Head and Face I Flashcards
What is the scalp?
Skin and connective tissue overlying the scalp.
What does the scalp run to and cover?
Anteriorly- supraorbital margin
Posteriorly- superior nuchal line
Laterally- temporalis muscle (temporal fascia) and zygomatic arch
What are the layers of the scalp?
Skin (deep) Connective tissue Aponeurosis Loose connective tissue Periosteal layer of the bone (pericranium)
What is the aponeurosis of the scalp?
The aponeuorsis of the occipitalfrontalis muscle.
What arteries provide blood supply to the scalp? (x5)
Supratrochlear artery, supraorbital artery, superficial temporal artery, posterior auricular artery, and occipital artery
What nerves provide cutaneous innervation to the scalp? (x7)
Where do they come from?
Supratrochlear nerve (V1), supraorbital nerve (V1), zygomaticotemporal nerve (V2), auriculotemporal nerve (V3), lesser occiptial nerve (C2-C3), greater occipital nerve (C2), and teritary (3rd) occiptial nerve (C3)
How many divisions are there of the trigeminal nerve? What are the names of each division?
3:
V1= opthalamic
V2= maxillary
V3= mandibular
Of the trigeminal branches, which are sensory (GSA)?
All three–however, the mandibular division also has motor fibers.
Which trigeminal branch has both motor and sensory fibers? What type of fibers are they?
V3 (mandibular)
Motor= SVE; sensory= GSA
What nerve innervates the muscles of facial expression? What type of fiber are they?
CN VII (facial nerve) SVE
What does CN VII innervate? (SVE fibers)
The muscles of facial expression plus 4 (stylohyoid, stapedius, posterior belly digastric, & platysma)
What does CN V innervate? (SVE fibers)
The muscles of mastication plus 4 (tensor tympani, tensor veli palatini, anterior belly digastric, & mylohyoid)
True or false:
The SCM and masseter muscles are muscles of facial expression.
False
What provides general cutaneous innervation to the face? To the neck?
Face= trigeminal nerve (V1, V2, V3) Neck= dorsal rami of cervical spinal nerves and branches from cervical plexus
What are the cutaneous branches of V1?
- supratrochlear nerve
- supraoccipital nerve
- infratrochlear nerve
- palpebral branch of lacrimal nerve
- external nasal branch of anterior ethmoidal nerve
What are the cutaneous branches of V2?
- infraorbital nerve
- zygomaticofacial nerve
- zygomaticotemporal nerve
What are the cutaneous branches of V3 to the face?
- mental nerve
- buccal nerve
- auriculotemporal nerve
What are the cutaneous branches to the neck from the medial branches of the dorsal rami of cervical spinal nerves?
- greater occipital nerve (C2)
- 3rd occipital nerve (C3)
- from 4th, 5th, 6th, & 7th nerves in succession below
What are the cutaneous branches of the neck from the cervical plexus?
- lesser occipital nerve (C2)
- great auricular nerve (C2-C3)
- transverse cervical nerve (C2-C3)
- supraclavicular nerves (C3-C4)
Describe the path of CN VII.
It takes the longest route through the bony structures of the skull and emerges through the stylomastoid foramen. After it emerges from this foramen, it enters the carotid gland and gives off 5 branches.
What are the five branches of CN VII?
Temporal Zygomatic Buccal (Marginal) Mandibular Cervical
What artery lies deep to the carotid gland?
Superficial temporal artery
Describe the branching pattern of the external carotid.
It gives off the facial artery, then continues on up the face. Then it gives off the zygomatico-orbital artery and continues as the superficial temporal artery. Then the superficial temporal artery splits into the frontal and parietal arteries.
Describe the branching pattern of the facial artery.
It comes off of the external carotid and then gives off three branches: 1st- superior and inferior labial arteries,
2nd- lateral nasal arteries
3rd- angular arteries
Where are the angular arteries located?
Near the medial corner of the eye.
Where does the facial nerve branch off the external carotid?
Near the angle of the ramus of the mandible.
What are the three arteries that arise from the opthalmic artery? What does the opthalmic artery come off of?
1) dorsal nasal artery
2) supratrochlear
3) supraorbital
The opthalmic comes off the internal carotid artery.
What courses across the masseter muscle?
Parotid duct
After coursing across the masseter muscle, what does the parotid duct do?
Dives into the buccinator muscle.
What type of cervical fascia is loose and irregulary arranged?
Superficial cervical fascia
What type of cervical fascia is dense and regularly arranged?
Deep cervical fascia
List the five types of deep cervical fascia.
1) Superficial (investing) layer
2) Pretrachial
3) Carotid
4) Prevertebral
5) Pharyngobasilar
What does the superficial (investing) layer of deep cervical fascia enclose?
SCM and trapezius
What does the superficial (investing) layer of deep cervical fascia attach to? (x3)
Mandible
Mastoid process
Occiptial bone
What does the pretrachial layer of deep cervical fascia enclose?
Larynx, trachea, and thyroid gland
What does the carotid sheath enclose? (x4)
Common carotid artery, internal carotid artery, inferior jugular vein,and vagus nerve
What does the prevertebral fascia enclose? (x4)
Scalene muscles, prevertebral muscles, posterior neck muscles, and sympathetic trunk.
What type of deep cervical fascia is continous with the endothoracic fascia?
Prevertebral
What type of deep cervical fascia is continous with the anterior longitudingtional ligament of the thoracic vertebrae?
Prevertebral
What type of deep cervical fascia extends laterally as the axillary fascia?
Prevertebral
What surrounds the pharynx?
Buccopharyngeal fascia
What lies between the pharyngeal constrictor muscles and the muscosal membrane of the pharynx?
Pharyngobasilar fascia
Where does the retropharangeal space lie?
Between the prevertebral fascia and buccopharangeal fascia.
What is the clinical significance of the retropharyngeal space?
It is a potential space for the spread of infection into the superior mediastinum.
What are the boundaries of the posterior triangle of the neck?
Anteriorly- SCM
Posteriorly- Trapezius
Inferiorly- Clavicle
What are the boundaries of the anterior triangle of the neck?
Anteriorly- Mandible
Posteriorly- SCM
Anterirorly- Midline
What divides the posterior triangle of the neck into two triangles?
Inferior belly of the omohyoid muscle
What are the two divisions of the posterior triangle of the neck?
Occipital and supraclavicular
What creates the roof of the posterior triangle of the neck?
Platysma
What creates the floor of the posterior triangle of the neck?
The muscles of the lateral neck:
Splenius capitus
Levator scapulae
Anterior/middle/posterior scalene
What are the contents of the posterior triangle of the neck?
CN XI (spinal accessory) Roots of brachial plexus Cutaneous nerves of the cervical plexus Suprascapular and transverse cervical artieries External jugular vein
What artery runs across the supraclavicular triangle?
Supraclavicular