Scalp and Superficial Face Flashcards
What are the layers of the scalp? What are their roles?
Skin
dense Connective Tissue= hold vasculature and nerves
Aponeurosis= area of potential spread of infection from back of skull to eyelids and tip of nose
Loose connective tissue= connects occipital frontalis muscle –> move skin over head wrinkle forehead
Pericranium= periosteum outside of bone, highly vascularized, innervated
Where can you find emissary vein?
In the loose connective layer connecting outside the cranium to inside
Infections can get into dural sinus (superior saggittal sinus) causing meningitis
What layers compose the scalp proper? How is this clinically significant in terms of detached scalp injuries?
Skin
Dense connective tissue
Aponeurosis
If you tear of scalp proper you still have most of the bloody supply/vasculature intact since runs inferior to superior so can easily reattach
What is the difference between a gaping and non-gaping scalp wound?
Gaping= normally coronal lesion, penetrates aponeurosis Non-gaping= only through the first 2 layers
How do scalp infections occur?
If you have a wound that goes into the loose connective tissue layer then infiltrate emissary vein causing spread of infection in dural sinuses
Where do you find the parotid gland?
Zygomatic arch to the inferior arch of the mandible
Extends a little into submandibular triangle
Surrounded by investing layer of deep cervical fascia
Where do you find the parotid duct?
On the masseter m.
What could possibly be effected by a tumor on the parotid gland?
Fascial N. (runs through the gland but does not innervate)
External carotid A.
Retromandibular N.
What nerve closes the eye?
Facial N.
What does the frontal belly of the Occipitofrontalis M. do?
Wrinkle the forehead
What does the ocibularis oculi m. do?
Close eye
Orbital= close tightly
Palpebral= gently
What does the levator labii superioris m. do?
Elevate the upper lip
What does the zygomaticus major and minor m. do?
Rises corners of the lip when a person smiles
What does the risorius m. do?
Retracts the angle of the mouch
What does the Oribcularis Oris m. do?
Purse lips and closes mouth
What does the Platysma M. do?
Wrinkles the neck
What does the Buccinator M. do?
Aid in smiling
What innervates the muscles of facial expression? Where are these muscles derived from?
CN VII= facial nerve
PA2 mesoderm
What connects the frontal and occipital body of the occipitofrontalis?
Epicranial aponeurosis
What foes the facial nerve go through to get into face? What does it pass through before branching?
Styloid mastoid foramen
Parotid and then branch into motor branches
What are the motor branches of the facial nerve?
“To Zanzibar By Motor Car”
Temporal Zygomatic Buccal Mandibular Cervical
What does the sensory root of the facial nerve supply?
Taste to the anterior 2/3 of the tongue via the Chorda tympani (also used by submandibular and sublingual glands)
Parasympathetic fibers to the lacrimal gland, submandibular, and sublingual glands
What carries the preganglionic parasympathetic fibers of the facial n.?
CN 3,7,9,10
What carries the postganglionic parasympathetic fibers of the facial n.
trigeminal n.
What nerve contributes to tears from the lacrimal gland?
Greater pretorsal n.
What is Bell’s Palsy?
Epsilateral paralysis of muscles of facial expression
What are the three main cutaneous branches of the trigeminal n? What do they split into?
Opthalmic (V1):
- suprathrochlear and supraorbital
- plapebral branch of lacrimal
- infratrochlear
- external nasl branch of anterior ethmoidal
Maxillary (V2):
- infraorbital
- zygomaticofacial
- zygomaticotemporal
Mandibular (V3):
- mental (inferior alveolar)
- buccal
- auriculotemporal
What nerves are involved in sensation to the scalp?
CN V1: supratrochlear and supra-orbital
CN V2: zygomaticotemporal
CN V3: auriculotemporal
Anterior rami of greater auricular and lesser occipital (C2 and C3)
Postrior rami of greater occipital (C2) and third occipital (C3)
What nerve provides motor innervation to the muscles of mastication?
Trigeminal, V3, Mandibular branch
How is the trigeminal nerve related to herpes zoster/shingles?
latent virus in dorsal root of the trigeminal
Shingles cause reactivation of virus so then the distribution of the virus is based on if its V1 V2 or V3
Can also have shingles in sensory ganglion and get pattern that follows dermatomes on arm and torso
What does the angular a. anastomose with?
Super trochlear a.
What does the supra orbital a. anastomose with?
superficial temporal a.
Where doe the supraorbital and supratrochlear a. come from? Which one is more medial?
The ophthalmic artery which is a branch of the internal carotid
supraorbital a.
What is the origin, course, and distribution of the facial artery?
External Carotid a.
Ascends deep to submandibular gland winds around inferior border of mandible and enters face
Muscles of facial expression and face
What is the origin, course, and distribution of the superior and inferior labial a.?
Facial a. near angle of the mouth
Run medially in upper and lower lip
Inferior= lower lip Superior= upper lip, ala, and spetum of nose
What is the origin, course, and distribution of the anuglar a.?
terminal branch of facial a.
Passes to medial angle of eye
superior part of cheek and inferior eyelid
What is the origin, course, and distribution of the lateral nasal a.?
Facial artery as it ascends alongside nose
Passes to ala of nose
skin to ala and dorsum of nose
What is the origin, course, and distribution of the occipital a.?
External carotid a.
Passes medial to posterior belly of digastric and mastoid process, accompanies occipital nerve in occipital region
Scalp of back of head as far as vertex
What is the origin, course, and distribution of the posterior auricular a.?
External carotid a.
Passes posteriorly, deep to parotid gland along styloid process between mastoid process and ear
Auricle of ear and scalp posterior to auricle
What is the origin, course, and distribution of the superficial temporal a?
Small terminal branch of external carotid
Ascends anterior to ear to region and ends in scalp
Facial muscles and skin of temporal frontal and temporal regions
What is the origin, course, and distribution of the transverse facial a?
Superficial temporal a. within parotid
Crosses superficial to masseter and inferior to zygomatic arch
Parotid gland and duct, muscles and skin of face
What is the origin, course, and distribution of the mental a.?
Terminal branch of inferior alveolar a.
Emerges from mental foramen and passes to chin
Facial muscles of skin and chin
What is the origin, course, and distribution of the supra-orbital a.?
Terminal branch of ophthalmic a.
Passes superiorly from supra-orbital foramen
Muscles and skin of forehead and scalp and superior conjunctiva
What is the origin, course, and distribution of the supratrochlear a.?
Terminal branch of ophthalmic a.
Passes superiorly from supratrochlear notch
Muscles and skin of forehead and scalp and superior conjunctiva
What important veins of the face drain into the cavernous sinus?
Superior and inferior opthalmic veins: from eye also connect with angular
Angular vein
Deep facial vein: connect to pterygoid venous plexus –> cavernous sinus
