Face Flashcards
How many bones are in the skull?
22
What are the two categories of skull bones?
Neurocranium
Viscerocranium
What are the neurocranium bones?
cranial vault
parietal temporal frontal occipital sphenoid ethmoid
What are the viscerocranium bones of the skull?
face
mandible maxilla palatine zygomatic lacrimal vomer nasal
Where do the muscles of the facial expression originate and insert?
Originate from bone
Insert into skin
What innervates ALL of the muscles of facial expression?
same motor innervation
Facial nerve CN 7
through parotid gland
Frontalis
Origin: occipital: highest nuchal line and mastoid process, Frontal: superior fibers of upper fascial muscles
Insertion: galeal aponeurosis
Action: wrinkles forehead and fixes galeal aponeurosis
Nerve: posterior auricular and temporal branches of facial VII
lifts up eye brows
Orbicularis oculi
upper eyelid pulls up
closes eye
circular muscle so constricts opening
Origin: medial orbital margin and lacrimal sac
Insertion: lateral palpebral raphe
Action: closes eyelids, aids passage and drainage of tears
Nerve: temporal and zygomatic branches of facial nerve VII
Is there a muscle that pulls the lower lid up?
NO
Zygomaticus major
from zygomatic process
pulls mouth back and up
Origin: anterior surface of zygomatic bone
Insertion: modiolus at angle of mouth
Action: elevates and draws angle of mouth laterally
Nerve: buccal branch of facial nerve VII
buccinator
deep muscle
insert into upper and lower lip
into “modailis”
chewing muscle
Origin: External alveolar margins of maxilla and mandible by molar teeth, to maxillary tubercle and pterygoid hamulus and posterior mylohyoid line respectively, then via pterygomandibular raphe between bones
Insertion: decussates at modiolus of mouth and intedigitates with opposite side
Action: aids mastiction, tenses cheeks in blowing and whistling, aids closure of mouth
Nerve: buccal branch of facial nerve VII
What pierces the buccinator?
parotid duct
What does sensory innervation for the face?
Trigeminal nerve CN V
3 divisions with branches
Where does facial nerve CN V7 exit skull?
stylomastoid foramen
Orbicularis oris
Origin: Near midline on anterior surface of maxilla and mandible and modiolus at angle of mouth
Insertion: mucous membrane of margin of kips and raohe with buccinator at modiolus
Action: narrows orifice of mouth, purses lips and puckers lip edges
Nerve: accessory parts are incisivus labii superioris and inferioris
What are the 5 major branches of the facial nerve?
Temporal (ten) zygomatic (zebras) buccal (bashed) marginal/mandibular (my) cervical (car)- platysma
What happens if the facial nerve is damaged?
Bell’s palsy
if need to remove parotid gland or inflammation near stylomastoid foramen
flaccid muscles so smooth
What happens if the facial nerve is damaged?
Bell’s palsy
if need to remove parotid gland or inflammation near stylomastoid foramen
flaccid muscles so smooth
What are the 3 divisions of the trigeminal nerve?
- ophthalmic
- maxillary
- mandibular
What is the difference between buccal facial and buccal trigeminal?
Facial- motor only
trigeminal- sensory only
What does auriculo temporal run with?
superficial temporal artery
What exit points line up?
supraorbital
infraorbital
mental
Where does the ophthalmic division V1 go?
purely sensory
passes through the cavernous sinus
exit through superior orbital fissure
What are the terminal branches of V1?
LaSSIE
Lacrimal- structures superior to the lateral canthus of the eyes
Supraorbital- superior to the orbit
supratrochlear- superior to the medial canthus of the eye
infratrochlear- the region of the medial canthus
external nasal- anterior and lateral aspect of the external nose
Where does maxillary division of V2 go?
Purely sensory
passes through cavernous sinus
leaves skull through foramen rotundum
What are the branches of maxillary division?
Zygomaticotemporal- lateral and superior to orbit
Zygomaticofacial- lateral and inferior to the orbit
Infraorbital- large nerve inferior to the orbit
Alveolar nerves (posterior superior, middle superior, anterior superior)
Where does the mandibular V3 branch go?
