Scalp, face and parotid gland

Question 1

Whatare the layers of the scalp?

Answer 1

5 layers
Skin
Connective tissue (fatty layer)
Aponeurotic layer
Loose connective tissues
Pericranium

Question 2

What innervates the skin over the skull?

Answer 2

Trigeminal is the main sensory of the anterior skull
Anterior and posteror rami of the cevical nerves C2-C4 are the main contributor to the posterior skull.

Where to put the anaesthesia depends on where the nerves are running from.

Question 3

What is the blood supply of the skull?

Answer 3

The internal and external carotid arteries contribute

The branches of the external carotid supply 2/3rds of the skull (ot the aterior egion). These branches include the posterior auricular artery.

The internal jugular vein branches in the skull into the supratrochlear artery and the supraorbital artery which exits the eye cavity and supplies the anterior skull

Question 4

What are the muscles facial expression?

Answer 4

Platysma - Attaches to the lower mandible and attaches to the clavicle and runs in the superficil fascia.

Occipitofromtalis - has two bellies (anterior belly is called fromtalis and posterielly is called occiptalis) on either side of the skull with an aponeurosis that covers the skull (is on one the five skull layers).

Auricularis mucles - three muscles, above, front and behind the ear (superior, anterior and posterior)

obiculari occuli.

Question 5

What do we need to know about the muscles of the lip?

Answer 5

That there is a group of muscles that goes to the upper lip and anther that goes to the lower lip.
Different innervation.

Some muscles go to the corner of the mouth. They pull up or down on the lip

Question 6

What innervates obiccularis oculi and what happens if it is damamed? What are the two regions of this muscle?

Answer 6

The facial nerve. Can’t shut the eye.

Palpebral (inner) and orbital (outer)

Question 7

What are the muscles of the nose?

Answer 7

Called nasalis

Question 8

What is the muscle in the cheeks?

Answer 8

The buccinator. The parotid duct perforates it.

Question 9

What nerves proevide sensory innervation to the face?

Answer 9

All branches of the trigeminal:
Opthalamic
Maxillay
Mandibular

Question 10

Where does the opthalamic division of trigeminal run and what are it’s branches and where does it supply sensory information?

Answer 10

It run through the orbitalcanal and runs p the skull with he supraorbital and supratrochlear nereve branches.

The lacramal nerve goes to the lacramal gland.
Ifratrochlear branch and external nasal nerve

Question 11

Where does the paroid gland sit?

Answer 11

The sperificial portion of theparotid sits on the ramus of the mandable.
Below the zygomatic arch, in front of the ear.

The deep branch wraps around the ramus

Question 12

What innervats the parotid gland and it’s fascia?

Answer 12

Sensory: parotid gland is from V3 and the parotid fascia is from C2 (great auricular nerve).
Secretomotor: parasympathetic fibres CNIX and a little from V3
Sympathetic fibres: superior cervical ganglion via external carotid artery

Question 13

Where does the fascia around the paroid gland come from?

Answer 13

Continuation of the investing layer of the neck.

Innervation for the fascia comes from the great auricular nerve (C2)

Question 14

What innervats the parotid gland and it’s fascia?

Answer 14

Sensory: parotid gland is from a branch of V3 (auriculotemporal nerve) and the parotid fascia is from C2 (great auricular nerve).
Secretomotor: parasympathetic fibres CNIX and a little from V3
Sympathetic fibres: superior cervical ganglion

Question 15

Where does the parotid duct run?

Answer 15

It opens in the mouth next to the upper second molar.

Question 16

Where does the parotid duct run?

Answer 16

Formed in the deep lobe, emerging at the anterior order of the parotid it travels superficially over the masseter muscle then pierces the buccinator. It opens in the mouth next to the upper second molar.

Question 17

What is the surface marking of the parotid duct

Answer 17

Make a line from the tragus to the corner of the mouth (cheilion). Then take the middle third and go 1.5 cm above and below that line you will find he parotid duct below there.

Question 18

What are the branches of the facial nerve?

Answer 18

The facial nerve gets out of the stylomastoid foramen then it runs through the parotid gland in two divisions, temporalzygomatic and cervicofacial.

Temporozygomatic branches:
Temporal
zygomatic
Buccal

Cervicofacial divisions:
Marginal mandibular
cervical

The temporal and marginal mandibular divisions get damaged often by clinicians. Their course is superficial. Damage to these areas = send to plastic surgeon

Question 19

What happens if you damage the temporal or marginal mandibular nerves?

Answer 19

Temporal: Loss of ability to close the eye because it sometimes innervates the obicularis oculi.

Marginal mandibular: muscles going to the lower lip = lip being puled up by the upper muscles of the lip.

Question 20

Where does the facial nerve run in the parotid gland and what is deep to the facial nerve?

Answer 20

It runs between the mastoid and styloid process penetrates the parotid gland between the deep and supeficial parotid and then crosses the retromandibular vein, the external carotid artery, the mandible and the masseter muscle.

You have to see the nerve before you see the blood vessels.