Face and scalp Flashcards

1
Q

muscles of scalp

A
  • Frontalis
  • Occipitalis
  • Temporalis
    • Anterior to ear: Supratrochlear (V-1), Supraorbital (V-1), Zygomaticotemporal (V-2), Auriculotemporal (V-3)
    • Posterior to ear: lesser occipital nerve (APR of C2 and C3), greater occipital nerve (posterior primary rami [PPR] of C2)
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2
Q

what are layers in scalp?

A
  • Skin
  • Connective tissue:Contains neurovasculature, Tissue holds cut vessels open
  • Aponeurosis
  • Loose connective tissue
  • Pericranium
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3
Q

venous drainage into facial vein

A
  • Supratrochlear: Scalp, forehead, upper eyelid
  • Supraorbital: Scalp, forehead, upper eyelid
  • Nasal: External nose
  • Superior labial: Upper lip
  • Inferior labial: Lower lip
  • Muscular: Masseter (muscle of mastication)and buccinator muscles
  • Submental: Structures in submental triangle
  • Tonsillar: Palatine tonsil and tonsillar bed
  • Submandibular: Submandibular gland
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4
Q

Branches of max artery

A
  • Infraorbital
    • Inferior palpebral – lower eyelid
    • Nasal – lateral nose
    • Superior labial – upper lip
  • Buccal
    • skin and mucous membranes of cheek, vestibular gingiva of mandibular molars
  • Mental
    • chin,lower lip, vestibular gingiva of mandibular anterior teeth
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5
Q

Arteries of the scalp

A
  • Run in the connective tissue layer
  • From external carotid artery
    • Occipital
    • Posterior auricular
    • Superficial temporal
  • From the internal carotid artery(ophthalmic branch)
    • Supratrochlear
    • Supraorbital
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6
Q

veins of the scalp

A
  • Superficial scalp
    • Supraorbital & supratrochlear to the angular vein ->becomes the facial vein
  • Superficial temporal veins and posterior auricular veins
    • Drain scalp anterior and posterior to the auricles
  • Occipital veins
    • Drain occipital region scalp
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7
Q

skin

A
  • Medium-to-thin thickness
  • Movable layer of tissue
  • Covers a layer of loose areolar connective tissue
    • Not in nose and ears – fixed to cartilage
  • Numerous sweat and sebaceous glands
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8
Q

superficial fascia

A
  • Subcutaneous connective tissue
  • Layers of fat
  • Contains:Vessels, Nerves, Superficial muscles of facial expression
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9
Q

where are Muscles of facial expression?

A
  • Located within the superficial fascia
    • Around facial orifices
    • Control opening/closing of orifices
    • Move overlying skin
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10
Q

what are muscles of facial expression?

A
  • Orbicularis oris: Levator labii superioris & Levator anguli oris
  • Zygomaticus major
  • Zygomaticus minor
  • Depressor anguli oris: Depressor labii inferioris & Risorius
  • Orbicularis oculi: Mentalis, Nasalis, Buccinator, Platysma
  • Frontalis
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11
Q

orbicularis oris

A
  • Origins: Extrinsic (Circumoral muscles) & Instrinsic (Incisive fossae)
  • Insertions: Extrinsic (Sphincter around mouth within lips) & Intrinsic (Skin of lip)
  • Innervation: VII – zygomatic, buccal, mandibular branches
  • Action: Closes mouth & Protrudes lips
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12
Q

Depressor Anguli oris

A
  • Originates:Oblique line of mandible
  • Inserts:Angle of mouth
  • Innervation:VII—buccal and mandibular branches
  • Action:Depresses angle of mouth
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13
Q

levator anguli oris

A
  • Originates: Canine fossa
  • Inserts: Angle of mouth
  • Innervation: VII—buccal and zygomatic branches
  • Action:Elevates angle of mouth
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14
Q

zygomatic major

A
  • Originates:Zygomatic Bone
  • Inserts:Angle of mouth
  • Innervation:VII—buccal and zygomatic branches
  • Action: Draws angle of mouth superoposteriorly
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15
Q

zygomatic minor

A
  • Originates: Zygomatic Bone
  • Inserts:Skin of upper lip
  • Innervation:VII— zygomatic and buccal branches
  • Action:Elevates upper lip
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16
Q

risorius

A
  • Originates:Contributions of platysma fibers, fascia of parotid and masseteric regions
  • Inserts: Angle of mouth
  • Innervation: VII—buccal and mandibular branches
  • Action:Draws angle of mouth laterally
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17
Q

