Scalp & Superficial Face Flashcards
The scalp is composed of 5 layers, which are what?
Skin CT (Dense) Aponeurosis Loose CT Pericranium
***Layers make word SCALP
This layer of the scalp has abundant arterial supply and glands.
Skin
This layer of the scalp is a thick dense, richly vascularized subcutaneous layer. It also has nerves.
CT (Dense)
This layer of the scalp is a broad strong tendinous sheet and is the attachment for muscles.
Aponeurosis
This layer of the scalp is a sponge-like layer and is a potential space.
Loose CT
This layer of the scalp is a dense layer of CT that forms the external periosteum of the neurocranium.
Pericranium
What layers come off when a person is “Scalped”?
1st 3 layers – Skin, CT (dense), and Aponeurosis
When there is a scalp injury (i.e., being scalped), how is it possible for a person to fully heal with the vasculature intact?
The neurovascular supply of the scalp is from inferior to superior, so if the top layers of the scalp are ripped off then the neurovasculature is still intact and can supply the remaining areas. We can reapply and suture the scalp and reattach vessels.
These veins connect the outside of the scalp to the inside, and are located in the Loose CT layer. If there is an infection here, it can get into the venous sinuses.
Emissary Vs.
What layer of the scalp does an infection usually occur?
Loose CT
If the scalp is cut into, what layer does it have to reach for it to be a “gaping” wound?
Aponeurosis
***Anything superficial to this is considered “non-gaping”
What is included in the superficial face?
Parotid gland and duct Cutaneous Ns. -- Great Auricular N. Facial N. -- 5 branches Muscles of facial expression Muscles of mastication Facial A. and V.
What muscle does the Parotid duct dive into?
Buccinator M.
What layer of fascia surrounds the Parotid gland?
Investing Layer of Deep Cervical Fascia
***Remember, this is why mumps are so painful! Gland swells and because of fascia it can’t move.
What nerve, artery, and vein are within the Parotid Gland?
Facial N.
External Carotid A.
Retromandibular V.
What are the muscles of facial expression?
Frontalis (Occipitofrontalis) Orbicularis Oculi Levator Labii Superioris Zygomaticus (Major and Minor) Risorius Orbicularis Oris Platysma Buccinator
This muscle of facial expression connects to the aponeurosis.
Frontalis (Occipitofrontalis)
This muscle of facial expression closes the eyes.
Orbicularis Oculi
This muscle of facial expression closes the mouth.
Orbicularis Oris
This muscle of facial expression keeps cheeks taut during chewing.
Buccinator
This muscle of facial expression is at the corners of the mouth.
Risorius
What nerve innervates the muscles of facial expression?
CN VII (Facial)
What embryologic component develops the muscles of facial expression?
2nd Pharyngeal Arch
What are the muscles of mastication?
Temporalis
Masseter
Medial Pterygoid
Lateral Pterygoid
These muscles are deep to the Masseter M.
Medial Pterygoid
Lateral Pterygoid
What innervates the muscles of mastication?
CN V(V3) - Mandibular branch of Trigeminal N.
Where does the Facial N. exit the skull?
Stylomastoid Foramen
What are the branches of the Facial N.?
Temporal Zygomatic Buccal Mandibular Cervical
***To Zanzibar By Motor Car
T/F. The Facial N. has a motor and sensory root.
True
What is the sensory innervation provided by the Facial N.?
- Taste to the anterior 2/3 tongue via Chorda Tympani
What is the parasympathetic innervation provided by the Facial N.?
- Fibers to the Lacrimal Gland, Submandibular Gland, and Sublingual Glands
What branch of the Facial N. supplies the Submandibular and Sublingual Glands?
Chorda Tympani
What branch of the Facial N. supplies the Lacrimal Glands to help produce tears?
Greater Petrosal N.
***Remember, Lesser Petrosal N. (CN IX) branches and goes to the Otic Ganglion and supplies the Parotid Gland!
What cranial nerves carry preganglionic parasympathetic fibers?
