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3 - RCA > Head and Neck 1 > Flashcards

Head and Neck 1 Flashcards

1
Q

Name the individual bones of the skull.

A 
Maxilla
Nasal
Mandible
Zygomatic 
Frontal 
Parietal
Occipital
Temporal 
Sphenoid
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2
Q

Name the foramen associated witht he skull.

A

Supraorbital foramen
Infraorbital foramen
Mental foramen
Mandibular foramen (medial aspect of ramus of mandible)

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3
Q

Name the different parts of the mandible.

A 
Body 
Angle 
Ramus 
Condylar process, head and neck 
Coronoid process
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4
Q

Where do the facial muscles develop from and what innervates them?

A

Develop from 2nd pharyngeal arch

Innervated by the facial nerve (VII)

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5
Q

What is the name of the muscle surrounding the eye?

A

Orbicularis oculi

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6
Q

Name the two parts and their functions of the orbicularis oculi muscle.

A

Orbital part - closes eye tightly
Palpebral part - closes eye lightly
= blinking and distribution of tears

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7
Q

Where is the orbicularis oris found and where does it insert?

A

Surrounds the oral cavity

Inserts into the mucous membrane of the lips

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8
Q

What is the action of the orbicularis oris?

A

Compresses and protrudes lips in whistling expression (kissing muscle)

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9
Q

What forms the modiolus?

A

At the angle of the mouth, the orbicularis oris and fibres from the buccinator form the modiolus
BUCCINATOR AND ORBICULARIS ORIS

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10
Q

Where is the buccinator muscle found?

A

Muscle of the cheek

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11
Q

What is the origin and attachment of the buccinator muscle?

A

Origin: posteriorly from the ptyerygomandibular raphe, processes of maxilla and mandible
Insertion: angle of mouth (modiolus)

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12
Q

What is the action of the buccinator?

A

Presses cheek against molar teeth - aiding chewing
Compresses distended cheeks - expulsion of air from oral cavity (trumpeters muscle)
Pushing food onto grinding surface

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13
Q

What is the frontalis muscle?

A

Muscle of scalp

Positioned near forehead

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14
Q

Where does the frontalis muscle arise/insert?

A 
Epicranial aponeurosis (galea aponeurotica) - flat tendon
Inserts into skin of forehead
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15
Q

What is the action of the frontalis muscle?

A

Elevates eyebrows and wrinkles forehead

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16
Q

What is the platysma?

A

Superficial muscle of the neck

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17
Q

Where does the platysma arise from and insert?

A

Arises from superficial fascia of deltoid and pectoral regions
Inserts into mandible and orbicularis oris

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18
Q

What is the action of the platysma?

A

Depresses the lower lip

Tenses the skin

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19
Q

What is the action of the zygomaticus major and minor?

A

Major: pull the angle of the mouth superolaterally (elevate and evert angle)
Minor: pulls upper lip backward, upward and laterally

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20
Q

Describe the position of the parotid gland.

A

Lies outside the oral cavity
Sternocleidomastoid posterior, ramus of mandible in front, superior is external acoustic meatus and posterior to zygomatic arch
Over masseter muscle

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21
Q

What vessels lie deep to the parotid gland?

A

External carotid artery

Retromandibular vein

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22
Q

Which nerve lies within the parotid gland?

A

Facial nerve (VII)

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23
Q

Describe the pathway of the parotid duct.

A

Leaves anteriorly across masseter muscle, pierces buccinator and enters vestibule of oral cavity opposite 2nd molar tooth
Has thickened fascial capsule

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24
Q

What is the innervation of the platysma muscle?

A

Cervical branch of facial nerve (VII)

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25
Q

SCALP

A

Skin
Connective tissue (superficial fascia)
Aponeurosis (connecting frontalis and occipitalis muscles)
Loose connective tissue
Pericranium (outer periosteum of bony skull)

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26
Q

Where do most of the blood vessels and nerves run? (which layer of the scalp? )

A

Connective tissue layer of the scalp which is dense

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27
Q

Why do scalp lacerations bleed profusely?

A

Blood vessels are held open by the dense connective tissue layer

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28
Q

Which bone is the mastoid process part of?

A

Temporal bone

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29
Q

Where is the superficial temporal artery and where does this arise from?

A

Emerges from the parotid gland anterior to the ear

Originates from the external carotid artery

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30
Q

What is the origin and insertion of the masseter muscle?

A

Origin - zygomatic arch

Insertion - lateral surface of ramus of mandible

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31
Q

What is the action of the masseter muscle?

A

Elevation of the mandible

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32
Q

What is the innervation of the masseter?

