Face Flashcards
What is the function of the eye ?
For vision
What is the function of the nose ?
Part of the upper respiratory tract and for olfaction
What is the function of the mouth ?
Taste and digestion
What is the function of the ear ?
Hearing and balance
Why is the face important ?
- allows recognition
- conveys mood by facial expression
How is the shape of the face determined ?
By the underlying bones
Name some bones of the facial skeleton
- nasal
- lacrimal
- zygomatic
- vomer
- maxilla
- mandible
- inferior conchae
What forms the middle 1/3 of the face ?
The maxilla
How is the facial skeleton divided ?
By Le Fort fractures
What are the 3 Le fort fractures ?
- Le Fort I
- Le Fort II
- Le Fort III
Summarise Le Fort I
- mildest fracture
- linear fracture
- separates the hard palate from the rest of the face
Summarise Le Fort II
- pyramidal fracture
- the apex is at the level of the nasal bone
- the base is from the maxilla
- it misses the orbit but slightly involves the floor of the orbit
Summarise Le Fort III
- most severe fracture
- pretty much the whole face will be dissociated
- starts at the nasal bone but involves the medial, posterior and inferior border of the orbit
- spares the superior orbital fissure
- CSF leak can occur
Which nerve supplies the skin over the face ?
- the trigeminal nerve
What are the 5 branches of the ophthalmic division of the trigeminal nerve ?
- Supratrochlear
- Lacrimal
- Infratrochlear
- External nasal
- Supraorbital
What are the 3 branches of the maxillary division of the trigeminal nerve ?
- Zygomaticotemporal
- Zygomaticofacial
- Infraorbital
What are the 3 branches of the mandibular division of the trigeminal nerve ?
- Auriculotemporal
- Buccal
- Mental
What is the test for the ophthalmic division of the trigeminal nerve ?
Corneal reflex - the whites of the sclera are touched with cotton and there is a blinking reflex
What is the test for the maxillary division of the trigeminal nerve ?
Fine touch - close eyes and touch the territories of V2
What is the test for the mandibular division of the trigeminal nerve ?
Motor - clench jaw so masseter becomes prominent
What are the 2 groups of facial muscles ?
- muscles of facial expression
- muscles of mastication
What is the innervation of the muscles of facial expression ?
Innervated by the facial nerve
What is the innervation of the muscles of mastication ?
Innervated by the mandibular division of the trigeminal nerve
What is the function of the depressor labii inferioris ?
Lowers the lower lip
What are the different parts of the orbicularis oculi ?
- palpebral part
- lacrimal part
- orbital part
What is the function of the depressor anguli oris ?
Depresses the corners of the mouth
What is the function of the frontal belly of the occipitofrontalis ?
Frowning and raising the eyebrows
Why do cheek dimples form ?
Because the zygomaticus major is short or split
Why do chin dimples form ?
Because the mentalis hasn’t fused properly in the midline
What are the muscles of mastication ?
- temporalis
- masseter
- medial and lateral pterygoids
Describe the route of the facial nerve
- emerges via the stylomastoid foramen
- runs through the parotid gland
How is the superficial and deep lobes of the parotid gland differentiated ?
The facial nerve is used as a landmark to differentiate
What are the 5 branches of the facial nerve ?
1) temporal
2) zygomatic
3) buccal
4) marginal mandibular
5) cervical
What does occlusion mean ?
Occlusion is when the teeth in the mandibular arch come into contact with those in the maxillary arch in any functional relation
What is Angle’s classification of occlusion ?
The mesiobuccal cusp of the upper first molar should align with the buccal groove of the mandibular first molar in a normal occlusion
What is meant by malocclusion ?
Anything which deviates from a normal occlusion
Summarise Classe I of Angle’s classification
The maxillary first molar is moved back
Summarise Classe II of Angle’s classification
The maxillary first molar is moved in front and this is known as an overbite
Summarise Classe III of Angle’s classification
The mandibular first molar is moved in front and this is known as an underbite
What is bone resorption ?
With age the bone density decreases and the distance between the nose and chin may decrease due to tooth and bone loss
What are the consequences of the mental foramen moving closer to the surface of the teeth due to bone resorption ?
The mental foramen is a passage for the mental nerve which is a sensory nerve and so if this nerve was pushed down the person would experience more pain
What is the function of the parotid gland ?
It produces saliva - secretions are serous in nature meaning they are watery and enzymatic
What is the largest salivary gland ?
The parotid gland
Describe the structure of the parotid gland
- it has 2 lobes : superficial and deep
- it is pyramid shaped
- it is surrounded by a fibrous capsule
- it is associated with the stylomandibular ligament
What is mumps disease ?
It occurs due to swelling of the parotid gland
Describe the course of the parotid duct
- starts at the anterior sulcus of the parotid gland
- crosses the masseter
- pierces the buccinator
- opens by the maxillary 2nd molar
- can be an accessory gland
What are the 3 structures associated with the parotid duct ?
- facial nerve
- retromandibular vein
- external carotid artery
Describe the innervation of the parotid gland
- the facial nerve is embedded in the parotid gland but it doesn’t innervation it
Sensory innervation -
- auriculotemporal nerve (branch of V3)
- greater auricular nerve (cervical plexus)
Parasympathetic innervation -
- presynaptic from the lesser petrosal nerve
- postsynaptic from the auriculotemporal nerve
Why is the facial artery slightly wiggly ?
Because it is found on bone which can move is it gives the artery stretch so it doesn’t snap
Why is the facial artery pulsated ?
It is a superficial artery and it is found over a bone so it doesn’t push down when pressed
Which artery does the facial artery anastomose with ?
It anastomoses with terminal branches of the ophthalmic artery
Summarise the danger triangle of the face
It is a triangle on the face including the nose and upper lip
- this area of the face contains emissary veins meaning if any spots in this area get infected then the infection will spread to the brain
What are emissary veins ?
Emissary veins are veins which connect intercranial and extracranial veins
What are the advantages of emissary veins ?
They can have a cooling effect on the brain
What are the disadvantages of emissary veins ?
They don’t have any valves so infection can reach the cavernous sinus in the skull
What is the function of the orbicularis oculi ?
closes the eyelids gently
What is the function of the orbicularis oris ?
closes the lips or protrudes the lips
What is the function of the zygomaticus major ?
draws the corners of the mouth upwards and laterally
What is the nerve supply of the buccintor muscle ?
facial nerve
Which nerve innervates the skin over the parotid gland ?
Auricular temporal nerve - branch of V3
Give an extra function of the facial nerve
special sensory innervation to the anterior 2/3 of the tongue
