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P2 Head, Neck and Neuro > Muscles of the face, facial wound > Flashcards

Muscles of the face, facial wound Flashcards

1
Q

What are the main vessels which supply the face?

A

Facial artery

Superficial temporal artery

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2
Q

Where does the facial artery arise from?

A

External carotid

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3
Q

Where does the facial artery cross onto the face?

A

Crosses lower border of mandible 2.5cm in front of the angle of the mandible.

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4
Q

Where in the face are the best facial artery anastomoses?

A

By the superior and inferior labile branches - makes a vascular ring within the tissues of the lips

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5
Q

Where does the superficial temporal artery arise from?

A

The maxillary branch of the external carotid

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6
Q

What is the path of the superficial temporal artery?

A

Runs upwards from the neck, immediately in front of the tragus of the ear, where is can be felt

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7
Q

Describe the venous drainage of the face.

A

Main veins are paired with arteries and drain to the internal jugular vein

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8
Q

Which salivary gland is the largest?

A

Parotid gland

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9
Q

Which important vessels are found within the parotid gland?

A

Facial nerve and branches Where the external carotid artery branches to superficial temporal artey Reteromandibular vein

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10
Q

How long is the parotid duct?

A

5cm long

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11
Q

What is the nervous supply of the parotid gland?

A

Parasympathetic nerves stimulate secretion - Glossopharyngeal nerve - CN IX; via the otic ganglion

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12
Q

Where is the submandibular gland located?

A

Between the lower surface of the mandible and myohyoid muscle - floor of the mouth

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13
Q

Where does the submandibular duct open in the mouth?

A

On either side of the midline of the floor of the mouth

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14
Q

Which gland is the closest to the oral cavity?

A

Sublingual gland

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15
Q

How does the sublingual gland pass its secretions into the mouth?

A

Through a dozen minute ducts - some open straight into the floor - others open into submandibular duct

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16
Q

What kind of cells are found in the acinus of the salivary glands?

A

Serous cells Mucous cells

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17
Q

What is the parasympathetic supply of other glands than the parotid?

A

Facial nerve - CN VII

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18
Q

List functions of saliva.

A

Facilitates swallowing Helps speech Contains alpha-amylase Contains IgA Contains lysozyme

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19
Q

How much of total secretions from the salivary glands does each one provide?

A

Parotid - 25% Submandibular - 70% Sublingual - 5%

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20
Q

How is the isotonic fluid (the primary secretion) formed in the acinar cells of the salivary glands?

A

Active transport of electrolytes followed by passive movement of water

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21
Q

What aquaporin channels are found in salivary acinar cells?

A

AQ5

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22
Q

How does secondary modification of salivary fluid occur?

A

Ion transport pumps are in the epithelial cells lining the ducts. Sodium and chloride are reabsorbed and potassium and bicarbonate are secreted

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23
Q

What osmolality is the final salivary secretion compared to plasma?

A

Hypotonic

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24
Q

What can form if the parotid duct is damaged?

A

Salivary mucocele - a collection of salivary leaked from a damaged salivary duct or gland

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25
Q

What does a salivary mucocele look like?

A

A blue/transleuent swelling just under the lining of the mouth

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26
Q

Where does the facial nerve originate?

A

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
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27
Q

Where does the facial nerve leave the cranial fossa?

A

The internal acoustic meatus

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28
Q

Where do the two facial nerve roots fuse?

A

Petrous part of the temporal bone

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29
Q

What is formed when the 2 roots fuse?

A

Geniculate ganglion

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30
Q

Which nerve is given off from the facial at the geniculate ganglion?

A

Greater petrosal nerve - carries mainly preganglionic parasympathetic fibres

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31
Q

Which other nerves does the facial nerve give off before it exits the stylomastoid foramen?

A

Stapedius nerve

Chorda tympani - anterior 2/3 of the tongue and subm. and subl. glands

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32
Q

What are the five terminal groups of branches of the facial nerve?

A
  • Temporal
  • Zygomatic
  • Buccal
  • Marginal mandibular
  • Cervical
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33
Q

How is the facial nerve tested for clinically?

