Facial Muscles & Nerves Flashcards
Why are facial muscles different from other muscles?
They have at least one attachment point to skin, soft tissues or other muscles rather than to bone.
The muscle surrounding the eye. Helps with winking and closing the eyes.
Orbicularis orbis
Happy muscle. Very superficial - found over the top of the buccinator muscle and inferior to the Zygomatic major. Very small muscle.
risorius
Pushes cheek against the teeth. Used during chewing to push food against the teeth.
buccinator
Elevates the upper lip. Lateral to the Levator labii superioris alaeque nasi.
Levator labii superioris
role: help elevate ?????
zygomatic minor
Happy muscle superior to the risorius.
zygomatic major. Pulls up the corners of the mouth for smiling.
Elevates the upper lip. Runs down the side of the nose.
levator labii superioris alaeque nasi
Depresses the lower lip
depressor labii inferioris
Lowers the cnr of the mouth - “sad muscle”
depressor anguli oris
Elevates and wrinkles the chin. Can also help to pull the lower lip outwards.
mentalis
A big sheet-like muscle that extends over the mandible and across the neck. Very superficial, lying directly under the skin. Helps to lower the mandible.
platysma
The nervous system has 2 major components. What are they?
CNS Central Nervous System (brain & spinal cord)
PNS Peripheral Nervous System (cranial nerves, spinal nerves)
PNS
Peripheral Nervous System
PNS is composed of what?
- Cranial Nerves
- Spinal Nerves
Individual neurons can only carry out one function. True or false?
True
Motor nerve fibres ONLY travel to muscles and glands. True or False?
True
What do autonomic nerves innervate?
- Cardiac Muscle
- Smooth muscle
- Glands
Nerves have 2 major roles. What are they?
- Motor signals to muscles and glands (motor nerve fibres)
- Carry information about the body’s environment from the tissues to the brain, ie temperature, pressure, pain.
Motor nerve fibres that ennervate only skeletal muscles. We have voluntary control over movements through these.
*Voluntary motor nerve fibres.
General Sensory Nerve fibres
Basic sensory information, ie temperature, pressure and pain, body position so that we can make adjustments to maintain homeostasis.
Special Sensory Nerve fibres
5 special senses: Vision, hearing, balance, taste and smell. Whole organs designed just for these senses.
Even though each neuron can only carry one type of information, one peripheral nerve is made up of hundreds on neurons all bundled together. What does this imply?
Each nerve can carry different types of information because it can be made up of a combination of motor, special sensory and general sensory.
How many pairs of cranial nerves are there?
12
How many individual cranial nerves are there?
24 - 12 pairs
How are cranial nerves numbered?
I - XII Anterior to Posterior, plus a name for each nerve.
Where are cranial nerves attached?
To the base of the brain.
How do the cranial nerves emerge through the skull?
via Foramina
2 important nerves innervate structures of the face. Which ones?
- CN V (Trigeminal Nerve)
- CN VII (Facial Nerve)
The Trigeminal Nerve carries which types of Neurons?
- General Sensory (whole FACE)
- Motor (TMJ muscles only)
Which nerve provides motor innervation for all of the muscles of facial expression?
CN VII (Facial Nerve)
All sensory information from the muscles and tissues of the face come in through which nerve?
CNV Trigeminal Nerve
Which nerve carries information from the happy muscles to let us know that we are smiling?
CNV Trigeminal Nerve
The Trigeminal ganglion gives rise to 3 branches, called…?
- Opthalmic Branch (V1)
- Maxillary Branch (V2)
- Mandibular Branch (V3)
This nerve carries sensory information from the forehead and nose.
CNV1 Opthalmic Nerve
This nerve carries sensory information from the cheekbones, temples, upper lip and sides of the nose.
CNV2 Maxillary Nerve
This nerve carries sensory information from the lower jaw, bottom lip and lateral cheeks and lateral temples.
CNV3 Mandibular Nerve
What would be the effect of damage to the Maxillary nerve (CNV2)
Loss of sensation to the upper lip, sides of the nose, upper cheeks and temples.
Where does CNVII emerge from the skull?
Stylomastoid Foramen
Which nerve emerges near the base of the ear and fans into 5 branches?
CNVII (motor)
The Facial Nerve
Which nerve emerges near the base of the ear and fans into 5 branches?
CNVII
The Facial Nerve
Name the 5 branches of the Facial Nerve.
1* The Temporal Branch 2* The Zygomatic Branches 3* The Buccal Branch 4* The Marginal Mandibular Branch 5* The Cervical Branch
The Temporal Branch of the Facial Nerve provides motor innervation to what structures?
