Face and Scalp Flashcards
The scalp consists of five layers, with the first three layers intimately bound together. What are they.
• A mnemonic device uses the first letter of each of the five layers, forming the word SCALP.
- Skin – thick, with hair and sebaceous glands.
- Connective tissue – fibrous, fatty connective tissue with septa that connect the skin to the aponeurosis.
- Aponeurosis – (epicranial), a thin, tendinous sheet that connects the bellies of the occipitofrontalis.
- Loose areolar connective tissue – located in the subaponeurotic space.
- Pericranium – the periosteum covering the outer surface of the skull bones.
Muscles of the Scalp
• The _______ has two bellies.
occipitofrontalis
Muscles of the Scalp
The _______ belly originates from the nuchal line of the occipital bone and inserts into the epicranial aponeurosis.
occipital
Muscles of the Scalp
The ______ belly originates from the skin and superficial fascia of the eyebrow area and inserts into the epicranial aponeurosis.
frontal
Muscles of the Scalp
The action of the ______ is to move the scalp on the skull and raise the eyebrows. It is innervated by the facial nerve.
occipitofrontalis
Sensory Nerve Supply of the Scalp
The sensory nerves are located in the _________.
superficial fascia
Sensory Nerve Supply of the Scalp
What are the nerves of the scalp?
- Supratrochlear nerve
- Zygomaticotemporal nerve
- Auriculotemporal nerve
- Lesser occipital nerve
- Greater occipital nerve
Sensory Nerve Supply of the Scalp
The _______ nerve is a branch of the ophthalmic division of the trigeminal nerve.
supratrochlear
Sensory Nerve Supply of the Scalp
______ nerve is a branch of the ophthalmic division of the trigeminal nerve.
Supraorbital
Sensory Nerve Supply of the Scalp
________ nerve is a branch of the maxillary division of the trigeminal nerve.
Zygomaticotemporal
Sensory Nerve Supply of the Scalp
________ nerve is a branch of the mandibular division of the trigeminal nerve.
Auriculotemporal
Sensory Nerve Supply of the Scalp
___________ nerve is a branch of the cervical plexus (C2)
Lesser occipital
Sensory Nerve Supply of the Scalp
___________ nerve is a branch of the dorsal ramus of C2.
Greater occipital
Arterial Supply of the Scalp
The scalp has an extensive blood supply, and for this reason any cut to the scalp bleeds profusely. What are the arteries?
- Supratrochlear artery
- Supraorbital artery
- Superficial temporal artery
- Posterior auricular artery
- Occipital artery
Arterial Supply of the Scalp
_____ and ______ arteries are branches of the ophthalmic artery and they ascend over the forehead.
Supratrochlear and supraorbital arteries
Arterial Supply of the Scalp
_________ is a terminal branch of the external carotid artery. It ascends IN FRONT of the ear.
Superficial temporal artery
Arterial Supply of the Scalp
________ is a branch of the external carotid artery; ascends BEHIND the ear.
Posterior auricular artery
Arterial Supply of the Scalp
_____ is a branch of the external carotid artery; supplies the skin over the back of the skull.
Occipital artery
Venous Drainage of the Scalp
The ____and ______ veins unite at the medial margin of the orbit to form the facial vein.
supratrochlear and supraorbital veins
Venous Drainage of the Scalp
The ________ unites with the maxillary vein to form the retromandibular vein.
superficial temporal vein
Venous Drainage of the Scalp
The _______ unites with the posterior division of the retromandibular vein to form the external jugular vein.
posterior auricular vein
Venous Drainage of the Scalp
The ______ drains into the suboccipital venous plexus, which in turn drains into the vertebral veins or the internal jugular vein.
occipital vein
Venous Drainage of the Scalp
The veins of the scalp freely anastomose with each other and are connected to the _______ veins of the skull bones and the intracranial venous sinuses via _____ veins.
diploic
emissary
Lymph Drainage of the Scalp
Lymph vessels in the anterior part of the scalp and forehead drain into the ______ lymph nodes.
submandibular
Lymph Drainage of the Scalp
Drainage from the lateral part of the scalp above the ear is into the ________ nodes.
superficial parotid (preauricular)
Lymph Drainage of the Scalp
Lymph vessels in the part of the scalp above and behind the ear drain into the ______ nodes.
mastoid nodes
Lymph Drainage of the Scalp
Vessels in the back of the scalp drain into the _____ nodes.
occipital nodes
Clinical Correlate: Scalp Lacerations
- The scalp has an abundant blood supply to nourish the hair follicles.
