Module 7a: The Head Flashcards
Layers of the scalp
-skin
-dense connective tissue
-aponeurosis
-loose connective tissue
-pericranium
Skin of the scalp
-contains hair follicles and sebaceous glands
Dense connective tissue of the scalp
-highly innervated and vascularized, also contains hair follicles
Aponeurosis of the scalp
-tendon-like sheet covers dome of skull
-intermediate muscle between occiptalis and frontalis muscle
Loose connective tissue of the scalp
-danger area
-infections can spread easily between in and enter cranial cavity
-provides plane of separation between upper 3 layers and pericranium
Pericranium of the scalp
-very thin layer of connective tissue that covers bones of skull
-serves for protection and provides nutrients o the bone
Complications with hair transplants
-nerve damage
-prolonged pain
Nerve damage with hair transplant
-numbness/lack of sensation
-bleeding from vascular damage
Prolonged pain with hair transplants
-pain that doesnt subside after 4-5 weeks may indicate infection
Ducts of the salivary gland
-parotid gland
-submandibular gland
Parotid gland
-secretions from gland exit through stensens duct, which passes superficial to masseter muscle and pierces buccinator to open into oral cavity
Submandibular gland
-in the neck
-medial to lower border of mandible
-secretions exit through whartons duct
Salivary gland stones
-calcified stones that form when chemicals in saliva accumulate in duct or gland
Salivary gland symptoms
-swelling of gland
-pain in lower jaw
-difficulty opening mouth due to blockage
Salivary gland stones risk factors
-dehydration
-poor eating
-use of certain medications
-trauma
-genetics
Which gender has a higher risk of salivary stones
-males
Function of the muscles of facial expression
-protect orifices of face by acting as sphincters and dilators
-attach to face and cause changes in expression
Buccinator
-contraction pulls cheeks tightly against teeth
-preventing food from collecting between teeth and gums during mastication
-works with tongue to keep food between molars
Branches of the facial nerve
-temporal
-zygomatic
-marginal mandibular
-cervical
-buccal
Buccinator muscle strain
-can occur from strenuous activity of jaw such as chewing gum, ill-fitted mouthpieces, or a contact injury to the face
What nerve is the buccinator innervated by
-buccal branch of facial nerve
Buccinator muscle strain
-deep pain in cheek
-pain during chewing, smiling, and swallowing
Function of the trigeminal nerve
-carries sensory and motor innervation to the face
Trigeminal nerve branches
-mandibular branch
-maxillary branch
-ophthalmic branch
Mandibular branch of trigeminal nerve
-supplies skin of lower lip, lower face, temporal region, and upper part of external ear, motor info to muscles of mastication
Maxillary branch of trigeminal nerve
-innervates skin of lateral sides of nose, lower eyelid, cheek, temporal region, and upper lip
Ophthalmic branch
-carries sensory info from skin of forehead, upper eyelid, and midline of nose
Trigeminal neuralgia
-chronic pain condition resulting from trigeminal nerve impairment
-can be caused by compression of nerve by neighbouring structures, multiple sclerosis, or natural aging/plastic surgery
Trigeminal neuralgia symptoms
-stabbing or shooting pain
-jaw and/or gum region
-forehead region triggered by brushing hair/teeth
-pain can last seconds or minutes with multiple attacks a day
Axis’ of extraocular muscles of eye
-horizontal axis
-vertical axis
Superior rectus
-elevation of eyeball
Inferior oblique
-elevation of eyeball
Inferior rectus
-depression of eyeball
Superior oblique
-depression of eyeball
Lateral rectus
-abduction of eyeball
Medial rectus
-adduction of the eyeball
Lateral rectus
-abduction of the eyeball
Arterial supply of the orbit
-ophthalmic artery branches off internal carotid artery and enters orbit through optic canal
-branches of this artery supply contents of orbit and eyelids
Central retinal artery
-branch of the ophthalmic artery that nourishes the retina of eyeball
Venous drainage of the orbit
-superior ophthalmic vein which is formed by smaller veins that drain into orbit, passes through superior orbital fissure to drain into cavernous sinus
