Face Flashcards
What is the face bound by superiorly, laterally, and inferiorly?
Superior: Frontal region
Lateral: auricular regions
Inferior: Inferior margin of the mandible
What are the 5 openings of the face?
2 palpebral fissures (eyes)
2 nares (nostrils)
1 oral fissure
What is the term used for the bridge of the nose?
dorsum
What flanks each side of the tip of the nose and partially surrounds the nares?
the ala of the nose
What separates the nares? (interior and exterior)
the nasal septum (interior)
the nasal columella (exterior)
What are the three areas of the lips as defined by their surface tissue?
skin, vermillion zone, mucosa
The oral fissure is flanked on each side by the ______________.
angles of the mouth
What are the names for the two kinds of folds that can be found around the mouth?
the nasolabial fold
the mentolabial fold
When present, where can the nasolabial folds be found?
extending laterally to the nose and curving towards the angles of the mouth.
When present, where can the mentolabial folds be found?
it can be found as a horizontal cleft between the lower lip and the chin.
What are the different layers of facial fasciae?
the skin covers a layer of fibro-adipose tissue (varies in depth), which covers the Superficial Musculo-Aponeurotic System.
What is the fibro-adipose layer of fascia made up of? What does it allow?
It is made up of dense connective tissues. This allows the facial muscles to move and shape the skin of the face.
What is the SMAS? What does it encompass?
A layer of fascia that either invests, or covers the muscles of facial expression. It extends from the platysma to the epicranial aponeurosis
What fascia can be found above the zygomatic arch, co-planar to the SMAS?
the temporoparietal fascia
What does the temporoparietal fascia cover?
the temporal region, superficial to the temporal fascia.
What is the temporal fascia?
deep, investing layer of the temporalis m.
What fascia is deep to the SMAS?
the parotid-masseteric fascia
What does the parotid-masseteric fascia cover?
the parotid gland, masseter m., parotid duct, and branches of both the facial n., and mandibular n. (V3) (typically facial and mandibular n. are found deep to this layer)
What are the layers of facial fascia superficial to deep?
Skin>Fibro-adipose tissue>SMAS and muscles of facial expression>(superior zygomatic) temporoparietal (inferior zygomatic but superficial of buccal fat) parotid-masseteric fascia>Facial n. brs.>buccopharyngeal fascia (deep to buccal fat) and muscles of mastication
the infra-orbital fascial space is found deep to the ___________________.
quadradis labii superioris m. group
What muscles are included in the quadradis labii superioris m. group?
levator labii superioris alaeque nasi m., levator labii superioris m., and the zygomaticus minor m.
What space is continuous with the infra-orbital space (posteriorly)?
the buccal space
Infections to the canine or first pre-molar (if left untreated) could spread from the __________ to the _________ and or the __________________.
infraorbital space : buccal space : orbital vasculature and cavernous sinus
what artery, vein, and nerve are found in the in the infraorbital space?
angular a., angular v., infraorbital n. (of V2)
What space is continuous with the buccal space posteriorly? Posteromedially?
the (sub)masseteric space : Pterygomandibular space
What routes might an infection take to get from the areas around the mouth to the retropharyngeal space?
buccal space/(sub)masseter space > ptyerygomandibular space > lateral pharyngeal space > retropharyngeal space
OR
sublingual space/submandibular space > lateral pharyngeal space > retropharyngeal space
What are the two major groups of the muscles of the head?
epicranial and craniofacial
What area do the epicranial muscles primarily act upon?
the scalp
What are do the craniofacial muscles primarily act upon?
the facial region (typically referred to as the muscles of facial expression)
What muscles are included in the epicranial muscles? What are their actions?
the frontal and occipital bellies of the occipitofrontalis m. : Frontal - elevates brow/creases forehead : Occipital - pulls scalp posteriorly
What are the three subgroups of the craniofacial muscles?
circumorbital and palpebral mm., buccolabial mm., and nasal muscles
What muscles are included in the circumorbital and palpebral muscle group and what are their actions?
the orbicularis oculi m. (shuts palpebral fissure), and the currogator supercilii m. (pulls brows inferomedially)
What muscles are included in the buccolabial muscle group?
levator labii superioris, levator anguli oris, zygomaticus minor, zygomaticus major, buccinator, risorius, depressor anguli oris, depressor labii inferioris, mentalis, orbicularis oris
What muscles are included in the nasal muscles group?
levator labii superioris alaeque nasi m., transvers part of the nasalis, and the alar part of the nasalis.
What are the actions of the levator labii superioris, levator anguli oris, zygomaticus minor, zygomaticus major, and risorius mm.?
(1) elevates and (weakly) everts upper lip
(2) pulls angle of the mouth laterally and superiorly
(3) elevates upper lip (shows canine)
(4) elevates and laterally draws upper lip
(5) draws angle of mouth laterally
What are the actions of the buccinator, depressor anguli oris, depressor labii inferioris, mentalis, and orbicularis oris?
(1) draws cheeks toward teeth
(2) draws angle of the mouth inferiorly and laterally
(3) draws lower lip inferiorly
(4) elevates skin of chin and lower lip
(5) purses lips
What are the actions of the craniofacial nasal muscles?
Transverse nasalis - compresses naris
Alar nasalis - dilates naris
LLS alaeque nasi - dilates naris/elevates upper lip
What muscles of the face are innervated by both the zygomatic and buccal branches of the facial n.?
nasalis (compressor and dilator), LLS alaeque nasi, LLS, zygomaticus minor, zygomaticus major.
