Lec 3

Question 1

What are the topographic territories of the Facial muscles

Answer 1

Mental, Oral, buccal, temporal, zygomatic, orbital, infra and supra orbital

Question 2

What the important muscles of facial expression

Answer 2

Platysma, Orbicularis Oculi, Orbicularis Oris, Buccinator, Frontalis

Question 3

What are the parts of the Orb Oculi

Answer 3

Orbital part (wink) Palpebral (med and lat ligaments for blinking) Lacrimal (release tears)

Question 4

Function of Orb Oris

Answer 4

Manipulate food and purse lips

Question 5

Funciton of Buccinator

Answer 5

Swallow, attaches at ptrygo-mandible raphae with sup pharyngeal constrictor

Question 6

Describe the Frontalis

Answer 6

Associated with galea aponeurotica which extends to occipitalis muscle

Question 7

What are the major branches of Facial Nerve

Answer 7

The 5 peripheral branches are temporal, zygomatic, buccal, mandibular, cervical all of which pass through parotid gland as a plane

Question 8

What and how do you represent Bell’s Palsy

Answer 8

Paralysis of facial peripheral nerves - lyme disease
Clinical presentation:
Orb Oris - drool
Bucc - disruption of swallowing and speech
Orb Oculi - ulceration

Question 9

Pathway of facial nerve

Answer 9

Axons of facial motor form knee bend around CN6 to exit cranial cavity though internal aud meatus w/ CN8. Nerve passes through facial canal where it innervates stapedius (dampens sound). Remaining axons exit skull at stylomastoid foramen where they innervate the stylohyoid and post belly of digastric before branching

Question 10

Lesions of Facial Nerve

Answer 10

1. Near Stylomastoid Foramen - Bells Palsy
2. Facial Canal - Bells and hyperacusis
3. IAM - Bells, hyperacusis, hearing and balance
4. Supra Nuclear - selective inhibition of CN7 fx
5. injury of facial canal also leads to taste loss of ant 2/3 tongue

Question 11

Parotid Gland info, duct path, and diseases

Answer 11

Salvatatory duct
Stensons duct crosses face, wraps medial to masseter, pierces buccinator, enters mouth at 2nd maxillary nerve
Problems:
1. Parotitis (mumps) viral infection, swell and pain, impact on testis
2. Pleomorphic adenomas - benign tumor

Question 12

What is parasympathetic path of Parotid gland and problems thereof

Answer 12

Pre-g in inf saliv nucleus - CN9 - V3 - otic ganglion - post g- auricotemporal branch of V3 - gland
Removal of Parotid severs PSNS axons which regen and attach to sym of nearby sweat glands = Frey’s Syndrome

Question 13

What is innervation and muscles of mastication

Answer 13

V3 to masseter, temporalis, medial and leteral pterygoids. Work as unit not as particular UMN

Question 14

What are the afferent portions of the Trigeminal Nerve

Answer 14

V1: supra orbital, supratrochlear, infratrochlear, and lacrimal
V2: infraorbital, zygomaticofacial, zygomaticotemporal
V3: Mental, Buccal, auricotemporal

CNV also sense for teeth, gums, meninges, cerebral blood vessels, and cornea

Question 15

What are the unique characteristics of CN V

Answer 15

No overlay in periphery, each section of nerve can be tested and anesth separately.
Trigeminal Neuralgia (Tic Dolorux) - pain in infraorbital nerve
V1 refers pain to skin of forehead and eye

Question 16

What are the common fractures of the skull

Answer 16

1. Nasal Bone - readily repaired

2. Mandible - sites across foramina and matched by contralateral side. Need to repair by no maloclusions

Question 17

What the types of Le Fort fracturs

Answer 17

1. Horizontal across mandible
2. Through max sinus and infraorbital foramina - used to repair Crouzon’s Syn (flat face)
3. Horizontal through supraorbital fissure

Question 18

What are the layers of the scalp

Answer 18

S - Skin
C-Connective Tissue
A - Aponeurosis
L - Loose CT
P - Periosteum

Question 19

What are the characteristics of C layer

Answer 19

Dense connective tissue and contains superficial blood and nerves.

1. Arteries from both sides of scalp anas here so blow will lead to excessive bleeding
2. Recon surg moves skin and blood of scalp to face
3. Superficial facial veins anas w/ skull and can carry infection

Question 20

What are the characteristics of L layer

Answer 20

Loose conn tissue, bleeding in space leads to ecchymosis (Raccoon Eyes). Also has access of meninges via emissary veins