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Regional Gross Anatomy > Region 11 - Face > Flashcards

Region 11 - Face Flashcards

1
Q

What is the structure of the parotid gland?

A

Serous acini ONLY
Connective tissue capsule
Dense fibrous capsule:
- Extends as stylomandibular ligament

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2
Q

Where does the parotid duct lie?

A

~1 fingers breadth below zygomatic arch

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3
Q

What is the course of the parotid duct?

A

Passes anteriorly from anterior end of gland
Turns medially at anterior end of masseter:
- Pierces buccal fat pad and bucinnator
- Enters oral cavity opposite 2nd upper molar tooth

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4
Q

How can the parotid gland be palpated?

A

If masseter is tensed

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5
Q

What is the parotid plexus?

A

The branch point of the facial nerve which lies within the parotid gland

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6
Q

What are the branches of the parotid plexus?

A 
Temporal branches
Zygomatic branches
Buccal branches
Marginal mandibular branch
Cervical branch
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7
Q

What nerve branches from the parotid plexus between it leaving the stylomastoid foramen and before it entering the parotid gland?

A

Posterior auricular nerve

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8
Q

What are the two terminal branches of the ECA within the parotid gland?

A

Superficial temporal artery

Maxillary artery

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9
Q

What veins join to form the retromandibular vein within the parotid gland?

A

Superficial temporal vein

Maxillary vein

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10
Q

What does the facial nerve divide the parotid gland into?

A

Superficial part

Deep part

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11
Q

How do parasympathetic secretomotor fibres from the glossopharyngeal nerve reach the parotid gland?

A
  1. CN IX leaves skull through jugular foramen
  2. CN IX gives off tympanic branch
  3. Tympanic branch travels through tympanic hiatus
  4. Tympanic branch enters tympanic plexus
  5. PNS fibres enter lesser petrosal nerve
  6. Lesser petrosal nerve leaves through foramen ovale
  7. Lesser petrosal nerve enters otic ganglion
  8. PNS fibres synapse in otic ganglion
  9. Postsynaptic PNS fibres travel to parotid gland in auriculotemporal nerve (CN V3 branch)
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12
Q

How do sympathetic fibres reach the parotid gland?

A

Postganglionic SNS fibres from superior cervical ganglion travel alongside the middle meningeal artery

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13
Q

What is the innervation to the muscles of mastication?

A

Mandibular division of trigeminal nerve

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14
Q

What movements of the mandible are the muscles of mastication responsible for?

A 
Elevation
Depression
Protrusion
Retrusion
Lateral sliding
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15
Q

What covers the temporalis muscle?

A

Temporal fascia

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16
Q

What are the proximal attachments of the temporalis muscle?

A

Floor of temporal fossa

Deep surface of temporal fascia

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17
Q

What are the distal attachments of the temporalis muscle?

A

(Tip and medial surface of) Coronoid process

Anterior border of ramus of mandible

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18
Q

What are the functions of the temporalis muscle?

A

Anterior and superior fibres elevate mandible

Posterior fibres retract mandible

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19
Q

What is the innervation to temporalis?

A

Deep temporal nerves (x2) from anterior trunk of CN V3

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20
Q

What are the origins of masseter?

A

Maxillary process of zygomatic arch

Zygomatic arch

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21
Q

What are the insertions of masseter?

A

Angle and lateral surface of the ramus of the mandible

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22
Q

What is the function of masseter?

A

Elevates mandible

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23
Q

What is the innervation to masseter?

A

Masseteric nerve from anterior trunk of CN V3

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24
Q

What are the origins of lateral pterygoid?

