Muscles of the face, facial wound Flashcards
What are the main vessels which supply the face?
Facial artery
Superficial temporal artery
Where does the facial artery arise from?
External carotid
Where does the facial artery cross onto the face?
Crosses lower border of mandible 2.5cm in front of the angle of the mandible.
Where in the face are the best facial artery anastomoses?
By the superior and inferior labile branches - makes a vascular ring within the tissues of the lips
Where does the superficial temporal artery arise from?
The maxillary branch of the external carotid
What is the path of the superficial temporal artery?
Runs upwards from the neck, immediately in front of the tragus of the ear, where is can be felt
Describe the venous drainage of the face.
Main veins are paired with arteries and drain to the internal jugular vein
Which salivary gland is the largest?
Parotid gland
Which important vessels are found within the parotid gland?
Facial nerve and branches Where the external carotid artery branches to superficial temporal artey Reteromandibular vein
How long is the parotid duct?
5cm long
What is the nervous supply of the parotid gland?
Parasympathetic nerves stimulate secretion - Glossopharyngeal nerve - CN IX; via the otic ganglion
Where is the submandibular gland located?
Between the lower surface of the mandible and myohyoid muscle - floor of the mouth
Where does the submandibular duct open in the mouth?
On either side of the midline of the floor of the mouth
Which gland is the closest to the oral cavity?
Sublingual gland
How does the sublingual gland pass its secretions into the mouth?
Through a dozen minute ducts - some open straight into the floor - others open into submandibular duct
What kind of cells are found in the acinus of the salivary glands?
Serous cells Mucous cells
What is the parasympathetic supply of other glands than the parotid?
Facial nerve - CN VII
List functions of saliva.
Facilitates swallowing Helps speech Contains alpha-amylase Contains IgA Contains lysozyme
How much of total secretions from the salivary glands does each one provide?
Parotid - 25% Submandibular - 70% Sublingual - 5%
How is the isotonic fluid (the primary secretion) formed in the acinar cells of the salivary glands?
Active transport of electrolytes followed by passive movement of water
What aquaporin channels are found in salivary acinar cells?
AQ5
How does secondary modification of salivary fluid occur?
Ion transport pumps are in the epithelial cells lining the ducts. Sodium and chloride are reabsorbed and potassium and bicarbonate are secreted
What osmolality is the final salivary secretion compared to plasma?
Hypotonic
What can form if the parotid duct is damaged?
Salivary mucocele - a collection of salivary leaked from a damaged salivary duct or gland
What does a salivary mucocele look like?
A blue/transleuent swelling just under the lining of the mouth
Where does the facial nerve originate?
In the pons as large motor root and small sensory root - intermediate nerve
4 nuclei:
- superior salivary nucleus
- facial motor nucleus
- Solitary nucleus
- Spinal trigeminal nucleus + tract
Where does the facial nerve leave the cranial fossa?
The internal acoustic meatus
Where do the two facial nerve roots fuse?
Petrous part of the temporal bone
What is formed when the 2 roots fuse?
Geniculate ganglion
Which nerve is given off from the facial at the geniculate ganglion?
Greater petrosal nerve - carries mainly preganglionic parasympathetic fibres
Which other nerves does the facial nerve give off before it exits the stylomastoid foramen?
Stapedius nerve
Chorda tympani - anterior 2/3 of the tongue and subm. and subl. glands
What are the five terminal groups of branches of the facial nerve?
- Temporal
- Zygomatic
- Buccal
- Marginal mandibular
- Cervical
How is the facial nerve tested for clinically?
Ask patient to: - raise eyebrows - frown - show their teeth - puff out their cheeks against pursed lips - scrunch up their eyes, and try to gently open them - check for symmetry
In which four modes can violence be inflicted?
- Physical
- Sexual
- Psychological attack
- Deprivation
Physical violence can be broken down into three sub-types.
- Self-directed harm
- Intrapersonal violence
- Collective violence
Intrapersonal violence can be broken down into two more subtypes
Family
- child
- partner
- elder
Community
- acquaintance
- stranger