert (pull things forward)

Question 20

What do muscles of the lower lip do?

Answer 20

• Depress
• Retract
• Evert (pull things forward)

Question 21

What is the circular muscle around the mouth?

Answer 21

Orbicularis oris

Question 22

What is the main muscle of facial expression in the cheek?

Answer 22

Buccinator

Question 23

If the orbicularis oris muscle is not completely intact in a patient why does this need to be operated on?

Answer 23

As the patient will be unable to eat or speak

Question 24

What is the function of the buccinator muscle and what medical condition can affect this muscle?

Answer 24

• 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

Question 25

What is the palpebral part of the orbicularis oculi muscle?

Answer 25

Tiny muscles in eyelid - while asleep they are continuously contracted

Question 26

What is the orbital part of the orbicularis oculi muscle?

Answer 26

Goes around eye - allows you to scrunch up eyes (protective mechanism)

Question 27

What is facial palsy/paralysis?

Answer 27

Weakness/paralysis of the face

Question 28

What is a parotidectomy?

Answer 28

Removal of parts or all of the parotid gland

Question 29

What is facial reanimation?

Answer 29

How to bring peoples face back to life again - bringing function back to the face

Question 30

What is Bell's palsy?

Answer 30

- Facial paralysis on one side of the face: forehead, cheek and chin - If it is a stroke it does not include the forehead

Question 31

What is the most common facial neuropathy?

Answer 31

Bell's palsy | - Diagnosed only if no specific cause can be identified

Question 32

What is Bell's palsy caused by?

Answer 32

- Controversial: don't know why people get it - no known cause, sometimes it just happens - Herpes simplex virus may be linked

Question 33

What is Prednisolone?

Answer 33

- Synthetic steroid used to reduce swelling | - Can be used for Bell's palsy

Question 34

What is Acyclovir?

Answer 34

- Medication to treat the herpes simplex virus | - Can be used for Bell's palsy

Question 35

Where do parotid pathologies occur?

Answer 35

Extra-temporal portion of the facial nerve

Question 36

What % of all head and neck tumours occur on the extra temporal portion of the facial nerve?

Answer 36

3%

Question 37

What percentage of head and neck tumours (not inside the brain) are in the parotid gland?

Answer 37

75%-85%

Question 38

What percentage of tumours in the head and neck are benign?

Answer 38

70%-80%

Question 39

What does treatment of facial reanimation depend on?

Answer 39

- The level of injury | - The duration of paralysis

Question 40

What are the 3 levels of facial reconstruction in terms of time duration?

Answer 40

- Immediate/early reconstruction (dynamic) - Intermediate reconstruction (dynamic) - Late reconstruction (static)

Question 41

What is an anastomosis?

Answer 41

The connection of 2 things that are usually diverging

Question 42

What is a hypoglossal - facial anastomosis used for?

Answer 42

- 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

Question 43

What does static facial reanimation use?

Answer 43

Autogenous fascia Lata (fibrous tissue of the thigh)