Lectures 7, 8 & 9 Face, scalp, parotid, facial nerve (CN VII) Flashcards
Muscles of facial expression are _________ structures (ie they form part of the skin.
cutaneous
T/F - Facial expression muscles usually originate in one or more of the bones of the skull (usually) and insert into deep skin.
True
T/F - Every facial muscle of expression is paired.
False, they’re all paired except for orbicularis oris
What are the muscles of the forehead?
Frontal belly of occipitofrontalis
Corregator supercilii
T/F - Corregator supercilii is superficial to orbicularis oris and frontalis
False, it is deep.
Occipitofrontalis consists of ___________ & _____ bellies separated by a single flat fibrous sheet - ________.
frontal, occipital, epicranial aponeurosis.
What is/are the muscle(s) of the eye?
orbicularis oculi (circles eye).
Function of orbicularis oris?
Closes eye, directs tear flow (paralysis prevents eye closure leading to dry cornea. lower eyelid falls down and tears run out and dirt in).
T/F - levator palbebrae superioris elevates/opens upper eyelid
True
Muscles of nose?
procerus, nasalis, levator labii superioris alaque nasi - nasal/alar head.
What are the seven muscles joining into modiolis?
zygomaticus major levator anguli oris buccinator platysma depressor anguli oris orbicularis oris risorius
_______ - fibromuscular structure extending from skin to mucosa - anchoring point for muscles which move corners of mouth and adjacent structures
Modiolis
________ - zygomer just in front of zygomaticotemporal suture to modiolis, elevates corner of mouth (may be bifid resulting in cheek dimple
Zygomaticus major
________ - origin - maxilla just below infraorbital foramen to modiolis (deep to facial vein and z. minor). elevates corner of mouth
levator anguli oris
________ - origin - outer surfaces of maxilla and mandible (over molars) and pterygomandibular raphe to attach to modiolis. Draw in/position cheeks, direct food over molars
Buccinator
_______ - origins - body of mandible, modiolis and modiolar muscles to skin over pectoralis. Function slight but can depress lower lip and corners of mouth.
Platysma
__________ - origin - mandible to modiolis - corners of mouth down
Depressor anguli oris
__________ - sphincter of mouth, modiolis to modiolis - other muscles e.g. buccinator converge to it. No direct bony attachments, but some of the fibres of ______ are derived from buccinator. Reinforced by small muscles.
Orbicularis oris, orbicularis oris.
________ - variable in development, origins also variable zygomatic arch parotid fascia to modiolis, moves corner of mouth
Risorius
__________ (deep) -origin - maxilla and zygomer just above infraorbital foramen to upper lip. Raises upper lip
levator labii superioris
________________ - origin - frontal process of maxilla - raises upper lip, dilates nostril.
Levator labii superioris alaque nasi
__________ - origin - zygomer just behind zygomaticomaxillary suture to upper lip. Raises upper lip
zygomaticus minor
__________ - situated medial to depressor anguli oris - origin - mandible, lower lip down.
depressor labii inferioris
_______ - origin - mental symphysis to mid lower lip. Raises base of lower lip - protrusion and eversion.
Mentalis
T/F - auricular muscles are rudimentary and usually non-functional in humans (though important in surgery on auricle - cosmetic of reconstructive)
True
What are extrinsic rudimentary muscles?
posterior extrinsic auricular muscle
anterior and superior extrinsic auricular muscles
T/F - intrinsic rudimentary muscles are on both lateral and cranial aspects of auricle and change shape of auricle in some animals.
True
T/F - Temporoparietalis is between anterior and posterior auricular muscles (ear elevation in some individuals)
False, it is between anterior and superior auricular muscles
How do you identify levator labii superioris alaque nasi?
Identify by two heads, - one to nostril, and one into upper lip (arises beneath orbicularis oris)
How do you identify levator labii superioris?
Deep and lateral to levator labii superioris alaque nasi. Fibres of two muscles converge inferiorly
How do you identify levator anguli oris?
very deep, lateral to levator labii superioris, deep to zygomaticus minor
T/F - zygomaticus major is larger and more lateral than zygomaticus minor.
True
T/F - z. major and z. minor both arise from zygomatic bone.
True
T/F - both z. major and z.minor both blend with orbicularis oculi but zygomaticus minor goes to corner of mouth whereas zygomaticus major goes to upper lip lateral to levator labii superioris and levator labii superioris alaque nasi.
False, they blend with orbicularis oris, and its zygomaticus major that goes to mouth corner, and z. minor that goes to upper lip.
T/F - mentalis arises tip of chin and fans laterally and downward.
False, fans upward.
T/F - depressor labii inferioris arises medially and converges laterally and downward to blend with orbicularis oris.
False, it arises laterally and converges medially and upward.
T/F - depressor labii inferioris is superficial to mentalis
True
How do you identify buccinator?
Parotid duct pierces muscle before it passes into oral cavity.
T/F - pterygomandibular raphe is attached to mandible and maxilla.
True
T/F - pterygomandibular raphe cannot be located inside oral cavity as a thin tight ridge running horizontally from upper back to lower back molar.
