FACE AND SCALP Flashcards
1
Q
The SCALP
A
-Consist of five layers (Skin, Connective tissue, Aponeurosis, Loose areolar connective tissue, and Pericranium)
_ First three layers intimately bound together
2
Q
Skin
A
Thick, with hair and sebaceous glands
3
Q
Connective Tissue
A
Fibrous, fatty connective tissue with septa that connects the skin to the aponeurosis
4
Q
Aponeurosis
A
(Epicranial) a thin, tendinous sheet that connects the bellies of the occipitofrontalis
5
Q
Loose areolar CT
A
Located in the subaponeurotic space
6
Q
Pericranium
A
The periosteum covering the outer surface of the skull bones
7
Q
Occipitofrontalis
A
Muscle of the scalp
8
Q
Occipitofrontalis action is
A
To move the scalp on the skull and rise the eyebrows
9
Q
Occipitofrontalis is innervated by
A
The facial nerve
10
Q
The Occipitofrontalis has two bellies (parts):
A
1- The occipital belly originates from the nuchal line of the occipital bone and inserts into the epicranial aponeurosis
2- The frontal belly originates from the skin and superficial fascia of the eyebrow area and inserts into the epicranial aponeurosis (minor action)
11
Q
Sensory Nerves of the Scalp are located in
A
The superficial fascia
12
Q
Sensory Nerves of the Scalp
A
- Supratrochlear nerve (CN4)
- Supraorbital nerve
- Zygomaticotemportal nerve
- Auriculotemporal nerve
- Lesser occipital nerve
- Greater occipital nerve
13
Q
Supratrochlear nerve
A
Branch of the ophthalmic division of the trigeminal nerve
14
Q
Supraorbital nerve
A
Branch of the ophthalmic division of the trigeminal nerve
15
Q
Zygomaticotemporal nerve
A
Branch of the maxillary division of the trigeminal nerve
16
Q
Auriculotemporal nerve
A
Branch of the mandibular division of the trigeminal nerve
17
Q
Lesser occipital nerve
A
A branch of the cervical plexus (C2)
18
Q
Greater occipital nerve
A
A branch of the dorsal ramus of C2
19
Q
The scalp has an extensive
A
Blood supply, so any cut to the scalp bleeds profusely
20
Q
Arterial supply of the scalp
A
- Supratrochlear and Supraorbital arteries
- Superficial temporal artery
- Posterior auricular artery
- Occipital artery
21
Q
Supratrochlear and Supraorbital arteries
A
Branches of the ophthalmic artery, ascends over the forehead
22
Q
Superficial temporal artery
A
Terminal branch of the external carotid artery; ascends in front of the ear
23
Q
Posterior auricular artery
A
A branch of the external carotid artery, ascends behind the ear
24
Q
Occipital Artery
A
A branch of the external carotid artery; supplies the skin over the back of the skull
25
The veins of the scalp freely (important to remember)
Anastomose with each other and are connected to the diploic veins of the skull bones and the intracranial venous sinuses via emissary veins
26
Veins of the scalp
- Supratrochlear and Supraorbital veins
-The superficial temporal vein
-The posterior auricular vein
_ The occipital vein
27
The supratrochlear and Supraorbital veins
Unite at the medial margin of the orbit to form the facial vein
28
The superficial temporal vein
Unites with the maxillary vein to form the retromandibular vein
29
The posterior auricular vein
Unites with the posterior division of the retromadibular vein to form the external jugular vein
30
The occipital vein
Drains into the suboccipital venous plexus, which in turn drains into the vertebral veins or the internal jugular vein
31
Lymph vessels in the anterior part of the scalp and forehead drain into
the submandibular lymph nodes.
32
Drainage from the lateral part of the scalp above the ear is into
the superficial parotid (preauricular) nodes.
33
Lymph vessels in the part of the scalp above and behind the ear drain into
the mastoid nodes
34
Vessels in the back of the scalp drain into
the occipital nodes.
35
Bleeding of the scalp is often hard to stop because
the arterial walls are attached to fibrous septa in the subcutaneous tissue
Note: The attachment to the fibrous septa makes the walls unable to contract or retract to allow blood clotting to take place. Local pressure applied to the laceration is the only
effective way to stop the bleeding. The tension of the epicranial aponeurosis,
which is produced by the tone of the
occipitofrontalis muscle, 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
36
1-The skin of the face possesses
2- It is connected to the underlying bones
3- There is NO
4- Wrinkles of the face result due to
1- many sweat and sebaceous
glands
2- by loose connective
tissue; the muscles of facial expression are embedded in this connective tissue.
3- deep fascia in the face
4- repeated folding of the
skin perpendicular to the long axis of the underlying muscles
37
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 mandible and the parotid gland, which is supplied by the great auricular nerve(C2 and 3)
38
The divisions of the trigeminal nerve are
Ophthalmic, Maxillary, Mandibular
39
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.
