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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
Q

What are the insertions of lateral pterygoid?

A

Upper head:
- Joint capsule and articular disc of TMJ
Lower head:
- Neck of condyloid process of mandible

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26
Q

What are the functions of the lateral pterygoid?

A 
Acting bilaterally:
- Protracts mandible
- Depresses mandible
Acting unilaterally:
- Swings jaw to contralateral side
- Lateral chewing movements (with medial pterygoid)
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27
Q

What is the innervation to lateral pterygoid?

A

Nerve to lateral pterygoid from anterior division of CN V3

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28
Q

What are the origins of medial pterygoid?

A 
Superficial head:
- Tubercle of maxilla
Deep head:
- Medial surface of lateral pterygoid plate
(- Pyramidal process of palatine bone)
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29
Q

What is the insertion of the medial pterygoid?

A

Medial surface of the angle of the mandible

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30
Q

What is the function of medial pterygoid?

A 
Elevates mandible (with masseter)
Lateral chewing movements (with lateral pterygoid)
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31
Q

What is the innervation to medial pterygoid?

A

Nerve to medial pterygoid from main trunk of CN V3

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32
Q

What movements occur at the TMJ during elevation of the mandible?

A

Head of mandible and disc move backwards

Head of mandible rotates on lower surface of disc

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33
Q

What muscles are involved in elevation of mandible?

A

Temporalis
Masseter
Medial pterygoid

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34
Q

What movements occur at the TMJ during depression of the mandible?

A

Head of mandible rotates on undersurface of disc

Mandible pulled forward

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35
Q

What muscles are involved in depression of the mandible?

A 
Lateral pterygoid
Digastric
Geniohyoid
Mylohyoid
(Gravity)
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36
Q

What movements occur at the TMJ during protrusion of the mandible?

A

Disc and head of mandible move forward

Movement in upper part of cavity

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37
Q

What muscles are involved in protrusion of the mandible?

A

Lateral pterygoid:

- Assisted by medial pterygoid

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38
Q

What movements occur at the TMJ during retrusion of the mandible?

A

Disc and head of mandible pulled backwards into mandibular fossa

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39
Q

What muscles are involved in retrusion of the mandible?

A

Temporalis (posterior fibres)

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40
Q

How is lateral chewing carried out?

A

Protrusion and retrusion of the mandible combined

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41
Q

What muscles are involved in lateral chewing?

A

Lateral pterygoid

Medial pterygoid

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42
Q

Where do the sensory and motor branches of CN V3 unite?

A

After the nerves pass through the foramen ovale

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43
Q

What are the branches of CN V3 from its main trunk (ie pre-division)?

A

Meningeal branch
Nerve to medial pterygoid (which also supplies):
(- Tensor tympani)
(- Tensor veli palatini)

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44
Q

What are the motor branches of the anterior division of CN V3?

A

Masseteric nerve
Nerve to lateral pterygoid
Deep temporal nerves (x2)

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45
Q

What are the sensory branches of the anterior division of CN V3?

A

Buccal nerve:

  • Skin of cheek
  • Mucous membrane of mouth
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46
Q

What are the sensory branches of the posterior division of CN V3?

A 
Auriculotemporal nerve:
- Scalp
- Auricle
- TMJ
- EAM
- Tympanic membrane
Lingual nerve:
- Floor of mouth
- Anterior 2/3 of tongue (general sensory)
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47
Q

What are the dual motor and sensory branches of the posterior division of CN V3?

A 
Inferior alveolar nerve:
- Lower teeth
- Skin
Mylohyoid nerve:
- Mylohyoid
- Anterior belly of digastric
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48
Q

What ganglion does the nerve to medial pterygoid pass through?

A

Otic ganglion

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49
Q

What does the medial pterygoid nerve supply via the otic ganglion?

A

Tensor veli palatini

Tensor tympani

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50
Q

What does the auriculotemporal branch of CN V3 act as a carrier for?

A

Postganglionic PNS fibres from otic ganglion to parotid gland

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51
Q

What nerves joins the lingual branch of CN V3?

A

Chorda tympani

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52
Q

What fibres does the lingual nerve carry that originate from CN VII?

A

PNS fibres in chorda tympani to:
- Submandibular gland
- Sublingual glands
Taste from anterior 2/3 of tongue

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53
Q

Where does the external carotid artery terminate?

