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NE > Scalp and Superficial Face > Flashcards

Scalp and Superficial Face Flashcards

1
Q

What are the 5 layers of the scalp?

A

*use SCALP mnemonic*

  • Skin (integument)
  • Connective tissue (dense CT)
  • Aponeurosis
  • Loose areolar CT
  • Pericranium (periosteum)
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2
Q

What is the cutaneous innervation of the face and scalp?

A
  • trigeminal N. (CN V): front part of the face and anterosuperior part of the scalp
    • opthalmic (V1) division: supraorbital N., supratrochlear N., and infratrochlear N.
    • maxillary (V2) division: infraorbital N., zygomaticofacial N., zygomaticotemporal N.
    • mandibular (V3) division: mental N., buccal N., auriculotemporal N.
  • spinal nerves C2-3
    • anterior rami of C2, C3: greater auricular and lesser occipital Ns.
    • posterior rami of C2: greater occipital N.
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3
Q

What is the sensory component of the trigeminal N.?

What pathways does its branches take?

A
  • ophthalmic (V1) division: exits cranium via superior ophthalmic (orbital) fissure (supraorbital N. exits via supraorbital foramen, supratrochlear N. exits via supratrochlear foramen, and infratrochlear N.)
  • maxillary (V2) division: exits cranium via foramen rotundum (infraorbital N. exits infraorbital foramen)
  • mandibular (V3) division: exits cranium via foramen ovale (mental N. exits via mental foramen, buccal N.)
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4
Q

What is the arterial supply of the scalp?

A
  • posterior auricular A. (from external carotid)
  • superficial temporal A. (from maxillary)
  • occipital A. (from external carotid)
  • supraorbital/supratrochlear A. (ophthalmic A.)
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5
Q
  • superficial injury: superficial to aponeurosis, holds edges of wounds together
  • deep injury: through aponeurosis, forms gap because of pull of occipitofrontalis M.
  • both bleed profusely as CT tends to hold cut vessels open
  • infections: can spread into cranium via small emissary veins (anastomoses between intra- and extracranial veins)
A

scalp injuries

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6
Q

What are the muscles of facial expression?

A
  • epicranius M. (frontalis and occipitalis): create expressions of surprise and/or fright; also collectively called occipitofrontalis M.
  • orbicularis oculi M.: orbital and palebral portions; close eyelids
  • levator labii superioris M.: lifts upper lip
  • zygomaticus major and minor and levator anguli oris M.: smiling and laughing muscles
  • depressor labii inferioris M. and depressor anguli oris M.: depress lower lip
  • orbicularis oris M.: closes mouth and pout
  • buccinator M.: muscle of cheek, holds cheek close to teeth
  • buccinator and oribicularis oris M.: kissing muscles

*all innervated by facial N. (CN VII)*

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7
Q

Describe facial N. (CN VII):

  • motor innervation:
  • sensory innervation:
  • autonomic innervation:
A
  • motor innervation: facial expression muscles (posterior auricular, temporal region, zygomatic region, buccal region, mandibular region, and cervical region)
  • sensory innervation: taste anterior 2/3 of tongue
  • autonomic innervation: parasympathetics to lacrimal, nasal cavity, and submandibular and sublingual glands
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8
Q
  • damage of facial N. due to surgery or infection
  • muscle weakness/paralysis including inability to close eyelides (prone to cornea ulceration)
A

Bell’s palsy

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9
Q
  • tx that blocks neuromuscular transmission by inhibiting acetylcholine release
  • used to treat eye disorders, migraines, muscle spasms, and used cosmetically
A

botox injections

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10
Q

What is the OIN of the muscles of mastication?

A
  • masseter M.: origin at zygomatic arch, insertion at lateral ramus and angle of mandible
  • temporalis M.: origin at floor of temporal fossa and deep temporal fascia, insertion at coronoid process and anterior border of mandible; elevates and closes mandible, contributes to mandibular retraction
  • medial pterygoid M.: origin at medial surface of lateral pterygoid plate and maxillary tuberosity, insertion at medial surface of mandibular ramus; elevates and protrudes mandible
  • lateral pterygoid M.: origin at greater wing of sphenoid and lateral surface of lateral pterygoid plate, insertion at neck of mandible, articular disc, and TMJ capsule; protracts mandible, swings jaw to contralateral side, contributes to lateral chewing

*all innervated by trigeminal N., mandibular division (CN V3)*

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11
Q

What muscles does the trigeminal N. provide motor innervation to?

A
  • muscles of mastication: masseter, medial pterygoid, lateral pterygoid, temporalis
  • mylohyoid M.
  • anterior giastric M.
  • tensor tympani M.
  • levator veli palatini M.
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12
Q
  • initial infection of chickenpox virus
  • lesions due to reactivation of virus that can appear anywhere on the body
  • many produce lesions in cranial ganglia w/ most involving trigeminal N. (CN V)
  • ophthalmic division commonly affected, usual cornea involved leading to painful corneal ulceration
A

herpes zoster virus

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13
Q

What are the 3 salivary glands?

A
  • parotid gland: largest, serous gland encapsulated by tough fascia
  • submandibular gland: located in submandibular triangle inferior to mandible, mixed serous and mucous gland
  • sublingual gland: located within oral cavity beneath tongue, mucous gland
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14
Q

What are the structures found within/near the parotid gland?

