Diessction 1-Skull, Face And Scalp

Question 1

Ophthalmic Division of the Trigeminal Nerve (V1)

Answer 1

Skin of the forehead, upper eyelids and nose

Question 2

Maxillary division of the Trigeminal Nerve (V2)

Answer 2

Skin of the lower eyelid, cheek and upper lip

Question 3

Mandibular Division of the Trigeminal Nerve (V3)

Answer 3

Skin of the lower face and part of the side of the head

Question 4

Cervical Spinal Nerves 2 and 3

Answer 4

Skin of the back of the head and the area around the ear

Question 5

Facial Nerve (CN VII)

Answer 5

Motor innervation to the muscles of facial expression

Question 6

Platysma Muscle

Answer 6

Extends into the face along the inferior border of the mandible
Inferior attachment is the superficial fascia of the upper thorax
Forms a sheet of muscle that covers the anterior neck
Superior attachment: inferior border of the mandible, skin of the cheek and angle of the mouth

Question 7

Masseter Muscle

Answer 7

Thick muscle of mastication

Question 8

Parotid duct

Answer 8

Diameter of a probe handle and it crosses the lateral surface of the masseter muscle about 2cm inferior to the zygomatic arch
Duct turns deeply at the anterior border of the masseter muscle and pierces the buccinator muscle of the cheek and drains into the oral cavity

Question 9

Facial Nerve (path)

Answer 9

Emerges from the base of the skull through the stylomastoid foramen, just deep to the inferior aspect of the ear
Branches radiate from that point
At the anterior border of the parotid gland, locate branches of the facial nerve. It exits the stylomastoid foramen and forms a plexus within the substance of the parotid gland.
From this plexus branches of the facial nerve exit the anterior border of the gland

Question 10

Branches of the Facial Nerve

Answer 10

Temporal branch (crosses the zygomatic arch)
Zygomatic branch: crosses the zygomatic bone
Buccal branches: cross the superficial surface of the masseter muscle to innervate the buccinator muscle
Mandibular branch: parallels the inferior border of the mandible
Cervical branch: crosses the angle of the mandible to enter the neck

Question 11

Facial Artery

Answer 11

Crosses the inferior border of the mandible at the anterior edge of the masseter muscle
Facial Vein is located posterior to the facial artery

(Vein is straighter and takes a more direct course to the nose while the artery is more coiled and winding)

Question 12

Branches of the facial artery

Answer 12

Inferior labial and superior labial arteries given off near the angle of the mouth

Question 13

Angular artery

Answer 13

Continuation of the facial artery at the lateral side of the nose

Question 14

Angular Vein

Answer 14

Has clinically important anastomotic connection with the ophthalmic veins in the orbit

Question 15

Orbicularis Oculi Muscle

Answer 15

Encircles the palpebral fissure (opening of the eyelid)
Medial attachment: medial orbital margin, medial palpebral ligament and the lacrimal bone
Lateral attachment: skin around the orbital margin
Innervation: Temporal and zygomatic branches of the facial nerve

Question 16

Orbital part of the Orbicularis oculi muscle

Answer 16

Surrounds the orbital margin and is responsible for the tight closure of the eyelid

Question 17

Palpebral Part of the Orbicularis Oculi Muscle

Answer 17

A thinner portion, which is contained in the eyelids and is responsible for blinking of the eyelid

Question 18

Orbicularis Oris Muscle

Answer 18

Medial attachments to the maxilla, mandible and skin in the median plane and a lateral attachment to the angle of the mouth
It’s a sphincter of the mouth

Question 19

Buccinator Muscle

Answer 19

Has proximal attachments to the pterygomandibular raphe and the lateral surfaces of the alveolar processes of the maxilla and mandible
distal: angle of the mouth
Compresses the cheek against the molar teeth, keeping food on the occlusal surfaces during chewing

Question 20

Levator Labii Superioris Muscle

Answer 20

Has a superior attachment to the maxilla just below the orbital margin and an inferior attachment to the upper lip. It elevates the upper lip

Question 21

Zygomaticus Major Muscle

Answer 21

Has a lateral attachment to the zygomatic bone and a medial attachment to the angle of the mouth. It draws the angle of the mouth superiorly and posteriorly

Question 22

Depressor Anguli oris muscle

Answer 22

Has an inferior attachment to the mandible and a superior attachment to the angle of the mouth (corner of the mouth) it depresses the angle of the mouth

Question 23

Risorius

Answer 23

Arises from the parotid fascia and buccal skin and inserts into the angle of the mouth; retracts the angle of the mouth to produce a smile

Question 24

Levator anguli oris

Answer 24

Arises from infraoribtal maxilla and inserts into the angle of the mouth; elevates the angle of the mouth

Question 25

Facial Nerve Bell’s palsy

Answer 25

Sudden loss of control of the muscles of facial expression on one side of the face. The patient presents with a drooping of the mouth and inability to close the eyelid on the affected side

Question 26

Supraorbital Nerve

Answer 26

A branch of the ophthalmic division (V1) of the trigeminal nerve that passes through the supraorbital notch. It is seen when the scalp is studied

Question 27

Infraorbital Nerve

Answer 27

A branch of the maxillary division of the Trigeminal nerve (V2) that passes through the infraorbital foramen. It supplies sensory innervation to the inferior eyelid, side of the nose and upper lip

Question 28

Mental Nerve

Answer 28

A branch of the mandibular division of the trigeminal nerve (V3) that passes through the mental foramen
Sensory innervation to the lower lip and chin

Question 29

Mental Nerve, artery and vein

Answer 29

All exit the mental foramen

Question 30

Dental Anesthesia

Answer 30

Study the infraorbital foramen and infraorbital canal in the skull. For purposes of dental anesthesia, the infraorbital nerve may be infiltrated where it emerges from the infraorbital foramen. The needle is inserted through the oral mucosa deep to the upper lip and directed superiorly

Question 31

Layers of the Scalp

Answer 31

Skin
SubQ Connective tissue: contains vessels and nerves of scalp
Aponeurosis (epicranial aponeurosis): connecting the frontalis muscle to the occipitalis muscle
Loose Connective Tissue: Permits the scalp to move over the calvaria
Pericranium: the outer periosteum of the cranial bones

Question 32

Scalp (in the clinic)

Answer 32

The CT layer of the scalp contains collagen fibers that attach to the external surface of blood vessels. When a blood vessel of the scalp is cut, the CT holds the lumen open, resulting in profuse bleeding. If an infection occurs in the scalp, it can spread within the loose CT layer. Therefore the loose CT layer is often called the “dangerous area”. From the “dangerous area” the infection may pass into the cranial cavity through emissary veins

Question 33

Occipitalis

Answer 33

Inferior attachment: occipital bone
Superior: epicranial aponeurosis (galea aponeurotica)
innervation: facial nerve

Question 34

Frontalis

Answer 34

Superior attachment: epicranial aponeurosis
inferior: skin of the forehead and eyebrows
Innervation: facial nerve

Question 35

Supraorbital nerve, artery and vein

Answer 35

Exit the supraorbital notch and enter the deep surface of the scalp