Scalp/Superficial Face Flashcards
Mnemonic for Scalp layers
-their characteristics
what is the Mt. Fuji sign
mt fuji is air in anterior cranial fossa
depressed skull fractures lead to
Nerves of the scalp
companion nerves and arteries of the scalp
Arteries of the scalp and what they supply
- branches of external carotid
- branches of internal carotid via ophthalmic a.
Venous drainage of the scalp:
- named how
- emissary vein function and clinical significance
SMAS
- what is it
- location relationships
- surgical relevance
- extends from platysma to what and is continuous with what fascia
Parotid Gland:
- what might be embedded in its parenchyma
- when is it grossly inflamed?
- Surface anatomy relationships
Facial nerve and retromandibular vein relationship to parotid
Relationships of the Parotid with other Structures Superficial parotid fascia is continuous with the investing fascia of the neck and the masseteric fascia of the cheek. The facial nerve is embedded in the parenchyma of the gland. The buccal branches of VII can be found immediately above or below the parotid duct. The temporofacial and cervicofacial divisions of the facial nerve cross the retromandibular superficially.
The five branches of the facial nerve should be dissected completely in the laboratory. There are numerous branching patterns of these branches. The retromandibular vein and the external carotid artery lie deep to the facial nerve and are embedded in the gland.
The medial boundary of the parotid gland is formed by the deep parotid fascia. This fascia forms the stylomandibular ligament, which extends from the styloid process to the inner surface of the ramus of the mandible.
The internal jugular vein, cranial nerves IX, X, XI, and XII, the internal carotid artery lie deep to this fascia, in that order.
Superficial and deep parotid lymph nodes drain into the deep cervical nodes.
Facial nerve safety zones
- off the tip of eyebrow lateral orbit temporal branch (cant raise eyebrows)
- buccal branches in cheek
- marginal mandibular branch (depressor muscles paralyzed)
innervation to parotid gland:
- postganglionic sympathetic fiber origin, how they get to parotid
- preganglionic parasympathetic fibers origin, course to parotid
Parotid duct:
-course, relationship w/ closeby structures
Brainstem nuclei associated w/ facial nerve:
Facial Nerve Brainstem Nuclei associated with the Facial Nerve
Descending nucleus of V (GSA) receives information from the skin of the posterior surface of the auricle.
Solitary nucleus receives SVA taste impulses from taste
buds on the anterior 2/3’s of the tongue. Motor nucleus of VII (SVE) innervates the muscles of
facial expression, stylohyoid, posterior digastric, and
stapedius. Superior salivatory nucleus (GVE-p) supplies
preganglionic parasympathetic fibers to the sphenopalatine
and submandibular ganglia, which send postganglionic fibers to the lacrimal and submaxillary
glands, respectively.
Course of the Facial Nerve
Course of the Facial nerve The facial nerve exits the brainstem, passes through the internal auditory canal and enters the facial canal. The facial canal is a sigmoid-shaped tunnel embedded in the petrous temporal bone, and intimately associated with internal ear. The facial nerve exits the facial canal at the stylomastoid foramen. There are three branches of the facial nerve during its course through the facial canal. A lesion of the:
Nerve to the stapedius muscle results in hyperacusis.
Greater superficial petrosal nerve results in decreased
lacrimation. Chorda tympani nerve results in a loss of taste sensations from
the anterior 2/3’s of the tongue and decreased salivation from the
submaxillary glands.
Facial nerve branhes/muscles and clinical signs
Bell’s Palsy etiology, symptoms
What are the mimetic muscles and what innervates them
what are the muscles of facial expression and what specific branches innervate them
Muscles of the nose
Muscles around mouth, innervation
Superficial Vessels of the Face
Superficial Veins of the Face Angular vein is formed by the junction of the supratrochlear and supraorbital veins at the medial angle of the eye. In this region it has extensive anastomoses with tributaries of the superior ophthalmic vein. Inferior to the lateral nasal vein, it becomes continuous with the facial vein.
Infections in the region of the nose may spread to the veins and sinuses, which drain the brain via the anastomoses between the angular and ophthalmic veins.
Facial vein is located superficial and lateral to the facial artery. The course of the artery is tortuous while that of the vein is straight. It drains the infraorbital, cheek (via the deep facial vein), and mental regions.
The facial vein usually crosses the external carotid and empties into the internal jugular vein at or below the level of the hyoid. Frequently, the facial vein drains into the anterior jugular via a communicating vein.
Retromandibular vein is a short vein is formed by the junction of the superficial temporal and maxillary veins. It is located deep to the mandible, parotid gland and the facial (VII) nerve, and lateral to the external carotid artery. The retromandibular vein is an important landmark in the dissection of the facial nerve. The retromandibular vein drains the temporal and cheek regions. The retromandibular vein usually joins with the posterior auricular to form the external jugular vein. Terminal Tributaries of the Superficial Face
Supraorbital and Supratrochlear veins drain into the angular vein.
Infraorbital vein drains into the pterygoid plexus.
Mental vein drains into the pterygoid plexus.
Veins of the face
Cutaneous nerves of the Trigeminal CN 5
-V1, V2, V3 and what they supply
Ophthalmic Division (V1)
Supraorbital nerve supplies the skin of the lateral aspect of the forehead and scalp. Supratrochlear nerve supplies the skin of the medial aspect of the forehead and scalp.
Maxillary Division (V2)
Infraorbital nerve supplies the skin of the antero-superior cheek region. Zygomaticofacial nerve supplies the skin of the malar prominence.
Mandibular Division (V3)
Auriculotemporal nerve supplies the skin of the temporal region. Buccinator nerve or buccal branch of V
The buccinator nerve (long buccal nerve) supplies the mucous membrane and skin of the inner and outer cheek, respectively. The buccinator nerve does not innervate the buccinator muscle. Mental nerve supplies the skin of the chin region.
