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Anatomy Unit 2 > Face and Parotid > Flashcards

Face and Parotid Flashcards

1
Q

Why is the face small at birth?

A

Maxilla and mandible are not yet fully developed, and paranasal sinuses in facial bones have not started to form

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2
Q

How does the face change during early life?

A

Face becomes longer, zygomatic bone becomes more prominent and cheeks lose some fat.

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3
Q

What are the bones of the face?

A

Frontal, zygomatic, nasal, maxilla, mandible, temporal

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4
Q

What is all sensory innervation of the face derived from?

A

Three major subdivisions of the trigeminal nerve (5th cranial)

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5
Q

What facial structures does the trigeminal nerve innervate? (CN5)

A

facial structures derived from first pharyngeal arch

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6
Q

What facial structures does the facial nerve innervate? (CN7)

A

facial structures derived from second pharyngeal arch

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7
Q

What are the three divisions of CN5?

A

V1 - Ophthalmic division - 4 branches
V2 - Maxillary division - 3 branches
V3 - Mandibular division - 4 branches

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8
Q

What are the 4 cutaneous branches of the ophthalmic division (V1) of the trigeminal nerve?

A

SISE
Supratrochlear - Exits at medial end of supraorbital margin, supplies forehead and upper eyelids
Infratrochlear - Exits at medial end of infraorbital margin, supplies medial side of upper and lower eyelid, skin of nose and lacrimal sac
Supraorbital - Exits through supraorbital foramen, supplies forehead, scalp, upper eye, and frontal sinus. Continuation of frontal nerve
External nasal - Exits between bony and cartilaginous part of nose, supplies skin of nose

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9
Q

What are the 3 cutaneous branches of the maxillary division (V2) of the trigeminal nerve?

A

ZIZ
Zygomaticofacial - Exits through Z-facial foramen, supplies skin of face
Infraorbital - Exits through infraorbital foramen, supplies conjunctiva and skin of lower eyelid, skin of nose, lip, and mucuous membrane of mouth
Zygomaticotemporal - Exits through Z-temporal foramen, supplies temporal part of head

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10
Q

What are the 4 cutaneous branches of the mandibular division (V3) of the trigeminal nerve?

A

BIMA
Buccal - Pierces buccinator muscle, is anterior division of the mandibular nerve
Inferior alveolar - Supplies lower teeth and skin of chin and lower lip
Mental - Termination of inferior alveolar, emerges through mental foramen supplies skin of lower lip and chin
Auriculotemporal - is the posterior division of mandibular nerve. Arises from two roots that encircle the middle meningeal artery, closely related to parotid gland and superficial temporal artery. Supplies skin of external ear and temporal scalp

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11
Q

What is herpes zoster ophthalmicus?

A

A viral infection of the face involving ophthalmic branch V1. Can affect corneal nerve supply and also cause paralysis of ocular muscles, indicating involvement with CN3, CN4, and CN6

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12
Q

What is an infraorbital nerve block?

A

Local anesthestic in maxillary division, easy sinc ethe infraorbital foramina can be palpated, but try not to injury blood vessels. It is commonly injured in fracture of maxilla. Numbs the upper lip, cheek, upper teeth, etc.

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13
Q

How might the inferior alveolar nerve be damaged and what are the symptoms?

A

Fracture of ramus of mandible, will cause loss of sensatory of lower teeth, skin of chin, and lower lip.

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14
Q

What is trigeminal neuralgia?

A

Lesion of entire trigeminal nerve. Has following symptoms:
Loss of sensation in anterior half of skull, face, cornea and conjunctiva, mucous membrane of nose, mouth, anterior 2/3 of tongue, atrophy of mastication muscles

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15
Q

What causes wrinkles?

A

Since muscles of the face are so superficial and do not move skeletal bones, they are responsible for pulling skin and controlling facial expressions. Wrinkles will appear perpendicular to the axis of the facial muscles since you lose muscle tonus as you get older.

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16
Q

What nerve innervates the facial muscles?

A

Facial nerve (cranial nerve 7) - Passes through the parotid gland, but does not innervate the parotid gland

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17
Q

What is the muscle of the forehead?

A

Occipitofrontalis muscle - Consists of four bellies (two occipital and two frontalis) connected by the galea aponeurotica. Raises and wrinkles the forehead

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18
Q

What is the orbicularis oculi and its three parts?