A

Upper head:
- Infratemporal surface of the greater wing of sphenoid
Lower head:
- Lateral surface of lateral pterygoid plate (sphenoid)

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25
What are the insertions of lateral pterygoid?
Upper head: - Joint capsule and articular disc of TMJ Lower head: - Neck of condyloid process of mandible
26
What are the functions of the lateral pterygoid?
``` Acting bilaterally: - Protracts mandible - Depresses mandible Acting unilaterally: - Swings jaw to contralateral side - Lateral chewing movements (with medial pterygoid) ```
27
What is the innervation to lateral pterygoid?
Nerve to lateral pterygoid from anterior division of CN V3
28
What are the origins of medial pterygoid?
``` Superficial head: - Tubercle of maxilla Deep head: - Medial surface of lateral pterygoid plate (- Pyramidal process of palatine bone) ```
29
What is the insertion of the medial pterygoid?
Medial surface of the angle of the mandible
30
What is the function of medial pterygoid?
``` Elevates mandible (with masseter) Lateral chewing movements (with lateral pterygoid) ```
31
What is the innervation to medial pterygoid?
Nerve to medial pterygoid from main trunk of CN V3
32
What movements occur at the TMJ during elevation of the mandible?
Head of mandible and disc move backwards | Head of mandible rotates on lower surface of disc
33
What muscles are involved in elevation of mandible?
Temporalis Masseter Medial pterygoid
34
What movements occur at the TMJ during depression of the mandible?
Head of mandible rotates on undersurface of disc | Mandible pulled forward
35
What muscles are involved in depression of the mandible?
``` Lateral pterygoid Digastric Geniohyoid Mylohyoid (Gravity) ```
36
What movements occur at the TMJ during protrusion of the mandible?
Disc and head of mandible move forward | Movement in upper part of cavity
37
What muscles are involved in protrusion of the mandible?
Lateral pterygoid: | - Assisted by medial pterygoid
38
What movements occur at the TMJ during retrusion of the mandible?
Disc and head of mandible pulled backwards into mandibular fossa
39
What muscles are involved in retrusion of the mandible?
Temporalis (posterior fibres)
40
How is lateral chewing carried out?
Protrusion and retrusion of the mandible combined
41
What muscles are involved in lateral chewing?
Lateral pterygoid | Medial pterygoid
42
Where do the sensory and motor branches of CN V3 unite?
After the nerves pass through the foramen ovale
43
What are the branches of CN V3 from its main trunk (ie pre-division)?
Meningeal branch Nerve to medial pterygoid (which also supplies): (- Tensor tympani) (- Tensor veli palatini)
44
What are the motor branches of the anterior division of CN V3?
Masseteric nerve Nerve to lateral pterygoid Deep temporal nerves (x2)
45
What are the sensory branches of the anterior division of CN V3?
Buccal nerve: - Skin of cheek - Mucous membrane of mouth
46
What are the sensory branches of the posterior division of CN V3?
``` Auriculotemporal nerve: - Scalp - Auricle - TMJ - EAM - Tympanic membrane Lingual nerve: - Floor of mouth - Anterior 2/3 of tongue (general sensory) ```
47
What are the dual motor and sensory branches of the posterior division of CN V3?
``` Inferior alveolar nerve: - Lower teeth - Skin Mylohyoid nerve: - Mylohyoid - Anterior belly of digastric ```
48
What ganglion does the nerve to medial pterygoid pass through?
Otic ganglion
49
What does the medial pterygoid nerve supply via the otic ganglion?
Tensor veli palatini | Tensor tympani
50
What does the auriculotemporal branch of CN V3 act as a carrier for?
Postganglionic PNS fibres from otic ganglion to parotid gland
51
What nerves joins the lingual branch of CN V3?
Chorda tympani
52
What fibres does the lingual nerve carry that originate from CN VII?
PNS fibres in chorda tympani to: - Submandibular gland - Sublingual glands Taste from anterior 2/3 of tongue
53
Where does the external carotid artery terminate?
Behind neck of mandible
54
What are the terminal branches of the ECA?
