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MRCS > H&N - Face and Scalp > Flashcards

H&N - Face and Scalp Flashcards

1
Q

Surface marking for parotid gland

A

Starts around tragus

Follows inferior to zygomatic arch

Drops down to angle of mandible and wraps around it

Climbs to inferior part of lobule

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2
Q

Parotid duct aka

A

Stensen’s duct

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3
Q

Surface marking of Stenson duct

A

Middle third of a line between intertragic line (between tragus and anti tragus) and philtrum

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4
Q

How does parotid duct get into mouth

A

After masseter muscle, dives into buccal fat and pierces buccinator muscle

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5
Q

End point of parotid duct

A

Near the second upper molar tooth

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6
Q

Structures through the parotid gland

A

Facial nerve

External carotid artery (and its branches; the maxillary and superficial temporal)

Retromandibular vein

Auriculotemporal nerve

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7
Q

Branches of facial nerve in facial canal

A
  1. greater petrosal nerve
  2. nerve to stapedius
  3. chorda tympani
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8
Q

Facial nerve branches through the stylomastoid foramen

A

Posterior auricular

Digastric

Stylohyoid

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9
Q

Facial nerve branches after entering parotid gland

A

The Zebra Buggered My Cat

Temporal branch

Zygomatic branch

Buccal branch

Marginal mandibular branch

Cervical branch

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10
Q

Functions of facial nerve

A

Face, ear, taste, tear

Taste: anterior 2/3

Tear: PSN to lacrimal and salivary glands

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11
Q

Facial nerve end branches motor test

A

Temporal: raise eyebrow

Zygomatic: close eyes tightly

Buccal : blow cheeks

mandibular: show lower teeth
cervical: tense skin under your chin

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12
Q

External carotid artery branches

A

Some attendings like freaking out potential medical students

Sup thyroid

Ascending Pharyngeal

Lingual

Facial

Occipital

Post auricular

Maxillary

Sup temporal

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13
Q

Tribuaries of retromandibular vein

A

superficial temporal and maxillary veins

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14
Q

Arterial supply of parotid

A

External carotid artery

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15
Q

Venous supply of parotid

A

Retromandibular vein

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16
Q

Lymphatic drainage of parotid

A

deep cervical

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17
Q

Innervation of parotid gland

A

Glossopharyngeal -> otic ganglion -> Auriculotemporal

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18
Q

Branches of opthalmic nerve

A

Supra-orbital

Supratrochlear

Infratrochlear
Lacrimal

External nasal

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19
Q

Branches of maxillary nerve

A

Zygomaticotemporal

zygomaticofacial

Infra-orbital

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20
Q

Branches of mandibular nerve

A

Auriculotemporal

Lingual

Inferior alveolar

Nerve to the mylohyoid

Mental

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21
Q

Layers of scalp

A

Skin

Connective tissue (dense)

Aponeurotic layer of occipito frontalis (Galear layer)

Loose connective tissue
Pericranium (ie periosteum)

22
Q

Innervation of scalp

A

Anterior to vertex: trigeminal

Posterior to vertex: C2 and C3 (great auricular, lesser and greater occipital, third occipital)

23
Q

In which layer of scalp do blood vessels and nerves lay

A

In dense connective tissue

24
Q

Scalp blood supply

A

Opthalmic artery (internal carotid): supratrochlear and supraorbital

External carotid: Post auricular, superficial temporal, occipital

25
Q

Why scalp lacerations bleed so profusely

A

Arterial wall firmly attached to fibrous tissue, cant vasospasm/contract so continues to bleed.

26
Q

How to rx scalp laceration and bleed

A

apply pressure

primary closure by suturing

27
Q

Which muscles close the jaw

A

Medial pterygoid

Masseter

Temporalis

28
Q

Submandibular gland duct

A

Whartons duct

29
Q

Which muscle divides the submnadibular gland into two parts

A

mylohyoid muscle

30
Q

Nerve around whartons duct

A

lingual

31
Q

What is the acini composition of the three salivary glands

A

Parotid: mainly serous

Sublingual: mainly mucous

Submandiblar: mixture of mucous and serous

32
Q

Where do majority of salivary gland stones form

A

Submandibular:

Slow movement of saliva

  • up ward against gravity
  • mucous composition
  • alkaline (deposits calcium crystals)
33
Q

Muscles of mastication

A

Masseter

Temporalis

Medial /lateral pterygoid

34
Q

Which muscle opens the jaw

A

lateral pterygoid muscle

35
Q

Position of lacrimal gland

A

Superior and lateral to the orbit

36
Q

Angle of the jaw innervation

A

C2-C3 (greater auricular nerve)

37
Q

Which muscles does mandibular nerve innervate

A

Muscles of mastication

Tensor veli oalatine

Mylohyoid

Anterior belly of digastric

Tensor tympani

38
Q

Blood supply of lacrimal apparatus

A

Ophthalmic artery

39
Q

Which nerve runs close to parotid duct

A

Buccal nerve of facial

40
Q

Mx of facial nerve laceration

A

Lateral to lateral canthus: surgical repair

Medial to lateral canthus line: surgery =conservative

Always check parotid duct (look for blood at papilla or put a cannula in)

41
Q

Where are scalp flaps taken from

A

Subgaleal layer (loose areolar connective tissue), fewer vessels

More superficial is very vascular and firmly attached

Deeper also done sometime but more vascular/attached to suture lines

42
Q

Branches of the maxillary artery

A

Terminal 6:

  • Posterior superior alveolar
  • Pterygoid canal
  • Palatine (greater- > hard palate, lesser → soft palate)
  • Sphenopalatine/nasopalatine
  • Pharyngeal
  • Infraorbital
43
Q

Muscles of soft palate

A

Tensor veli palatini

Levator veli palatini

Palatoglossus

Palatopharyngeus

Muscularis uvulae

44
Q

Action of tensor veli palatini

A

Pulls laterally flattening and tensing palate

45
Q

Action of levator veli palatini

A

Elevates soft palate, stopping food entering nasopharyinx during eating

Also helps tensor veli palatini to open the cartilagenous auditory tube to equalise middle ear pressure

46
Q

Action of palatopharyngeus

A

Elevates larynx and pharynx

Depresses soft palate

47
Q

Action of palatoglossus

A

inserts into lateral portion of tongue

Depresses soft palate

48
Q

Nerve supply to soft palate muscles

A

All vagus (pharyngeal plexus from CN10 and CN11)

Except tensor veli palatini → CN5V3

49
Q

Facial muscles

A

Frontalis

Procerus

Orbicularis oculi

Nasalis

Levator labi superioris alaeque nasi

Levator labi superioris

Zygomaticofacial major and minor

Orbicularis oris

Risorius

Depressor labii inferioris

Depressor anguli oris

Mentalis

50
Q

Muscles deep to facial nerve

A

Mentalis

Buccinator

levator anguli oris

51
Q

Where are facial muscles cause horizontal and vertical wrinkles in glabella region?

A

Vertical: Corrugator causes

Horizontal: procerus

MRCS (29 decks)

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