Facial and Scalp

Question 1

What one muscle (2 parts) elevates the eyebrows and produces transverse wrinkles on the forehead? What nerve is this muscle innervated by?

Answer 1

Occipitofrontalis (Occipitalis + Frontalis)

- Innervated by CN VII

Question 2

What muscle is responsible for closing the eye? Which part of the muscle gently closes the eye, and what part tightly closes the eye?

What nerve are these muscle innervated by?

Answer 2

Orbicularis Oculi

• Palpebral portion: gently closes eye
• Orbital portion: tightly closes eye

Both are innervated by CN VII

Question 3

What muscle is responsible for drawing the angle of the mouth superolaterally (smiling)? What nerve is this muscle innervated by?

Answer 3

Zygomaticus Major

- Innervated by CN VII

Question 4

What muscle is responsible for increasing the rigidity of the cheek, helping to keep food between the molars, and resisting distention? What nerve is this muscle innervated by?

Answer 4

Buccinator

- Innervated by CN VII

Question 5

What muscle is responsible for resting activity (keeping mouth softly closed) and constricting/protruding lips? What nerve is this muscle innervated by?

Answer 5

Orbicularis Oris

- Innervated by CN VII

Question 6

What is Satchmo’s Syndrome? What profession often experiences this?

Answer 6

Tearing of the Orbicularis Oris

- Often seen in brass players (trumpets)

Question 7

What three muscles are responsible for elevating the upper lip/mouth?

Answer 7

• Levator Labii Superioris
• Levator Labii Superioris Alaeque Nasi
• Levator Anguli Oris

Question 8

What two muscles are responsible for depressing the lower lip/mouth?

Answer 8

• Depressor Labii Inferioris

- Depressor Anguli Oris

Question 9

What muscle is responsible for wrinkling the chin?

Answer 9

Mentalis

Question 10

What are the three branches of the External Carotid a. in the face?

Answer 10

• Facial a.
• Superficial Temporal a.
• Maxillary a.

Question 11

What are the three branches of the Facial a., one branch of the Superficial Temporal a. and the two branches of the Maxillary a. in the face?

Answer 11

Facial a.

• Superior labial a.
• Inferior labial a.
• Angular a.

Superficial Temporal a.
- Transverse Facial a.

Maxillary a.

• Mental a.
• Infraorbital a.

Question 12

What is the one branch of the Internal Carotid a. in the face? What is one of its branches, and with what a. does it create an anastamosis?

Answer 12

Ophthalmic a.
- Supraorbital a.

Anastamosis with Angular a.

Question 13

What are the three superficial veins of the face?

Answer 13

• Facial v.
• Superficial Temporal v.
• Retromandibular v.

Question 14

What are the five deep veins of the face?

Answer 14

• Maxillary v.
• Deep Facial v.
• Pterygoid Plexus of vv.
• Ophthalmic vv.
• Cavernous Sinus

Question 15

What are the six lymphatics of the face?

Answer 15

• Submandibular nodes
• Submental nodes
• Buccal nodes
• Parotid nodes
• Mastoid nodes
• Occipital nodes

Question 16

Which nerve (3 parts) provides the sensory innervation for the anterior face/scalp? Which nerve (2 parts) provides the sensory innervation for the posterior face/scalp?

Answer 16

Anterior head: CN V

• V1
• V2
• V3

Posterior head: Spinal rami

• Anterior
• Posterior

Question 17

What nerve provides the motor innervation for the face/scalp? What plexus is included in this, and what five branches are found within the plexus? What visceral structure engulfs this plexus?

Answer 17

CN VII (Facial n.) includes the Parotid Plexus, which has five branches:

• Temporal
• Zygomatic
• Buccal
• Mandibular
• Cervical

Parotid Plexus is engulfed by the parotid gland

Question 18

Bell’s Palsy indicates a lesion to which nerve?

Answer 18

CN VII

Question 19

What two lymph node groups are affected by carcinoma of the lower lip?

Answer 19

Submental nodes (medially) and Submandibular nodes (laterally)

Question 20

What three structures are found within the parotid gland?

Answer 20

• Parotid Plexus (Temporal, Zygomatic, Buccal, Mandibular, Cervical)
• Retromandibular v.
• External Carotid a.

Question 21

What is the parasympathetic innervation of the parotid gland (5 steps)?

Answer 21

Parotid gland parasympathetic innervation:

1. Preganglionic at CN IX
2. Tympanic plexus
3. Lesser petrosal n.
4. SYNAPSE in Otic Ganglion
5. Postganglionics hitchhike on Auriculotemporal n. (CN V3) to parotid gland

Question 22

What is the plexus that provides sympathetic innervation to the viscera of the face?

Answer 22

External Carotid sympathetic plexus

Question 23

With cranial sympathetic innervation, what ganglion do preganglionic axons synapse? After synapsing, what vessels do the postganglionic axons form a sympathetic plexus around?

Answer 23

Cranial sympathetic innervation:

• Preganglionic axons synapse in the Superior Cervical ganglion
• Postganglionic axons form a sympathetic plexus around the Carotid aa.

Question 24

What are the five layers of the scalp (hint: S.C.A.L.P.) from superficial to deep?

Answer 24

1. Skin
2. Connective tissue
3. Aponeurosis
4. Loose connective tissue
5. Pericranium

Question 25

The “danger area” is found between what two layers of the scalp? Why is this (hint: think veins)?

Answer 25

The danger area of the scalp is found between the aponeurosis and loose connective tissue due to emissary veins draining into this area (can carry infection into cranial cavity)

Question 26

What are the three branches of the External Carotid a. that supply blood to the scalp?

Answer 26

• Occipital a.
• Posterior Auricular a.
• Superficial Temporal a.

Question 27

What are the two branches of the Internal Carotid a. that supply blood to the scalp?

Answer 27

• Supraorbital a.

- Supratrochlear a.