False, it can be located inside oral cavity and runs vertically.
T/F - Risorius is vertical and is often absent.
False, it is horizontal.
List five layers of scalp
skin superficial fascia - loculated fat (highly vascular) epicranial aponeurosis loose fascia periosteum
T/F - epicranial aponeurosis is a tendon connecting frontal and occipital bellies of occipitofrontalis and attaches to temporal and superior nuchal lines. Otherwise occipitofrontalis - inserts into skin not bone.
True
_____ innervation of facial muscles is via cutaneous branches of the facial nerve,
Motor
________ innervation of face is via cutaneous branches of the three divisions of the trigeminal nerve.
Sensory
T/F - intrinsic salivary glands are numerous small and in oral mucosa
True
T/F - extrinsic salivary glands have two pairs, and are large, outside oral cavity and drain into it via ducts.
False, there are three pairs
T/F - parotid capsule/fascia is derived from deep cervical fascia and attached to zygomatic arch, mandible, tympanic plate and styloid process.
True
The part of the ______ capsule attached to ______ process and angle of ______ forms _________ (one of the supporting structures for the TMJ).
parotid, styloid, mandible, stylomandibular ligament
T/F - Parotid gland is medial to ramus of mandible and masseter on face and between mandible and sternocleidomastoid on upper neck.
False, it is lateral to mandible
T/F - internal jugular, carotid and vagus are lateral to the parotid and separated from it by the styloid muscles.
False, they are medial
T/F - parotid gland is totally serous secreting in humans
True
Nerve supply to parotid gland?
- Parasympathetic fibres from glossopharyngeal hitchhiking on auriculotemporal nerve (branch of V/3)
- sympathetic from external carotid plexus
- sensory innervation is from greater auricular branch of the cervical plexus (superficial and inferior parts of the gland) and auriculotemporal nerves (deep and superior parts).
What is the arterial blood supply to parotid gland?
Usually transverse facial artery & posterior auricular artery,
What is the venous blood supply to parotid gland?
Superficial temporal and some sources also include retromandibular vein.
Which structures pass through parotid gland?
External carotid artery, retromandibular vein, facial nerve
T/F - Parotid duct leaves posterior border of gland, often associated with one or more accessory parotid glands
False, anterior border of gland
Parotid duct crosses superficial surface of masseter, ________ _______ to empty into ______ of oral cavity above second upper molar
pierces buccinator, vestibule
T/F - Parotid duct has a thick fibromuscular wall, lined with columnar epithelium.
True
What is diameter of parotid duct with fibromuscular wall?
3mm diameter
(Structures within parotid gland)
Vessels are posterior to _____ of ______, _____ ______ is roughly horizontal with branches radiating anteriorly. Parotid gland develops around these structures as an outgrowth from the ________ ____ _______
ramus, mandible, facial nerve, embryonic oral vestibule
Deepest structures within parotid gland:
the external carotid enters ______ surface, divides within gland to form _______ artery which passes medial to neck of mandible & ______ _____ artery which gives off _______ _____ artery & then emerges from ______ surface of parotid. ________ _________ artery may also arise within parotid.
posteromedial, maxillary, superficial temporal, transverse facial, superior, Posterior auricular
Intermediate structures within parotid gland:
______ _______ & ______ veins accompany arteries into parotid to form retromandibular vein. This divides within parotid into ______ & _____ branches
superficial temporal, maxillary, anterior, posterior
Superficial structures within parotid gland:
____ ______ - divides in parotid into cutaneous branches. ____ ____ does not innervate parotid gland.
Facial nerve, facial nerve
T/F - first parts of auriculotemporal nerve & superficial temporal artery & vein pass through the lower part of the parotid
False, they pass through upper part of the parotid
T/F - Facial nerve has two roots - a larger sensory root & a smaller motor root arising from different nuclei in the pons
False, its larger motor, and smaller sensory
The motor root of facial nerve sends fibres to which muscles?
- Stapedius muscle (in middle ear)
- muscles of facial expression including buccinator, auricular muscles, stapedius, stylohyoid, posterior belly of digastric
Smaller sensory root of facial nerve called ______ _______ carries sensory & parasympathetic fibres
nervus intermedius
Sensory fibres convey _____ from the anterior ____ _____ of the tongue & soft palate plus general sensation from some of the skin of ____ _____
taste, two thirds, external ear
Parasympathetics are _________ (involved in glands producing secretion) to _______, ______ & ______ glands & to glands of palate & nasal mucosa
secromotor, submandibular, sublingual, lacrimal
T/F - the facial nerve initially travels with the vestibulocochlear nerve
True
T/F - small nervus intermedius (part of facial nerve) passes separate, not in a groove between them.