A
  • parotid duct: runs over masseter M., pierces buccinator and opens on surface of oral cavity near upper second molar
  • facial N.: exits stylomastoid foramen and enters the gland after innervating stylohyoid and posterior digastric M.
  • retromandibular V.
  • external carotid A.
  • auriculotemporal N.: CN V3 sensory
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15
Q

Describe the vascularization of the face and scalp:

A
  • facial A.: branch off external carotid A.; gives rise to labial and angular As.
  • occipital A.: branch off external carotid A.; supplies posterior scalp
  • posterior auricular A.: branch off external carotid A.
  • superifical temporal A.: terminal branch of external carotid A.
  • transverse facial A.: branch off the superficial temporal A.
  • infraorbital A.: branch off the maxillary A.
  • supraorbital and supratrochlear As.: branches off ophthalmic A.
  • mental A.: terminal branch of inferior alveolar A.
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16
Q
  • artery: facial
  • origin:
  • course:
  • distribution:
A
  • artery: facial
  • origin: ECA
  • course: ascends deep to submandibular gland, winds around inferior border of mandible and enters face
  • distribution: muscles of facial expression and face
17
Q
  • artery: inferior labial
  • origin:
  • course:
  • distribution:
A
  • artery: inferior labial
  • origin: facial A. near angle of mouth
  • course: runs medially in lower lip
  • distribution: lower lip
18
Q
  • artery: superior labial
  • origin:
  • course:
  • distribution:
A
  • artery: superior labial
  • origin: facial A. near angle of mouth
  • course: runs medially in upper lip
  • distribution: upper lip and ala (side) and septum of nose
19
Q
  • artery: lateral nasal
  • origin:
  • course:
  • distribution:
A
  • artery: lateral nasal
  • origin: facial A. as it ascends alongside nose
  • course: passes to ala of nose
  • distribution: skin on ala and dorsum of nose
20
Q
  • artery: angular
  • origin:
  • course:
  • distribution:
A
  • artery: angular
  • origin: terminal branch of facial A.
  • course: passes to medial angle (canthus) of eye
  • distribution: superior part of cheek and inferior eyelid
21
Q
  • artery: occipital
  • origin:
  • course:
  • distribution:
A
  • artery: occipital
  • origin: ECA
  • course: passes medial to posterior belly of digastric and mastoid processes; accompanies occipital N. in occipital region
  • distribution: scalp of back of head, as far as vertex
22
Q
  • artery: posterior auricular
  • origin:
  • course:
  • distribution:
A
  • artery: posterior auricular
  • origin: ECA
  • course: passes posteriorly, deep to parotid gland, along styloid process between mastoid process and ear
  • distribution: auricle of ear and scalp posterior to auricle
23
Q
  • artery: superficial temporal
  • origin:
  • course:
  • distribution:
A
  • artery: superficial temporal
  • origin: smaller terminal branch of ECA
  • course: ascends anterior to ear to region and ends in scalp
  • distribution: facial muscles and skin of temporal frontal and temporal regions
24
Q
  • artery: transverse facial
  • origin:
  • course:
  • distribution:
A
  • artery: transverse facial
  • origin: superficial temporal A. within parotid gland
  • course: crosses face superficial to masseter and inferior to zygomatic arch
  • distribution: parotid gland and duct, muscles and skin of face
25
Q
  • artery: mental
  • origin:
  • course:
  • distribution:
A
  • artery: mental
  • origin: terminal branch of inferior alveolar A.
  • course: emerges from mental foramen and passes to chin
  • distribution: facial muscles and skin of chin
26
Q
  • artery: supra-orbital
  • origin:
  • course:
  • distribution:
A
  • artery: supra-orbital
  • origin: terminal branch of ophthalmic A. from ICA
  • course: passes superiorly from supra-orbital foramen
  • distribution: muscles and skin of forehead and scalp and superior conjunctiva
27
Q
  • artery: supratrochlear
  • origin:
  • course:
  • distribution:
A
  • artery: supratrochlear
  • origin: terminal branch of ophthalmic A. from ICA
  • course: passes superiorly from supratrochlear notch
  • distribution: muscles and skin of forehead and scalp and superior conjunctiva
28
Q

Describe the vein distribution of the face and scalp:

A
  • generally follow path of the As.
  • facial V. empties into internal jugular but has other anastomoses
  • superficial temporal Vs.: join maxillary V. to form retromandibular V.
  • retromandibular V.: joins posterior auricular V. to make external jugular
  • anastomoses between supratrochlear, supraorbital, angular V. of facial V. w/ intracranial Vs. (potential spread of exterior infections into the cranium)
29
Q

Describe the lymphatics of the face and scalp:

A
  • superficial cervical nodes: located along EJV draining superficial tissues of neck (submental, submandibular, parotid, mastoid, and occipital nodes)
  • inferior deep cervical nodes: drain lateral cervical area and run along path of SCM (jugulo-digastric and jugulo-omohyoid nodes)
  • all drain into nodes and lymphatics running along IJV
  • lymphatics join to form lymphatic trunks that then join to form lymphatic ducts that empty into subclavian vein near its junction w/ IJV

NE (36 decks)

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