A

Behind neck of mandible

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54
Q

What are the terminal branches of the ECA?

A

Maxillary artery

Superficial temporal artery

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55
Q

What is the occipital branch of the ECA crossed by?

A

CN XII

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56
Q

What is the course of the occipital artery?

A

Posterior branch of ECA
Close to origin of facial artery
Passes under posterior belly of digastric:
- Into posterior triangle of neck

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57
Q

What does the occipital artery supply?

A

Back of scalp

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58
Q

What is the course of the posterior auricular artery?

A

Posterior branch of ECA

Arises at level of upper border of belly of digastric

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59
Q

What does the posterior auricular artery supply?

A

Scalp

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60
Q

Where does the ascending pharyngeal artery ascend?

A

Between:

  • ICA
  • Pharynx
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61
Q

Where does the ascending pharyngeal artery arise?

A

From deep/medial surface of ECA

62
Q

What is the course of the superior thyroid artery?

A

1st anterior branch of ECA near origin

Runs with external laryngeal nerve

63
Q

What does the superior thyroid artery gives branches to supply?

A

SCM

Superior laryngeal artery

64
Q

What is the course of the lingual artery?

A

2nd anterior branch of ECA:
- Arises opposite tip of greater cornu of hyoid
Passes deep to hyoglossus

65
Q

What crosses the lingual artery?

A

CN XII

66
Q

What does the lingual artery supply?

A

Oral cavity

67
Q

What is the course of the facial artery?

A

3rd anterior branch of ECA:
- Arises above tip of greater cornu of hyoid
Passes deep to posterior belly of digastric

68
Q

What are the branches of the facial artery?

A 
Superior and inferior labial arteries
Angular artery (to face)
69
Q

What is the course of the superficial temporal artery?

A

Smaller terminal branch of ECA

Ascends anterior to auricle

70
Q

What branch does the superficial temporal artery give off?

A

Transverse facial artery

71
Q

What does the superficial temporal artery supply?

A

Skin over frontal and temporal regions via anterior and posterior branches`

72
Q

Where does the maxillary artery arise?

A

Terminal branch of ECA behind neck of mandible

73
Q

What does the maxillary artery supply?

A 
Muscles of mastication
Tympanic membrane
Upper and lower teeth
Palate
Nasal cavity
Nasopharynx
Meninges
74
Q

What is the infratemporal fossa?

A

A ‘space’ between the base of the skull between:

  • The skull AND
  • The ramus of mandible
75
Q

What are the boundaries of the infratemporal fossa?

A 
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
Q

What are the contents of the infratemporal fossa?

A 
Lateral and medial pterygoids
CN V3 and its branches
Maxillary artery and its branches
Pterygoid venous plexus
Chorda tympani
Otic ganglion
77
Q

What are the branches from the superior aspect of the mandibular part of the maxillary artery?

A

Deep auricular artery
Anterior tympanic artery
Middle meningeal artery
Accessory meningeal artery

78
Q

What is the branch from the inferior aspect of the mandibular part of the maxillary artery?

A

Inferior alveolar artery:

  • Branch to mylohyoid
  • Inferior alveolar artery proper
79
Q

What are the branches from the superior aspect of the pterygoid part of the maxillary artery?

A

Masseteric artery

Deep temporal branches (x2)

80
Q

What are the branches from the inferior aspect of the pterygoid part of the maxillary artery?

A

Pterygoid branch

Buccal branch

81
Q

What are the branches of the pterygopalatine part of the maxillary artery?

A 
Posterior superior alveolar artery
Infraorbital artery
Anterior superior alveolar branches
Palatine artery
Pharyngeal artery
Sphenopalatine artery
82
Q

What does the pterygoid venous plexus surround?

A

Lateral pterygoid

83
Q

What veins contribute to the pterygoid venous plexus?

A

Veins from:

  • Orbit
  • Nasal cavities
  • Oral cavity
84
Q

What does the pterygoid venous plexus communicate with?

A

Cavernous sinus

Facial vein

85
Q

What drains the pterygoid venous plexus?

A

Maxillary vein

86
Q

What is the clinical implication of the pterygoid venous plexus?