A

Thin elliptical muscle surrounding orbital rib. Three parts are orbital, palpebral, and lacrimal

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19
Q

What is the orbital part of the orbicularis oculi?

A

Outermost, attaches to medial palpebral ligament. Winks and tightly closes the eye

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20
Q

What is the palpebral part of the orbicularis oculi?

A

Middle, attaches to medial palpebral ligament and laterally to the lateral palpebral ligament which attaches to the zygomatic bone (orbital tubercule).
Upper and lower eyelid gentle closer

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21
Q

What is the lacrimal part of the orbicularis oculi?

A

Lies behind medial palpebral ligament and lacrimal sac. Arises from crest of lacrimal bone and inserts to the inferior and superior tarsal plate. May compress lacrimal sac for tears but function is unknown.

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22
Q

What is the corrugator supercilii?

A

Arises from frontal bone and attaches to skin of medial half of eyebrow, pulls eyebrows medially and downward

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23
Q

What is the procerus muscle?

A

Regarded as inferior extension of occipitofrontalis muscle down the nose, draws down medial angle of eyebrows and wrinkles top of nose

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24
Q

What is the nasalis muscle?

A

Best developed nose muscle, muscles from two sides form aponeurosis on dorsum of nose. Aids in widening of nostril

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25
Q

What is the dilator nares?

A

Attaches to the wing of nose and is response for nostril flaring

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26
Q

What is the depressor septi?

A

Attaches to nasal septum, lowers nasal septum during allergies and sniffling (inferior to nose)

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27
Q

What are the elevators of the lip from medial to lateral?

A
  1. Levator labii superioris alaeque nasi
  2. Levator labii superioris
  3. Levator anguli oris
  4. Zygomaticus minor
  5. Zygomaticus major
  6. Risorus
28
Q

What is the levator labii superioris alaeque nasi?

A

Most medial muscle of upper lip, arises high on maxilla and gives one branch to ala of nose and one branch to upper lip

29
Q

What is the levator labii superioris?

A

Muscle running on infraorbital ridge, just lateral to the superioris alaeque nasi. Usually covers the infraorbital foramen

30
Q

What is the levator anguli oris?

A

Arising below the infraorbital foramen, it is mostly covered by the levator labii superior and crosses at an angle

31
Q

What is the zygomaticus minor?

A

Muscle of upper lip, arises from zygomatic bone and inserts on upper lip between superioris and z. major

32
Q

What is the zygomaticus major?

A

Muscle of upper lip, large than minor attaching to zygomatic bone and corner of upper lip

33
Q

What is the risorius?

A

Muscle from parotid region inserting on corner of mouth, below z. major

34
Q

What are the muscles of the lower lip from lateral to medial?

A
  1. Depressor anguli oris
  2. Depressor labii inferioris
  3. Mentalis
35
Q

What is the depressor anguli oris?

A

Most lateral depressor of lower lip, arises from body of mandible and inserts on an angle to the corner

36
Q

What is the depressor labii inferioris?

A

Covers the mental foramen, arises from the mandible and inserts into lower lip. Depresses the lower lips.

37
Q

What is the pouting muscle?

A

Most medial depressor of lower lip called the mentalis muscle. Arises from incisive fossa of mandible and inserts on chin

38
Q

What is the orbicularis oris?

A

Circular muscle fibers surrounding the mouth - important in kissing, puckering, talking, etc

39
Q

What is the buccinator?

A

Principle muscle of cheek, it is quadrilateral between the maxilla and mandible. Helps in mastication but is not for it, and presses your cheek in. The parotid duct pierces this muscle opposite the second molar

40
Q

What is superficial to the buccinator?

A

Buccopharyngeal fascia and buccal fat pat, which is well developed in children

41
Q

What is the platysma and its action?

A

Arises from superficial fascia, ascends up to mandible from p. major and deltoid. Can depress lower lip laterally and inferiorly.

42
Q

What is the path of the facial artery?

A

A branch of external carotid, crosses ramus of mandible anterior to masseter muscle after passing behind submandibular gland, then terminates at medial angle of eye anastomosing with branches of ophthalmic artery.

43
Q

What are the branches of the facial artery?

A

As it proceeds up the face:

  1. Inferior labial
  2. Superior labial
  3. Lateral nasal
  4. Angular
44
Q

What is the superficial temporal artery?

