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Head and Neck Anatomy > Face > Flashcards

Face Flashcards

1
Q

What is the intracranial course of the facial nerve?

A

Originates between the pons and medulla > Internal acoustic meatus >Facial canal (petrous part of the temporal bone) >exists through the stylomastoid foramen

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2
Q

Branches of the facial nerve

A

Divides into 5 branches within the parotid gland
- Temporal
- Zygomatic
- Buccal
- Marginal mandibular
- Cervical

Branches before entering the parotid gland
- Digastric
- Posterior auricular
- Cervicofacial
- Temporofacial

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3
Q

Which cranial nerves transmit parasympathetic fibres?

A

Oculomotor, glossopharyngeal, vagus and facial

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4
Q

What is the surface anatomy of the parotid duct?

A

The middle third of a line drawn between the intertragic notch and the middle of the philtrum

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5
Q

Where does the parotid duct open?

A

Crosses the masseter, pierces the buccinator and opens adjacent to the upper 2nd molar (stensen’s duct)

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6
Q

Which structures pass through the parotid gland?

A

Facial nerve (most superficial structure)
External carotid artery
Retormandibular vein
Auriculotemporal nerve
Deep parotid lymph nodes

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7
Q

What are the relations of the parotid gland?

A

Anterior - masseter, medial pterygoid, superficial temporal and maxillary arteries, facial nerve and stylomandibular ligament

Posterior - posterior belly of digastric muscles, SCM, Stylohyoid, internal carotid artery, mastoid process and styloid process

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8
Q

What is the arterial supply of the parotid gland?

A

Branches of the external carotid artery

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9
Q

What is the venous drainage of the parotid gland?

A

Retromandibular vein (union of the superficial temporal and maxillary veins)

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10
Q

What is the lymphatic drainage of the parotid gland?

A

Deep and superficial parotid LN > upper and lower deep cervical lymph nodes

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11
Q

What is the innervation of the parotid gland?

A

Parasympathetic - secretomotor from the otic ganglion
Sympathetic - superior cervical ganglion
Sensory - greater auricular nerve

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12
Q

What is the surface anatomy of the parotid gland

A

Upper end - curved line from the tragus to the centre of the mastoid bone
Anterior border - a line from the tragus to the centre of the posterior border of the masseter then to the point 2cm below and behind the angle of the mandible

Posterior - straight line from the mastoid process to a point 2cm below and behind the angle of the mandible

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13
Q

What type of secretions does the parotid gland produce?

A

Serous

parasympathetic stimulation produces watery serous saliva
Sympathetic stimulation produces low volume, enzyme rich saliva

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14
Q

Name some differential diagnoses of a parotid swelling

A

Infection - parotitis, mumps
Obstructed duct - calculi, external compression
Neoplasm- pleomorphic adenoma, warthin’s tumour
Deep parotid lymph node

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15
Q

What is Frey syndrome?

A

Damage to the parasympathetic fibres from the auriculotemporal nerve results in excessive gustatory sweating in response to saliva production

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16
Q

Where can the facial artery be palpated

A

Where it crosses the inferior border of the mandible adjacent to the anterior border of the masseter

17
Q

Where is the submandibular duct opening located?

A

Opens in the floor of the mouth on either side of the lingual frenulum

18
Q

What type of secretions does the submandibular gland produce?

A

Mucous and serous

19
Q

Which nerves are at risk on submandibular gland excision?

A

Lingual nerve
Hypoglossal nerve > leads to deviation of the tongue towards the affected side on protrusion
Marginal mandibular branch of the facial nerve

20
Q

What is the difference between and UMN and LMN facial palsy?

A

UMN lesions spare the upper part of the face
LMN - all parts of the face are involved

21
Q

Which regions are drained by the pre-aurciular LNs

A

Upper half of the face
Temporal region
Auricle and EAM
Gums

22
Q

What is the nerve supply of the tongue?

A

Motor
- Hypoglossal nerve
- except for palatoglossus which is innervated by the vagus nerve

Sensory
- Posterior root of the tongue > vagus
- anterior 2/3 - mandibular nerve via the lingual
- posterior1/3 - glossopharyngeal

Taste
- posterior root of the tongue - vagus
- anterior 2/3 of the tongue - glossopharyngeal
- posterior 1/3 of the tongue - Facial nerve via chorda tympani

23
Q

Name the extrinsic muscles of the tongue

A

Styloglossus
hyloglossus
genioglossus
palatoglossus

24
Q

Which muscle retracts the tongue?

A

Styloglossus

25
Q

Which is the nerve supply to the tongue

A

All extrinsic muscles are innervated by hypoglossal nerve except for palatoglossus which is innervated by the vagus nerve

26
Q

What forms the roof of the middle ear?

A

Tegmen tympani

27
Q

How do middle ear infections cross the skull?

A

By direct erosion of the tegmen tympani which allows spread to the mastoid air cells causing mastoiditis

28
Q

Describe the clinical picture of meningism

A

Photophobia
Stiff neck
Fever

29
Q

Which structures pass through the IAM?

A

Facial nerve
Vesticubulocochlear nerve

30
Q

What disease process can lead to irreversible damage of the CN VIII?

A

Acoustic neuroma

31
Q

Why do patients with acoustic neuromas hear sounds loudly on the affected side?

A

They often have involvement of the facial nerve with paralysis of stapedius

32
Q

What are the relations of the middle ear?

A

Roof - Tegmen tympani- separates the tympanic cavity from the MCF

Floor - thin bone separates the tympanic cavity from the superior bulb of the IJV

Anterior wall - Thin bone, separates the tympanic cavity from the ICA. At upper part there are openings into two canals - auditory tube and canal for tensor tympani

Posterior - Aditus to the mastoid antrum superiorly and pyramid inferiorly

Lateral wall - tympanic membrane and lateral wall of epitympanic recess

Medial wall - lateral wall of the inner ear

Head and Neck Anatomy (4 decks)

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