Pterygomandibular Raphe

A

-Fibrous seam
-descends from the pterygoid hamulus of the medial pterygoid plate
-to the mylohyoid line of the mandible
-separates and gives rise to
superior constrictor of the pharynx
buccinator muscle

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18
Q

Buccinator

A
  • Origins: Pterygomandibular raphé, buccal alveolar processes of maxilla and mandible
  • Insertion:Corner of the lips & Deep to other facial expression muscles
  • Innervation: VII- Buccal branches
  • Action: Compresses cheeks against molars & Sucking/blowing
19
Q

Modiolus

A
Orbicularis oris
Buccinator
Levator anguli oris
Depressor anguli oris
Zygomaticus major
Risorius
20
Q

orbicularis oculi

A
  • Exists in 3 parts:Orbital, Palpebral, Lacrmial
  • Origin: Medial orbital margin and lacrimal bone
  • Insertion: Skin around orbit
  • Innervation: VII – temporal and zygomatic branches
  • Action:Orbital(Close eye forcefully), Palpebral (Close eye gently), Lacrimal(Squeeze tears against eyeball)
21
Q

corrugator

A
  • Deep to Orbicularis oculi
  • Origin:Medial aspect of supraorbital margin
  • Insertion:Skin underlying eyebrow
  • Innervation:VII – temporal
  • Action:Furrow eyebrows
22
Q

levator labii superioris

A
  • Origin:Maxillary frontal process & Inferior orbit of margin
  • Insertion: Cartilage and skin of nose & Upper lip
  • Innervation: VII – zygomatic and buccal branches
  • Action: Flares nostrils & Elevates upper lip
23
Q

depressor labii inferioris

A
  • Origin:Oblique line of mandible
  • Insertion: Lower lip
  • Innervation: VII – mandibular branches
  • Action: Depresses lower lip
24
Q

mentalis

A
  • Origin:Incisive fossa (mandible)
  • Insertion: Lower lip
  • Innervation:VII – mandibular branches
  • Action: Depresses lower lip & Puckers chin
25
Q

nasalis

A

-2 Origins: Compressor nares
(Canine eminence of the maxilla) & Dilator nares (Nasal notch of the maxilla)
-Insertion:
-Compressor nares( Midline aponeurosis over the lateral nasal cartilage)
-Dilator nare(Skin margin of nostril)
-Innervation:VII – zygomatic and buccal branches branches
-Action:Compresses nostrils &
Flares nostrils

26
Q

procerus

A
  • Origin: Nasal bone & Lateral nasal cartilage
  • Insertion:Glabellar skin
  • Innervation: VII – temporal and zygomatic branches
  • Action:Bridge of nose wrinkling
27
Q

frontalis

A
  • Origin:Aponeurosis of scalp
  • Insertion: Forehead skin
  • Innervation:VII – temporal branches
  • Action: Pulls scalp superoposteriorly
28
Q

occipitalis

A
  • Origin:Superior nuchal line & Mastoid process
  • Insertion: Occipital skin
  • Innervation:VII – posterior auricular branches
  • Action:Pulls scalp superoposteriorly
29
Q

platysma

A

-Origin:Pectoral fascia
-Insertion:Inferior border of mandible
-Innervation:VII – cervical branches
-Action
-Aids in depressing mandible
-Tense neck skin
If mandible is stabilized by muscles of mastication

30
Q

Facial nerve innervation

A
  • Temporal:orbicularis oculi, procerus, corrugator, frontalis, anterior auricular, posterior auricular, superior auricular
  • Zygomatic: orbicularis oris, levator anguli oris, zygomaticus major, zygomaticus minor, risorius, levator labii superioris alaque nasi, nasalis, orbicularis oculi, procerus
  • Buccal: orbicularis oris, depressor anguli oris, levator anguli oris, zygomaticus major, zygomaticus minor, risorius, levator labii superioris alaque nasi, buccinator, nasalis
  • Marginal mandibular:orbicularis oris, depressor anguli oris, depressor labii inferioris, depressor anguli oris, mentalis
  • Cervical – platysma
  • Posterior auricular – occipitalis
31
Q

