Facial Incised Wound

Question 1

Name the branches of the facial nerve?

Answer 1

Temporal 
Zygomatic 
Buccal 
Marginal Mandibular
Cervical

Question 2

Where do branches of the facial nerve arise?

Answer 2

In the parotid gland.

Question 3

Describe clinical tests for the facial nerve function?

Answer 3

Raise eyebrows
Frown 
Show you their teeth 
Puff out cheeks 
Scrunch up eyes and keep them closed against resistance.

Ensure facial symmetry when testing.

Question 4

Name the divisions of the trigeminal nerve?

Answer 4

Ophthalmic
Maxillary
Mandibular.

Question 5

What does V1 supply?

Answer 5

Sensory information from the forehead, scalp, upper eyelid, conjunctiva, cornea and dorsum of nose.

Question 6

What does V2 supply?

Answer 6

Sensory information from the lower eyelid, cheeks, lateral nose, upper teeth, gingiva and palate.

Question 7

What does V3 supply?

Answer 7

Sensory information from the floor or the oral cavity, lower lip, lower teeth and gingiva, and external ear.

It has motor supply to the muscles of mastication - Masseter, Temporalis, Medial and Lateral pterygoids.

Question 8

How would you test for trigeminal nerve function?

Answer 8

Close eyes and touch each area of the face (forehead, cheeks and chin) with a cotton wisp and ask if they can feel this.
Corneal reflex test.
Palpate temporalis and masster while patient clenches their jaw to check for atrophy. Test for pterygoid by keeping the jaw closed against resistance and by moving the jaw side to side against resistance.

Question 9

What is the corneal reflex?

Answer 9

‘Blink reflex’ - involuntary blinking is tested by touching the cornea lightly. Blinking should occur in both eyes.
Normally occurs in resopnse to foreign bodies, bright lights and loud noises.
Mediated by V1 sensing the stimulus on the cornea, and temporal and zygomatic branches of the facial nerve eliciting the motor response.

Question 10

Describe the anatomy of the parotid gland?

Answer 10

Anterior and inferior to the ear.
Between skin and masster muscle.
Secretes saliva to the oral cavity via the parotid duct which pierces buccinator muscle and enters the mouth at the 2nd back upper molar.
Serous secretion with 25% of saliva output.
Supplied by the Glossopharyngeal nerve.

Question 11

Describe anatomy of the Submandibular gland?

Answer 11

Found in the floor of the mouth.
Saliva enters the oral cavity lateral to the lingual frenulum.
Mixed seromucus gland.
70% of salivary output.
Supplied by the parasympathetic division of the facial nerve (Chorda tympani).

Question 12

Describe anatomy of Sublingual salivary glands?

Answer 12

Beneath tongue but superior to submandibular glands.
The lesser sublingual ducts open to the floor of the mouth, there is around a dozen.
Mainly mucous secretion.
5% of salivary output.
Innervated by chorda tympai from facial nerve.

Question 13

What initiates saliva secretion?

Answer 13

Sight/smell of food.

When food is ingested.

Question 14

How much saliva is produced in a day?

Answer 14

1.5L

Question 15

What are the functions of saliva?

Answer 15

Facilitates swallowing.
Aids in speech.
Contains alpha-amylase to initiate digestion.
Contains IgA.
Contains lysozyme to act on bacterial cell walls.

Question 16

List consequences of severing the parotid duct.

Answer 16

A blocked or damaged salivary gland can result in formation of a mucous-like cyst called a mucocele.
It typically occurs in the inner surface of the lower lip.
Appears as a blue/translucent swelling under the lining of the mouth.
Can spontaneously resolve or treated by surgical removal.

Question 17

Name the muscles of mastication and their function?

Answer 17

Masseter - elevates the mandible.
Temporalis - elevates and retracts mandible.
Medial Pterygoid - has a deep and superficial head. Elevates the mandible and moves it side to side.
Lateral pterygoid - Also has 2 head. Depresses and protrudes mandible.

Question 18

Briefly describe agencies working to reduce violence in Scotland?

Answer 18

Violence Reduction Unit - Part of Strathclyde Police, targets all forms of violent behaviour especially weapon carrying.

Medics Against Violence - Try change attitudes of young people through education and raising awareness. Has school projects in areas of deprivation and high youth violence.