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MBBS II HNNS > L25 - Face and scalp > Flashcards

L25 - Face and scalp Flashcards

1
Q

Explain the importance of knowing anatomy of the face and scalp.

A
  • Identity, contact, impression
  • Individuality from anatomical variation
  • Facial muscles critical to communcation
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2
Q

4 anatomical variations that determine the face shape?

A

 Underlying bones

 Deposition of fatty tissue

 Colour, effects of aging on overlying skin

 Abundance, placement, nature of hair

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3
Q

Name of the arch that form the upper border of face?

A

Supraciliary arch = upper border of face

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4
Q

Name of eyelid folds (superior and inferiorly)?

A

Suprapalpebral sulcus

Infrapalpebral sulcus

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5
Q

Name of nose bridge and flairs?

A

Dorsum of nose = nose bridge

Ala of nose = nose flairs

Apex of nose = tip of nose

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6
Q

Name for nostrils and what are they seperated by?

A

Naris

separated by nasal septum

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7
Q

Name of ridge in the centre above the upper lips?

A

Philtrum

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8
Q

Location of labial commissure of the face?

A

Edge of the oral fisure

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9
Q

What forms the inferior border of the face?

A

Mental protuberance

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10
Q

5 layers of the scalp?

A 
Skin
Connective tissue 
Aponeurosis
Loose connective tissue
Pericranium
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11
Q

Thickness, content, and blood supply of skin of scalp?

A

thin, many sweat and sebaceous glands; hair follicles;

Abundant arterial supply; good venous and lymphatic drainage

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12
Q

Thickness, content and nerve supply of connective tissue in scalp?

A

thick, richly vascularised subcutaneous layer;

well supplied with cutaneous nerves

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13
Q

Structure of the epicranial aponeurosis?

A

broad, strong tendinous sheet

covers calvaria

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14
Q

Function of the losse connective tissue of scalp?

A

allows free movement of the above layers over underlying calvaria

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15
Q

Damage to the scalp causing pain: Pain signal originates via which layer of the scalp?

A

Connective tissue layer

Abundant cutaneous nerves

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16
Q

Define the borders that separate neurocranium from viscerocranium?

A

A line between

Anterior: Supraorbital arch

Posterior = mastoid process

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17
Q

Function of the facial skeleton?

A
  • To house and protect the sense organs (eye, nose, & mouth)
  • To provide a frame on which soft tissues, including muscles of the face can act, and teeth can anchor
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18
Q

List the 2 muscles of the scalp?

A

1) Occipitofrontalis

2) Auricular muscles:
- Anterior auricular
- Superior auricular
- Posterior auricular

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19
Q

Function, origin and attachment of the occipitofrontalis muscle?

A

(2 bellies: occipital and frontal bellies)

Origin = superior nuchal line at occipital protuberance

Attach to skin above upper orbital arch: epicranial aponeurosis

  • raises the eyebrows
  • wrinkles the forehead
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20
Q

Embryonic origin of all the muscles for facial expression? Innervation of all these muscles?

A

2nd pharyngeal arch

Facial nerve (CNVII)

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21
Q

Which layer of tissue are muscles of facial expression located? How are they anchored?

A
  • Small, thin muscle bundles located in the subcutaneous tissue (superficial fascia)
  • not covered by own fascia (except buccinators)
  • most of them attaches to the bone/fascia and pull the skin, the rest attaches to the other muscles
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22
Q

3 functions of muscles of facial expression other than expression?

A

Sphincters and dilators of the facial orifices
= Protection (e.g. for the eyes)

Support food ingestion
= Closing mouth for swallowing

Involved in sound production

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23
Q

2 function of the orbital group of facial muscles?

A

Main functions of eyelids (L. palpebrae):
- protection of the eyeball from injury and excessive light

  • spreading the tears to keep the cornea moist
24
Q

Name the main superficial orbital muscle and it’s functions?