A

One of the terminal branches of external carotid (along with maxillary artery). It has branches transverse facial artery as well as branches with anastomose with supraorbital and supratrochlear branches of ophthalmic artery

45
Q

What is the branch of the superficial temporal artery that forms in the parotid gland, posterior to neck of mandible?

A

Transverse facial artery. It accompanies parotid duct and anastomoses with the facial artery.

46
Q

What is the facial vein? Where does in anastomose? Where does it primarily drain?

A

It primarily drains into the internal jugular vein. Anastomoses with ophthalmic vein, which drains into cavernous sinus.

47
Q

How might infection of face spread to brain?

A

Since ophthalmic vein drains into cavernous sinus, and it has no valves, infection could spread from ophthalmic vein to it.

48
Q

What are the motor branches of the facial nerve, supplying all face muscles?

A
  1. Temporal
  2. Zygomatic
  3. Buccal
  4. Marginal mandibular
  5. Cervical.
    Injury will cause paralysis of these muscles.

Facial nerve exits out of stylomastoid foramen

49
Q

What are the three groups of lymph nodes in the face?

A
  1. Submental
  2. Submandibular
  3. Preauricular / parotid nodes
50
Q

What is the function of the submental nodes?

A

Collect lymphatics from medial part of lower lip and chin

51
Q

What is the function of the submandibular nodes? Where are they?

A

They lie superficial to submandibular glands and inferior to body of mandible. Collects lymph from medial cornea of orbit, most of nose, medial cheek, and upper and lateral lower lip

52
Q

What is the function of the preauricular and parotid nodes? Where are they?

A

They lie anterior to the ear and collect lymphatics from most of the eyelids, parotid regions, and temporal areas

53
Q

What is the shape of the parotid gland?

A

Largest of three salivary glands, it is pyramidal with its apex pointing down. Base runs along zygomatic arch, apex points downwards and curves medially around posterior border of mandible

54
Q

What fascia covers the parotid gland?

A

Medially - fascia of masseter muscle

Laterally - Fascia of investing layer

55
Q

What is the function of the parotid gland?

A

It is a salivary gland under sympathetic and parasympathetic control

56
Q

Where does the parotid duct run?

A

Exits the gland anteriorly, crosses cheek superficial to masseter and runs with tranverse facial artery. Pierces buccinator to open into mouth

57
Q

What is superior to the parotid gland?

A

Zygomatic arch, superficial temporal artery, auriculo-temporal nerve, temporal branch of 7th nerve

58
Q

What things lie inferior to parotid gland?

A

Angle of mandible, external carotid artery, retromandibular vein and posterior auricular vein joining to form external jugular, cervical branches of CN7, platysma, great auricular nerve

59
Q

What lies anterior to parotid gland?

A

Parotid duct, transverse facial artery, zygomatic, buccal, and marginal mandibular branches of CN7

60
Q

What lies posterior to the parotid gland?

A

Styliod and mastoid process, external acoustic meatus, SCM, occipital vein, posterior auricular artery

61
Q

What lies medial to the parotid gland?

A

Internal carotid artery, masseter muscle

62
Q

What is the parotid plexus?

A

Most superficial structure, facial nerve emerges from stylomastoid foramen near posterior aspect of the gland. After entering the gland, it divides into the tempro-facial and cervico-facial divisions which branch repeatedly into the five branches supplying the facial nerves which we know.

63
Q

What other two structures pass through the parotid gland?

A
  1. External carotid artery
  2. Retromandibular vein

These also supply and remove blood

64
Q

What is the innervation of the parotid gland?

A

Sympathetic - from superior cervical ganglion

Parsympathetic - from glossopharyngeal nerve arising from otic ganglion

65
Q

How does mumps relate to parotid gland?

A

Inflammation of parotid gland caused by mumps virus can inflame parotid duct as well and cause pain during chewing

66
Q

What is Bell’s palsy?

A

Facial nerve damage causing facial paralysis. Causes:
Chilling of the face, middle ear infection, tumor or fractor near middle ear or stylomastoid foramen, or tumor near internal acoustic meatus.

67
Q

Why is facial nerve vulnerable to injury early in life?

A

Mastoid process is not present at birth, and does not fully develop until second year of life. Thus, the stylomastoid foramen opens beneath the skin and is very superficial

Anatomy Unit 2 (13 decks)

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