Facial expression and mastication Flashcards
supraorbital margin to superior nuchal line posteriorly, temporal fascia to zygomatic arch laterally
Scalp
S.C.A.L.P Mnemonic?
- Skin
- Connective tissue (dense)
- Apronerorisis (galea aponerutica): link frontalis and. occipitalis muscles
- Loose connective tissue (emissary vein drain to cranial sinus, dangus to spread infection)
- Pericranium
Below supraorbital margin to the chin, ear to ear
Face
Is facial expression both scalp and face? T or F
True
What is the superior and inferior compartment of the temporomandibular joint (TMJ)?
Superior compartment: mandibular fossa superiorly and disk inferiorly - translational movement
Inferior compartment: disk superiorly and mandibular condyle anteriorly- rotational movement
What type of cartilage is the disk that articulates with the TMJ joint?
Fibrocartilage disk
Ligaments that articulate with the temporomandibular joint (TMJ)
Joint capsule
Lateral (temporomandibular) ligament
Sphenomandibular ligament
Stylomandibular ligament
What is the TMJ motion?
- Depression vs. elevation: depression is weak in animal kingdom (alligator can bite but if you hold their mouth if closed)
- Protrusion vs. extrusion/retraction
- side to side excursion
What causes TMJ popping/clicking?
hypermobile joint capsule
tight lateral pterygoid muscle
damage disk place the disk anteriorly against the articular tubercle
Mandibular condyle reduces to the disc will cause clicking or popping noise
Temporal fossa boundaries & contents?
posteriorly and superiorly: temporal lines
anteriorly: frontal and zygomatic bones
laterally: zygomatic arch
inferiorly: infratempiral crest
roof: temporalis fascia
contents:
upper portion of temporalis
Infratemporal fossa: continues to temporal fossa
Boundary:
Contents:
Boundaries:
Deep to zygomatic arch and ramus of the mandible,
posterior to maxilla
bordered lateral pterygoid plate
Contents: The lower portion of the temporalis Lateral and medial pterygoid muscles maxillary artery Pterygoid venous plexus Mandibular inferior, alveolar, lingual, buccal, and chorda tympani nerves *Otic ganglion*
Pterygopalatine fossa
Boundaries:
Contents:
Boundaries: Roof: greater wing of the sphenoid Medially: perpendicular plate of palatine Anterioly: posterior aspect of maxilla Posteriorly: pterygoid process Floor: pyramidal process of palatine
Contents:
ptergoplataine ganglion
pterygopalatine of maxillary artery
CN VII: Facial Nerve (B S&M)
- Somatic Motor Functions:
- Visceral Motor (parasympathetic motor)
Somatic Motor:
Motor to stapedius muscle: middle ear
Motor to (2) suprahyoid muscles: stylohyoid and digastric posterior belly
Motor to facial expression muscles
Visceral motor:
Pterygopalatine ganglion: licrimal glands, nasal and palatine muscosa (greater petrosal nerve)
Submandibular ganglion: submandibular and sublingual salivary glands (chorda tympani)
Somatic sensation: external ear
Visceral sensation: taste of 2/3 anterior tongue -chemical sensation
diagnostic significance: Pathway of CN VII: Facial Nerve (before crossing internal meatus)
- in internal acoustic meatus after geniculate ganglion
- before crossing the tympanic cavity
- after crossing the tympanic cavity
- after leaving stylomastoid foramen
- greater petrosal nerve: losing lacrimal/sinus mucosal glands visceral motor
- stapedial nerve-hyperacusis
- chorda tympani- chemical sensation
- digastric posterior belly; stylohyoid, terminal branch
What are the facial expression branches of the CN VII: Facial N.
Temporal Zygomatic Buccal Mandibular Cervical Posterior articular
Mnemonic: Two Zebras Bit My Cookies
What are the three divisions of CN V: Trigeminal N.
What are there functions S, M, or B
V1: ophthalmic (S)
V2: maxillary (S)
V3: mandibular (S&M)
V1: ophthalmic n.
Passageway?
Terminal sensory branch?
passageway: superior orbital fissure
terminal sensory branch: supraorbital nerve
V2: Maxillary
Passageway?
Terminal sensory branch?