The forehead, the temple region and part of the muscles surrounding the eye.
The Zygomatic Branch of the Facial Nerve provides motor innervation to what?
Supplies the muscles located in the cheekbone area including most of the elevators of the upper lip, including the zygomatic muscles and the two levator labii superioris muscles
What does the buccal branch of the facial nerve provide to to buccal muscle?
Motor innervation.
Which nerve runs along the lower jawline, innervating (motor) the lower lip muscles?
The Marginal Mandibular branch of the Facial Nerve
Which nerves runs under the mandible, deep to the platysma and provides movement to the platysma?
The Cervical Branch of the Facial Nerve
What happens if a motor nerve to the face is damaged?
- Muscle paralysis
2. Drooping of facial features in the area innervated by the damaged nerve.
Result of damage to the Marginal Mandibular branch?
Would not be able to depress the lower lip and corners of the mouth. Sagging of the corners of the mouth.
What is Facial Nerve Cross-Over?
Before the nerve emerges from the skull and branches, nerve fibre cross-over of some neurons occurs within the brain.
How many nerve fibres from each facial nerve stay on the same side of the body that they originate from?
1/2 nerve fibres stay on the side of nerve origin in the brain, and innervate motor function in the upper facial region: ie fibres from LHS of brain - 1/2 innervate motor function of upper LHS face.
How many nerve fibres from the facial nerve cross over? Where do they go?
1/2 of the Nerve fibres from the FACIAL NERVE cross over and contribute motor nerve fibres to BOTH upper and lower face. ie 1/2 of the fibres from the LHS of brain innervate motor for upper and lower RHS of face.
When the LHS facial nerve emerges 1/2 of the fibres come from the LHS of brain, and 1/2 from RHS of brain. Where do the LHS orignating fibres go?
Motor Innervation for upper LHS of face.
When the LHS facial nerve emerges 1/2 of the fibres come from the LHS of brain, and 1/2 from RHS of brain. Where do the RHS orignating fibres go?
They innervate motor function for muscles in the upper and lower LHS of the face.
Structures coming from the opposite side of the body:
Contralateral
Why do the upper facial muscles receive a bilateral facial nerve supply?
Because most come from the same side of the brain, but some are cross-overs from the opposite side of the brain.
Why do lower facial muscles receive a contralateral facial nerve supply?
Because Facial nerve fibres from the same side of the brain only travel to the upper face on that side. Therefore the lower face recieves innervation only from fibres that have crossed over from the other side of the brain before emerging and splitting into the 5 branches.
The upper part of the face has Facial Nerve fibres from both sides of the brain. True or false?
True.
The lower parts of the face have Facial Nerve fibres only from the opposite side of the brain, and none from the same side. True or false?
True
A trauma damages the Facial Nerve on the LHS at the point it begins in the brain, before cross-over. What are the results?
Paralysis to only the lower RHS quarter of the face. (The other 3 quarters also have innervation from the nerve originating on the RHS)
What effect if the Facial Nerve is damaged after it emerges from the stylomastoid foramen on the RHS, before it splits?
Paralysis to the entire RHS of the face, as in Facial Nerve Palsy.
What happens if the Zygomatic Branch of the facial nerve on the LHS is damaged?
Paralysis only to the muscles innervated by the Zygomatic branch on the LHS of the face.
What is the main artery that supplies the tissues of the face?
The Facial Artery.
Which artery does the Facial Artery branch from?
The External Carotid Artery
What creates a pulse point about a fingers breadth anterior to the angle of the mandible?
The Facial Artery.
Where does the facial artery terminate?
The medial corner of the eye.
Which blood vessel travels deep to the zygomatic major and levator labii superioris muscles?
The Facial Artery
Which blood vessel travels about a fingers breadth from the corner of the mouth?
The Facial Artery
Which blood vessel drains venous blood from the face?
The Facial Vein
Which blood vessel does the Facial Vein drain into?
The Internal Jugular Vein
The Internal Jugular Vein travels alongside the Common Carotid Artery through the neck region towards the heart. True or False?
True.
The Common Carotid Artery divides at about the level of the ____ into Internal and External Carotid Arteries.
Thyroid Cartilage
Which blood vessel supplies the brain?
The Internal Carotid Artery
The external carotid artery gives rise to a series of blood vessels, including:
- The Facial Artery
- The Lingual Artery
- ….
Which nerve carries all sensory information from the tissues of the face?
CNV Trigeminal Nerve
Which Nerve carries the motor fibres to the TMJ?
