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Neuroendocrine > Scalp & Superficial Face > Flashcards

Scalp & Superficial Face Flashcards

1
Q

What is the anatomical relationship between the parotid gland and the masseter M.?

A

parotid gland (and duct) lay on the masseter M.

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2
Q

What is the anatomical relationship between the parotid duct and the buccinator M.?

A

the parotid duct dives into the buccinator M.

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3
Q

What nerve passes through the parotid gland?

A

facial N.

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4
Q

What blood vessels pass through the parotid gland?

A

retromandibular V.

external carotid A.

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5
Q

What innervates the parotid gland?

A
  • glossopharyngeal N. for stimulation (CN IX)

- auricular temporal for sensory (branch of V3)

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6
Q

What is the action of occipitofrontalis M.?

A

wrinkles the forehead

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7
Q

What is the action of orbicularis oculi M.?

A

closes the eye

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8
Q

What is the action of orbicularis oris M.?

A

closes the mouth

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9
Q

What is the action of the buccinator M.?

A

keeps cheek taut during chewing

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10
Q

What is the action of depressor anguli oris M.?

A

depresses the angle of the mouth

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11
Q

What is the action of zygomaticus major M.?

A

elevates corners of the mouth

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12
Q

What is the action of zygomaticus minor M.?

A

elevates upper lip

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13
Q

What are the two main artery anastamoses of the superficial face?

A
  • angular A. and supratrochler A

- supraorbital A. and superficial temporal A.

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14
Q

What are the five layers of the scalp, superficial to deep?

A
  • skin
  • connective tissue (dense)
  • aponeurosis
  • loose connective tissue
  • pericranium
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15
Q

What layers form the scalp proper?

A
  • skin
  • connective tissue (dense)
  • aponeurosis
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16
Q

Which layers are highly vascularized?

A
  • dense connective tissue

- pericranium

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17
Q

What does the aponeurotic layer connect?

A

frontal and occipital bellies of occipitofrontalis M.

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18
Q

Which scalp layer is prone to infection?

A

loose connective tissue

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19
Q

What passage could a meningitis infection take to get into the cranial vault?

A

an emissary V. that drains into one of the dural venous sinuses

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20
Q

What makes the scalp bleed so profusely?

A

the vasculature is superficial

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21
Q

What do the occipital lymph nodes drain?

A

posterior scalp and neck

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22
Q

What do the mastoid lymph nodes drain?

A

posterolateral scalp

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23
Q

Are the occipital and mastoid lymph nodes deep cervical or superficial lymph nodes?

A

occipital and mastoid lymph nodes are superficial lymph nodes

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24
Q

What do the parotid lymph nodes drain?

A

anterior ear, upper half of face and scalp

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25
Q

What do the submandibular lymph nodes drain?

A

gingiva, teeth and lateral lips

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26
Q

What do the submental lymph nodes drain?

A

middle of lower lip
floor of oral cavity
apex of the tongue

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27
Q

What do the jugulo-digastric lymph nodes drain?

A

tonsils and throat

28
Q

Name the five main deep cervical lymph nodes in the head and neck?

A 
parotid lymph nodes
submandibular lymph nodes
submental lymph nodes
jugulo-digastric lymph nodes
jugulo-omohyoid lymph nodes
29
Q

What cutaneous areas have sensory innervation by V1?

A

forehead
upper eyelid
bridge of nose

30
Q

What cutaneous areas have sensory innervation by V2?

A

lower eyelid
lateral nose
cheek
upper lips

31
Q

What cutaneous areas have sensory innervation by V3?

A 
temple
mandible
lower lip
anterior 2/3 of tongue
lower teeth
32
Q

What cutaneous pattern does herpes zoster follow?

A

terminal branches of the trigeminal N.

  • most commonly V1
  • can cause corneal ulceration and scarring
33
Q

What causes Bell’s Palsy?

A

lesion of the facial N. (CN VII)

34
Q

What is the clinical presentation of Bell’s Palsy?

A

ipsilateral paralysis of muscles of facial expression

35
Q

What problems does Bell’s Palsy present for a patient?

A
  • saliva dribbles out of mouth
  • affected speech
  • local skin irritation from wiping tears/saliva
  • cannot close eye
  • food stuck in oral vestibule
36
Q

Blue Box: Facial Lacerations and Incisions

A
  • tend to gape
  • skin must be sutured carefully to prevent scars from muscle distration b/c of superficial muscles attached cutaneously
  • fluid and blood accumulate easily, leading to swelling and bruising
  • aging wrinkles are perpendicular to muscle fibers
37
Q

Blue Box: Scalp Injuries

A
  • scalp A’s protected by dense connective tissue
  • lots of anastamoses
  • soft tissue scalp flaps and removal of part of calvaria should include superficial temporal A.
  • -scalp flap remains attached inferiorly to preserve N’s and vessels
38
Q

What is the blood supply to the calvarial bones?

A

middle meningeal A.