- Even a small laceration of the scalp can cause severe blood loss.
- Bleeding of the scalp is often hard to stop because the arterial walls are attached to ________ in the subcutaneous tissue.
- The attachment to the ______ makes the walls unable to contract or retract and this prevents ____ from taking place.
- Local pressure applied to the laceration is the only effective way to stop the bleeding.
Clinical Correlate: Scalp Lacerations
- The scalp has an abundant blood supply to nourish the hair follicles.
- Even a small laceration of the scalp can cause severe blood loss.
- Bleeding of the scalp is often hard to stop because the arterial walls are attached to fibrous septa in the subcutaneous tissue.
- The attachment to the fibrous septa makes the walls unable to contract or retract and this prevents blood clotting from taking place.
- Local pressure applied to the laceration is the only effective way to stop the bleeding.
Clinical Correlate: Scalp Lacerations
- The tension of the epicranial aponeurosis, which is produced by the tone of the _______, is an important factor in deep wounds of the scalp.
- If the aponeurosis has been divided, the wound will gape open.
- For healing to take place, the cut in the aponeurosis must be sutured.
occipitofrontalis muscle
The Face: Skin
• The skin of the face possesses many sweat and sebaceous glands.
• It is connected to the underlying bones by _____ connective tissue; the muscles of facial expression are embedded in this connective tissue.
loose connective tissue
Note: It is in loose connective tissue where muscles of facial expression are embedded.
The Face: Skin
• There is no ____ fascia in the face.
deep
The Face: Skin
• Wrinkles of the face result due to repeated folding of the skin ______ to the long axis of the underlying muscles.
- Aging skin loses its elasticity, which also contributes to wrinkle formation.
- Surgical scars of the face are less conspicuous if they follow the wrinkle lines.
perpendicular
The Face: Sensory Nerves
• The skin of the face is supplied by branches of the three divisions of the trigeminal nerve, except for a small area over the angle of the ______ and the ____ gland, which is supplied by the great auricular nerve (C2 and 3).
mandible and the parotid gland
The Face: Sensory Nerves
• The branches of the trigeminal nerve also supply sensory innervation to the mouth, teeth, nasal cavities, and paranasal air sinuses.
• The divisions of the trigeminal nerve are: ______, _________, _________.
Ophthalmic, Maxillary, Mandibular.
Ophthalmic Division
• The ophthalmic division supplies the skin of the forehead, the upper eyelid, the conjunctiva, and the side of the nose down to and including the tip.
There are five branches. What are they?
- Lacrimal nerve
- Supraorbital nerve
- Supratrochlear nerve
- Infratrochlear nerve
- External nasal nerve
Maxillary Division
- The maxillary division supplies the skin on the posterior part of the side of the nose, the lower eyelid, the cheek, the upper lip, and the lateral side of the orbital opening.
- There are three cutaneous branches and they are: _______, _________, and ________.
- Infraorbital nerve
- Zygomaticofacial nerve
- Zygomaticotemporal nerve
Mandibular Division
• The mandibular nerve supplies the skin of the lower lip, the lower part of the face, the temporal region, and part of the ear.
• There are three cutaneous branches: _______, ________, and ________
- Mental nerve
- Buccal nerve
- Auriculotemporal nerve
Arterial Supply of the Face
• The face receives its arterial supply from two sources: the ____ and ______ arteries.
facial and superficial temporal arteries
Arterial Supply of the Face
The blood supply is supplemented by small arteries that accompany the sensory nerves of the face.
- The facial artery courses upward and over the ________ gland.
- It curves around the inferior border of the mandible at the anterior border of the masseter muscle.
submandibular salivary gland
Arterial Supply of the Face
• The pulse of the facial artery can be felt where it crosses the mandible.
- The facial artery is covered by the _______ and ______ muscles and takes a torturous course from the angle of the mouth to the medial angle of the eye.
- At the medial angle of the eye, the facial artery anastomoses with branches of the _______ artery.
platysma and risorious muscles
ophthalmic
Arterial Supply of the Face
• The branches of the facial artery are:
- Submental artery
- Inferior labial artery
- Superior labial artery
- Lateral nasal artery
- Superficial temporal artery
- Transverse facial artery (a branch of the superficial artery)
- The supraorbital and supratrochlear arteries, branches of the ophthalmic artery, supply the skin of the forehead.
