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SPINE > Deep Face Anatomy > Flashcards

Deep Face Anatomy Flashcards

1
Q

What makes up the temporomandibular joint?
What type of joint is it?

A

Is a synovial joint
Articulation between the condylar process of the mandible and the mandibular fossa of the temporal bone
Joint is separated by a fibrocartilagenous disc.

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2
Q

What are the different types of movement that can occur at the temporomandibular joint?

A

Rotation - around the horizontal axis (aka spike through cheeks)
Translation - movement of candylar head - protraction, retraction, depression, elevation, lateral etc

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3
Q

What movements must proceed depression of the mandible?

A

Rotation of the condylar head in the horizontal axis
Translation of he andylar head anteriorly onto the articular eminence.

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4
Q

What is the funcation of the temporalis muscle related to massication?

A

Elevation and retraction of the mandible

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5
Q

What is the funcation of the masster muscle in relation to the mandible?

A

Elevation of the mandible

Partial protractor

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6
Q

What is the function of the lateral pterygoid muscle in relation to the mandible?

A

Extends from condylar neck of mandible to lateral pterygoid plate
Protrusion of the condylar neck
Depression of the mandible
Also enables side-to-side movement (to the contralateral side)
Essential for opening the jaw

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7
Q

What muscles are found within the infratemporal fossa?

A

Medial pterygoid
Lateral pterygoid
Temporalis

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8
Q

What is the function of the medial pterygoid relating to the muscles of mastication?

A

Extends from the angle of the mandible to the medial surface of the lateral pterygoid plate.
Elevates the mandible
Essential for closing the jaw
Fibre orientation allows for side-to-side movement (pull to the contralateral side)

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9
Q

What is the function of the meningeal nerve?

A

Supplies the dura mater in the middle cranial fossa
Follows the course of the middle meningeal artery.

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10
Q

What nerve supplies the muscles of massication?

A

The anterior division of the mandibular nerve
- nerve to lateral pterygoid
- nerve to masster
- deep temporal nerves
- nerve to medial pterygoid
(note also has a branch to tensor veli palatini)

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11
Q

What is the function of the buccal nerve?

A

General sensory fibres to the skin and the mucosa of the cheek deep to the buccinator muscle
Is a branch of the mandibular nerve

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12
Q

What is the purpose of the inferior alveolar branch? (nerve)

A

Part of the posterior division of the mandibular nerve
Supplies the mandibular gums and teeth.
Continues through the mandibular canal as to emerge through the mental foramen as the mental nerve to supply the skin of the mandibular region.

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13
Q

What provides taste to the anterio 2/3 of the tongue?

A

The facial nerve (CN7)
Transmitted by chorda tympani which is carried by the lingual nerve (CNV)

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14
Q

What provides general sensation to the anterior 2/3 of the tongue?

A

Lingual branch of the mandibular nerve (CNV3)

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15
Q

What nerves are important to know about as branches of the posterior division of the mandibular nerve?

A

Lingual branch (sensory)
Nerve to mylohyoid (motor)
Inferior alveloar nerve -> mental nerve) - sensory
Auriculotemporal nerve. (sensory)

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16
Q

What nerves are found in the infratemporal fossa?

A

The anterior and posterior division of the mandibular nerve (CNV3)
Chorda tympani
Otic ganglion

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17
Q

What are the boundaries of the infratemporal fossa?

A

Ant - post surface of maxilla
Post - tympanic plate, mastoid and styloid process.
Med - lateral pterygoid plate of sphenoid bone
Lat - ramus of mandibule
Sup - greater wing of sphenoid bone + temporal bone

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18
Q

What vasculature is found within the infratemporal fossa?

A

Maxillary artery (and branches)
Maxillary vein (tributaries) + pterygoid venous plexus

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19
Q

What are some important branches of the maxillary artery?

A

Middle meningeal
Descending palatine
Sphenopalatine

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20
Q

What does the sphenopalatine artery supply?

A

The lateral wall of the nasal cavity and contribute to the paranasal sinuses
The superior portion of the nasal cavity septum - anastomose with the des palatine.

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21
Q

What does the descending palatine artery supply?

A

Supplies the soft and the hard palate

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22
Q

Label the image to show what bones can be seen from the anterior view of the skeleton within the nasal cavity

A

Pink - nasal
Green - ethmoid
Blue - maxilla
Red - vomer

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23
Q

What are the basic different regions within the nasal cavity?