A

Orbicularis oculi = sphincter of the eye:

1) Palpebral part: closes eyelid gently
2) Orbital part: closes eyelid forcefully
3) Lacrimal part

25
Q

Name the deep orbital muscles and their functions?

A
  • Corrugator supercilii : draw eyebrows together (frown)

- Depressor supercilii : depress eyebrows

26
Q

List the nasal group muscles and their functions/ facial expression?

A

-Procerus [1]:
pulls eyebrows downward to produce transverse wrinkles over the nose

  • Nasalis [2]:
    a) Transverse part: compresses nostrils and wrinkle nose
    b) Alar part: opens nostrils laterally

-Depressor septi nasi [3]: pulls nose down

27
Q

Name the muscle that acts as the sphincter of the mouth?

A

Orbicularis oris [1] = sphincter of the mouth (most important): kiss

28
Q

Name the main muscle of the cheeks?

A

buccinator [5] (= muscle of the cheek, beneath fat): blow up cheeks

29
Q

List the 4 sets of muscles of the upper lip?

A

1) Zygomaticus major + zygomaticus minor: smiling / meh (elevate, draw angle of mouth)
2) Levator anguli oris
3) Levator labii superioris: bare teeth
4) Levator labii superioris alaeque nasi: moves nose up

30
Q

List 2 sets of muscles for the lower lip + the facial expression made?

A

1) Mentalis: pout

2) Depressor labii inferioris (medial) + depressor anguli oris (superficial): bare teeth

31
Q

Name the muscle for widening the mouth opening?

A

Risorius

widens mouth opening = fake smile (draws back angle of mouth)

32
Q

Function of the Platysma?

A

Tenses the skin over lower face and anterior neck

Depresses mandible (against resistance)

33
Q

Describe the sensory innervation of the head and neck dermatomes.

A

refer to lecture notes for visualization
Dermatome supplied by?

Anterior/ face = Trigeminal nerve (CN V):

  • Ophthalmic nerve [CN V1]
  • Maxillary nerve [CN V2]
  • Mandibular nerve [V3]

Posterior = Spinal nerves: C2, C3, C4

34
Q

List the spinal nerves that forms the cutaneous distribution of nerves of the posterior head + neck?

A

refer to lecture notes for visualization

Anterior rami:

  • Greater auricular nerve (C2, C3)
  • Lesser occipital nerve (C2, C3)

Posterior rami:

  • Greater occipital nerve (C2)
  • 3rd occipital nerve (C3)
35
Q

List all the branches of opthalmic nerve that forms the cutaneous distribution of nerve on the face. (5)

A 
Ophthalmic nerve [CN V1]: 
 Supraorbital 
 Supratrochlear 
 Infratrochlear 
 External nasal 
 Lacrimal
36
Q

List all the branches of Maxillary nerve that forms the cutaneous distribution of nerve on the face. (3)

A

Maxillary nerve [CN V2]:
 Infraorbital
 Zygomaticotemporal
 Zygomaticofacial

37
Q

List all the branches of Mandibular nerve that forms the cutaneous distribution of nerve on the face. (3)

A

 Mental
 Auriculotemporal
 Buccal

38
Q

Which 3 areas of the face can be tapped to check the intactness of the the facial nerve? Nerves that supply these area?

A
  • refer to lecture notes for visuals*
    1. Tap supraciliary arch = test supraorbital nerve from V1
    2. Tap zygomatic bone area/ medial cheek = test infraorbital nerve from V2
    3. Tap jaw lateral to chin = test mental nerve from V3
39
Q

Define the cause of trigeminal neuralgia “suicide disease”?

A

Severe pain in facial area served by one or more of the 3 branches of trigeminal nerve

Caused by compression of blood vessels / tumour at the base of skull

Occurs in people >50 (affects women more)

40
Q

Which nerve is responsible for the motor function of facial expression muscles?