What muscles of the face are innervated by the buccal branch (only) of the facial n.?
Levator anguli oris, buccinator, risorius
What muscles of the face are innervated by the buccal and marginal mandibular branches of the facial n.?
orbicularis oris, depressor anguli oris
What muscles of the face are innervated by the marginal mandibular (only) branch of the facial n.?
depressor labii inferioris, mentalis
What muscles of the face are innervated by the cervical branch of the facial n.?
platysma
What are the innervations of the occipital and frontal occipitofrontalis mm.?
occipital: posterior auricular bra. of facial
frontal: temporal bra. of facial
What nerve innervates the corrugated supercilii?
there temporal branch of the facial n.
what nerve innervates the orbiculares oculi m.?
the temporal and zygomatic branches of the facial n.
What artery and nerve typically accompanies the superficial temporal v.?
Superficial temporal a. and auriculotemporal n.
What are typically the first three anterior facing branches of the external carotid artery?
the superior thyroid, lingual, and facial aa.
What triangle does the facial a. typically traverse? What vein accompanies it? what nerves are typically superficial to it?
submandibular triangle before emerging over the body of the mandible.
The facial v.
the facial n.
What are the main branches of the facial artery?
the inferior labial, superior labial, lateral nasal, and angular a.
Where to the labial branches of the facial a. typically branch off?
adjacent to the modiolus
What does the inferior and superior labial branches typically run a course through?
in between the orbicularis oris and mucous membrane
Where does the lateral nasal branch typically arise?
lateral to the nose
What is similar about the inferior labial, superior labial, and lateral nasal branches?
they all anastomose with their counterparts
What artery may give rise to the lateral nasal branch?
the Superior labial branch
where does the angular a. course toward?
the medial canthus of the eye
What veins drain into the angular vein?
the supra-orbital v., supratrochlear v., superior ophthalmic v., and inferior ophthalmic v.
What regions of the face does the angular vein drain?
forehead and regions medial to the eye
What does the deep facial vein drain?
the pterygoid plexus of veins and the deep face
What is an example of how an anastomosis of the facial veins could allow a route to the cavernous sinus?
Infections in the area of the angular vein could drain into the ophthalmic veins to the cavernous sinus, or infections through the deep facial v., through the pterygoid plexus, to the cavernous sinus
What are the superior in inferior branches of the facial n. called? What do they traverse through?
the temporofacial division (superior) and the cervicofacial division (inferior). They (along with their branches) traverse the parotid gland.
What branches of the facial n. does the temporofacial division give rise to?
the temporal bra., the zygomatic bra., and a portion of the buccal brs.
What branches of the facial n. does the cervicofacial division give rise to?
a portion of the buccal brs., the marginal mandibular bra., and the cervical bra.
The trigeminal n. is generally responsible for ________________ (efferent), and _________________ (afferent).
innervating muscles of mastication (efferent) and sensation of the skin of the face (afferent)
What nerves of the trigeminal divisions afferently serve the face, and which branch do they come from?
supra-orbital n. (V1)
infra-orbital n. (V2)
mental n. (V3)
the cutaneous portion of the auriculotemporal n. (V3)
The supraorbital n. is the ___________ continuation of the ____________ n.
terminal : frontal n.
Where does the supraorbital n. exit the skull?
the supraorbital notch (foramen)
What does the supraorbital n. innervate?
Afferently, the conjunctiva, mucosa of the frontal sinus, and skin of the superior palpebra, forehead, and epicranial scalp
The ophthalmic n. gives rise to the ___________ which gives rise to the ___________.
frontal n. : supraorbital n.
The maxillary nerve exits the base of the middle cranial fossa through the ___________ and gives rise to the ___________ which exits the skull through the ____________.
foramen rotundum : infra-orbital n. : infra-orbital foramen
how (approximately) is the infraorbital foramen aligned with the supraorbital notch/foramen?
approximately in line with or slightly lateral.
What is innervated by the infraorbital n.?
Afferently, the mucosa of the maxillary sinus and gingiva, and skin of the: inferior palpebra, the lateral nose, upper lip, and cheek.
The mental n., is the ___________ of the ___________; a branch of the mandibular n. (V3).
terminal continuation : inferior alveolar n.
What is innervated by the mental n.?
Afferently, the mandibular gingiva, and skin of the: lower lip and chin.
What is the auriculotemporal n. a branch of?
the mandibular n. (V3)
What does the auriculotemporal n. serve?
afferently serves the skin of the: tragus of the ear, the external auditory meatus, and the area anterosuperior to the ear.
What is facial nerve palsy?
Bells Palsy is the ipsilateral paralysis of facial mm. due to a neuropathy of the facial n.
Where do many motor neurons of the temporofacial division originate?
bilaterally from the cerebral cortex
Where do the motor neurons of the cervicofacial division originate from?
contralaterally from the cerebral cortex
What might a cerebrovascular accident (or stroke) be mistaken for, and why?
Palsy of cervicofacial division. Because they both get motor neurons from contralateral cervical cerebral cortex
How can you tell the difference between facial nerve palsy, and cerebrovascular accident/stroke?
If you have facial a CVA, you would still be able to wrinkle the muscles of the forehead, whereas bell’s palsy you would not be able to.