Foramen rotundum
Infraorbital
V3: mandibular
Passageway?
Terminal sensory branch?
foramen ovale
sensory: mental neve
motor: muscles for mastication, suprahyoid muscles, tensor tympani, and tensor veli palantini
Which nerve detects sensory input at the mandibular angle?
Sensory terminal branch V3: Mandibular
-mental nerve
Visceral motor from ciliary ganglion to pupil muscle
-ciliary nerve of V1
CN III: Oculomotor
Visceral motor from pterygopalatine ganglion to lacrimal glands and nasal mucosa
-the zygomatic nerve of V2 (maxillary); lacrimal nerve of V1 (ophthalmic)
Visceral motor/sensory-chorda tympani to/from submandibular ganglion (submaibudlar/sublingual glands)
-lingual nerve V3 (mandibular)
CN VII: Facial N.
Postganglionic visceral motor from otic ganglion to otic gland
-auriculotemporal nerve of V3 (mandibular)
CN IX: glossopharyngeal n.
Branches of V3: Mandibular
- First fibers
- Anterior division
- Posterior division
First fibers:
Motor: tensor tympani, tensor veli palatini, medial pterygoid
Sensory: meningeal
Anterior division:
Motor: temporal, massster, lateral ptyerygoid
Sensory: buccal
Posterior divison:
Motor: mylohyoid
Sensory: lingual, (chorda tympami), inferior aleolar, auriculotemporal
External Carotid Artery( ECA) branches of face and scalp:
Lingual artery Facial artery: *very tortuous for facial expression* Ascending pharyngeal Ascending palatine artery Maxillary artery
Maxillary branches of face and scalp
Middle meningeal artery: wrapped by auriculotemporal nerve Inferior alveolar artery Greater and lesser palatine artery Sphenopalatine artery Deep temporal artery
Where does the venous system of the face and scalp drain?
Drain into external jugular vein
Drain into internal jugular vein
Drain into cavernous sinus
Emissary/diploic veins drain into superior sagittal sinus directly
triangle of death
All facial expression muscles are __________ to each other except one which is _______?
subcutaneous; buccinator
What facial muscle is pierced by the parotid gland?
Buccinator
Obicularis oculi-
Afferent:
Efferent:
Afferent: CN V1
Efferent: CN VII
The afferent limb of the reflex is the ophthalmic division of the trigeminal nerve (nasociliary branch). The efferent limb is the facial nerve (branch to the palpebral element of orbicularis oculi)
Obularis functions:
Closes eyelid
Orbital part: wink tightly
Palpebral part: blink reflex shut the eyelid
All muscles of mastication are innervated by what nerve?
CN V: trigeminal n.
What is posterior 1/3 chemical sensory of tongue innervated by:
CN IX: glossopharyngeal n.
What is the nerve that innervates the epiglottis?
CN X: Vagus
What tongue muscle is the only tongue muscle that is not innervated by CN XII
Plataoglossus; CN X
Upper motor injury (UMN):
damage above the lower motor nuclei in one hemisphere
Damage in and below the lower motor nuclei
Lower injury injury (LMN)
The UMN can elevate the eyebrows. T or F?
True
Bell’s Palsy: crocodile tears syndrome caused by what?
Visceral motor spread (LMN) - injury with greater petrosal nerve
What is the function of the buccinator?
holds food in mouth
The parotid duct pierces what muscle?
Buccinator
What is the function of the lateral pterygoid?
Initiate mandibular motion, protract mandible
What mastication muscles protract the mandible?
medial pterygoid
lateral pterygoid
Masseter
What mastication muscles elevate the mandible?
Medial pterygoid
Temporalis
Masseter
What nerve innervates anterior 2/3 chemical sensory input of the tongue
Facial N. CNVII
What nerve innervates posterior 1/3 chemical sensory input of the tongue
glossopharyngeal n. CN IX
What nerve innervates the epiglottis?
CN X (vagus)
All of the intrinsic and extrinic tongue muscles are innervated by CN XII EXCEPT?
Palatoglossus: CN X (Vagus)
The hypoglossal nerve is between medullary pyramid and inferior olive? T to F
True
If the patient has an upper motor injury (UMN) can he elevate his eyebrow?
Yes because the scalp is spared.
