Face and Scalp G43 Flashcards
Supraorbital notch contains
supraorbital and supratrochlear nerves and vessels
Palpebral fissure
slit between eyelids
Dorsum of nose
runs between the root and apex of nose
External nares
openings or nostrils
Alae
flared margins of the nostrils
3 nasal cartilages are:
lateral, septal, and alar
Vermillion
red zone of lips surrounds oral region
Philtrum
groove running from nasla septum to the upper lip
Competent lips
at rest, lips are lightly closed
Muscles of fascial expression are in what layer?
SUPERFICIAL FASCIA and originate on bone of fascia and insert on skin
Orbicularis oculi (3 parts and actions)
Orbital part: peripheral portion from orbital margin and medial palpebral ligament
Palpebral part: medial palpebral ligament to lateral palpebral raphe
Lacrimal part: posterior to lacrimal sac
sphincter of the eye
Responsible for less forceful closure of the eye (winking, blinking)
palpebral portion of orbicularis oculi
Responsible for forceful closure of eye
orbital portion of orbicularis oculi
Levator labii superioris alaeque nasi
maxilla to upper lip along side of nose, elevates lip and flares nostrils
Levator labii superioris
maxilla, inferior margin of orbit (deep to orbicularis oculi) to lateral half of upper lip, elevates lip
Zygomaticus minor
zygomatic bone (in front of major) oblique to lateral part of upper lip, elevates upper lip
Zygomaticus major
zygomatic bone oblique to corner of mouth, pulls mouth upward and outward, as in smiling and laughing
Levator anguli oris
maxilla to corner of mouth (deep to levator labii superiors) elevates corners of mouth
Risorius
parotid fascia and buccal skin to corner of mouth, widens mouth
Depressor anguli oris
mandible to angle of mouth, triangular shaped, depresses corners of mouth (grief)
Depressor labii inferioris
mandible to middle lower lip (fibers decussate), depresses lower lip and pulls it lateral
Mentalis
incisive fossa of mandible to chin, raises and protrudes lower lip (pout)
Orbicularis oris
fibers encircling the mouth interlacing with other facial muscles and the buccinator; lies within upper and lower lips encircling the oral orifice; protrudes, purses and closes lips
Buccinator
pterygomandibular raphe, mandible, and maxilla to insert on mouth, forming substance of the cheek, pierced by the parotid duct, aids in chewing, whistling, and blowing
pterygomandibular raphe
ligamentous band of the buccopharyngeal fascia, attached superiorly to the hamulus of the medial pterygoid plate, and inferiorly to the posterior end of the mylohyoid line of the mandible
What muscle is pierced by the parotid duct
buccinator
Platysma
from superficial fascia of the thorax through neck to lower face, wrinkles skin and active in DEEP inspiration
Occipitofrontalis
Frontalis + Occipitalis connected by an epicranial aponeurosis
Frontalis
epicranial aponeurosis to skin of forehead, wrinkles skin of forehead (both sides injured in Bell’s Palsy, in upper motor injury can still move with emotions
Occipitalis
occipital bone to epicranial aponeurosis, pulls scalp posteriorly and wrinkles skin on back of head
Two muscles of mastication?
Temporalis and Masseter
Masseter
zygomatic arch to angle and lateral surface of ramus of mandible to ELEVATE mandible and protract
Temporalis
temporal fossa (inferior temporal line) and fascia and tendon inserts on coronoid process of mandible, vertical fibers elevate and horizontal fibers retract mandible
What nerve innervates muscles of facial expression? (motor)
CN VII Facial n.
Path of facial n
through internal auditory meatus -> stylomastoid foramen through Parotid gland
Branches of facial n
temporal, zygomatic, buccal, marginal mandibular, and cervical
Motor innervation to the muscles of mastication?
Cranial Nerve V3 - Mandibular nerve (trigeminal)
Temporal, masseter, lateral and medial pterygoids
Sensory innervation to the face?
Cranial nerve V - Trigeminal n.
CNV-1
Opthalmic division: sensory to forehead, upper eye, and nose
Branches of CNV-1
Supraorbital and supratrochlear n.(medial eye and forehead) via supraorbital foramen (forehead and upper eye)
CNV-2
Maxillary division: sensory to lower eyelid, cheek, and upper lip
CNV-2 branch
Infraorbital n. via infraorbital foramen
CNV-3
Mandibular division: sensory to skin over mandible, lower lip, cheek, auricle, temple and MOTOR to muscles of mastication
CNV-3 branches
Mental n.: mental foramen to sensory over lip and mandible
Buccal n.: sensory to cheek and mucous membranes
Auriculotemporal n.:sensory to face and scalp in temporal region
What nerve supplies MOTOR innervation to the muscles of mastication?
Mandibular branch of the trigeminal n.
Great auricular n.