A

Facial nerve (CN VII)

41
Q

Outline the course and branches of the motor division of the facial nerve supplying the facial muscles?

A

Exits skull at stylomastoid foramen

Divides in parotid gland into 6 major branches in the face:

  1. Temporal
  2. Zygomatic
  3. Buccal
  4. Mandibular (marginal)
  5. Cervical
  6. Posterior auricular: occipital belly of occipitofrontalis + auricularis inferior)

Also supplies stapedius, posterior belly of digastric, stylohyoid

42
Q

What is the cause of Bell’s palsy?

A

Facial nerve injury

43
Q

2 major symptoms of Bell’s palsy?

A

Incomplete closure of the eye (orbicularis oculi)

Drooling

44
Q

List some complications that arise from incomplete closure of the eyes in Bell’s palsy?

A

Incomplete closure of the eye (orbicularis oculi)
– cause cornea to dry out [exposure keratitis]
– drooping of lower eyelid [ectropion]

45
Q

List some complications that arise from Bell’s palsy?

A

Dribbling saliva and drinks, difficult in chewing & speaking (orbicularis oris)

Decrease sense of taste (chorda tympani)

Sensitive to loud noise [hyperacusis] (stapedius)

46
Q

Explain why lacerations of the scalp leads to profuse bleeding?

A

rich blood supply from ECA and ICA

Bleeding is mainly arterial:

  • Venous pressure is extremely low in the erect position
  • Connective tissue around vessels prevents retraction
47
Q

List the 5 MAJOR arteries of the face and scalp?

A
  • Superficial temporal (branches)
  • Posterior auricular
  • Occipital
  • Maxillary (branches)
  • Facial (branches)
48
Q

Origin and branches of facial artery that supply the face?

A

Origin = ECA

(torturous) – branches into: 
 Angular artery (nose)
 Lateral nasal artery  (nose)
 Superior, inferior labial arteries (upper and lower lips)
(+ submental a.)
49
Q

Origin and branches of the superficial temporal artery?

A

Origin = ECA

Branches:

  • Parietal branch
  • Frontal branch
  • Transverse facial artery
  • Zygomaticoorbital artery
50
Q

Origin and branches of the Maxillary artery that supply the face?

A

Origin = ECA

Branches:

  • Mental branch (through mental foramen)
  • Buccal artery
  • Infraorbital artery (through infraorbital foramen)
51
Q

Origin and branches of the Opthalmic artery that Supply the face?

A

Origin = ICA (NOT ECA)

Branches:
 Supratrochlear artery
 Supra-orbital artery
+ Dorsal nasal artery)

52
Q

4 palpable locations for arterial pulse in the head?

A
  1. Temporal pulse @ pre-auricular region = superificial temporal artery
  2. Temporal pulse @ superior to pre-auricular region = Anterior branch of superficial temporal artery
  3. Facial pulse @ later to chin = facial artery
  4. Carotid pulse @ upper border of thyroid cartilage at neck = common carotid artery
53
Q

Compare the drainage of the 2 divisions of retromandibular vein?

A

 Anterior division drains into internal jugular vein

 Posterior division drains into external jugular vein

54
Q

Drainage of superficial temporal vein?

A

internal jugular vein

55
Q

Define the danger area of the face?

A

Triangle area drained by valveless facial vein, deep facial vein, infraorbital vein, ophthalmic veins

> > leads directly / indirectly (via pterygoid plexus) to cavernous sinus

> > route for infectious spread (e.g. Cavernous sinus thrombosis)

56
Q

Overview of the lymph drainage of the face and scalp?

A

Submental, submandibular, parotid nodes

> > superficial cervical lymph nodes

> > superior deep cervical lymph nodes

57
Q

List the lymph nodes located anterior and posterior to vertex?

A

Anterior to the vertex:
 Preauricular nodes
 Parotid nodes

Posterior to the vertex:
 Mastoid nodes
 Occipital nodes

MBBS II HNNS (57 decks)

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