A

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

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34
Q

In which four modes can violence be inflicted?

A
  • Physical
  • Sexual
  • Psychological attack
  • Deprivation
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35
Q

Physical violence can be broken down into three sub-types.

A
  • Self-directed harm
  • Intrapersonal violence
  • Collective violence
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36
Q

Intrapersonal violence can be broken down into two more subtypes

A

Family

  • child
  • partner
  • elder

Community

  • acquaintance
  • stranger
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37
Q

How is the public health approach to violence started?

A

Addressing the underlying risk factors that increase risk of someone becoming a victim or perpetrator of harm

38
Q

What are the four steps of the public health approach to violence?

A
  • Define problem
  • Establish why violence occurs using research
  • Find out what works to prevent violence
  • Implement effective and promising interventions
39
Q

What are the risk factors on an individual level for someone to perpetrate violence?

A
  • Personal history
  • Biological factors
  • Victim of child maltreatment
  • Psychological disorders
  • Alcohol/substance abuse
  • History of violence
40
Q

What are possible reasons on a societal level for someone to perpetrate violence?

A

Economic policies

Weapon availability

Social and cultural norms

  • dominance over women
  • dominance over children
  • endorsement of violence
41
Q

What are all the muscles of facial expression innervated by?

A

Facial nerve (CN VII)

42
Q

Which two facial muscles are associated with the orbital group?

A
  • Orbicularis oculi
  • Corrugator supercilii
43
Q

What is the function of the orbicularis oculi?

A

Closes the eyelids

44
Q

Name and describe the two major parts of the orbiculris oculi?

A
  • Outer orbital part - broad ring encircling the orbital orifice and extends beyond orbital ring
  • Inner palpebral part - in the eye lids, consisting of muscle fibres arching from medial to lateral corners of the eye
45
Q

What is the difference between the palpebral and orbital parts of the orbicularis oris?

A

Both close the eyes

  • palpebral gently
  • orbital - forcefully
46
Q

Describe the corrugator supercilii.

A
  • Deep to eyebrows and orbicularis oris.
  • Active during frowning
  • Arises from superciliary arch, passing up+laterally to insert into the skin of the medial half of the eyebrow
47
Q

What is the function of corrugator supercilii?

A

Draws eyebrows towards midline, causing vertical wrinkles above nose

48
Q

Which three muscles are in the nasal group?

A
  • Nasalis
  • Procerus
  • Depressor septi nasi
49
Q

What are the two parts of the nasalis?

A
  • Transverse part
  • Alar part
50
Q

What is the function of the transverse part of the nasalis?

A

Compresses the nares and forms an apopneurosis with its partner across the dorsum of the nose

51
Q

What is the function of the alar part of the nasalis?

A

Opens the nares/nostrils

52
Q

Describe the action of the procerus muscule.

A

Draws the medial border of the eyebrows downward to produce wrinkles over the bridge of the nose

53
Q

Describe the action of the depressory septi nasi.

A

Pulls the nose inferiorly, assisting the alar part of the nasalis to open the nares

54
Q

What is the function of the oral group, and what do they include?

A

They move the lips and cheek

  • orbicularis oris
  • buccinator
  • upper and lower group of muscles
55
Q

What is the function of orbicularis oris?

A

Narrows mouth, closes and purses lips

56
Q

Which is the deepest muscle of the cheek?

A

Buccinator

57
Q

What is the function of the buccinator muscle?

A

Forces air of out cheeks

Keeps cheeks toned and aids mastication by preventing food accumulation between teeth and cheeks

58
Q

Name the lower group of muscles (part of the oral group)

A
  • Depressor anguli oris
  • Depressor labii inferioris
  • Mentalis
59
Q

Describe the action of depressor anguli oris

A

Active during frowning

Depresses the corner of the mouth

60
Q

Describe the action of depressor labii inferioris.

A

Depresses the lower lip and moves it laterally

61
Q

Describe the action of the mentalis muscle.