False, it passes in a groove between CN VII and CNVIII
Name the three structures that enter internal acoustic meatus
Facial nerve, nervus intermedius, vestibulocochlear nerve
Facial nerve (including nervus intermedius) separates from vestibulocochlear nerve in the ____ _____ ____ & enters ____ ____ which passes in the horizontal plane ABOVE vestibule & _____ of inner ear.
internal acoustic meatus, facial canal, cochlea
Facial nerve then bends and passes ______ down medial wall of middle ear. The ______ _______ _______ is located at the bend. The parasympathetic _______ ________ ______ also arises here.
vertically, sensory geniculate ganglion, greater petrosal nerve
The vertical part of the facial nerve gives off:
1) stapedius nerve (motor)
2) chorda tympani (sensory)
3) sensory auricular (sensory)
T/F - Chorda tympani also carries the remainder of the sympathetic fibres which did not go to the greater petrosal nerve & ultimately to the geniculate ganglion.
False, they carry parasympathetic fibres and go to the pterygopalatine ganglion
T/F - Sensory auricular nerve goes to skin of external acoustic meatus & some of the external ear.
True
Facial nerve emerges from the skull at __________ _______ & curves medially to give off:
_________
_______________
stylomastoid foramen, posterior auricular nerve, small branch to post belly of digastric & stylohyoid
Which muscles does posterior auricular nerve innervate?
occipital belly of occipitofrontalis & auricular muscles
Name cutaneous branches of facial nerve that innervate muscles of facial expression:
1) Temporal
2) Zygomatic
3) Buccal
4) Marginal mandibular
5) Cervical
Name muscles that is supplied by temporal branches of facial nerve
- Occipitofrontalis
- superior part of orbicularis oculi
- corregator supercilii,
Name muscle supplied by zygomatic branches of facial nerve
Inferior part of orbicularis oculi
Name muscles supplied by buccal branches of facial nerve
- face between orbicularis oculi & oral fissure
- zygomaticus major,
- zygomaticus minor
- procerus
- nasalis
- levator labii superioris alaque nasi
- levator labii superioris
- levator anguli oris
- buccinator
- orbicularis oris
Name muscles supplied by marginal mandibular branches of facial nerve
- muscles of lower lip & chin & risorius
Name muscle supplied by cervical branch of facial nerve
Platysma
Name the sensory fibres of facial nerve in sensory geniculate ganglion
- taste fibres from chorda tympani
- taste fibres from the soft palate via greater petrosal nerve
- cutaneous sensory fibres (from skin of some parts of the external ear)
T/F - parasympathetic fibres pass through the geniculate ganglion without synapsing.
True
Some of the parasympathetic fibres that pass through geniculate ganglion form the _____ _____ _____ while others continue with the facial nerve and leave via the ______ ______
greater petrosal nerve, chorda tympani
Which fibres does the greater petrosal nerve carry?
- parasympathetic fibres to pterygopalatine ganglion
- special sensory fibres from palatal taste buds (via the palatine nerves not via chorda tympani)
T/F - the greater petrosal nerve and nerve of pterygoid canal passes through petrous temporal bone to an opening the facial hiatus, on floor of the posterior cranial fossa_, passes across floor of middle cranial fossa deep to geniculate ganglion and then into foramen spinosum
False, on floor of middle cranial fossa, deep to trigeminal ganglion, foramen lacerum
Where does greater petrosal nerve and nerve of pterygoid canal emerge and pass to?
Foramen lacerum, then passes to pterygoid canal along with or incorporating sympathetic fibres of deep petrosal nerve
T/F - greater petrosal nerve and nerve of pterygoid canal passes to pterygopalatine ganglion
True
Chorda tympani carries _________________ from anterior 2/3 of the tongue & ______________ ____ to the submandibular ganglion
taste fibres (special sensory fibres), parasympathetic fibres
Chorda tympani leaves facial nerve about ______ above stylomastoid foramen. Arches upwards across posterior wall of ______ ____, across upper part of ____ _____ then into bone again and down to __________ ______
5 mm, middle ear, tympanic membrane, petrotympanic fissure
Chorda tympani goes down medial surface of spine of ______ & then between the _____ ______ & ______ _____. Joins lingual nerve at an acute angle usually deep to _______ _____
sphenoid, lateral pterygoid, inferior alveolar nerve, lateral pterygoid
List cutaneous branches of the opthalmic division of the trigeminal
- supratrochlear
- supraorbital
- lacrimal
- infratrochlear
- external nasal
List cutaneous branches of the maxillary division of the trigeminal
- zygomaticofacial (foramen only)
- zygomaticotemporal (foramen only)
- Infraorbital (foramen only)
List cutaneous branches of the mandibular division of the trigeminal
- deep/sensory buccal
- auriculotemporal
- mental (foramen only)
the _______ nerve passes along the _______ _____, through the _______ ____ to emerge deep to orbicularis oculi as the cutaneous ______ ____
Infraorbital, infraorbital groove, infraorbital canal, infraorbital nerve
the _____________ branch passes through the _________ _______ on the lateral wall of the orbit & emerges as two branches:
_______ (canal opens on lateral surface of zygomatic bone)
- & the ______________ which emerges from a canal of the same name on the medial or temporal surface of the zygomer). The nerves are not likely to be seen in prosections but the bony foramina should be recognised.
zygomatico-orbital, zygomatico-orbital foramen, zygomaticofacial, zygomaticotemporal