Inferior ophthalmic vein
-usually joins superior ophthalmic vein before draining into cavernous sinus
Pyomositis of extraocular muscles
-acute bacterial infection caused by staphylococus aureus found in respiratory tract and on skin
Pyomositis of extraocular muscles symptoms
-pain
-swelling
-redness in eye
-restricted movement of eye
-vision impairments
-central retinal artery occlusion
Borders of the middle ear
-lateral
-medial
-posterior
-roof
-floor
-lower anterior
-upper anterior
Lateral border of middle ear
-tympanic membrane
Medial border of middle ear
-medial (labrinthe) wall
Posterior border of middle ear
-thin bone separating tympanic cavity from mastoid air cells
Roof of middle ear
-tegman tympani
Floor of middle ear
-thin bone separating middle ear from internal jugular vein
Lower anterior border of middle ear
-thin bone that separates tympanic cavity from internal carotid artery
Upper anterior border of middle ear
-incomplete because it has an opening for eustachian tube
Eustachian tube dysfunction
-temporary problem caused by inability to equalize pressure in middle ear
Eustachian tube dysfunction symptoms
-dulled hearing
-feeling of pressure or fullness in affected ear
Nasal septum
-forms the common medial wall that separates right and left nasal cavities
Nasal septum borders
-superior
-inferior
-anterior
Superior border of nasal septum
-perpendicular plate of ethmoid bone
Inferior border of nasal septum
-vomer bone
Anterior border of nasal septum
-septal cartilage
Arterial supply of nasal septum
-carotid arteries
-ophthalmic and maxillary arteries
-kiesselbachs plexus
Carotid arteries of nasal septum
-internal and external carotid arteries ascend towards the nasal septum
Ophthalmic and maxillary arteries of nasal septum
-ophthalmic branches off internal carotid
-maxillary branches off external carotid
Kiesselbachs plexus of nasal septum
-branches of ophthalmic and maxillary arteries anastomose to form this, which is a highly vascularized area in anterior portion of nasal septum
Sensory innervation of nasal septum
-carried by branches of trigeminal nerve
Special sensory innervation of nasal septum
-carried by olfactory nerve
Innervation of anterosuperior part of nasal septum
-innervated by ophthalmic branch
Innervation of the rest of the nasal septum
-innervated by maxillary branch
Nasal polyps
-soft, painless, non-cancerous growths that hang down like teardrops from lining of nasal cavity
Nasal polyps causes
-chronic inflammation of vascular supply in walls of nasal cavity associated with recurring infection, drug sensitivity, or certain immune disorders
Nasal polyps symptoms
-loss of smell
-breathing problems
-post-nasal drip
Nerves involved in innervation of the tongue
-glossopharyngeal nerve
-trigeminal nerve
-facial nerve
Glossopharyngeal nerve innervation of tongue
-has lingual branches that supply both general and special sensory innervation to posterior 1/3 of tongue
Trigeminal nerve innervation of tongue
-lingual branch supplies general sensory innervation to anterior 2/3 of the tongue
Facial nerve innervation of the tongue
-special sensory from anterior 2/3 of tongue is carried by lingual nerve to chorda tympani
The lingual artery
-a branch of the external carotid artery
What does the lingual artery supply
-the tongue
-sublingual gland
-floor of the mouth
Dysgeusia
-distortion of sense of taste
-complicated diagnosis because taste is linked to both facial and glossopharyngeal nerves
Dysgeusia symptoms
-distortion of taste
-issues with swallowing
-impaired gag reflex
The muscles of mastication function
-4 paired muscles that attach to the mandible and are responsible for movement of the jaw
Lateral pterygoid muscles
-fibres run horizontally to insert into neck of mandible as well as capsule and articular disc of temperomandibular joint
Medial pterygoid muscle
-fibres run obliquely downward and backwards to insert on to the medial surface of mandible near its angle
Actions of the muscles of mastication
-elevation
-depression
-lateral movement
-protraction
-retraction
Which muscles are responsible for elevation of the mandible
-temporalis