A

Raises and protrudes the lower lip as it wrinkles the skin

62
Q

Name the muscles within the upper group of muscles (part of the oral group).

A
  • Risorius
  • Zygomaticus major + minor
  • Levator labii superioris
  • Levator labii superioris alaeque nasi
  • Levator anguli oris
63
Q

Describe the action of the risorius muscle.

A

Helps produce a grin.

Extends laterally from a corner of amouth in an upwards direction - so contraction pulls the corner of mouth laterally and upwards

64
Q

Describe the action of zygomaticus major and minor muscle.

A

Helps produce a smile, raiseing corner of the mouth and moving laterally.

65
Q

Describe the action of levator labii superioris.

A

This deepens the furrow between the nose and the corner of the mouth during sadness

66
Q

Describe the action of levator labii superioris alaeque nasi.

A

This is medial to the levator labii superioris and assits in flaring the nares

67
Q

Describe the action of levator anglui oris.

A

Deep to other levators and zygomaticus muscles.

Elevates corner of mouth and helps deepen nose-mouth furrow when sad.

68
Q

Describe the platysma muscle

A

Large, thin sheet of muscle in superficial fascia of neck

69
Q

What is the function of the platysma muscle?

A

Tenses the skin of the neck and can move lower lip and corners of the mouth down

70
Q

Describe the articular muscles

A

Anterior, superior and posterior auricular muscles

71
Q

What is the function of the auricular muscles?

A
  • Anterior - pulls the ear upwards and forwards
  • Superior - elevates the ear
  • Posterior - retracts and elevates the ear
72
Q

Describe the occipitofrontalis muscle

A

Associated with the scalp

Consists of a frontal belly and occipital belly with a connecting aponeurotic tendon

73
Q

What is the function of the occipitofrontalis muscle?

A

Moves the scalp and wrinkles the forehead

74
Q

What are the muscles of mastication?

A
  • Masseter
  • Temporalis
  • Medial pterygoid
  • Lateral pterygoid
75
Q

What is the main difference between the muscles of facial expression and the muscles of mastication?

A

Muscles of mastication are supplied by the mandibular branch of the Trigeminal nerve, while the muscles of facial expression are supplied by the Facial nerve.

76
Q

Describe the masseter and its location.

A

The most powerful muscle of mastication Quadrangular in shape

Superficial to pterygoids and temporalis

77
Q

What is the function of the masseter muscle?

A

Elevates the mandible - closing the mouth

78
Q

Describe the temporalis.

A

Originates from temporal fossa and inserts on the coronoid process of the mandible

79
Q

What is the function of the temporalis muscle?

A
  • Elevates the mandible - closing the mouth
  • Retracts the mandible, pulling the jaw posteriorly
80
Q

What is the function of the medial pterygoid muscle?

A

Elevates the mandible, closing the mouth

81
Q

Describe the medial pterygoid muscle.

A
  • Quadrangular in shape, with two heads
  • Located inferiorly to the lateral pterygoid
82
Q

Describe the lateral pterygoid muscle

A
  • Triangular in shape with two heads
  • Horizontally orientates muscle fibre
83
Q

What is the function of the lateral pterygoid muscle?

A

It’s a major protracter of the mandible

Produces side to side movement of the jaw

84
Q

Which arteries supply the nose and medial corner of the eye and which artery do they branch of?

A

Angular artery (paired with angular vein)

85
Q

Which artery and vein are in the zygomatic region of the face and what artery does it branch of?

A

Transverse facial artery and vein; artery branches of the maxillary artery

86
Q

What does the parotid duct pierce?

A

Buccinator

87
Q

Through what structure does the facial nerve exits the facial canal?

A

Via the stylomastoid foramen - posterior to the styloid process of the temporal bone

88
Q

What are the 2 units in Scotland that are aiming to prevent violence?

A
  • The Scottish Violence Reduction Unit
  • Medics against violence in Scotland
89
Q

Label the fronta normalis

90
Q

Label the muscles of the face

91
Q

Label

P2 Head, Neck and Neuro (11 decks)

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