From cervical plexus also give sensory innervation to the auricle and angle of mandible
Bell’s Palsy
unilateral loss of innervation to facial expression muscles, unknown etiology, possibly from viral infection
Trigeminal Neuralgia
sensory disorder often involving regions supplied by V-2 and V-3, may be due to small arteries rubbing myelin sheath of trigeminal n.
Facial a.
Branch of the external carotid, crosses mandible anterior to masseter (can feel pulse, only covered by skin and platysma), tortuous as it heads towards nose, supplies lips and nose
Superficial temporal a.
Terminal branch of external carotid, passes upward in the temporal region
Supraorbital a., aupratrochlear a., infraorbital a., and mental a.
ALL course with veins and nerves of same name
Superficial temporal v.
joins the maxillary v. to form the retromandibular v.
Retromandibular v.
formed by superficial temporal and maxillary v., divides into two branches that will drain into internal and external jugular
Facial v.
joins the branch of the retromandibular v. that eventually drains into the internal jugular v., connections to the opthalmic v.
How can infection of the face spread to the interior of the cranium?
Bc the facial v. has connections to the opthalmic v, which drains into the interior of the cranium, VALVELESS VEINS allow the blood flow to pass in either direction, allowing infection to pass back into the cranium
Opthalmic v.
Opthalmic v. connects with facial v and drains into the cavernous sinus, spreading infections intracranially
Parotid lymph node
drains lateral face and scalp
Submandibular lymph node
drain upper lip and lateral lower lip
Submental lymph node
drain chin and central part of the lower lip
Deep cervical lymph nodes
along the internal jugular vein receive lymph from superficial lymph nodes
Scalp boundaries
Superior nuchal line to supraorbital margins to zygomatic arches
SCALP (S)
Skin: hair, sweat and sebaceous glands
SCALP (C)
Connective tissue: Superficial fascia, thick, dense, irregular CT with fat, arteries, veins, and nerves
SCALP (A)
Aponeurosis: Epicranial aponeurosis, thin membranous tendon of occipitofrontalis (facial n innervation) Skin, CT, and Aponeurosis are tightly bound
SCALP (L)
Loose CT: areolar CT, permitting movement of S,C, and A; fluid accumulation, anteriorly space extends into eyelids
SCALP (P)
Periosteum: loosely attached to bone, except over cranial sutures
Which layer of the scalp covering would allow fluid to accumulate in the eyes
LOOSE CT
Blood supply to scalp
Internal and External carotid branches: Supratrochlear, supraorbital, superficial temporal, posterior auricular, and occipital
Why would a cut to the scalp bleed profusely?
Extensive anastomoses of the arteries, and the occipitofrontalis m. pulls the cut apart
Emissary veins
veins that pass into the skull and drain into the dural venous sinuses
Sensory innervation to the scalp
Trigeminal n, C2 and C3 dorsal rami, and cervical plexus (ventral rami of cervical spinal nerves)
Parotid gland Region
angle of mandible to zygomatic arch to sternocleidomastoid posteriorly
Superficial part of the parotid gland
lies of the surface of the masseter
Deep part of the parotid gland
lies behind the ramus of the mandible
Deep part of the parotid contains:
External carotid a (terminal branches), retromandibular v., and auriculotemporal n.
Parotid duct pierces what muscle? and opens into what?
Buccinator; oral cavity opposite the second upper molar tooth
Parotid gland is surrounded by
Dense CT capsule derived from investing fascia of the neck
Mumps
causes inflammation of the parotid gland, putting pressure on the capsule, resulting in pain
Sympathetic innervation to the parotid gland
postganglionic sympathetic fibers carried on EXTERNAL CAROTID A
Parasympathetic innervation to the parotid gland
SECRETOMOTOR; postganglionic parasympathetic fibers carried by the auriculotemporal n.
Great Auricular Nerve
SENSORY innervation to the parotid gland, parotid sheath, and overlying skin
Structures embedded in the parotid gland (superficial to deep) NVA
Facial n. and its divisions, Retromandibular v, External Carotid a. (posterior auricular a., superficial temporal a., maxillary a.)
Viscerocranium
face (mainly maxilla and zygomatic)
glabella
space between the eyebrows, with crease
buccal fat pad
superior to buccinator, prominent in infants
the superficial and deep parotid parts are separated by what?
the facial n
What nerve innervates the muscles of facial expression?
CN7: Facial N
The supratrochlear and supraorbital n are branches of what cranial nerve?
CN5: Trigeminal N, Opthalmic division CN 5-1
What 2 muscles can elevates the upper lip
levator labii superioris and levator labii superioris alaeque nasi
What nerve innervates the buccinator muscle?
CN7: Facial N
Trigeminal nerve division that supplies the area beneath the eye?
Maxillary division -> infraorbital n.
