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SHB > Face > Flashcards

Face Flashcards

1
Q

How many bones are in the skull?

A

22

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2
Q

What are the two categories of skull bones?

A

Neurocranium

Viscerocranium

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3
Q

What are the neurocranium bones?

A

cranial vault

parietal
temporal
frontal
occipital
sphenoid
ethmoid
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4
Q

What are the viscerocranium bones of the skull?

A

face

mandible
maxilla
palatine
zygomatic
lacrimal
vomer
nasal
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5
Q

Where do the muscles of the facial expression originate and insert?

A

Originate from bone

Insert into skin

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6
Q

What innervates ALL of the muscles of facial expression?

A

same motor innervation
Facial nerve CN 7
through parotid gland

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7
Q

Frontalis

A

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

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8
Q

Orbicularis oculi

A

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

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9
Q

Is there a muscle that pulls the lower lid up?

A

NO

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10
Q

Zygomaticus major

A

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

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11
Q

buccinator

A

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

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12
Q

What pierces the buccinator?

A

parotid duct

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13
Q

What does sensory innervation for the face?

A

Trigeminal nerve CN V

3 divisions with branches

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14
Q

Where does facial nerve CN V7 exit skull?

A

stylomastoid foramen

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15
Q

Orbicularis oris

A

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

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16
Q

What are the 5 major branches of the facial nerve?

A 
Temporal (ten)
zygomatic (zebras)
buccal (bashed)
marginal/mandibular (my)
cervical (car)- platysma
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17
Q

What happens if the facial nerve is damaged?

A

Bell’s palsy
if need to remove parotid gland or inflammation near stylomastoid foramen
flaccid muscles so smooth

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18
Q

What happens if the facial nerve is damaged?

A

Bell’s palsy
if need to remove parotid gland or inflammation near stylomastoid foramen
flaccid muscles so smooth

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19
Q

What are the 3 divisions of the trigeminal nerve?

A
  1. ophthalmic
  2. maxillary
  3. mandibular
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20
Q

What is the difference between buccal facial and buccal trigeminal?

A

Facial- motor only

trigeminal- sensory only

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21
Q

What does auriculo temporal run with?

A

superficial temporal artery

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22
Q

What exit points line up?

A

supraorbital
infraorbital
mental

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23
Q

Where does the ophthalmic division V1 go?

A

purely sensory
passes through the cavernous sinus
exit through superior orbital fissure

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24
Q

What are the terminal branches of V1?

A

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

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25
Q

Where does maxillary division of V2 go?

A

Purely sensory
passes through cavernous sinus
leaves skull through foramen rotundum

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26
Q

What are the branches of maxillary division?

A

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)

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27
Q

Where does the mandibular V3 branch go?

A

Sensory AND motor
leaves skull through formen ovale
enter infratemporal fossa
divides into anterior and posterior divisions

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28
Q

What are the divisions of mandibular V3?

A

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

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29
Q

What is the parotid gland?

A

large superficially located salivary gland

secretes serous fluid via the parotid duct

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30
Q

What is the parotid duct?

A

stensons duct
pierces the buccinator muscle
enters the oral cavity adjacent to the upper 2nd molar

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31
Q

What innervates the parotid gland?

A

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
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32
Q

What is the main arterial supply for the face?

A

superficial tempral and facial

both are branches of external carotid

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33
Q

What is the arterial supply for the area above the orbits?

A

supraorbital and supratrochlear

branches of the ophthalmic a
originates from internal carotid

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34
Q

What supplies te posterior area of the skull?

A

branches of the external carotid a, occipital, and posterior auricular

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35
Q

What are the principle veins of the face?

A 
ophthalmic 
facial
deep facial
superficial temporal
retromandibular
36
Q

Where do the ophthalmic and deep facial vein drain>?

A

to the pterygoid plexus
and or cavernous sinus

pool of blood that keeps face warm

37
Q

What happens if an infection occurs in the upper face danger triangle?

A

potential bacteria can migrate to deep facial vein into cranum

infection can spread to pterygoid plexus and cavernous sinus
cause meningits or encephalitis

38
Q

Do facial plexus and arteries have valves?

A

No

39
Q

How does gravity affect the facial veins?

A

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

40
Q

Are there lymph nodes in the scalp?

A

NO

nothing above the zygomatic arch- uses gravity to drain

41
Q

What are the arteries of the scalp?

A

internal carotid (opthalmic)
supratrochlear
supraorbital

external carotid
superficial temporal
posterior auricular
occipital

42
Q

What are the nerves of the scalp?

A

ophthalmic nerve V1
supratrochlear
supraorbital

maxillary nerve V2
zygomatico-temporal

mandibular nerve V3
auriculotemporal

cervical plexus
lesser occipital
greater occipital

43
Q

Why do scalp injuries bleed so much?

A

so many arties in scalp so cant clamp off just one

apply pressure

44
Q

Where do all of the scalp nerves end up?