A

Nasal vestibules (nares)
Respiratory regions
Olfactory regions (superiorly)

Middle septum - means left and right of each region.

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24
Q

What is the basic function of each region of the nasal cavity?

A

Vestibule - stratified squamous keratinised - filtration of air, traps particles in hair.
Respiratory - pseudostratified columnar epi - trap in cilia, move to posterior nasal apertures to cough or sneeze out
Olfactory - bipolar olfactory cells, columnar cells and basal cells.

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25
Q

Describe the medial wall of the nasal cavity

A

May also be referrred to as the nasal septum
Posteriorly made of the ethmoid and vomer bones
Anteriorly the septal cartilage
All is covered in a mucosal layer.

26
Q

Label the key bony features that make up the lateral wall of the nasal cavity

A

Septal cartilage
Nasal bones
Maxilla
Lacrimal bone
Ethmoid bone
Sphenoid bone
Palatine bone
Inferior conchae

27
Q

What type of cartilage is found in the nose?

A

Hyaline

28
Q

What is the function of the nasal conchae?

A

Create passages called meatuses (sup, middle and inferior meatus)
THe spehnoethmoidal recess is found superior to the superior meatus.
Function to warm and humidity air
Lined with mucosa and highly vascularised.

29
Q

What are the starred areas on this image?

A

The frontal sinus
The orbit
The maxillary sinus

30
Q

Label this coronal section of the nasal cavity

A

The frontal bone
THe cristal gali - ethmoid bone
Superior conchae
Ethmoid bulla
Middle conchae
Maxilla
Zygomatic bone
Vomer
Inferior conchae
Maxilla

31
Q

Please label the starred sections of the image

A

Frontal sinus
Sphenoidal sinus

32
Q

What is a paranasal sinus?
What is their function?

A

An air-filled space within the facial bones, lined by a mucous membrane
Decrease weight of the skull, increased vocal resonance, air conditioning, insulation.

33
Q

What paranasal sinus is most frequently infected?

A

The maxillary sinus

34
Q

What are the different paranasal sinuses?

A

Frontal sinuses
Sphenoidal sinuses
Ethmoid air cells
Maxillary sinuses

35
Q

What are some potential routes of infection spread in the lateral wall of the nasal cavity?

A

The orifice of the maxillary sinus (found in the middle meatus)
The opening of the pharyngotympanic tube.

36
Q

What drains into the middle meatus of the nasal cavity?

A

The frontonasal, maxillary and some ethmoidal sinuses drain into the middle meatus.

37
Q

What drains into each meatus/region of the nasal cavity?

A

Sphenoethmoidal recess -> the sphenoid sinus
The superior meatus -> the posterior group of ethmoid air cells
The middle meatus - the bulbar sinuses , maxillary sinus and frontal nasal ducts.
The inferior nasal conchae - orifice of nasolacrimal duct.

38
Q

Give an overview of the two main origin contributions to the blood supply to the nasal cavity

A

Internal carotid contributes via branches of the ophthalmic artery (the posterior and anterior ethmoidal artery)
External carotid contributes by branches from the maxillary artery.

39
Q

What is meant by little areas?

A

Also known as Kiesselbachs plexus - rich blood supply from anastomosis of the internal and external carotid arteries.
Common areas for epistaxis.

40
Q

What is meant by anterior and posterior epistaxis?
Which is more dangerous?

A

Epistaxis = nosebleed
Anterior - blood leaves the nasal cavity through the anterior nasal orifice
Posterior - leaves through conchae and interior nasopharnyx, can lot and enter the lungs leading to aspiration hence is more dangerous.

41
Q

What are some basic methods of support for epistaxis?

A

Anterior - nipping the fleshy bridge, vasoconstrictors, ice pack. Or nasal tampon
Posterior - pack with gauze, foley catheter to prevent blood movement

42
Q

What vasculature tends to be responsible for posterior epistaxis?

A

Woodruffs plexus - venous plexus

located on the posterior end of the inferior meatus lateral side

43
Q

What is meant by the danger triangle of the face?

A

Triangle shape from upper libs to top of nose.
The veins of the nose drain directly into the nasal cavity
Facial vein has no valves, norm drains inferiorly eventually in jugular vein, however may flow in opposite direction.
Potential route for infection to spread to the brain and face.
Inflammation of the facial vein can cause clots - these may also spread upwards.

44
Q

What is the nerve supply to the nasal cavity?

A

Smell = olfactory nerve CN1
General sensation is provided by CNV1 and CNV2.