Sensory AND motor
leaves skull through formen ovale
enter infratemporal fossa
divides into anterior and posterior divisions
What are the divisions of mandibular V3?
posterior- 1ry sensory
auriculotemporal- anterior to ear and superiorly into temporal region (carries parasympathetic secetomotor fibers)
lingual- oral cavity
inferior alveolar/mental- teeth and upper lip
Anterior= 1ry motor
buccal- sensory to cheek and oral mucosa
What is the parotid gland?
large superficially located salivary gland
secretes serous fluid via the parotid duct
What is the parotid duct?
stensons duct
pierces the buccinator muscle
enters the oral cavity adjacent to the upper 2nd molar
What innervates the parotid gland?
parasympathetic GLOAP
glossopharyngeal nerve IX- travels in lesser petrosal nerve- synapses in otic ganglion (exiting foramen ovale)- travel in auriculotemporal nerve- to innervate parotid gland
What is the main arterial supply for the face?
superficial tempral and facial
both are branches of external carotid
What is the arterial supply for the area above the orbits?
supraorbital and supratrochlear
branches of the ophthalmic a
originates from internal carotid
What supplies te posterior area of the skull?
branches of the external carotid a, occipital, and posterior auricular
What are the principle veins of the face?
ophthalmic facial deep facial superficial temporal retromandibular
Where do the ophthalmic and deep facial vein drain>?
to the pterygoid plexus
and or cavernous sinus
pool of blood that keeps face warm
What happens if an infection occurs in the upper face danger triangle?
potential bacteria can migrate to deep facial vein into cranum
infection can spread to pterygoid plexus and cavernous sinus
cause meningits or encephalitis
Do facial plexus and arteries have valves?
No
How does gravity affect the facial veins?
disctibutes when standing up
laying down blood goes to plexus and cavernous sinus
can spread disease
canvernous sinus is inside the skull
pterygoid plexus is outside the skull but has connecting veins
Are there lymph nodes in the scalp?
NO
nothing above the zygomatic arch- uses gravity to drain
What are the arteries of the scalp?
internal carotid (opthalmic)
supratrochlear
supraorbital
external carotid
superficial temporal
posterior auricular
occipital
What are the nerves of the scalp?
ophthalmic nerve V1
supratrochlear
supraorbital
maxillary nerve V2
zygomatico-temporal
mandibular nerve V3
auriculotemporal
cervical plexus
lesser occipital
greater occipital
Why do scalp injuries bleed so much?
so many arties in scalp so cant clamp off just one
apply pressure
Where do all of the scalp nerves end up?
in trigeminal nucleus for sensory innervation
What are the boundaries of the scalp?
supraorbital ridge- anterior boundary
superior nuchal line- posterior boundary
zygomatic arch- lateral boundary
What are the layers of the scalp?
SCALP
Skin- hair follicles, sweat glands, sebaceous glands
connective tissue- tough, dense with arteries, veins, nerves
aponeurotic- epicranius muscle and galea aponeurotica
loose connective tissue layer- contains emissary veins
periostium- fibrous tissue that adheres to the bones of the skull
What layer contains the arteries, veins, nerves of the scalp?
aponeurotic layer
What muscles form the helmet?
galea aponeurotica
frontalis
occipitalis
Why are there black eyes from head wound?
Drainage
Blood travels under aponeurotic layer to soft tissue near eyes
Where is parotid gland located?
Superficial and then goes behind the mandible
Masseter
origin: anterior two thirds of zygomatic arch and zygomatic process of maxilla
Insertion: lateral surface of angle and lower ramus of mandible
Action: elevates mandible (enables forced closure of mouth)
Nerve: anterior division of mandibular nerve V
What two superficial face muscles are involved in mastication?
Masseter and temporalis
What nerve carries parasympathetic fivers of 9 to the parotid?
auriculotemporal- V3
Lateral pterygoid
thick triangle- OPEN mouth
Origin: superior head: infratemporal surface of sphenoid bone/ inferior head: lateral surface of lateral pterygoid plate
Insertion: superior- capsule and disc of TMJ/ inferior- anterior surface of the neck of the mandible at pterygoid fovea
Action: Depresses and protracts mandible to open mouth. Pulls forward cartilage of joint during opening of mouth. Aids in chewing and grinding food.
Nerve: nerves to lateral pterygoid (anterior division of mandibular nerve (V3)
Medial pterygoid
deep to lat pterygoid/parallel to masseter-
CLOSES mouth
Origin: Deep head medial side of lateral pterygoid plate and fossa between medial and lateral plates . Superficial head : Tuberosity of maxilla and pyramidal process of palatine bone
Insertion: Medial aspect of angle of mandible
Action: Elevates the mandible and assits in closing the jaw. Assists the lateral pterygoids in moving the jaw side-to-side/grinding
Nerve: Nerve to medial pterygoid (main trunk of mandibular nerve (V3)
What are the bones of the temporal fossa?
parietal
teporal
sphenoid (greater wing)
frontal
inferiorly- temporal fossa communicates with infratemporal fossa at the zygomatic arch
Temporalis
Origin: Temporal fossa between inferior temporal line (superficial fibers) and infratemporal crest (deep fibers)
Insertion Medial and anterior aspect of coronoid process of mandible
Action: Elevates mandible and posterior fibers retract
Nerve: Deep temporal branches from anterior division of mandibular nerve (V)
What is the ledge of bone in the infratemporal fossa?