A

in trigeminal nucleus for sensory innervation

45
Q

What are the boundaries of the scalp?

A

supraorbital ridge- anterior boundary
superior nuchal line- posterior boundary
zygomatic arch- lateral boundary

46
Q

What are the layers of the scalp?

A

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

47
Q

What layer contains the arteries, veins, nerves of the scalp?

A

aponeurotic layer

48
Q

What muscles form the helmet?

A

galea aponeurotica
frontalis
occipitalis

49
Q

Why are there black eyes from head wound?

A

Drainage

Blood travels under aponeurotic layer to soft tissue near eyes

50
Q

Where is parotid gland located?

A

Superficial and then goes behind the mandible

51
Q

Masseter

A

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

52
Q

What two superficial face muscles are involved in mastication?

A

Masseter and temporalis

53
Q

What nerve carries parasympathetic fivers of 9 to the parotid?

A

auriculotemporal- V3

54
Q

Lateral pterygoid

A

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)

55
Q

Medial pterygoid

A

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)

56
Q

What are the bones of the temporal fossa?

A

parietal
teporal
sphenoid (greater wing)
frontal

inferiorly- temporal fossa communicates with infratemporal fossa at the zygomatic arch

57
Q

Temporalis

A

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)

58
Q

What is the ledge of bone in the infratemporal fossa?

A

infratemporal crest

runs along a portion of greater wing of sphenoid to te squamous portion of the temporal bone

59
Q

What does the superomedial roof of the infratemporal fossa contain?

A 
foramen ovale (V3) (with para sympathetic nerve fibers)
foramen spinosum (middle meningeal artery)
petrotempanic fissure (chorda tympani nerve)
60
Q

What does the anterior wall of the infratemporal fossa contain?

A

alveolar foramen

inferior orbital fissure

61
Q

What does the lateral wall of the infratemporal fossa contain?

A

mandibular foramen (inferior alveolar n and A)

62
Q

What does the medial wall of the infratemproal fossa contain?

A

ptrygomaxillary fissure

strutures pass from pterygopalatine fossa to nasal cavity via sphenopalatine foramine

63
Q

What are the two muscles of the soft palate?

A

tensor and levator veli palatini

64
Q

What is in the infratemporal fossa?

A

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

65
Q

What jaw muscles protract?

A

lateral pterygoid
little bit of medial pterygoid
small contribution from masseter

66
Q

What muscles retract jaw?

A

posterior fibers of temporalis and deep fibers of masseter

67
Q

What muscles elevate the jaw (close)?

A

temporalis, masseter, medial pterygoid

68
Q

What muscles depress the jaw (open)?

A

lateral pterygoid, digastric (against resistance), mylohyoid, geniohyoid, infrahyoid

GRAVITY*

69
Q

What muscles grind and chew jaw?

A

ipsilateral masseter and temporalis, contralateral medial and lateral pterygoids
muscles act in series not at once

USE OPPOSITE- to move to right use left

70
Q

What mouth issue is usually preceived as jaw, tooth, temporal pain>

A

Temperomandibular joint- TMJ

71
Q

What kind of joint is TMJ?

A

synovial (diarthrodial)
does NOT contain usual hyaline cartilage
has dense irregular connective tissue articular disc

modified hinge joint to slide forward

72
Q

What are the 2 compartments of the TMJ?

A

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

73
Q

What are the 3 parts o the maxillary artery divided by the lateral pterygoid?

A

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

74
Q

What is MIDBIPS?

A 
Middle mengingeal a
inf alveolar a (lower teeth/mental)
ant/post deep temporal a
buccal a
infraorbial a
post sup., alveolar
sphenoplatine a
75
Q

How does mandibular division of trigeminal V3 travel?

A

edits middle cranial offa through foramen ovale
enters infratemporal fossa
anterior and posterior divisions

76
Q

What does the anterior division of the mandibular nerve branch to?

A

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

77
Q

What does the posterior division of the mandubular nerve branch to?

A

1ry SENSORY

auriculotemporal
lingual
inferior aveolar

78
Q

What is special about the auriculotemporal nerve?

A

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

79
Q

What does lingual n innervate?

A

V3 general sensory

innervate from anterior 2/3rds of tongue (pain, temp touch)

80
Q

What is special about the lingual nerve?

A

Receives the chorda tympani n CNII

81
Q

What does chorda tympani do?

A

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

82
Q

What carries fibers to all 3 salivary glands?

A

branches of CNV

83
Q

What does the inferior aveolar n do?

A 
pass through mandibular foramen
enters mandivular canal
supplies sensory innervation to mandibular (lower) teeth
goes anteriorly and exits mental foramen
= mental nerve
84
Q

What is special about the aveolar n?

A

gives off nerve to mylohyoid

before entering mandibular foramen

85
Q

What does nerve to mylohyoid do?

A

runs anteriorly and inferiorly to innervate MOTOR anterior belly of digastric and mylohyoid

SHB (22 decks)

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