face, scalp, parotid Flashcards
scalp
skin and CT covering neurocranium
extending from supraorbital margins of frontal to superior nuchal line of occipital bone
layers of scalp
S- skin C- CT dense contains vessels and nn A- aponeurosis epicranius L- loose CT- allows free mvmt of scalp this is normally the plane of cleavage for injury P- pericranium (periosteum)
spinal nn of scalp
greater occipital n (C2 ramus)
C3 (dorsal ramus)
lesser occipital n
great auricular n
CN of scalp
auriculotemporal br of V3
zygomaticotemporal br of V2
supraorbital br of V1
supratrochlear br of V1
arterial supply of scalp from external carotid
occipital a
posterior auricular a
superficial temporal a
arterial supply of scalp from internal carotid
supraorbital a
supratrochlear a
orbicularis oculi
orbital part- surrounds orbit and forcefully closes eye
palpebral part- w/in eyelid gently closes eye
lacrimal part- w/in medial corner of eye, assists w/lacrimal drainage
corrugator supercilli
draws eyebrows down and in
occipitofrontalis
frontal and occipital bellies attached by epicranial aponeurosis
frontal bellies- elevates eyebrows, wrinkles skin of forehead
occipital belly- retracts scalp, assists frontal belly in surprised expression
orbicularis oris
closes lips/mouth
buccinator
keeps cheeks in contact w/gums so that food does not accumulate in vestibule of mouth
levator labii superioris
elevates upper lip
levator anguil oris
elevates upper lip, widens mouth
zygomaticus major
elevates upper lip, main smile m
zygomaticus minor
elevates upper lip
risorius
stretches lips laterally, wide smile
levator
stretches lips laterally, wide smile
levator labii superioris aleque nasi
elevates upper lip, flares nostrils
depressor anguli oris
depresses lower lip, frown
depressor labii inferioris
depresses lower lip, frown, pout
mentalis
protudes lower lip
procerus
wrinkles skin over dorsum of nose
nasalis
flares nostrils
platysma
depresses mandible, tenses skin of lower face and neck
facial nerve
SVE, component provides innervation to all mm of facial expression
course of facial
exits brainstem
enters internal accoustic meatus
courses laterally btwn cochlea, semicircular canals after which it makes a bend posteriorly and inferiorly to then course along the post wall of middle ear
exits canal via stylomastoid formen
br of facial n
posterior auricular n
diagastric
stylohyoid
temporofacial trunk (temporal br, zygomatic br, buccal brr)
cervicofacial trunk (buccal brr, marginal mandibular brr, cervical brr)
V1
supplies embryonic frontonasal prominence
provides skin of forehead, upper eyelid, nose
V2
supplies embryonic maxillary prominence
provides skin of temporal region, upper cheek and lip, lower eye lid, ala of nose
brr of V1
brr: supratrochlear n supraorbital n infratrochlear n external nasal n
brr of V2
zygomaticotemporal
zygomaticofacial
infraorbital
V3
provides embryonic mandibular prominence
provides skin of lower cheek, lower lip, and chin
Brr of V3
auriculotemporal
buccal
mental
great auricular n
C2,3
provides skin over angle of mandible
trigmeninal neuralgia
sensory disorder of V, sudden excruciating facial pain, can become so severe that patients can become suicidal and depressed
the cause is believed to be demyelinating
V2>V3>V1
buccal nerve block
enter via oral vestibule just post to 3rd mandibular molar
herpes zoster infection
affects trigem ganglion usually affects V1 leading to scarring/ulceration of cornea
facial a
br of external carotid w/in submandibular triangle
course through submandibular gland
arches over mandible just ant to masseter to enter face
takes toruous course to allow for mvmt of face
brr of facial a
inferior labial a
superior labial a
lateral nasal a
angular a
superficial temporal a
br of external carotid gives off transverse facial a frontal br parietal br
maxillary a
br of external carotid brr infraoribital buccal a mental a
ophalmic a
br of internal carotid brr supraorbital supratrochlear lacrimal medial palpebral dorsal nasal
facial v
communicates w/deeper plexuses
pterygoid plexus via deep facial v
cavernous sinus via ophlamic vv
lymp drainage
drain to submental, submandibular, and parotid nodes, to deep cervical along internal jugular
parotid gland
largest salivary gland
lies posterolateral over madibular ramus
parotid bed
sup- zygomatic arch medial- ramus of mandible, styloid process, and associated musculature post- external ear inf- mandible, post diagastric ant- masseter
parotid fascia
continuation of investing fasica
parotid duct
crosses masseter, turns around ant border of mm and pierces the buccinator m and mucosa of cheek to enter oral cavity opposite 2nd upper molar tooth
infections can spread to parotid gland via duct
important structures embedded w/in parotid duct
facial n
retromandibular n
external carotid a
parasympathetics preganglionics to parotid
cell bodies in salivatory nucleus in brainstem
travel w/IX
exits at jugular foramen and give off tympanic
tympanic n enters middle ear via tympanic canaliculus
travels thru middle ear forms as lesser petrosal
lesser petrosal n enters thru hiatus for lesser petrosal and exits thru foramen ovale
synapses in otic ganglion
parasympathetics postganglionics to parotid
cell bodies in otic ganglion
travel w/ auriculotemporal br of V3
secretomotor stimulates gland secretion
sympathetics
T1-4
superior cervical ganglion
post fibers with external carotid n to parotid
vasomotor
parotiditis
very painful
pain carried in auriculotemporal V3 and greater auricular n
pain refers to auricle, TMJ, and external acoustic meatus
sialolith
calcified concretion that can sometimes form in parotid, can block duct, very painful
