Lecture 2 - Superficial Face and Neck

Question 1

muscles of facial expression

Answer 1

originate on skull and insert directly onto skin
innervated by facial nerves
developed from branchial arch 2
branchiomotor

Question 2

orbicularis oculi

Answer 2

arranged in circle

close eyes

Question 3

orbicularis oris

Answer 3

arranged in circle

pucker lips

Question 4

occipital frontalis

Answer 4

attached to galea aponeurotica

raise eyebrows

Question 5

platysma

Answer 5

in the neck as thin sheet of muscle

Question 6

buccinator

Answer 6

compresses cheeks
keeps food between teeth
well developed in infants
fish face

Question 7

facial nerves

Answer 7

innervate muscles of facial expression --> branchiomotor
exits skull through stylomastoid foramen 
temporal 
zygomatic
buccal
marginal mandibular
cervical 
"The Zebra Bought My Car"

Question 8

Parotid gland

Answer 8

salivary gland
innervated by glossopharyngeal (CN 9)
enclosed by tough fascial sheath
duct opens into oral cavity and runs anterior to masseter, through the buccinator to ~2nd molar

Question 9

bell’s palsy

Answer 9

facial nerve palsy
paralysis of muscles of facial expression
many possible causes

Question 10

vessels of the face

Answer 10

facial artery
facial vein -> facial vessels run deep to zygomaticus major
superficial temporal artery (temple pulse)
external carotid artery (internal to brain)

Question 11

anastomoses of the face

Answer 11

branches of internal carotid artery (forehead+top of scalp)
branches of external carotid (every where else)
cavernous sinus - venous anastamoses
facial vein

Question 12

anterior cervical triangle

Answer 12

mandible, edge of neck, sternocleidomastoid

contains common carotid artery, internal jugular vein

Question 13

posterior cervical triangle

Answer 13

clavicle, traps, sternocleidomastoid

contains spinal accessory nerve (CN11), cutaneous branches of cervical plexus

Question 14

fascial layers of neck

Answer 14

cervical investing fascia - outermost, super thick
prevertebral fascia - surrounes msucles around vertebra
carotid sheath - carotid arter, veins + nerves
pretracheal fascia - surrounds trachea and thyroid
-> buccopharyngeal fascia - posterior region of pretracheal

Question 15

retropharyngeal space

Answer 15

behind the pretracheal/buccopharyngeal
AKA danger space
continuous with posterior mediastinum
infection/abscess can spread

Question 16

superficial veins of neck

Answer 16

external jugular vein
      - superficial to investing fascia 
      - held open by investing fascia near clavicle
anterior jugular vein 
      - superficial to investing fascial

Question 17

cervical lymph nodes

Answer 17

cervical collar of lymph nodes –> superficial
deep cervical lymph nodes –> drain from superficial
jugulodigastric node + supraclavicular nodes

Question 18

sternocleidomastoid (SCM)

Answer 18

connects from mastoid to sternum and clavicle
innervated by CN11
lateral flexion to same side
rotation to opposite side

Question 19

torticollis

Answer 19

“wry neck”

congenital: shortened SCM
spasmodic: abnormal tonicity of SCM
treatments: stretching, surgical lengthening, muscle relaxants, botox

Question 20

spinal accessory nerve

Answer 20

branchiomotor fibers only (CN11)
possibly from 5th arch, but unsure because 5th arch degenerates before it can be visualized
spinal cord levels C1-C4
sensory (proprioceptive) fibers from cervical spinal nerves travel with CN11
innervates SCM + traps

Question 21

cervical plexus

Answer 21

ventral rami of C1-C4
CN12, CN11, CN10
phrenic
ansa cervicalis (loop of nerves on carotid sheath)
- somatomotor fivers only
cutaneous branches of cervical plexus
- sensory and sympathetic fibers only

Question 22

ansa cervicalis

Answer 22

motor portion of cervical plexus (C1-C3)
branch of C1 joins hypoglossal nerve (CN12)
- geniohyoid innervation (suprahyoid muscles)
innervates infrahyoid muscles

Question 23

Hyoid muscles

Answer 23

supra and infra muscles
support tongue, mandible, pharynx movement
assists with swallowing and speaking

Question 24

suprahyoid muscles

Answer 24

elevate hyoid and depress the mandible
digastric
- anterior belly: V3 innervation
- posterior belly: CN VII innervation
mylohyoid (V3)
stylohyoid (VII)
geniohyoid (C1) - bend of mandible (postotic somite)

Question 25

scalene muscles

Answer 25

anterior, middle, posterior
from cervical to ribs
phrenic nerve goes through
brachial plexus and subclavian arteries go btw anterior and middle