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Neuro I > Face, Scalp, Parotid Gland > Flashcards

Face, Scalp, Parotid Gland Flashcards

1
Q

Layers of the scalp

A

S- skin
C- connective tissue (dense) - contains vessels and nerves
A- aponeurosis epicranius (galea aponeurotica)
L- loose CT - allows free movement of scalp; plane of cleavage for injury
P- pericranium (periostium)

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2
Q

Innervation to the scapl: Spinal nerves

A

a. Greater occipital n (C2 dorsal ramus)
b. C3 (dorsal ramus)
c. Lesser occipital n
d. Greater auricular n

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3
Q

Innervations to the scalp: Cranial Nerves

A

a. Auriculotemporal branch V3
b. Zygomaticotemporal branch of V2
c. Supraorbital branch of V1
d. Supratrochlear branch of V1

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4
Q

Arterial supply to the scalp: from External Carotid

A

a. Occipital a
b. Posterior auricular a
c. Superficial temporal a

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5
Q

Arterial supply to the scalp: from Internal Carotid

A

a. Supraorbital a

b. Supratrochlear a

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6
Q

Venous drainage of the scalp

A
  1. Vena comitantes of arteries
  2. Emissary veins - drain through bones of skull to dural venous sinuses
    - Emissary veins are valveless and may spread infections from the scalp to the intracranial cavity
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7
Q

General features of muscles of facial expression

A

a. All are derived from pharyngeal arch 2
b. All are innervated by CN VII (SVE component)
c. All are superficial muscles which can move the skin and fascias of the face

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8
Q

Orbicularis oculi

A

a. Orbital part - surrounds orbit and forcefully closes eye
b. Palpebral portion - within eyelid; gently closes eye
c. Lacrimal portion - within medial corner of eye; assists with lacrimal fluid drainage

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9
Q

Currugator supercilli

A

draws eyebrows down and in (worried look)

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10
Q

Occipitofrontalis

A

a. Frontal and occipital bellies attached by epicranial aponeurosis
b. Frontal belly - elevates eyebrows; wrinkles forehead
c. Occipital belly - retracts scalp; assists frontal belly in “surprised” expression

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11
Q

Muscles associated with the mouth

A

a. Orbicularis oris - closes lips/mouth
b. Buccinator - keeps cheeks in contact with gums so food doesn’t accumulate in vestibule of the mouth.
c. Levator labii superioris - elevates upper lip
d. Levator anguli oris - elevates upper lip; widens mouth
e. Zygomaticus major - elevates upper lip; main smile muscle
f. Zygomaticus minor - elevates upper lip
g. Risorius - stretches lips laterally; wide smile
h. Levator labii superioris alaeque nasi - elevates upper lip; flare nostrils
i. Depressor anguli oris - depresses lower lip; frown
j. Depressor labii inferioris - depresses lower lip; frown; pout
k. Mentalis - protrudes lower lip

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12
Q

Muscles associated with the nose

A

a. Procerus - wrinkles skin over dorsum of nose (dislike)

b. Nasalis - flares nostrils

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13
Q

Facial nerve: SVE to all mm of facial expression

A
  1. Exits the brainstem
  2. Enters internal acoustic meatus
  3. Courses laterally between cochlea and semicircular canals, after which it bends posteriorly and inferiorly to course along posterior wall of the middle ear
  4. Exits facial canal via stylomastoid foramen
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14
Q

Branches of the Facial nerve

A
  1. Post. auricular n - supplies belly of occupitofrontalis
  2. Digastric n
  3. Stylohyoid n
  4. Temporofacial trunk (temporal, zygomatic, buccal branches)
  5. Cervicofacial trunk (buccal, marginal mandibular, cervical branches)
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15
Q

Facial (Bell’s) Nerve Paralysis

A
  1. Causes - many are idiopathic; links to herpes virus, trauma or lesion anywhere along course of nerve, otitis media
  2. Paralysis of mm of facial expression
  3. Facial asymmetry and drooping
  4. Drooping of lower eyelid causes drainage of tears and ulceration of eye
  5. Paralysis of orbicularis oris causes dribbling of saliva
  6. Loss of buccinator leads to accumulation of food within vestibule
  7. Impaired speech
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16
Q

Cutaneous Inn to Face: Opthalmic n (V1)

A

a. Supplies embryonic frontonassal prominence
b. Provides skin of forehead, upper eyelid, nose

Branches

  1. Supratrochlear n
  2. Supraorbital n
  3. Lacrimal n
  4. Infratrochlear n
  5. External nasal n
17
Q

Cutaneous Inn to Face: Maxillary n (V2)

A

a. Supplies embryonic maxillary prominence
b. Provides skin of temporal region, upper cheek and lip, lower eyelid, ala of nose