39
Q

Blue Box: Scalp Wounds

A

-deep scalp wounds (penetrating the aponeurotic layer) gape if lacerated in the coronal plane bc the bellies of the occipitofrontalis M. pull in opposite directions

40
Q

Blue Box: Scalp Infections

A
  • blood/pus spreads easily in loose connective tissue
  • infection can pass into cranial cavity via emissary V’s
  • infection can’t spread into neck or laterally past zygomatic arches
  • infection CAN spread to to eyelid and root of nose
  • eyelid skin is the thinnest of the body and highly susceptible to accumulation of fluid
41
Q

Blue Box: Sebaceous Cysts

A
  • develop when gland ducts around hair follicles retain secretions
  • cysts move w/scalp bc they’re in the skin
42
Q

Blue Box: Cephalohematoma

A
  • difficult birth may cause rupture of multiple periosteal A’s that nourish calvarial bones
  • usually over parietal bone
  • bleeding b/c pericranium and calvaria
43
Q

Blue Box: Flaring of Nostrils

A

-habitual mouth breathers may have lost or diminished ability to flare nostrils

44
Q

Blue Box: Infraorbital Nerve Block

A
  • work on maxillary incisors
  • injection near infraorbital foramen at junction of oral mucosa and gingiva
  • careless injection could cause temporary paralysis of extraocular muscles or inadvertent injection into a blood vessel
45
Q

Blue Box: Mental and Incisive Nerve Blocks

A
  • to suture a lacerated lip
  • anesthetize skin and mucous membrane of lower lip and chin skin
  • injection into area of mental foramen, blocks mental N.
46
Q

Blue Box: Buccal N. Block

A
  • anesthetize skin and mucous membrane of cheek

- injection into retromolar fossa

47
Q

Blue Box: Trigeminal Neuralgia

A
  • middle aged and elderly
  • sudden, excruciating pain, lasts 15 or more mins
  • V2 frequently involved
  • set off by touching “trigger zone”
  • demyelination of axons in sensory root
48
Q

Blue Box: Lesions of Trigeminal N.

A
  • widespread anesthesia
  • -anterior half of scalp, face, cornea and conjunctive
  • -paralysis of muscles of mastication
  • -mucous membrane of nose and mouth
  • -anterior 2/3 of tongue
49
Q

What would happen if the facial N. had a lesion near the pons or proximal to the origin of the greater petrosal N. (proximal to geniculate gangltion)?

A
  • loss of motor functions
  • loss of gustatory
  • loss of autonomics
50
Q

What would happen if the facial N. had a lesion distal to the geniculate ganglion, but proximal to chorda tympani?

A
  • loss of motor functions
  • loss of gustatory
  • lacrimal gland NOT affected
  • loss of salivation by submandibular and submental glands
51
Q

What would happen if the facial N. had a lesion near the stylomastoid foramen?

A

-loss of motor function

52
Q

What is the most common cause of non-traumatic facial N. palsy (facial paralysis)?

A

inflammation near stylomastoid foramen

53
Q

What could be a traumatic cause of facial N. palsy (facial paralysis?

A

-Fx of temporal B.

54
Q

Facial N. palsy can follow exposure to what outside factor?

A

Cold (i.e. riding in a car with the window down)

55
Q

Name some risk factors for developing facial N. palsy.

A 
dental manipulation
pregnancy
vaccination
HIV
Lyme Disease
otitis media
56
Q

Blue Box: Compression of Facial A.

A
  • can be occluded by pressure against mandible where vessel crosses it
  • numerous anastamoses, so wounds bleed freely, but heal quickly
57
Q

Blue Box: Scalp Lacerations

A
  • bleed profusely, can be fatal
  • A’s don’t retract bc dense connective tissue holds them open
  • occipitofrontalis M. spasms cause gaping
58
Q

Blue Box: Squamous Cell Carcinoma

A
  • cancer cells from central part of lower lip, floor of mouth and apex of tongue drain into submental lymph nodes
  • cancer cells from lateral parts of lower lip drain into submandibular lymph nodes
59
Q

Blue Box: Infection of Parotid Gland

A
  • mumps is painful b/c investing layer of deep fascia resists swelling
  • severe pain when chewing b/c the gland wraps around posterior border of the ramus of the mandible and gets compressed against mastoid process when mouth is open
60
Q

Blue Box: Parotid Gland Disease

A

-pain in auricle, external acoustic meatus, temporal region and TMJ

–b/c auriculotemporal N. and great auricular N. send sensory to parotid gland AND to skin over temporal fossa and auricle

61
Q

Blue Box: Abscess in Parotid Gland

A
  • could be from gland and/or duct itself

- could be from abscess of dental origin

62
Q

Blue Box: Sialography of Parotid Duct

A
  • radiopaque fluid injected into duct by cannula through orifice of duct inside cheek
  • demonstrates parts of duct system that are displaced/dilated by disease
63
Q

What could block the parotid gland?

A

-a calculus (calcified deposit)

64
Q

Blue Box: Mandibular Nerve Block

A

-injection near mandibular N. where it enters the infratemporal fossa

  • injection through mandibular notch
  • -anesthetizes the auriculotemporal N., inferior alveolar N., lingual N. and buccal N.
65
Q

Blue Box: Inferior Alveolar Block

A
  • injection around mandibular foramen
  • -mandibular teeth, skin and mucous membrane of lower lip, labial alveolar mucosa and gingivae, and chin skin

-problems: may inject parotid gland or medial pterygoid M.

66
Q

Blue Box: Dislocation of TMJ

A
  • heads of mandible dislocate anteriorly
  • -mandible remains depressed, can’t close
  • careful during surgical procedures
  • -facial N. and auriculotemporal N.
67
Q

Blue Box: Arthritis of TMJ

A

-dental occlusion and clicking

Neuroendocrine (8 decks)

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