Maxillary artery | Superficial temporal artery
55
What is the occipital branch of the ECA crossed by?
CN XII
56
What is the course of the occipital artery?
Posterior branch of ECA Close to origin of facial artery Passes under posterior belly of digastric: - Into posterior triangle of neck
57
What does the occipital artery supply?
Back of scalp
58
What is the course of the posterior auricular artery?
Posterior branch of ECA | Arises at level of upper border of belly of digastric
59
What does the posterior auricular artery supply?
Scalp
60
Where does the ascending pharyngeal artery ascend?
Between: - ICA - Pharynx
61
Where does the ascending pharyngeal artery arise?
From deep/medial surface of ECA
62
What is the course of the superior thyroid artery?
1st anterior branch of ECA near origin | Runs with external laryngeal nerve
63
What does the superior thyroid artery gives branches to supply?
SCM | Superior laryngeal artery
64
What is the course of the lingual artery?
2nd anterior branch of ECA: - Arises opposite tip of greater cornu of hyoid Passes deep to hyoglossus
65
What crosses the lingual artery?
CN XII
66
What does the lingual artery supply?
Oral cavity
67
What is the course of the facial artery?
3rd anterior branch of ECA: - Arises above tip of greater cornu of hyoid Passes deep to posterior belly of digastric
68
What are the branches of the facial artery?
``` Superior and inferior labial arteries Angular artery (to face) ```
69
What is the course of the superficial temporal artery?
Smaller terminal branch of ECA | Ascends anterior to auricle
70
What branch does the superficial temporal artery give off?
Transverse facial artery
71
What does the superficial temporal artery supply?
Skin over frontal and temporal regions via anterior and posterior branches`
72
Where does the maxillary artery arise?
Terminal branch of ECA behind neck of mandible
73
What does the maxillary artery supply?
``` Muscles of mastication Tympanic membrane Upper and lower teeth Palate Nasal cavity Nasopharynx Meninges ```
74
What is the infratemporal fossa?
A 'space' between the base of the skull between: - The skull AND - The ramus of mandible
75
What are the boundaries of the infratemporal fossa?
``` Anterior = Posterior surface of maxilla Posterior = Styloid (and mastoid) process of temporal bone Superior = Infratemporal surface of greater wing of sphenoid Inferior = Medial pterygoid attachment to mandible Medial = Lateral pterygoid plate of sphenoid Lateral = Ramus of mandible ```
76
What are the contents of the infratemporal fossa?
``` Lateral and medial pterygoids CN V3 and its branches Maxillary artery and its branches Pterygoid venous plexus Chorda tympani Otic ganglion ```
77
What are the branches from the superior aspect of the mandibular part of the maxillary artery?
Deep auricular artery Anterior tympanic artery Middle meningeal artery Accessory meningeal artery
78
What is the branch from the inferior aspect of the mandibular part of the maxillary artery?
Inferior alveolar artery: - Branch to mylohyoid - Inferior alveolar artery proper
79
What are the branches from the superior aspect of the pterygoid part of the maxillary artery?
Masseteric artery | Deep temporal branches (x2)
80
What are the branches from the inferior aspect of the pterygoid part of the maxillary artery?
Pterygoid branch | Buccal branch
81
What are the branches of the pterygopalatine part of the maxillary artery?
``` Posterior superior alveolar artery Infraorbital artery Anterior superior alveolar branches Palatine artery Pharyngeal artery Sphenopalatine artery ```
82
What does the pterygoid venous plexus surround?
Lateral pterygoid
83
What veins contribute to the pterygoid venous plexus?
Veins from: - Orbit - Nasal cavities - Oral cavity
84
What does the pterygoid venous plexus communicate with?
Cavernous sinus | Facial vein
85
What drains the pterygoid venous plexus?
Maxillary vein
86
What is the clinical implication of the pterygoid venous plexus?
Route for infection
87