45
Q

Describe the basics of general sensation nervous supply to the nasal cavity/

A

Anterior ethmoid nerve from opthalmic division of CNV supplies the superior/anterior region of the lateral wall
The septal branches of this supply the anterior septum

CNV2 has many branches - including nasopalatine (septum) and lateral nasal, infera-orbital and superior alveolar nerve (lateral)

For reference do not try to learn.

46
Q

Describe blood supply to the nasal cavity

A
47
Q

What is the relevance of the ophthalmic nerve to the innervation of the nose?

A

Ophthalmic nerve has a nasociliary branch after it exist the supraorbital fissure.
Nasociliary nerve gives rise to the anterior and posterior ethmoidal branches.

48
Q

Describe the parasympathetic innervation to the nasal cavity.

A

Preganglionic secretomotor fibres from the facial nerve (Via greater petrosal) synapse in the pterygopalatine ganglion
Postganglionic distributed on existing nerves (V2)
Synapse on glands of the nasal cavity and paranasal sinuses

49
Q

Describe the sympathetic innervation of the nasal cavity

A

Preganglionic from the sympathetic chain ascend and synapse in the superior cervical ganglion
Post-ganglionic axons project along the path of the internal carotid artery
Then leave to form the deep petrosal nerve, this joints the greater petrosal nerve (as passes through the pterygopalatine ganglion) to follow fibres from CNV2 and synapse on glands.

50
Q

What is the clinical treatment for nasal fractures?

A

Minor = analgesia and anti-inflammatories
Major = requires realignment

51
Q

How to treat trubinate hypertrophy?

A

Streoids to reduce mucosal inflammation/nasal congestion
Turbinate education (surgical)

52
Q

How to treat anosmia?

A

Treatments for nasal congestion may help
Limited recovery after head trauma.

53
Q

What ligaments support the TMJ?
What do they do?

A

Sphenomandibular - limits depression + lateral movement of the mandible
Tempormandibular - prevents posterior dislocation,
Stylomandibular - prevents anterior dislocation + limits lateral movement

54
Q

Please label the relevant parts of the CN1 in the nasal cavity

A

From left to right
The olfactory bulb
The olfactory nerve
The olfactory nerve septal branches

(yellow labels)

55
Q

Please label the relevant parts of the ophthalmic (CNV1) nerve in the nasal cavity.

A

External nasal branch of anterior ethmoid
Anterior ethmoid
Septal branch of anterior ethmoidal nerve

Left ro right
Red labels

56
Q

Please label the relevant aprts of the maxillary nerve CNV2 within the nasal cavity.

A

The internal nasal branches of the infra-orbital nerve
Nasal branch of superior alvolar nerve
Posterior inferior lateral nasal nerves
Posterior superior lateral nasal nerves
Nasopalatine nerve

Left to right
Orange labels.

57
Q

Describe the basic venous drainage of the face

A

The inferior opthalmic vein (orbit) and the nasal cavity drain into the facial vein.
Facial vein may drain into the internal jugular vein directly
Or the deep facial vein may drain into the pterygoid plexus - this has connections to the intracranial circulation via the missionary veins through the meninges into the cavernous sinus. Or drains into the external jugular directly
Note the facial vein has no vavles so blood can drain in both directions
Acts as a potential route for the spread of infection.

58
Q

What is the physiological process underpinning a sneeze?

A

Stimulation of bare nerve endings in the nasal mucosa
Signal up to brain via trigeminal nerve
Efferent signal is reflexive
Large inspiratory action (abdomuscles)
Causes expiration against a closed glottis (vocal cords closed), increasing pressure
Tongue closes off mouth
Rapid and abrupt expulsion of air when glottis and vocal cords snap open- creates sound and sneeze as pressure expels air from nose

59
Q

What are some common causes of epistaxis?

A

Trauma
Drug use (cocaine)
Recent surgery
Tumours
Inflammation (rhinosinitis or nasal polyps)
Bleeding diathesis

60
Q

What muscles are supplied by the mandibular nerve?

A

The muscles of mastication (masseter, temporalis, lateral and medial pterygoid).
Alongside the tensor veli tympani, levator veli palatine, anterior body of digastric and mylohyoid.

61
Q

What are the four extrinsic muscles of the tongue?
What are their function?

A

Styloglossus - elevates and retrude tongue
Palatoglossus - elevate tongue, bring palatoglossus arches together
Genioglossus - protudes and depresses the tongue
Hyoglossues - depresses the tongue

SPINE (23 decks)

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