Scalp, Face, Parotid Flashcards
5 layers of scalp
S - skin C - dense CT - neurovascular A - aponeurosis epicranius L - loose CT - plane of cleavage P - pericranium
innervation posterior scalp
greater occipital C2
C3
lesser occipital
great auricular
cervical plexus / dorsal rami**
innervation anterior scalp
CN V - trigeminal
- auriculotemporal V3
- zygomaticotemporal V2
- supraorbital and supratrochlear V1
blood supply scalp
external carotid
- occipital a
- posterior auricular a.
- superficial temporal a.
internal carotid
- supraorbital a
- supratrochlear a
scalp vasculature?
layer 2 dense CT
also anastomose - cannot compress to stop bleeding
venous drainage scalp?
vena comitantes arteries
emissary veins - through bones to dural venous sinuses
emissary veins
drain through bones of skull to drain dural venous sinuses
-valveless - spread infection
scalp infections and bleeding spread?
layer 4 - loose CT
ecchymosis
spread of blood
muscles of facial expression
arch 2**
nerve - CN VIII SVE component facial nerve
orbicularis oculi
orbital - surround eyeball
palpebral - in eyelid
lacrimal - medial corner of eye
corrugator supercilli
draws eyebrow down - worried look
occipitofrontalis
frontal and occipital bellies
frontal - elevate eyebrow
occipital - retract eyebrow - surprised expression
buccinator
keep food in mouth
elevate upper lip?
levator labii superioris levator anguli oris zygomaticus major zygomaticus minor levator labii superioris alaeque nasi
flare nostril
levator labii superioris alaeque nasi
mentalis
protrude lower lip
depress lower lip
depressor anguli oris
depressor labii inferioris
procerus
wrinkles skin over dorsum of nose
nasalis
flares nostrils
platysma
depress mandible
tense skin of lower face and neck
orbicularis oris
around mouth
facial nerve to muscles of facial expression?
SVE
exit brainstem > internal acoustic meatus > between cochlea and semcircular canals > courses posterior along middle ear > exits facial canal via stylomastoid forman
lesion at stylomastoid foramen
only SVE of facial nerve
-to facial expression mm.
branches of SVE facial
posterior auricular n digastric n stylohyoid n. temporofacial trunk cervicofacial trunk
temporofacial trunk
superior
temporal branches
zygomatic branches
buccal branches
cervicofacial trunk
inferior
buccal branches
marginal mandibular branches
cervical branches
ptosis
affects upper eyelid
bells palsy
facial nerve
-idiopathic, herpes, lesion, otitis media
facial asymmetry and drooping
- drooping lower eyelid - drainage of tears and ulceration
- dribbling of saliva - paralyze orbicularis oris
- accumulation of food in vestibule - buccinator m.
opthalmic nerve
V1
-skin, forehead, upper eyelid, nose
supratrochlear n supraorbital n lacrimal n infratrochlear n external nasal nerves
maxillary nerve
through pterygopalatine fossa
V2
skin of temporal region, upper cheek and lip, lower eyelid, ala of nose
zygomaticotemporal n
zygomaticofacial n
infraorbital n
mandibular nerve
through infratemporal fossa
skin of lower cheek, lower lip, chin
auriculotemporal n
buccal n
mental n
great auricular nerve
C2,3
skin over angle of mandible
trigeminal neuralgia
tic douloureux
sudden excruciating facial pain - maybe suicide/depression
demyelination of neurons
V2 > V3 > V1
superior cerebellar artery compression
artery of trigeminal neuralgia
compressed superior cerebellar artery
division affected in trigeminal neuralgia
V2 > V3 > V1
herpes zoster
can affect trigeminal ganglion
- most often V1
- scarring/ulceration of cornea
facial artery
branch of external carotid a
branches:
- inferior labial a
- superior labial a
- lateral nasal a
- angular a
superficial temporal artery
branch of external carotid a
branches:
- transverse facial a
- frontal branches
- parietal branches
maxillary artery
branch of external carotid a
branches:
- infraorbital a
- buccal a
- mental a
ophthalmic artery
branch of internal carotid a
branches:
- supraorbital a
- supratrochlear a
- lacrimal a
- medial palpebral a
- dorsal nasal a
venous drainage
retromandibular vein
retromandibular vein
formed from superficial temporal and maxillary veins
anterior and posterior division
anterior retromandibular vein
merges with facial - common facial vein
common facial vein
to internal jugular vein
from anterior retromandibular and facial vein union
posterior retromandibular vein
merges with posterior auricular vein - external jugular vein
external jugular vein
from posterior auricular and posterior retromandibular veins
lymph drainage
submental, submandibular, parotid nodes
ultimately, to deep cervical nodes
danger area
central face area
-infection travel from superficial to deep face or skull
facial vein communication
pterygoid plexus via deep facial vein
cavernous sinus via ophthalmic veins
parotid gland
largest of salivary glands
-overlying ramus of mandible
parotid duct
crosses masseter
-enters oral cavity opposite 2nd upper molar
abscess or infection of dental origin
may spread to parotid gland via parotid duct
within parotid gland (parotidectomy be careful)**
facial nerve
retromandibular vein
external carotid artery
parasympathetic to parotid
salivatory nucleus > glossopharyngeal nerve CN IX
- exits at jugular foramen > tympanic branch
- enters middle ear - tympanic canaliculus
- reforms lesser petrosal nerve
- exits hiatus for lesser petrosal n
-exits foramen ovale - synapse on otic ganglion
postganglion - fibers with auriculotemporal branch V3
sympathetic to parotid
preganglionic - T1-4
-postganglionic SCG
-fibers travel with external carotid nerve to parotid tissue
parotiditis
inflammation of parotid gland
-pain - stretch parotid sheath
-carried with auriculotemporal branch of V3 and great auricular nerve
referred to auricle, TMJ, external acoustic meatus ***
sialolith
calculus
- calcification in parotid
- passes into duct - quite painful