A

Route for infection

87
Q

In what ganglion do the various fibres of the facial nerve coalesce?

A

Geniculate ganglion

88
Q

What are the functions of the chorda tympani branch of CN VII?

A 
PNS fibres (secretomotor) to:
- Submandibular salivary gland
- Sublingual salivary glands
Taste from anterior 2/3 of tongue
89
Q

What nerve carries the fibres from the chorda tympani to its destinations?

A

Lingual nerve (branch of CN V3)

90
Q

What are the PNS fibre contents of the otic ganglion?

A

Synapse of fibres from lesser petrosal nerve onto postganglionic fibres in auriculotemporal nerve

91
Q

What are the SNS fibre contents of the otic ganglion?

A

Postganglionic vasomotor fibres:

- Then travel via auriculotemporal nerve

92
Q

What are the motor fibre contents of the otic ganglion?

A

CN V3 branches to:
- Tensor tympanic
- Tensor veli palatini
(Do not synapse in ganglion)

93
Q

What is the joint of the TMJ between?

A

Head of mandible inferiorly
AND
Mandibular fossa and articular tubercle of squamous temporal bone superiorly

94
Q

What are the articular surfaces of the TMJ covered in?

A

Fibrocartilage articular disc of the TMJ

95
Q

What surrounds the TMJ?

A

Fibrous capsule

96
Q

What is the nerve supply to the TMJ?

A 
Auriculotemporal nerve (immediately in front)
Masseteric nerve
97
Q

What reinforces the joint capsule of the TMJ laterally?

A

Lateral (temporomandibular) ligament

98
Q

What reinforces the joint capsule of the TMJ medially?

A

Sphenomandibular ligament

Stylomandibular ligament

99
Q

What is the function of the articular disc of the TMJ?

A

Increases congruity of articular surfaces

Divides joint cavity into superior and inferior parts

100
Q

What movements are possible between the head of the mandible and the articular disc?

A

Elevation and depression:

  • Of mandible
  • Acts as a hinge
101
Q

What movements does the articular disc and the mandibular fossa permit?

A

Protrusion and retrusion:

  • Of mandible
  • Gliding movements
102
Q

What movements of the mandible close the mouth?

A

Elevation and retraction:

- Pull the condyle backwards

103
Q

What movements of the mandible open the mouth?

A

Depression and protrusion:

  • At both sides
  • Slide disc and condyle forwards towards tubercle
104
Q

What does asynchronous gliding of both TMJs allow?

A

Chewing

105
Q

What does the fascia in the scalp blend with and extend into?

A

Blends with superficial fascia in neck posteriorly

Extends into temporal regions laterally

106
Q

What is the parotid fascia a layer of?

A

Deep cervical fascia

107
Q

What does the parotid fascia cover and invest?

A

Covers masseter

Invests parotid gland

108
Q

What are the origins and insertions of the muscles of facial expression?

A

Most originate on facial bones

Most insert into the skin/connective tissue of the face

109
Q

What can the frontalis muscle also be considered?

A

The anterior belly of occipitofrontalis

110
Q

What are the functions of frontalis?

A

Helps express suprise or curiosity:

  • Elevates eyebrows
  • Wrinkles skin of forehead
111
Q

What are the functions of corrugator supercilli?

A

Helps express concern or worry:

  • Draws eyebrows medially and inferiorly
  • Creates vertical wrinkles over nose
112
Q

What are the functions of platysma?

A

Conveys tension and stress:
- Tenses skin of lower face and neck
(Also depresses mandible)

113
Q

What are the functions of procerus PLUS transverse part of nasalis?

A

Conveys disdain or dislike:

  • Depresses medial end of eyebrow
  • Wrinkles skin over dorsum of nose
114
Q

What are the functions of the alar part of nasalis PLUS levator labii superioris alaeque nasii?

A

During anger or exertion:

- Depresses ala laterally = Flaring of nostrils

115
Q

What is the function of buccinator acting alone?

A

Sucks in cheeks

116
Q

What are the function of orbicularis oris acting alone?

A

Pouts lips (kissing):

  • Compresses lips
  • Protrudes lips
117
Q

What is the function of buccinator PLUS orbicularis oris?

A

Puffs out cheeks (such as when blowing out air)

118
Q

What are the functions of orbicularis oculi?