In what ganglion do the various fibres of the facial nerve coalesce?
Geniculate ganglion
88
What are the functions of the chorda tympani branch of CN VII?
``` PNS fibres (secretomotor) to: - Submandibular salivary gland - Sublingual salivary glands Taste from anterior 2/3 of tongue ```
89
What nerve carries the fibres from the chorda tympani to its destinations?
Lingual nerve (branch of CN V3)
90
What are the PNS fibre contents of the otic ganglion?
Synapse of fibres from lesser petrosal nerve onto postganglionic fibres in auriculotemporal nerve
91
What are the SNS fibre contents of the otic ganglion?
Postganglionic vasomotor fibres: | - Then travel via auriculotemporal nerve
92
What are the motor fibre contents of the otic ganglion?
CN V3 branches to: - Tensor tympanic - Tensor veli palatini (Do not synapse in ganglion)
93
What is the joint of the TMJ between?
Head of mandible inferiorly AND Mandibular fossa and articular tubercle of squamous temporal bone superiorly
94
What are the articular surfaces of the TMJ covered in?
Fibrocartilage articular disc of the TMJ
95
What surrounds the TMJ?
Fibrous capsule
96
What is the nerve supply to the TMJ?
``` Auriculotemporal nerve (immediately in front) Masseteric nerve ```
97
What reinforces the joint capsule of the TMJ laterally?
Lateral (temporomandibular) ligament
98
What reinforces the joint capsule of the TMJ medially?
Sphenomandibular ligament | Stylomandibular ligament
99
What is the function of the articular disc of the TMJ?
Increases congruity of articular surfaces | Divides joint cavity into superior and inferior parts
100
What movements are possible between the head of the mandible and the articular disc?
Elevation and depression: - Of mandible - Acts as a hinge
101
What movements does the articular disc and the mandibular fossa permit?
Protrusion and retrusion: - Of mandible - Gliding movements
102
What movements of the mandible close the mouth?
Elevation and retraction: | - Pull the condyle backwards
103
What movements of the mandible open the mouth?
Depression and protrusion: - At both sides - Slide disc and condyle forwards towards tubercle
104
What does asynchronous gliding of both TMJs allow?
Chewing
105
What does the fascia in the scalp blend with and extend into?
Blends with superficial fascia in neck posteriorly | Extends into temporal regions laterally
106
What is the parotid fascia a layer of?
Deep cervical fascia
107
What does the parotid fascia cover and invest?
Covers masseter | Invests parotid gland
108
What are the origins and insertions of the muscles of facial expression?
Most originate on facial bones | Most insert into the skin/connective tissue of the face
109
What can the frontalis muscle also be considered?
The anterior belly of occipitofrontalis
110
What are the functions of frontalis?
Helps express suprise or curiosity: - Elevates eyebrows - Wrinkles skin of forehead
111
What are the functions of corrugator supercilli?
Helps express concern or worry: - Draws eyebrows medially and inferiorly - Creates vertical wrinkles over nose
112
What are the functions of platysma?
Conveys tension and stress: - Tenses skin of lower face and neck (Also depresses mandible)
113
What are the functions of procerus PLUS transverse part of nasalis?
Conveys disdain or dislike: - Depresses medial end of eyebrow - Wrinkles skin over dorsum of nose
114
What are the functions of the alar part of nasalis PLUS levator labii superioris alaeque nasii?
During anger or exertion: | - Depresses ala laterally = Flaring of nostrils
115
What is the function of buccinator acting alone?
Sucks in cheeks
116
What are the function of orbicularis oris acting alone?
Pouts lips (kissing): - Compresses lips - Protrudes lips
117
What is the function of buccinator PLUS orbicularis oris?
Puffs out cheeks (such as when blowing out air)
118
What are the functions of orbicularis oculi?
Closes eyes: - Palpebral part does so gently Winking: - Orbital part closes eyelids tightly
119
What are the functions of zygomaticus major and minor?
