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MD1 Neuroscience > Face, Scalp and Parotid > Flashcards

Face, Scalp and Parotid Flashcards

1
Q

What is the extent of the scalp?

A

From nuchal line to supraorbital margins

Laterally extends down to zygomatic arches

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2
Q

What does the nuchal line correspond to?

A

External posterior protuberance

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3
Q

What are the five layers of the scalp?

A 
S - skin
C - connective tissue (dense)
A - aponeurosis
L - loose connective tissue
P - pericranium
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4
Q

What does the skin have associated with it?

A

Hair follicles

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5
Q

What is in the dense connective tissue layer?

A

Fat
Vessels
Nerves

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6
Q

What muscle is the aponeurosis of the scalp of?

A

Occipitofrontalis

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7
Q

What are the two bellies of the occipitofrontalis?

A 
Anterior = frontalis
Posterior = occipitalis
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8
Q

What does the occipitofrontalis do?

A

Moves scalp

Frowns forehead

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9
Q

Why does a scalp wound deep to the aponeurosis gape?

A

Opposing pull of two bellies of occipitofrontalis

Also contributes to heavy bleeding

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10
Q

Why can you move the upper part of the scalp?

A

Because of loose connective tissue layer

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11
Q

Which layers of the scalp are moved when you “move the scalp”?

A

Outer three layers that are fused together over bone

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12
Q

Why can infection localise in the loose connective tissue of the scalp?

A

Because of consistency

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13
Q

What is under the periosteum/pericranium?

A

Skull and meninges

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14
Q

Which layer of the scalp is the neurovascular layer?

A

Layer 2

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15
Q

Which arteries are in the scalp?

A

Branches of internal and external carotid arteries

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16
Q

Do the branches of the internal and external carotid arteries communicate in the scalp?

A

Yes, via free and rich anastomoses

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17
Q

Why do scalp wounds bleed so heavily?

A

Because of rich arterial supply

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18
Q

Why don’t scalp wounds clot easily, and therefore contribute to the heavy bleeding?

A

Connective tissue septa in layer 2 adhere to margins and hold open cut vessels

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19
Q

What is the best treatment to stop bleeding in a scalp wound?

A

Apply tourniquet around head near wound

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20
Q

What is the difference in the layered organisation between the face and scalp?

A

No layer 4

No aponeurosis - muscles of facial expression instead

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21
Q

What is the origin of the muscles of facial expression?

A

Bone or fascia

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22
Q

What is the attachment of the muscles of facial expression?

A

Skin of face

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23
Q

What are the muscles of facial expression arranged around?

A

Facial orifices

  • Eye
  • Nasal cavity
  • Mouth
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24
Q

What is the arrangement of the muscles of facial expression around the orifices?

A

Surround orifice as sphincter - close

Radiate out linearly from orifice - open

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25
Q

What are pharyngeal arches?

A

Embryological structures each supplied by a cranial nerve

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26
Q

Where are the muscles of facial expression derived from?

A

Second pharyngeal arch

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27
Q

Which nerve supplies the muscles of facial expression?

A

CN VII - facial nerve

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28
Q

Which nerve/s supply the sensory information from the skin of the face and scalp anterior to the ears?

A

CN V - trigeminal nerve

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29
Q

What are the three divisions of the trigeminal nerve?

A

Ophthalmic
Maxillary
Mandibular

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30
Q

What region does the ophthalmic nerve innervate?

A

Eye region including forehead and top of nose

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31
Q

What region does the maxillary nerve innervate?

A

Cheek region

  • Cheek
  • Upper lip
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32
Q

What region does the mandibular region innervate?

A

Jaw region

  • Lower lip
  • Jaw
33
Q

Where does mandibular innervation go laterally?

A

Turns up to go over ear

34
Q

What is the cutaneous innervation to the skin behind the ear?

A

Articular branch of CN X - vagus nerve

35
Q

What cutaneous innervation does the skin on the back of the head have?

A

Dorsal rami

36
Q

What is the cutaneous innervation of the C1 dorsal ramus?

A

None

37
Q

What is the cutaneous innervation of the C2 dorsal ramus?

A

Back of head

38
Q

What is the cutaneous innervation of the C3 dorsal ramus?

A

Back of neck - where cervical collar worn

39
Q

What kind of nerve is the mandibular nerve?

A

Mixed

40
Q

What is the motor innervation of the mandibular nerve?

A

Muscles of mastication

41
Q

What does the trigeminal ganglion divide into?

A

Ophthalmic nerve
Maxillary nerve
Mandibular nerve

42
Q

Where is he trigeminal ganglion?

A

Apex of petrous part of temporal bone - in middle of middle cranial fossa

43
Q

What is the route of the ophthalmic nerve?