Branches

  1. Zygomaticotemporal n
  2. Zygomaticofacial n
  3. Infraorbital n
18
Q

Cutaneous Inn to Face: Mandibular n (V3)

A

a. Provides embryonic mandibular prominence
b. Provides skin of lower cheek, lower lip, and chin

Branches

  1. Auriculotemporal n
  2. Buccal n
  3. Mental n
19
Q

Cutaneous Inn to Face: Great auricular n (C2, C3)

A

Provides skin over angle of mandible

20
Q

Trigeminal Neuralgia (tic douloureux)

A

a. Sensory disorder of trigeminal nerve which causes sudden, excruciating facial pain
b. Cause is believed to be demyelination of axons within sensory root of CN V; in some cases due to compression by superior cerebellar a.
c. Divisions affectes: V2 > V3 > V1

21
Q

Nerve blocks for facial/dental surgery

A

a. Infraorbital n - anesthetic agent injected around infraorbital foramen; accessed by inserting needle through superior portion or oral vestibule.
b. Mental n - anesthetic agent injected around the mental foramen on the chin
c. Buccal n - anesthetic agent injected via the oral vestibule just posterior to the 3rd mandibular molar

22
Q

Herpes Zoster Infection

A

Often affects the trigeminal ganglion. It most often affects V1 and can lead to scarring/ulceration of cornea

23
Q

Facial artery course

A
  1. Branches from ext carotid a. within submandibular triangle
  2. Courses through substance of submandibular gland
  3. Arches over mandible just anterior to masseter to enter face
  4. Takes tortuous course to allow for movement of face; course along angle of mouth, then along lateral side of nose medial to angle of eye
24
Q

Branches of the Facial Artery

A
  1. Inferior labial a
  2. Superior labial a
  3. Lateral nasal a
  4. Angular a
25
Q

Superficial temporal artery

A 
a. Branch of ext carotid
Branches
1. Transverse facial artery
2. Frontal branches
3. Parietal branches
26
Q

Maxillary artery

A 
a. Branch of ext carotid
Branches
1. Infraorbital a
2. Buccal a
3. Mental a
27
Q

Ophthalmic a

A 
a. Branch of int carotid
Branches
1. Supraorbital a
2. Supratrochlear a
3. Lacrimal (lateral palpebral) a
4. Medial palpebral a
5. Dorsal nasal a
28
Q

Venous drainage of the face: Retromandibular vein

A

a. Formed from union of superficial temporal and maxillary veins
b. Courses posterior to ramus of mandible within substance of parotid gland
c. Divides into anterior and posterior divisions
d. Anterior division merges with facial vein
e. Posterior division merges with posterior auricular vein to form ext jugular

29
Q

Facial vein

A

a. Begins at medial corner of eye as angular vein; descend face receiving venae comitantes of artery
b. Joins anterior division of retromandibular vein to form the common facial vein which drains to int jugular
c. Communicates with deeper plexuses
1. With pterygoid plexus via deep facial vein
2. With cavernous sinus via ophthalmic veins
3. Clinical correlation: the central face is a “danger area” for an infection to travel into the skull or into the deep face

30
Q

Lymphatic drainage of the face

A
  1. Lymphatic vessels of the face drain to submental, submandibular, and parotid lymph nodes
  2. Ultimately, lymph flow is to deep cervical lymph nodes along int jugular
31
Q

Parasympathetic preganglionic innervation to the face

A
  1. Location of cell bodies - salivatory nucleus w/in brainstem
  2. Pregang fibers travel with CN IX
  3. CN IX exits jugular foramen and immediately gives a tympanic branch
  4. The tympanic nerve then enters the middle ear via tympanic canaliculus
  5. Travels through the middle ear, then reforms as the lesser petrosal nerve
  6. Lesser petrosal nerve exits middle ear via hiatus for lesser petrosal; nerve is now in middle cranial fossa and exits via foramen ovale
  7. Lesser petrosal n is now in infratemporal fossa and synapses in otic ganglion
32
Q

Parasympathetic postganglionics in face

A
  1. Location of cell bodies - otic ganglion

2. Postgang fibers travel with auriculotemporal branch of V3

33
Q

Sympathetic innervation to the face

A

a. Pregang symp cell bodies in SC T1-T4
b. Postgang symp cell bodies in superior cervical sympathetic ganglion
c. Postgang fibers travel with ext carotid nerve to parotid tissue
d. Function: vasomotor

34
Q

Parotiditis

A

Refers to inflammation of parotid gland. Very painful bc of stretching of parotid sheath. Pain from parotid region is carried via auriculotemporal branch of V3 and the great auricular nerve. Often, pain will “refer” to the auricle, TMJ, and ext acoustic meatis.

35
Q

Sialolith (calculus)

A

A calcified concretion that can sometimes form in the parotid gland. If it passes into the parotid duct, the duct can become blocked.

Neuro I (5 decks)

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