A

Masseteric nerve of mandibular nerve (V3)

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33
Q

What is the supply and drainage of the parotid gland?

A

Branches of ECA

Venous drainage to retromandibular vein

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34
Q

List some clinical issues with the parotid gland.

A 
Parotid gland can have viral infection = mumps 
Parotiditis = abscesses
Calcified deposits (sialogram) - more common in submandibular duct
Bell's Palsy = consequence of parotid problems = facial muscle weakness
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35
Q

What are the signs of 7th cranial nerve damage and what urgent care is needed?

A

Facial muscle paralysis/muscle twitching/weakness

Eye protection - no functioning eyelids/distribution of fluid = dry eye

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36
Q

Where do most arteries of the face come from?

A

External carotid artery

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37
Q

Where do most veins of the face drain into?

A

Internal jugular vein

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38
Q

List the medial branch of the ECA.

A

Ascending pharyngeal

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39
Q

List the 3 front branches of the ECA.

A

Superior thyroid, lingual, facial

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40
Q

List the 2 branches from behind the ECA.

A

Occipital, posterior auricular

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41
Q

List the terminal branches of the ECA.

A

Maxillary and superficial temporal

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42
Q

Which is the smaller of the two terminal branches of ECA?

A

Superficial temporal

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43
Q

Where does the superficial temporal branch of ECA go and what does it supply?

A

Emerges on the face between the TMJ and the ear and ascends to temporal region.
Distributes to the skin and facial muscles of the frontal and temporal regions.

44
Q

Where does the facial artery arise from?

A

Anterior branch of ECA

45
Q

Describe the pathway of the facial artery.

A

Ascends deep to submandibular gland
Winds around the inferior border of the mandible just anterior to the masseter muscle
Tortuous course upwards and medially to medial angle (canthus) of the eye

46
Q

Where does the facial artery send branches to?

A

Upper and lower lip and side of the nose

47
Q

Where does the ophthalmic artery arise from?

A

Internal carotid artery

48
Q

Name the terminal branch of the ophthalmic artery.

A

Supraorbital

Supratrochlear

49
Q

Where is the facial vein?

A

Begins at the medial canthus, runs posterior to facial artery
Joins with retromandibular vein and drains into internal jugular vein

50
Q

Which structures does the facial vein communicate with?

A

Superior ophthalmic vein at the medial canthus and pterygoid plexus via the deep facial vein

51
Q

What is the pterygoid plexus?

A

Network of small veins around the lateral pterygoid muscle

52
Q

What is important to note about the pterygoid plexus?

A

No valves in veins = infection can move freely in any direction and end up in the cavernous sinus

53
Q

Why are pustules of the upper lip dangerous?

A

In danger triangle of face
Interconnections between veins and lack of valves mean infections of the face can spread intracranially (i.e. into the cavernous sinus)

54
Q

Facial vs temporal pulse

A

Temporal pulse: temple region, anterior to ear

Facial: anterolateral angle of masseter muscle against bony surface of mandible

55
Q

Which nerve and its divisions is responsible for the sensory innervation of the face?

A

Trigeminal nerve (V)

  • Ophthalmic division (V1)
  • Maxillary division (V2)
  • Mandibular division (V3)
56
Q

Name the divisions of the ophthalmic division (V1).

A

Frontal
Lacrimal
Nasociliary

57
Q

Where does the ophthalmic division enter?

A

Through the superior orbital fissure

58
Q

What does the lacrimal nerve supple?

A

Lateral skin and conjunctiva of the upper eyelid

59
Q

What is the largest branch of V1?

A

Frontal

60
Q

What does the frontal nerve supply?

A

Upper eyelid, forehead and scalp

61
Q

What does the frontal nerve give rise to?

A

Large supraorbital nerve

Small supreatrochlear nerve

62
Q

What does the nasociliary nerve supply?

A

Skin of the dorsum of the nose

63
Q

Where does the maxillary division leave/enter?

A

Leaves the middle cranial fossa through the foramen rotundum
Enters the pterygopalatine fossa

64
Q

Name the branches of the maxillary division.

A

Zygomatic nerve
Posterior superior alveolar nerve
Main nerve = infraorbital nerve

65
Q

Which nerve of the maxillary division travels through the inferior orbital fissure?

A

Infraorbital nerve

66
Q

Where does the infraorbital nerve emerge?

A

Emerges on the face through the infraorbital foramen.

67
Q

What does the infraorbital nerve supply?

A

Lower eyelid, cheek and upper lip

68
Q

What is important to note about the mandibular division (V3)?