infratemporal crest
runs along a portion of greater wing of sphenoid to te squamous portion of the temporal bone
What does the superomedial roof of the infratemporal fossa contain?
foramen ovale (V3) (with para sympathetic nerve fibers) foramen spinosum (middle meningeal artery) petrotempanic fissure (chorda tympani nerve)
What does the anterior wall of the infratemporal fossa contain?
alveolar foramen
inferior orbital fissure
What does the lateral wall of the infratemporal fossa contain?
mandibular foramen (inferior alveolar n and A)
What does the medial wall of the infratemproal fossa contain?
ptrygomaxillary fissure
strutures pass from pterygopalatine fossa to nasal cavity via sphenopalatine foramine
What are the two muscles of the soft palate?
tensor and levator veli palatini
What is in the infratemporal fossa?
medial and lateral pterygoid muslces
maxillary artery and branches
mandibular division of the trigeminal nerve V3
seniory and motor branches of facial nerve 7- chorda tympani
branches of glossopharyngeal nerve 9
What jaw muscles protract?
lateral pterygoid
little bit of medial pterygoid
small contribution from masseter
What muscles retract jaw?
posterior fibers of temporalis and deep fibers of masseter
What muscles elevate the jaw (close)?
temporalis, masseter, medial pterygoid
What muscles depress the jaw (open)?
lateral pterygoid, digastric (against resistance), mylohyoid, geniohyoid, infrahyoid
GRAVITY*
What muscles grind and chew jaw?
ipsilateral masseter and temporalis, contralateral medial and lateral pterygoids
muscles act in series not at once
USE OPPOSITE- to move to right use left
What mouth issue is usually preceived as jaw, tooth, temporal pain>
Temperomandibular joint- TMJ
What kind of joint is TMJ?
synovial (diarthrodial)
does NOT contain usual hyaline cartilage
has dense irregular connective tissue articular disc
modified hinge joint to slide forward
What are the 2 compartments of the TMJ?
1st movement- lower compartment
hinge movement (rotational)
causes jaw to open 1 finger breadth
2nd movement- uppper compartment
after lower hinge
sliding gliding movement
fully opning 2 finger breadth and protrusion of mandible
articular disc moves with the head of mandible- not bone on bone
What are the 3 parts o the maxillary artery divided by the lateral pterygoid?
mandibular- passes anteriorly, deep to theneck of mandibular condyle
pterygoid- passes across the lateral pterygoid
pterygopalatine- after passes through the pterygomaxillary fissure to enter infratempora fossa
What is MIDBIPS?
Middle mengingeal a inf alveolar a (lower teeth/mental) ant/post deep temporal a buccal a infraorbial a post sup., alveolar sphenoplatine a
How does mandibular division of trigeminal V3 travel?
edits middle cranial offa through foramen ovale
enters infratemporal fossa
anterior and posterior divisions
What does the anterior division of the mandibular nerve branch to?
1pry MOTOR
anterior and posterior deep temporal n
nerve to the lateral pterygoid
nerve to masseter
EXCEPT: buccal= sensory to external cheek and oral cavity
What does the posterior division of the mandubular nerve branch to?
1ry SENSORY
auriculotemporal
lingual
inferior aveolar
What is special about the auriculotemporal nerve?
sensory to anterior ear and temporal region
1) GLOAP: Lesser pretrosal nerve (pregang parasym) derived from glossopharyngeal nerve IX runts to the Otic ganglion to synapse. Post gang fibers leaving OG run with auriculotemporal n to supply seretomotor fivers to parotid gland.
2) Auriculotemporal splits to encircle the middle meningeal artery before foramen spinosum. rejoins to conintue in front of ear through parotid gland
What does lingual n innervate?
V3 general sensory
innervate from anterior 2/3rds of tongue (pain, temp touch)
What is special about the lingual nerve?
Receives the chorda tympani n CNII
What does chorda tympani do?
CNVII exits petrotympanic fissure and enters infratemporal to join lingual
SVA fibers for taste from anterior 2/3 of tongue
also carry pregang para GVE from submanidibular ganglion
post gang fibers from submand g provide secetomotor innervation to the submand and subling glands
What carries fibers to all 3 salivary glands?
branches of CNV
What does the inferior aveolar n do?
pass through mandibular foramen enters mandivular canal supplies sensory innervation to mandibular (lower) teeth goes anteriorly and exits mental foramen = mental nerve
What is special about the aveolar n?
gives off nerve to mylohyoid
before entering mandibular foramen
What does nerve to mylohyoid do?
runs anteriorly and inferiorly to innervate MOTOR anterior belly of digastric and mylohyoid