-masseter
-medial pterygoid
Which muscles are responsible for depression of the mandible
-none
-primary gravity
-relaxation of the muscles
Which muscles are responsible for lateral movement of the mandible
-medial and lateral pterygoids
Which muscles are responsible for protraction of the mandible
-lateral pterygoid
Which muscles are responsible for retraction of the mandible
-temporalis
Innervation of the muscles of mastication
-mandibular branch of trigeminal nerve
-sensory innervation to face as well as motor innervation to muscles of mastication
Lateral pterygoid strain
-may be caused by overuse, clenching of the jaw or TMJ dysfunction
Symptoms of lateral pterygoid strain
-pain radiating to maxilla
-pain at TMJ aggravated by chewing
-impairment of masticatory function
-clicking noise
Temperomandibular joint
-synovial modified hinge joint between head of mandible, the mandibular fossa, and the articular tubercle of the temporal bone
What is between the surfaces of the TMJ
-fibrocartilaginous articular disc
Movements of the TMJ
-elevation
-retraction
How is elevation of the TMJ achieved
-temporalis and masseter muscles
How is retraction of the TMJ achieved
-temporalis muscle
Temperomandibular joint syndrome
-can arise form problems with the muscles of the jaw or the joint itself being compromised
-typically due to excessive teeth grinding and jaw clenching
Temperomandibular joint syndrome symptoms
-jaw clicking
-pain and tenderness
-pain in one or both temperomandibular joints
-difficulty chewing
-locking of joint
Vasculature of masticatory apparatus
-maxillary artery
-middle meningeal artery
Maxillary artery
-supplies muscles of mastication
Middle meningeal artery
-enters cranial cavity to supply much of the dura mater
Epidural hematoma
-fracture in skull may tear arterial branches of middle meningeal artery in dura mater and cause intracranial bleeding
Epidural hematoma causes
-blunt injury
Epidural hematoma symptoms
-initial loss of consiousness
-rapid neurological deterioration
-severe headaches due to increase in intracranial pressure
Lateral rectus muscle innervation
-abducens nerve
Lower teeth sensation innervation
-trigeminal nerve
Muscles of facial expression innervation
-facial nerve
Muscles of the tongue innervation
-hypoglossal nerve
Sound and balance innervation
-vestibulocochlear nerve
What are the parasympathetic ganglia
-ciliary
-pterygopalatine
-submandibular
-otic
Otic ganglia
-functionally associated with glossopharyngeal nerve and innervates the parotid gland
Otic preganglionic parasympathetic fibres
-leave medulla oblongata of brainstem as the glossopharyngeal nerve
Otic postganglionic parasympathetic fibres
-join the auriulotemporal nerve
-a branch of mandibular division of trigeminal nerve
-innervated parotid gland
Frey’s syndrome
-when auriculotemporal nerve is damaged
Frey’s syndrome symptoms
-gustatory sweating which is sweating in the anticipation of eating
Arterial supply of face
-ophthalmic artery
-superficial temporal artery
-facial artery
Ophthalmic artery of the face
-supplies eyes and forehead
Superficial temporal artery of the face
-supplies skin and muscles of temple and scalp
-parotid gland
Where can the pulse of the superficial temporal artery be felt
-where it crosses the zygomatic arch, anterior to the ear
Facial artery of the face
-accommodates movements of the face
-mostly in the regions of the eyes, mandible, and lips
Where can the pulse of the facial artery be felt
-where it crosses the mandible
Superficial temporal artery aneurysm
-bulging or weakening of the artery, brought on my traumatic injury
Superficial temporal artery aneurysm symptoms
-lump of forehead
-headaches
What is the main vein that drains face
-facial vein
What does the facial vein travel alongside
-internal jugular vein
What does the facial vein drain into
-cavernous sinus
Why are the veins in the face a conduit for infection
-they do not contain valves, allowing blood to flow in either direction
-therefore infection can spread from the face intercranially
The danger triangle
-the trochlear nerve, abducens nerve, and ophthalmic nerve would likely be infected by infection of cavernous sinus