A

Mixed nerve - (sensory large, motor small)

69
Q

Where does the mandibular division travel?

A

Descends through the foramen ovale - gives a nerve to medial pterygoid and then divides into anterior and posterior branches.

70
Q

List the anterior branches of the mandibular division (all motor except one)

A

Nerves to lateral pterygoid, temporalis, masseter

Sensory: buccal nerve - cheek skin and vestibular gum

71
Q

Name the posterior branches of the mandibular division (all sensory except one)

A

Auriculotemporal, lingual, inferior alveolar nerve

Motor: nerve to mylohyoid

72
Q

What does the auriculotemporal nerve supple?

A

Sensory to skin in temporal region

73
Q

Where does the buccal nerve run?

A

Anteriorly to supply the cheek

74
Q

What does the mental nerve supple?

A

Skin of chin and lower lip

75
Q

What is the terminal branch of the inferior alveolar nerve?

A

Mental nerve

76
Q

Where does the mental nerve arise from?

A

Mental foramen

77
Q

Which spinal nerves make up the cranial plexus?

A

C1-C4

78
Q

Which spinal nerves make up the great auricular nerve?

A

C2 and C3

79
Q

Where does the great auricular nerve go and what does it supply?

A

Ascends across sternocleidomastoid muscle

Supplies skin over the auricle and angle of the mandible

80
Q

Where do cutaneous branches from the plexus emerge?

A

Middle of the posterior border of the sternomastoid

81
Q

Where is the cervical plexus distributed?

A

Skin on anterior and lateral side of the neck and lateral side of the head

82
Q

List the nerves in the cervical plexus.

A

Greater auricular, lesser occipital, transverse cervical, supraclavicular

83
Q

What muscles are supplied by the nerves of the cervical plexus?

A

Strap muscles and small muscles in posterior of neck

84
Q

What does the phrenic nerve supply sensation to?

A

Pericardium, pleura and diaphragm

85
Q

What spinal nerve levels make up the phrenic nerve?

A

C3, C4, C5

86
Q

Why do facial lacerations tend to gape widely?

A

Because the face has no distinct deep fascia and the connective tissue between the facial muscles is loose.

87
Q

What is the nerve supply of the platysma?

A

Cervical branch of the facial nerve (VII)

88
Q

What structures pass through the inferior orbital fissure?

A

Maxillary artery and nerve

Zygomatic nerve

89
Q

Which two fossa does the inferior orbital fissure communicate with?

A

Ptyergopalatine fossa

Infratemporal fossa

90
Q

The infraorbital nerve is a branch of which nerve?

A

Maxillary division (V2) of trigeminal nerve

91
Q

Where does the infraorbital nerve emerge on the face?

A

Infraorbital foramen

92
Q

Which nerve gives rise to the supraorbital nerve?

A

Ophthalmic nerve

93
Q

What might be signs in the face if the 7th cranial nerve is damaged in its course through the parotid gland?

A

Facial muscle paralysis of the affected side
Expressive lines in facial skin obliterated and facial distortion
Unable to close eyelids/lips, whistle, blow
Blood and saliva dribbles out of mouth on affected side

94
Q

What is the most urgent action that needs to be taken for a damaged 7th cranial nerve and why?

A

Eye protection - eyelids will not be able to move = no protection or distribution of tears, leading to a dry eye.
Infection may set in causing ulceration and fibrosis leading to blindness.

95
Q

Which cranial nerve does the corneal reflex test?

A

Trigeminal nerve (V)

96
Q

The branches of which cranial nerve emerge from the anterior border of the parotid gland?

A

Facial nerve (VII)

97
Q

The auricotemporal nerve is a branch of?

A

The mandibular division of the trigeminal nerve (V)

98
Q

Describe two sites in the face where arterial pulsation can be felt.

A

Facial artery - when it winds around the inferior border of the mandible just anterior to the masseter ‘
Superficial temporal artery - compress it against the root of the zygomatic bone

99
Q

Why are pustules of the upper lip dangerous?

A

Infection could spread via the facial vein - superior ophthalmic vein into the cavernous sinus.

100
Q

Where does the facial artery terminate?

A

Medial angle of the eye

101
Q

Superficial temporal artery is a branch of?

A

Terminal branch of ECA

102
Q

What is the structure directly anterior to the jugular foramen?

A

Carotid canal

103
Q

The mastoid process is part of…

A

The temporal bone

104
Q

Where does the parotid duct open into?

A

Oral cavity opposite the crown of the upper second molar

105
Q

The main sensory nerve to the lower lip is the…

A

Mental nerve

3 - RCA (5 decks)

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