CNV Trigeminal Nerve
What nerve carries the information to let us know that we are frowning?
CNV Trigeminal Nerve
Upper facial muscles receive a bilateral nerve supply. True or false?
From which nerve?
True
CNVII Facial Nerve
Lower facial muscles receive a contralateral nerve supply only. True or false?
From which nerve?
True
CNVII Facial Nerve
The space between your lips and teeth is called…?
The Vestibule
How many spaces in the oral cavity?
2
What are the spaces in the oral cavity called?
- The Vestibule
* The Oral Cavity Proper
What is the boundary between the oral cavity proper and the oropharynx called?
The Faucial Pillars (2 lateral arches, or pillars of tissue)
What is the soft palate made of?
Muscle, overlaid by mucous membrane.
What is the Median Raphe?
A bony ridge running down the midline of the hard palate.
Another name for the soft palate?
The Velum
What is the Velum?
The soft palate
In which cone-shaped structure does the velum terminate?
The Uvula
What does the uvula do?
Cover the nasopharynx during swallowing, preventing food/drink from coming out of your nose.
How many faucial pillars are there?
2 on each side (ie - 4)
- Posterior Faucial pillars which continue from the uvula to blend in with the walls of the oropharynx.
- Anterior Facial pillars
What is the palato-pharyngeal Arch also known as?
The posterior faucial Pillar.
What is the palato-glossal Arch also know as?
The anterior faucial pillar.
Where is the plato-pharyngeal muscle?
Inside the posterior faucial pillar/s
Where is the palato-glossal muscle?
Inside the anterior faucial pillar?
Where are the palatine tonsils located?
Embedded between the posterior and anterior faucial pillars.
These are bundles of immune cells that contribute to filtering out bacteria and other foreign substances that we take in whilst eating and drinking.
Tonsils
This connects your tongue to the floor of the mouth
Lingual frenulum
Why is saliva so important in the digestive function of the oral cavity?
- Keeps the oral cavity moist and lubricated.
- Helps to form food into a bolus for swallowing.
- Contains some digestive enzymes and antibacterial substances
Are salivary glands exocrene or endocrene?
Exocrene glands because they secrete saliva directly via ducts into the oral cavity.
Which are the largest of the salivary glands?
Parotid glands
How many salivary glands are there?
3 main pairs
The facial nerve goes through the largest salivary gland. True or false?
True
Salivary glands that are tucked up underneath the mandible…
Submandibular glands
Sublingual glands are located under and deep to the tongue. True or false?
True.
Name the 3 main pairs of salivary glands…
- Parotid gland
- Submandibular gland
- Sublingual gland
The terms ‘lingual’ and ‘glossal’ both refer to the tongue. True or false?
True
TMJ
Temporomandibular Joint
The articulation between the mandible and the temporal bone.
TMJ
The articulation between the mandible and the temporal bone.
Temporomandibular Joint
This joint represents the basis for all lower jaw movements…
TMJ
The cheek bone is also called….?
The zygomatic arch
This is the part of the temporal bone that articulates with the mandible at the TMJ.
The zygomatic process
The condyle of the mandible articulates with which part of the temporal bone to form the TMJ?
The zygomatic process.
Which part of the temporal bone joins with the zygomatic bone?
The zygomatic process
Which part of the mandible articulates with the temporal bone to form the TMJ?
The Condyle of the mandible.
How is the coronoid process of the mandible involved in the TMJ?
The coronoid process attaches to one of the muscles of the TMJ.
The indentation between the condyle and the coronoid process is called…?
The notch of the mandible.
What is the ramus?
The upright portion of the mandible, superior to the angle of the mandible.
The 90 degree angle in the mandible is called…?
The Angle of the Mandible.
What is the body of the mandible?
The horizontal part of the mandible.
What is the Infratemporal Fossa?
The space between the zygomatic arch and the mandible.
What fills the infratemporal fossa?
Soft tissues such as muscles, nerves and blood vessels.
What is the Temporal fossa?
The space above the zygomatic arch.
Viewing the base of the skull, what is the oval shaped knob on the inferio-posterior part of the temporal bone?
The Mastoid process
Where is the mastoid process located?
Just behind the ear
What is the mastoid process for?
It serves as an attachment point for muscles.
What is the thin, pointed process on the inferior part of the temporal bone called?
The styloid process
What does the styloid process do?
It serves as an attachment point for muscles and ligaments.
Name the muscles that attach to the styloid process.