Venous Drainage of the Face
• The facial vein is formed at the medial angle of the eye by the union of the _____and ________veins.
supraorbital and supratrochlear veins
Venous Drainage of the Face
• The facial vein is connected to the superior ophthalmic vein directly through the _______vein.
supraorbital vein
Venous Drainage of the Face
• The facial vein is connected to the ____ sinus by way of the superior ophthalmic vein; this connection is very important clinically because it provides a path for infection to spread from the face to the cavernous sinus.
cavernous sinus
Venous Drainage of the Face
• The facial vein descends behind the facial artery to the lower margin of the mandible.
• It crosses superficial to the _______ gland and is joined by the anterior division of the ______ vein.
submandibular salivary gland
retromandibular vein
Venous Drainage of the Face
• The facial vein drains into the _______.
internal jugular vein
Venous Drainage of the Face
• The facial vein receives tributaries that correspond to the branches of the facial artery.
- It is also joined to the ________ plexus by the deep facial vein and to the cavernous sinus by the ______vein.
- The transverse facial vein joins the superficial temporal vein in the ______ gland.
pterygoid venous plexus
superior ophthalmic vein
parotid gland
Lymph Drainage of the Face
• Lymph from the forehead and the anterior part of the face drains into the 1. __________ nodes. There may be a few 2._____ lymph nodes along the course of these lymph vessels.
- submandibular lymph nodes
2. buccal lymph nodes
Lymph Drainage of the Face
- The lateral part of the face, including the lateral parts of the eyelids, is drained by lymph vessels that terminate in the 1._____ lymph nodes.
- The central part of the lower lip and the skin of the chin drain into the 2.______ lymph nodes.
parotid lymph nodes
submental lymph nodes
Muscles of Facial Expression
- The muscles of the face are embedded in the ______ fascia.
- Most of the muscles originate from the bones of the skull and insert into the skin.
superficial fascia
Muscles of Facial Expression
• The facial orifices, the orbit, nose, mouth, are surrounded by _______ or _______.
sphincters or dilators.
Muscles of Facial Expression
- Facial muscles also modify facial expression.
- All facial muscles are innervated by the _____ nerve.
facial nerve
Muscles of Facial Expression
• The sphincter muscle of the eyelid is the orbicularis oculi and the dilator muscles are the ________ and _______.
levator palpebrae superioris and occipitofrontalis
Muscles of Facial Expression
• The sphincter muscle of the nose is the ________- and the dilator is the ________.
compressor naris
dilator naris
Muscles of Facial Expression
• The sphincter muscle of the mouth is the ________; the dilator muscles consist of a series of small muscles that radiate out from the lips.
orbicularis oris
Muscles of the Lips and Cheeks
- The dilator muscles of the lips radiate out from the lips.
- Their action is to separate the lips.
- The muscles arise from bones and fascia around the mouth and converge as they insert into the lips.
- The list of the muscles is:
• These muscles are innervated by the buccal and mandibular branches of the facial nerve.
• The list of the muscles is:
- Levator labii superioris alaeque nasi
- Levator labii superioris
- Zygomaticus major and minor
- Zygomaticus minor
- Levator anguli oris
- Risorious
- Depressor anguli oris
- Depressor labii inferioris
- Mentalis
• These muscles are innervated by the buccal and mandibular branches of the facial nerve.
Muscle of the Cheek: Buccinator
• The buccinator originates from the outer surface of the alveolar margins of the mandible and maxilla, opposite the molars; it also originates from the _________ ligament.
pterygomandibular ligament
Muscle of the Cheek: Buccinator
• The buccinator is pierced by the _____ duct.
parotid duct
Muscle of the Cheek: Buccinator
• At the angle of the mouth, the muscle fibers decussate, or cross, and then blend with and forms part of, the ________.
orbicularis oris
Muscle of the Cheek: Buccinator
- The buccinator is innervated by the buccal branch of the facial nerve.
- Its action is to ________ the cheeks and lips against the teeth.
compress
Facial Nerve
• The facial nerve runs forward in the substance of the parotid gland, where it divides into its five terminal branches. What are they?
*Remember the nmeonic: To Zanzibar By Motor Car
- Temporal branch
- Zygomatic branch
- Mandibular branch
- Cervical branch
Facial Nerve
The ________ supplies the anterior and superior auricular muscles, frontal belly of occipitofrontalis, orbiularis oculi, and corrugator supercilii.
temporal branch
Facial Nerve
The ________ supplies orbicularis oculi.
Zygomatic branch
Facial Nerve
The ________ supplies buccinator, muscles of the upper lip and nostril. .
Buccal branch
Facial Nerve
The ________ supplies muscles of the lower lip.
Mandibular branch
Facial Nerve
The ________ supplies platysma.
Cervical branch