A

Closes eyes:
- Palpebral part does so gently
Winking:
- Orbital part closes eyelids tightly

119
Q

What are the functions of zygomaticus major and minor?

A

Displaying sneering and disdain:

- Elevates corner of mouth (unilaterally)

120
Q

What do the ‘dilators’ of the mouth work together to do?

A

To show a full ‘teethy’ smile

121
Q

What are the ‘dilators’ of the mouth?

A 
Levator labii superioris
Levator anguli oris
Risorius
Depressor labii inferioris
Depressor anguli oris
122
Q

What is the function of depressor anguli oris?

A

Frowning (sadness):

- Depresses angle of mouth bilaterally

123
Q

What are the functions of mentalis?

A

Elevates lower lip

Protrudes lower lip

124
Q

What does the facial nerve traverse?

A

Internal acoustic meatus

125
Q

What are the branches of the facial nerve within the temporal bone?

A

Greater petrosal nerve
Nerve to stapedius
Chorda tympani

126
Q

How does the facial nerve leave the cranium?

A

Stylomastoid foramen

127
Q

What does the facial nerve have the longest course of?

A

Longest intra-osseous course of any cranial nerve

128
Q

What is the motor supply of the posterior auricular branch of CN VII?

A

Occipitalis
Posterior belly of digastric
Stylohyoid

129
Q

What is the motor supply of the temporal branch of CN VII?

A

Frontalis

Orbicularis oculi

130
Q

What is the motor supply of the zygomatic branch of CN VII?

A

Orbicularis oculi

131
Q

What is the motor supply of the buccal branch of CN VII?

A 
Zygomaticus major and minor
Levator labii superioris
Levator anguli oris
Buccinator
Orbicularis oris
Nasalis
132
Q

What is the motor supply of the marginal mandibular branch of CN VII?

A

Depressor anguli oris
Depressor labii inferioris
Mentalis

133
Q

What is the motor supply of the cervical branch of CN VII?

A

Platysma

134
Q

What are the branches of the facial artery?

A

Submental
Superior and inferior labial
Lateral nasal
(Continues as angular artery)

135
Q

Where does the superficial temporal artery give off the transverse facial artery?

A

When it runs within the parotid gland

136
Q

From what artery does the mental artery arise?

A

Inferior alveolar artery

137
Q

What are the terminal branches of the ophthalmic artery?

A

Supra-orbital artery

Supratrochlear artery

138
Q

Into what vein do the supra-orbital and supratrochlear veins drain to? Where?

A

Angular vein:

- Root of nose

139
Q

What does the angular vein continue as? Where?

A

Facial vein:

- At inferior margin of orbit

140
Q

Where does the facial vein drain to?

A

Joins anterior division of retromandibular vein:

  • Forms common facial vein
  • Which then drains into IJV
141
Q

What is the drainage pattern of the superficial temporal vein?

A

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
Q

What are the layers of the scalp (from external to internal)?

A 
S = Skin
C = Connective tissue
A = Aponeurosis (of occipitofrontalis)
L = Loose areolar connective tissue
P = Periosteum (pericranium)
143
Q

What branches of the internal carotid artery supply the scalp?

A

Ophthalmic:

  • Supratrochlear artery
  • Supra-orbital artery
144
Q

What branches of the external carotid artery supply the scalp?

A

Superficial temporal artery
Posterior auricular artery
Occipital artery

145
Q

What are the emissary veins?

A

Communicating veins between:

  • Superficial veins of scalp (in connective tissue layer)
  • Dural venous sinuses
146
Q

What are the clinical implications of the emissary veins?

A

Potential route for infection

147
Q

What is the nerve supply to the scalp?

A 
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
Q

What are the sensory branches of the ophthalmic nerve (CN V1)?

A 
Frontal nerve:
- Supraorbital nerve
- Supratrochlear nerve
Nasociliary nerve:
- Lacrimal nerve
149
Q

What are the sensory branches of the maxillary nerve (CN V2)?

A

Infraorbital nerve

Superior alveolar nerve

150
Q

What are the sensory branches of the mandibular nerve (CN V3)?

A

Lingual nerve
Inferior alveolar nerve
Auriculotemporal nerve

Regional Gross Anatomy (14 decks)

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