- styloglossus muscle
- stylohyoid muscle
- stylopharyngeus muscle
Viewing the skull from the bottom, what are the bits on the inferio-medial part of the sphenoid bone that look like snake fangs attached to the top of rainbows (one fang for each rainbow)?
The Medial Pterygoid Plates (the medial ones) and the Lateral Pterygoid Plates (the lateral ones!)
What kind of a joint is the TMJ?
A Synovial joint that allows for movement in 3 planes.
There are 2 fluid filled cavities in between the articulating bone surfaces of the TMJ. True or false?
True.
What are the articular surfaces making up the TMJ?
- The condyle of the mandible (inferior) AND
* The mandibular fossa of the temporal bone (superior)
What is the mandibular fossa of the temporal bone?
An indentation in the zygomatic arch of the temporal bone.
3 ligaments help strengthen the TMJ and prevent dislocation. Name them:
- Lateral ligament
- Stylomandibular ligament
- Sphenomandibular ligament
This is a very thick ligament that surrounds the TMJ joint and is continuous with the joint capsule formed by the cartilage.
The lateral ligament
Which very strong, reinforcing ligament has the main job of preventing the TMJ from dislocating posteriorly?.
The lateral ligament
Which ligament runs from the styloid process to the angle of the mandible?
The Stylomandibular ligament
A thin TMJ ligament that is stabilising, but does not contribute much to the strength of the TMJ.
The Stylomandibular ligament
This TMJ ligament attaches to the sphenoid bone and the interior surface of the mandible.
The sphenomandibular ligament.
The sphenomandibular ligament and stylomandibular ligament helps to stabilise the TMJ, but don’t contribute much to the strength of the joint. True or false?
True.
The lateral ligament does virtually all of the strength work in the TJM. True or false?
True.
What are the 3 planes of movement at the TMJ?
- Depression/elevation
- Retraction/protraction aka retrusion/protrusion
- Deviation ……(deviant giraffe)
How many muscles act on the TMJ?
4
How many muscles of mastication are there?
4
What are the muscles that act on the TMJ known as?
The muscles of mastication
The large fan shaped muscle filling the temporal fossa is called….?
The Temporalis Muscle.
The temporalis muscle runs from the temporal bone, through the temporal fossa to the…..?
Coronoid process
This large muscle passes through the temporal fossa deep to the zygomatic arch.
The Temporalis muscle.
The major function of the Temporalis muscle is to…?
Elevate the mandible (also contributes to retrusion/retraction of the mandible)
A very large and strong muscle of mastication.
The Masseter
This muscle attaches to the zygomatic arch and folds under the ramus and body of the mandible.
The Masseter
The masseter is a major elevator of the mandible. True or false?
True.
The two smallest muscles of mastication.
The medial and lateral pterygoid muscles.
Name the muscles of mastication:
- Temporalis muscle
- Masseter
- Medial Pterygoid muscle
- Lateral Pterygoid muscle
This muscle attaches to the lateral pterygoid plate on the sphenoid bone and the condyle of the mandible.
The Lateral Pterygoid muscle.
This muscle’s main job is to protrude the mandible.
The Lateral Pterygoid muscle.
This muscle attaches to between the pterygoid plates and the interior surface of the ramus of the mandible, near the angle of the mandible.
The Medial Pterygoid muscle.
This muscle contributes to mandibular elevation (working with the masseter and temporalis).
The medial pterygoid muscle.
Which muscles are responsible for jaw deviation?
The medial and lateral pterygoid muscles.
You use the right medial and lateral pterygoid muscles to deviate the your jaw to the left. True or false?
True
Why are the right pterygoid muscles involved in left deviation of the jaw, and vice versa?
When the pterygoid muscles contract they pull the ramus of the mandible towards the skull (attachment points pterygoid plates), deviating the jaw to the opposite side.
How do the Hyoid muscles aid TMJ movement?
- All of the hyoid muscles: by stabilising the Hyoid bone during mandibular movement.
- The suprahyoid muscles can help to depress the mandible.
The same nerve is both sensory and motor for the TMJ, true or false?
True
Which nerve innervates the TMJ for both sensory and motor functions?
The Mandibular Nerve - the 3rd branch of the trigeminal nerve (CNV3)
Damage to CNV3 - the Mandibular branch of the trigeminal nerve would have what effect?
Paralysis of the TMJ and numbness of the TMJ and lower jaw region.
Name the ligaments that attach to the styloid process
- stylomandibular ligament
* stylohyoid ligament
Name two of the muscles that attach to the mastoid process?
- Sternocleidomastoid
* posterior belly of the Digastric muscle