CN III, VII, IX, X
What cranial nerves carry postganglionic parasympathetic fibers?
CN V (fibers travel along its branches)
If there is an injury to the Facial N., and the patient has droopy eyes and can’t raise one side of their mouth, what could this be?
Bell’s Palsy
Review Facial N. chart - Slide 14!!!
Review 5 minutes
This nerve provides cutaneous (sensory) sensation to the face and motor to muscles of mastication.
CN V
What are the branches of CN V?
V1 - Ophthalmic (sensory)
V2 - Maxillary (sensory)
V3 - Mandibular (sensory and motor)
What are the branches of CN V1 (Ophthalmic) that provide cutaneous innervation?
Supraorbital N. (more lateral)
Supratrochlear N. (more medial)
What are the branches of CN V2 (Maxillary) that provide cutaneous innervation?
Infraorbital N.
Zygomaticofacial N.
Zygomaticotemporal N.
What are the branches of CN V3 (Mandibular) that provide cutaneous innervation?
Mental N.
Buccal N.
Auriculotemporal N.
***Remember, there is a Buccal branch off CN VII (Facial) too. Don’t mix them up!
What nerves from the Cervical Plexus provide cutaneous innervation to the neck/head?
Lesser Occipital N. (C2-3)
Great Auricular N. (C2-3)
Transverse Cervical N. (C2-3)
Supraclavicular N. (C3-4)
What nerves from the dorsal rami of cervical spinal nerves supply cutaneous innervation to the head/neck?
Greater Occipital N. (C2)
3rd Occipital N. (C3)
This branch of the Trigeminal N. (CN V) provides motor innervation to the muscles of mastication.
CN V3 (Mandibular)
This presents as shingles or chicken pox, and affects the branches of the Trigeminal N. Depending on which branch it affects, the lesions will appear in that area. V1 would be forehead and bridge of nose, V2 is sides of nose and maxilla area, and V3 is in the mandibular area.
Herpes Zoster
What are the main blood vessels within the superficial face?
Facial A. and V. Superficial Temporal A. and V. Transverse Facial A. and V. Supraorbital A. and V. Supratrochlear A. and V.
What does the Supraorbital A. and Supratrochlear A. branch from?
Internal Carotid A.
The Superficial Temporal A. runs with what nerve?
Auriculotemporal N.
This is a branch of the Facial A. and it anastomoses with the Supratrochlear A.
Angular A.
These are branches off the Facial A. and they anastomose on either side.
Superior Labial A.
Inferior Labial A.
This is a smaller terminal branch of the ECA.
Superficial Temporal A.
This artery branches off the Superficial Temporal A. within the Parotid Gland.
Transverse Facial A.
This vein connects back to the Pterygoid Venous Plexus, which can then drain back to the Cavernous Sinus. This can be bad in the event of infection.
Deep Facial V.
These veins feed back into the Cavernous Sinus, and connect with the Angular V.
Superior Ophthalmic V.
Inferior Ophthalmic V.
These LNs from the Superficial Ring (Pericervical collar) drain into the Deep Cervical LNs.
Submental LNs
Submandibular LNs
Parotid (Pre-Auricular) LNs
These LNs from the Superficial Ring (Pericervical collar) drain into the Superficial Cervial LNs, which will then drain into the Deep Cervical LNs.
Mastoid LNs
Occipital LNs
What are the two types of Deep Cervical LNs?
Jugulo-digastric
Jugulo-omohyoid
These LNs empty the lower lip, chin, and tip of tongue.
Submental LNs
These LNs empty the gingiva, teeth, lateral lower lip, and upper lip.
Submandibular LNs
These LNs empty the anterior ear and upper half of the face and scalp.
Parotid (Pre-Auricular) LNs
These LNs empty the posterolateral scalp.
Mastoid LNs
These LNs empty the posterior scalp and neck.
Occipital LNs
