PBL - Patient With Facial Incised 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 it the parotid duct?
5cm long
What is the nervous supply of the parotid gland?
Parasympathetic nerves stimulate secretion
Effected by impulses that run in the CNXI, and then the CNVIII branch
Where is the submandibular gland located?
Between the lower surface of the mandible and myohyoid muscle
Where does the submandibular duct open in the mouth?
Beside the frenulum of the tongue
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 kind of cells have processes that extend over the outer surface of the acini?
Myoepthielial cells?
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
If flow rate of secretion increases, what happens to the ionic concentration of sailiva?
It increases in sodium, chloride and bicarbonate concentration, and decreases in potassium.
What can form is 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?
Between the pons and the medulla
What is the intermediate nerve of the facial nerve?
Contains special afferent fibres for taste
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
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
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 smile - check symmetry
Ask patient to screw up eyes, and you gently try to pull them open - should resist
Ask patient to raise eyebrows - check symmetry
What are the three theoretical models of the violence reduction unit?
Typology of Violence
Public heath approach
Ecological framework
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
How is the public health approach to violence started?
Addressing the underlying risk factors that increase risk of someone becoming a victim or perpetrator of harm
What are the four steps of the public heath approach to violence?
Define problem
Establish why violence occurs using research
Find out what works to prevent violence
Implement effective and promising interventions
What are possible reasons on an individual level for someone to perpetrate violence?
Personal history Biological factors Victim of child maltreatment Psychological disorders Alcohol/substance abuse History of violence
What are possible reasons on a societal level for someone to perpetrate violence?
Economic policies Weapon availability Social and cultural norms - dominance over women - dominance over children - endorsement of violence