40
There are five branches in the Ophthalmic Division
```
– Lacrimal nerve
– Supraorbital nerve
– Supratrochlear nerve
– Infratrochlear nerve
– External nasal nerve
```
41
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.
42
There are three cutaneous branches of the Maxillary Division
– Infraorbital nerve
– Zygomaticofacial nerve
– Zygomaticotemporal nerve
43
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.
44
There are three cutaneous branches of the Mandibular Division
– Mental nerve
– Buccal nerve
– Auriculotemporal nerve
45
The face receives its arterial supply from two sources:
the facial and superficial temporal arteries
46
The facial artery courses
upward and over the submandibular
salivary gland. It curves around the inferior border of the mandible at the anterior
border of the masseter muscle. The pulse of the facial artery can be felt where it crosses the mandible.
47
The facial artery is covered by
the platysma and risorious 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 ophthalmic artery
48
The branches of the facial artery are:
– Submental artery
– Inferior labial artery
– Superior labial artery
– Lateral nasal artery
49
Superficial temporal artery
Transverse facial artery (a branch of the superficial artery)
50
The supraorbital and supratrochlear arteries,
branches of the ophthalmic artery, supply the skin of the forehead.
51
The facial vein is formed at the medial angle of the eye by
the union of the supraorbital and supratrochlear veins. It is connected to the superior ophthalmic vein directly
through the supraorbital vein.
52
The facial vein is connected to the cavernous 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.
53
The facial vein descends behind the
facial artery to the lower margin of the mandible. It crosses superficial to the submandibular salivary gland
and is joined by the anterior division of the
retromandibular vein.
54
The facial vein drains into
the internal jugular vein
55
The facial vein receives tributaries that
| correspond to the branches of
the facial artery. It is also joined to the pterygoid venous plexus by the deep facial vein and to the cavernous sinus by the superior ophthalmic vein. The transverse facial vein joins the superficial
temporal vein in the parotid gland.
56
Lymph from the forehead and the anterior part of the face drains into the
submandibular lymph nodes
57
There may be a few
buccal lymph nodes along the course of these lymph vessels.
58
The lateral part of the face, including the lateral parts of the eyelids, is drained by lymph vessels that terminate in
the parotid lymph nodes.
59
The central part of the lower lip and the skin of the chin drain into
the submental lymph nodes
60
The muscles of the face are embedded within
the superficial fascia. Most of the muscles originate from the bones of the skull and insert into the skin. The facial orifices, the orbit, nose, mouth, are surrounded by sphincters or dilators. Facial muscles also modify facial expression.
61
All facial muscles are innervated by
the facial nerve
62
The sphincter muscle of the eyelid is
the orbicularis oculi and the dilator muscles are the levator palpebrae superioris and occipitofrontalis
63
The sphincter muscle of the nose is the
compressor naris and the dilator is the dilator naris
64
The sphincter muscle of the mouth is
the orbicularis oris; the dilator muscles consist of a series of small muscles that radiate out from the lips
65
Muscles of the Lips and Cheeks
```
--Levator labii superioris alaeque nasi
– Levator labii superioris
– Zygomaticus major and minor
– Levator anguli oris
– Risorious
– Depressor anguli oris
– Depressor labii inferioris
– Mentalis
```
66
The orbicularis oris is the sphincter muscle of
the lips. The muscle encircles the mouth within the substance of the lips. Some fibers originate from the underlying bones,
while others arise from the deep surface of the skin.
67
The orbicularis oris is innervated by
the buccal and mandibular branches of the facial nerve.
68
The action of this muscle is
to compress the lips together
69
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.
70
Muscles of the Lips and Cheeks are innervated by
These muscles are innervated by the buccal and mandibular
| branches of the facial nerve.
71
Muscle of the Cheek
Buccinator
72
The buccinator originates from
the outer surface of the
alveolar margins of the mandible and maxilla, opposite the molars; it also originates from the pterygomandibular ligament.
73
The buccinator is pierced by
the parotid duct. At the angle of the mouth, the muscle fibers decussate, or cross, and then blend with and forms part of, the
orbicularis oris.
74
The buccinator is innervated by
the buccal branch of the facial nerve. Its action is to compress the cheeks and lips against the teeth.
75
The facial nerve runs
forward in the substance of the
parotid gland, where it divides into its five terminal branches (Temporal branch, Zygomatic branch, Buccal branch, Mandibular branch, Cervical branch)
76
Temporal branch
supplies the anterior and superior
| auricular muscles, frontal belly of occipitofrontalis, orbiularis oculi, and corrugator supercilii.
77
Zygomatic branch
supplies orbicularis oculi
78
Buccal branch
supplies buccinator, muscles of the upper
| lip and nostril.
79
Mandibular branch
supplies muscles of the lower lip
80
Cervical branch
supplies platysma