A

Exits skull via superior orbital fissure
Enters orbit
Up forehead

44
Q

What is the route of the maxillary nerve?

A

Exits skull via foramen rotundum

Onto cheek

45
Q

What is the route of the mandibular nerve?

A

Exits skull via foramen ovale

Onto jaw

46
Q

What area of the scalp does the ophthalmic branch of the internal carotid supply?

A

Central forehead via branches winding out of orbit

47
Q

What are the two major branches of the internal carotid on the central forehead?

A 
Medial = supratrochlear arteries
Lateral = supraorbital arteries
48
Q

What is the main artery of the face?

A

Facial artery

49
Q

What artery is the facial artery a branch of?

A

External carotid artery

50
Q

What is the route of the facial artery?

A

Winds around inferior border of mandible and onto face
Heads to inferior border of eye
Tortuous course across cheek to inner corner of eye
Branches to
- Lower lip
- Upper lip
- Cheek
- Nose
Anastomoses with internal carotid branches at eye

51
Q

What is the route of the superficial temporal artery?

A

Passes up and over zygomatic arch

Supplies anterior and lateral part of scalp

52
Q

What are the branches of the external carotid artery supplying the face and scalp?

A

Facial artery
Superficial temporal artery
External auricular artery
Occipital artery

53
Q

What areas do the external auricular and occipital arteries supply?

A

Behind ear

54
Q

Which branches of the external carotid artery are accompanied by veins?

A

All

55
Q

What is the main venous drainage of the face?

A

Facial vein

56
Q

Where is the facial vein, and what is its shape?

A

Behind facial artery

Straighter than facial artery

57
Q

How do the tissues of the face drain into the cavernous sinus?

A

Via emissary veins

Directly through facial bones

58
Q

Can infections from the face spread into the brain and meninges and cause encephalitis and meningitis?

A

Yes, because facial tissues drain into cavernous sinus

59
Q

Which lymph nodes drain the face and scalp?

A 
Those in ring around base of scalp
- Submental anteriorly
- Submandibular more posteriorly and laterally
- Pre-auricular and parotid near ear
- Mastoid
- Occipital
Move into deep cervical nodes
60
Q

What is the parotid gland?

A

Salivary gland

61
Q

Where is the parotid gland?

A 
Below zygomatic arch
Above angle of mandible
In front of ear
Behind massoter muscle
Superficial to styloid process
62
Q

What is the parotid gland wrapped in?

A

Parotid fascia

63
Q

What happens when the parotid gland is infected, as happens on mumps, for example?

A

Gland swells
Fascia doesn’t
Causes intense pain

64
Q

How does the parotid gland deliver saliva to the mouth?

A

Via duct

  • Comes forward from anterior border of gland
  • Across massoter muscle
  • Reaches anterior border and pierces buccinator muscles
  • Enters oral cavity near second molar
65
Q

What are the structures inside the parotid gland, from superficial to deep?

A

Facial nerve
Retromandibular vein
External carotid artery

66
Q

How does the facial nerve exit the skull?

A

Via stylomastoid foramen, in between styloid and mastoid processes at base of skull

67
Q

Which motor nerve innervates the occipitalis bell of the occipitofrontalis muscle?

A

Facial nerve branch

68
Q

What else does the facial nerve innervate, that isn’t a muscle of facial expression?

A

Posterior belly of digastric and stylohyoid muscles

69
Q

Where does the facial nerve enter the parotid gland?

A

Posteromedial surface

70
Q

What does the facial nerve do inside the parotid gland?

A

Creates plexus within substance of gland

71
Q

What is the name of the plexiform arrangement of the facial nerve within the parotid gland?

A

Pes anserinus

72
Q

What are the five branches of the facial nerve, from superior to inferior?

A 
Tall - temporal
Zulus - zygomatic
Bear - buccal 
Many - mandibular
Children - cervical
73
Q

What do the branches of the facial nerve innervate?

A

Muscles of facial expression

74
Q

Where does the retro mandibular vein run?

A

Behind mandible

75
Q

What forms the retromandibular nerve?

A

Union of superficial temporal and maxillary veins

76
Q

What does the external carotid artery divide into after entering the parotid gland?

A

Superficial temporal artery
Maxillary artery
Given off within substance of gland

77
Q

What is a very important branch of the maxillary artery?

A

Medial meningeal artery

78
Q

What is the risk of performing surgery near the parotid gland?

A

Damaging facial nerve

Damage supply of muscles of facial expression in that side

79
Q

What is Bell’s palsy?

A 
Affects branches of facial nerve
Unknown aetiology - possible previous viral infection
Happens overnight
Characteristics
- Drooping eyelid
- Flattening of nasolabial fold
- A little drooling
Treatment
- High dose steroids
- Can recover in weeks-months-years, but sometimes never

MD1 Neuroscience (55 decks)

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