Scalp and Superficial Face Flashcards
5 layers of the scalp
Skin, Connective tissue, Aponeurosis, Loose connective tissue, Pericranium
Clinical relevance of the emissary V
Loose connective tissue just superior can drain into the emissary vein, which can drain into the superior sagittal sinus. This can lead to meningitis.
Loose connective tissue can transmit infection to…
scalp, around eye, and nose
Describe characteristics of the dense connective tissue in the scalp
Most vascularized, nerves
Scalp proper
Skin, connective tissue, aponeurosis
Difference between gaping and non-gaping scalp wounds
If the wound cuts coronally through the aponeurosis, muscle will pull and lead to a gaping appearance.
Which cranial nerve closes the eye?
Facial nerve
What muscle is attached to the aponeurosis of the scalp?
Occipitalis Frontalis Muscle
What direction does the neurovasculature of the scalp travel?
Inferior to superior
Where is the parotid gland?
Goes from Zygomatic Arch to Inferior Border of Mandible
What are the three major structures passing through the Parotid gland?
Facial Nerve (does not innervate gland)
Retromandibular Vein
External Carotid Artery
What muscle does the parotid duct dive into?
Buccinator Muscle
What is the sensory innervation of the parotid gland?
What is the parasympathetic innervation of the parotid gland?
Sensory: Auricolotemporal Nerve (branch of CN V3) and Great Auricular Nerve
Parasympathetic: CN IX
Why would a patient with mumps have pain in the cheek?
Parotid gland is swelling and is constricted by investing layer of deep cervical fascia and cannot expand
What part of the orbicularis oculi closes the eye tightly?
Orbital part
What part of the orbicularis oculi gently closes the eye?
Palpebral part
What cranial nerve closes the eye?
What cranial nerve opens the eye?
Closes: Cranial Nerve VII (Facial)
Opens: Cranial Nerve III (Oculomotor)
What is the embryonic origin of the muscles of facial expression?
Pharyngeal Arch 2
Mesoderm
What are the four muscles of mastication?
What cranial nerve innervates them all?
Temporalis Muscle Masseter Muscle Medial Pterygoid Muscle Lateral Pterygoid Muscle *Innervated by Cranial Nerve V3
What is the embryonic origin of the muscles of mastication?
Pharyngeal Arch 1
Mesoderm
What are the branches of Facial Nerve providing motor innervation?
Posterior Auricular N
Temporal N.
Zygomatic N.
Buccal N.
Mandibular N.
Cervical N.
pA Tiny Zenbra Bit My Cheek
Where does the Facial Nerve enter the skull?
Where does the Facial Nerve exit the skull?
Enter: Internal Acoustic Meatus
Exit: Stylomastoid Foramen
What branch of Facial Nerve provides sensory information to the anterior 2/3 of the tongue?
Chorda Tympani
What branch of Facial N. carries parasympathetic fibers to the submandibular and sublingual salivary glands?
Chorda Tympani
What branch of Facial Nerve transmits parasympathetic fibers to the lacrimal gland?
Greater Petrosal Nerve
What are some symptoms of Bell’s Palsy?
Damage done to ipsilateral side
Loss of parasympathetic innervation to lacrimal ducts No tear production Loss of innervation to stapedius muscle No protection from loud noises Loss of taste to anterior ⅔ of tongue Lose parasympathetic innvervation to submandibular and sublingual salivary glands Cannot move facial muscles Cannot close eye Loss of general sensory to ear
If the Facial Nerve was damaged in the Internal Acoustic, what symptoms would be seen?
Loss of all functions of Facial Nerve
If the Facial Nerve was damaged at the entrance of the facial canal, what symptoms would we see?
Loss of all functions of Facial Nerve except parasympathetic innervation to lacrimal gland
If the Facial Nerve was damaged right before the branch of the Chorda Tympani, what symptoms would we see?
Loss of all functions of Facial Nerve except parasympathetic innervation to lacrimal gland and innervation to stapedius muscle
Only will have tear production and protection against loud sounds!
If the Facial Nerve was damaged at the stylomastoid foramen, what symptoms would we see?
Symptoms
Unilateral flaccid paralysis of facial muscles
Loss of sensation around ear
Will have tear production, protection against loud sounds, taste to tongue, and salivary production
What is the sensory innervation of the bridge of the nose?
Opthalmic V1
What is the sensory innervation of the sides of the nose?
Maxillary V2
What is the sensory innervation of the upper eyelid?
Opthalmic V1
What is the sensory innervation of the lower eyelid?
Maxillary V2
What is the sensory innervation of the cornea?
Opthalmic V1
What provides cutaneous sensation to the angle of the mandible?
Cervical plexus
What provides motor innervation to the Buccinator M.?
What provides sensory innervation?
Motor: Buccal branch of Facial N. CN VII
Sensory: Buccal Nerve (branch of CN V3)
Where do the Supratrochlear and Supraorbital Nerves arise from?
What do they innervate?
Ophthalmic Nerve (V1)
Sensory innervation to eyelid, forehead, scalp, and vertex
What are the branches of the Maxillary Nerve?
Infraorbital Nerve
Zygomaticofacial Nerve
Zygomaticotemporal Nerve
What are the branches of the Mandibular Nerve?
Auriculotemporal Nerve
Buccal Nerve
Mental Nerve
Where does Herpes Zoster normally lie dormant?
Sensory root ganglia/dorsal root ganglia of trigeminal nerve
Most common in V1
A 50 y/o patient presents with a rash to her forehead and bridge of her nose. She has a history of chicken pox as a child. What nerve has the virus taken the distribution of? Specifically what division?
Trigeminal N V1 (ophthalmic)
What is the anastamosis between ICA and ECA on the forehead?
ECA: Superficial Temporal Artery
ICA: Supraorbital Artery
What two arteries anastomose around the medial part of the eyes and nose?
ICA: Supratrochlear Artery
ECA: Angular Artery (continuation of Facial Artery)
What two arteries anastomose around the lip?
Superior and Inferior Labial Arteries
Both from Facial Artery
What do the Occpital Lymph Nodes drain?
Back of Head
What do the Mastoid Lymph Nodes drain?
Posterior lateral sides of the head (posterior to ear)
What do the Parotid Lymph Nodes drain?
Forehead, lateral face, eyes
What do the Submandibular Lymph Nodes drain?
Top lip and lateral lower lips
What do the Submental Lymph Nodes drain?
Central lower lip and Chin
What lymph nodes drain into deep cervical?
Partoid
Submandibular
Submental
What lymph nodes drain into superficial cervical?
Occipital
Mastoid
