Scalp, Face, Parotid Flashcards

1
Q

5 layers of scalp

A
S - skin
C - dense CT - neurovascular
A - aponeurosis epicranius
L - loose CT - plane of cleavage
P - pericranium
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2
Q

innervation posterior scalp

A

greater occipital C2
C3
lesser occipital
great auricular

cervical plexus / dorsal rami**

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3
Q

innervation anterior scalp

A

CN V - trigeminal

  • auriculotemporal V3
  • zygomaticotemporal V2
  • supraorbital and supratrochlear V1
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4
Q

blood supply scalp

A

external carotid

  • occipital a
  • posterior auricular a.
  • superficial temporal a.

internal carotid

  • supraorbital a
  • supratrochlear a
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5
Q

scalp vasculature?

A

layer 2 dense CT

also anastomose - cannot compress to stop bleeding

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6
Q

venous drainage scalp?

A

vena comitantes arteries

emissary veins - through bones to dural venous sinuses

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7
Q

emissary veins

A

drain through bones of skull to drain dural venous sinuses

-valveless - spread infection

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8
Q

scalp infections and bleeding spread?

A

layer 4 - loose CT

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9
Q

ecchymosis

A

spread of blood

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10
Q

muscles of facial expression

A

arch 2**

nerve - CN VIII SVE component facial nerve

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11
Q

orbicularis oculi

A

orbital - surround eyeball
palpebral - in eyelid
lacrimal - medial corner of eye

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12
Q

corrugator supercilli

A

draws eyebrow down - worried look

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13
Q

occipitofrontalis

A

frontal and occipital bellies

frontal - elevate eyebrow
occipital - retract eyebrow - surprised expression

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14
Q

buccinator

A

keep food in mouth

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15
Q

elevate upper lip?

A
levator labii superioris
levator anguli oris
zygomaticus major
zygomaticus minor
levator labii superioris alaeque nasi
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16
Q

flare nostril

A

levator labii superioris alaeque nasi

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17
Q

mentalis

A

protrude lower lip

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18
Q

depress lower lip

A

depressor anguli oris

depressor labii inferioris

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19
Q

procerus

A

wrinkles skin over dorsum of nose

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20
Q

nasalis

A

flares nostrils

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21
Q

platysma

A

depress mandible

tense skin of lower face and neck

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22
Q

orbicularis oris

A

around mouth

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23
Q

facial nerve to muscles of facial expression?

A

SVE

exit brainstem > internal acoustic meatus > between cochlea and semcircular canals > courses posterior along middle ear > exits facial canal via stylomastoid forman

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24
Q

lesion at stylomastoid foramen

A

only SVE of facial nerve

-to facial expression mm.

25
Q

branches of SVE facial

A
posterior auricular n
digastric n
stylohyoid n.
temporofacial trunk
cervicofacial trunk
26
Q

temporofacial trunk

A

superior

temporal branches
zygomatic branches
buccal branches

27
Q

cervicofacial trunk

A

inferior

buccal branches
marginal mandibular branches
cervical branches

28
Q

ptosis

A

affects upper eyelid

29
Q

bells palsy

A

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.
30
Q

opthalmic nerve

A

V1
-skin, forehead, upper eyelid, nose

supratrochlear n
supraorbital n
lacrimal n
infratrochlear n
external nasal nerves
31
Q

maxillary nerve

A

through pterygopalatine fossa
V2

skin of temporal region, upper cheek and lip, lower eyelid, ala of nose

zygomaticotemporal n
zygomaticofacial n
infraorbital n

32
Q

mandibular nerve

A

through infratemporal fossa

skin of lower cheek, lower lip, chin

auriculotemporal n
buccal n
mental n

33
Q

great auricular nerve

A

C2,3

skin over angle of mandible

34
Q

trigeminal neuralgia

A

tic douloureux

sudden excruciating facial pain - maybe suicide/depression

demyelination of neurons

V2 > V3 > V1

superior cerebellar artery compression

35
Q

artery of trigeminal neuralgia

A

compressed superior cerebellar artery

36
Q

division affected in trigeminal neuralgia

A

V2 > V3 > V1

37
Q

herpes zoster

A

can affect trigeminal ganglion

  • most often V1
  • scarring/ulceration of cornea
38
Q

facial artery

A

branch of external carotid a

branches:

  • inferior labial a
  • superior labial a
  • lateral nasal a
  • angular a
39
Q

superficial temporal artery

A

branch of external carotid a

branches:

  • transverse facial a
  • frontal branches
  • parietal branches
40
Q

maxillary artery

A

branch of external carotid a

branches:

  • infraorbital a
  • buccal a
  • mental a
41
Q

ophthalmic artery

A

branch of internal carotid a

branches:

  • supraorbital a
  • supratrochlear a
  • lacrimal a
  • medial palpebral a
  • dorsal nasal a
42
Q

venous drainage

A

retromandibular vein

43
Q

retromandibular vein

A

formed from superficial temporal and maxillary veins

anterior and posterior division

44
Q

anterior retromandibular vein

A

merges with facial - common facial vein

45
Q

common facial vein

A

to internal jugular vein

from anterior retromandibular and facial vein union

46
Q

posterior retromandibular vein

A

merges with posterior auricular vein - external jugular vein

47
Q

external jugular vein

A

from posterior auricular and posterior retromandibular veins

48
Q

lymph drainage

A

submental, submandibular, parotid nodes

ultimately, to deep cervical nodes

49
Q

danger area

A

central face area

-infection travel from superficial to deep face or skull

50
Q

facial vein communication

A

pterygoid plexus via deep facial vein

cavernous sinus via ophthalmic veins

51
Q

parotid gland

A

largest of salivary glands

-overlying ramus of mandible

52
Q

parotid duct

A

crosses masseter

-enters oral cavity opposite 2nd upper molar

53
Q

abscess or infection of dental origin

A

may spread to parotid gland via parotid duct

54
Q

within parotid gland (parotidectomy be careful)**

A

facial nerve
retromandibular vein
external carotid artery

55
Q

parasympathetic to parotid

A

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

56
Q

sympathetic to parotid

A

preganglionic - T1-4
-postganglionic SCG

-fibers travel with external carotid nerve to parotid tissue

57
Q

parotiditis

A

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 ***

58
Q

sialolith

A

calculus

  • calcification in parotid
  • passes into duct - quite painful