Branches of Facial Nerve

A
  • Temporal
  • Zygomatic
  • Buccal
  • Marginal mandibular
  • Cervical
32
Q

parotid gland

A

-Largest salivary gland
-Covered in parotid sheath
very, very strong
-Parotid duct
-passes anteriorly and horizontally from anterior edge of gland
-Enters the oral cavity opposite M2
-Structures within the gland
-Facial nerve branches
-Retromandibular vein
-External carotid artery and branches
-Parotid lymph nodes

33
Q

Parotitis

A

-Mumps
-Swollen parotid gland
-Redness of parotid papilla
-Bacterial infection
-Poor oral hygiene(Infection spreads back through parotid duct)
Need to be able to determine if swelling is glandular (mumps) or dental abscess (bacteria)

34
Q

innervation of parotid bed & gland

A
  • Great auricular nerve (C2 and C3) carries sensory fibers from the parotid sheath and overlying skin
  • Parasympathetic component of Glossopharyngeal nerve (CN IX) supplies secretory fibers to the parotid gland
  • The fibers are conveyed from the otic ganglion by the auriculotemporal nerve (CN V-3)
    • Stimulation of these fibers produces saliva
  • Sympathetic fibers derived from the cervical ganglia through the external carotid nerve plexus
35
Q

inferior alveolar block

A
  • Goal is to inject near the inferior alveolar nerve right at the mandibular foramen
  • If needle is pushed to far posteriorly->Puncture parotid gland capsule
36
Q

Trigeminal (CN V) in the face

A
  • has 3 branches: ophthalmic (V1), maxillary nerve (V2), mandibular (V3)
37
Q

Ophthalmic nerve (V1)

A
-Branches:Lacrimal, Supraorbital
Supratrochlear, Infratrochlear, External nasal, Frontal
-Sensory innervation 
  -skin of forehead
  -scalp
  -upper eyelids and nose
  -conjunctiva of upper eyelid
  -mucosa of frontal sinus
  -lacrimal gland
38
Q

Maxillary nerve (V2)

A
  • Branches: Infraorbital, Zygomatic
  • Sensory Innervation
    • skin of zygomatic arch
    • anterior temporal region
    • Cheek
    • lower lid
    • lateral nose
    • upper lip
    • Maxillary teeth
    • mucosa of upper oral region
    • Maxillary sinus
39
Q

Mandibular (V3)

A
  • Branches:Auricotemporal,Buccal, Mental
  • Sensory Innervation
    • skin anterior to ear
    • posterior temporal region
    • Auricle
    • Cheek
    • Chin and lower lip
    • Mucosa of cheek
    • Buccal gingiva and lower lip
    • Mandibular teeth
40
Q

Arterial vasculature of the face

A
  • Arise from external and internal carotid arteries

- Most arteries of the face are branches of the external carotid artery

41
Q

facial artery

A
  • Most prominent artery of the face
  • Branch of the external carotid
  • Travels over inferior border of mandible as it travels through the submandibular gland
  • Medial portion of face to the eye
  • Branches anastomose with branches of the ophthalmic artery of internal carotid artery
42
Q

facial artery branches

A
  • Ascending palatine: Palatine tonsil and bed
  • Tonsillar: Palatine tonsil and bed
  • Glandular: Submandibular gland
  • Submental: Structures of submental triangle
  • Inferior labial: Lower lip
  • Superior labial: Upper lip
  • Angular: Medial angle of the eye
43
Q

Ophthalmic artery branches

A
  • Branch of internal carotid artery
  • Anastomoses with facial artery
  • Branches include:
    • Supraorbital: upper eyelid, forehead, scalp
    • Supratrochlear: upper eyelid, forehead, scalp
    • Dorsal nasal: upper eyelid, lacrimal sac, bridge of nose
    • Lacrimal: internal aspect of upper lid
    • External nasal:median aspect of external nose below the nasal bones
    • Zygomatic: skin of upper temporal region
44
Q

Maxillary artery branches

A
  • Infraorbital
    • Inferior palpebral: lower eyelid
    • Nasal – lateral nose
    • Superior labial – upper lip
  • Buccal: skin and mucous membranes of cheek, vestibular gingiva of mandibular molars
  • Mental: chin, lower lip, vestibular gingiva of mandibular anterior teeth