Displaying sneering and disdain: | - Elevates corner of mouth (unilaterally)
120
What do the 'dilators' of the mouth work together to do?
To show a full 'teethy' smile
121
What are the 'dilators' of the mouth?
``` Levator labii superioris Levator anguli oris Risorius Depressor labii inferioris Depressor anguli oris ```
122
What is the function of depressor anguli oris?
Frowning (sadness): | - Depresses angle of mouth bilaterally
123
What are the functions of mentalis?
Elevates lower lip | Protrudes lower lip
124
What does the facial nerve traverse?
Internal acoustic meatus
125
What are the branches of the facial nerve within the temporal bone?
Greater petrosal nerve Nerve to stapedius Chorda tympani
126
How does the facial nerve leave the cranium?
Stylomastoid foramen
127
What does the facial nerve have the longest course of?
Longest intra-osseous course of any cranial nerve
128
What is the motor supply of the posterior auricular branch of CN VII?
Occipitalis Posterior belly of digastric Stylohyoid
129
What is the motor supply of the temporal branch of CN VII?
Frontalis | Orbicularis oculi
130
What is the motor supply of the zygomatic branch of CN VII?
Orbicularis oculi
131
What is the motor supply of the buccal branch of CN VII?
``` Zygomaticus major and minor Levator labii superioris Levator anguli oris Buccinator Orbicularis oris Nasalis ```
132
What is the motor supply of the marginal mandibular branch of CN VII?
Depressor anguli oris Depressor labii inferioris Mentalis
133
What is the motor supply of the cervical branch of CN VII?
Platysma
134
What are the branches of the facial artery?
Submental Superior and inferior labial Lateral nasal (Continues as angular artery)
135
Where does the superficial temporal artery give off the transverse facial artery?
When it runs within the parotid gland
136
From what artery does the mental artery arise?
Inferior alveolar artery
137
What are the terminal branches of the ophthalmic artery?
Supra-orbital artery | Supratrochlear artery
138
Into what vein do the supra-orbital and supratrochlear veins drain to? Where?
Angular vein: | - Root of nose
139
What does the angular vein continue as? Where?
Facial vein: | - At inferior margin of orbit
140
Where does the facial vein drain to?
Joins anterior division of retromandibular vein: - Forms common facial vein - Which then drains into IJV
141
What is the drainage pattern of the superficial temporal vein?
Joins maxillary vein to form retromandibular vein: - Anterior division joined by facial vein - Posterior division joins posterior auricular vein to form external jugular vein
142
What are the layers of the scalp (from external to internal)?
``` S = Skin C = Connective tissue A = Aponeurosis (of occipitofrontalis) L = Loose areolar connective tissue P = Periosteum (pericranium) ```
143
What branches of the internal carotid artery supply the scalp?
Ophthalmic: - Supratrochlear artery - Supra-orbital artery
144
What branches of the external carotid artery supply the scalp?
Superficial temporal artery Posterior auricular artery Occipital artery
145
What are the emissary veins?
Communicating veins between: - Superficial veins of scalp (in connective tissue layer) - Dural venous sinuses
146
What are the clinical implications of the emissary veins?
Potential route for infection
147
What is the nerve supply to the scalp?
``` Supratrochlear and supra-orbital nerves (CN V1) Zygomaticotemporal nerve (CN V2) Auriculotemporal nerve (CN V3) Lesser occipital nerve (C1) Greater occipital nerve (C2) Third occipital nerve (C3) ```
148
What are the sensory branches of the ophthalmic nerve (CN V1)?
``` Frontal nerve: - Supraorbital nerve - Supratrochlear nerve Nasociliary nerve: - Lacrimal nerve ```
149
What are the sensory branches of the maxillary nerve (CN V2)?
Infraorbital nerve | Superior alveolar nerve
150
What are the sensory branches of the mandibular nerve (CN V3)?
Lingual nerve Inferior alveolar nerve Auriculotemporal nerve

Regional Gross Anatomy (14 decks)

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