Superficial Face Flashcards
Describe trigeminal neuralagia
Tic douloureux: sensory disorder of the tirgeminal nerve, characterized by sudden attacks of excruciating facial pain; predominantly affects V2 and V3; most cases probably due to compression of nerve root by blood vessels
What are the facial nerve branches in the face?
Tiny, zebra, bit, my, cheek; Temporal, zygomatic, buccal (NOT TO BE CONFUSED WITH BUCCAL N OF TRI), mandibular, cervical
Describe Bell’s Palsy
Unilateral facial nerve paralysis; idiopathic, injury, cold, disease (herpes, lyme); cant blink, pucker lips, cant keep food in mouth while chewing
What is the treatment for Bell’s Palsy?
Steroid to reduce inflammation, antivirals, and eyedrops; for idiopathic causes: 80% recovery
What is the arterial supply for the for the superficial face and scalp?
External carotid arteries
What branches of the internal carotid supply the superficial face and scalp?
Supra-orbital artery and the supratrochlear artery
What are the branches of facial artery?
Superior and inferior labial aa. And angular a.(terminal branch)
What is the terminal branch of the inferior alveolar a that supplies the face?
Mental a
What arteries anastomose at the top of superficial head?
Supratrochlear, supra-orbital, superficial temporal, posterior auricular artery, occipital aa.
Veins of the face drain to what?
External jugular veins
What part of the face is most expressive?
the mouth
What consists of muscle fibers that encircle the opeing of the mouth?
Orbicularis oris
When the orbicularis oris contracts what happens?
the mouth closes
What muscle causes a frown?
Depressor anguli oris
What muscles causes you to blink/close eyes?
Orbicularis oculi
What muscle causes a smile?
Zygomaticus major
What muscle causes you to close mouth/kiss?
Orbicularis oris
What muscle causes you to wrinkle forehead, raise eyebrows
Frontal belly of occipitofrontalis
What muscle tense skin of neck?
Playtsma
What is the largest salivary gland?
Parotid gland
Where is the parotid gland and duct is located?
located laterally in the face, just anterior and inferior to the ear
What does the parotid gland and duct receive its sensory innervation from?
Great auricular nerve
Parasympathetics of the paratid gland and ducts is via?
Glossopharyngeal n IX via posterior auricular n (postsynaptic from otic ganglion)
Where does the parotid duct deliver saliva?
To oral cavity, just lateral to the 2nd upper molar teeth
What are the parasympatheic actions of the facial nerve?
Salivation, tear productrion and nasal mucosa
What are the general sensory functions of the facial nerve?
Parts of the ear
Facial nerve provides motor to some neck muscles and muscle of middle ear True or False?
TRUE
What is the orbit?
A bony and soft tissue structure that houses the eye ball but also transmits vessels and nerves to the area surrounding the ocular region and the upper face
What is a layered organ that contains the optical apparatus of the visual system?
Eyeball
What is the function of the buccinator m? What is the innervation?
Compresses check, holds food between teeth during chewing. CN VII
What is the function of the depressor anguli oris m? Innervation?
Draws corners of mouth inferiorly and laterally
CN VII
What is the function of the depressor labii inferioris m? Innervation?
Draws lower lip inferiorly
CNVII
What is the function of levator anguli oris m? innervation?
Draws corners of mouth superiorly and laterally
CNVII
What is the function of levator labii superioris m? innervation?
Opens lips; raises and furrows the upper lip
CNVII
What is the function and innervation of mentalis m?
Protrudes lower lip; wrinkles chin
CNVII
What is the function and innervation of orbicularis oris m?
Compresses and purses lips
CNVII
What is the function and innervation of risorius m?
Draws corner of lip laterally; tenses lips; synergist of zygomaticus
CNVII
What is the function and innervation of zygomaticus major m?
Elevates corner of the mouth
CNVII
What is the function and innervation of zygomaticus minor?
Elevates corner of the mouth
CNVII
What creates the roof of the orbit?
sphenoid bone
frontal bone
What creates the lateral wall of orbit?
frontal bone
sphenoid bone
zygomatic bone
What creates the medial wall of orbit?
sphenoid bone
ethomoid bone
maxillary bone
lacrimal bone
What creates the floor of orbit?
palatine bone
maxillary bone
zygomatic bone
Nerves to the orbit and eyeball enter the orbit via what fissure ?
The superior orbital fissure in the sphenoid bone
*except optic nerve,
What does the optic nerve enter the orbit via?
optic foramen
What are the somatomotors to the extrinsic eye muscles?
Occulomotor n CNII
Trochlear n CNIV
Abducent n CN VI
What are the secretomotor (autonomics) to the eye?
Parasym = short cilliary nerves (postsynaptic from occulomotor n) Parasym= lacrimal nerve (postsynaptic from facial n) Sympath = long ciliary nerves (from carotid plexus) and short ciliary nerves
What are the somatosensories of the eye?
Opthalmic division of trigeminal (CN VI) (frontal n, nasociliary, infratrochlear n)
What is the special sense vision n for the eye?
optic nerve (CN II)
What is the main arterial supply to the orbit and eyeball?
Ophthalmic artery (branch of internal carotid a)
The venous drainage of the eye and optic is via what?
Superior and inferior ophthalmic veins
to cavernous sinus or pterygoid venous plexus
What are the layers of the eyeball?
Fibrous, vascular and inner layer
What makes up the fibrous layer of the eyeball?
outer layer consists of sclera and cornea
What makes up the vascular layer of the eyeball?
Middle layer consists of choroid, ciliary body and iris
What makes up the inner layer of the eyeball?
inner layer consists of retina (visual and nonvisual parts)
What is the sclera?
opaque outer covering
What is the cornea?
transparent part of sclera
What is the choroid?
Layer between sclera and retina; very vascular
What is the ciliary body?
Muscular, provides attachment for lens and connects choroid to iris; controls thickness of lens; secretes aqueous humor
Ciliary muscles are controlled by parasympathetics
What is the anterior chamber?
chamber of the eye between cornea and iris/pupil
What is the posterior chamber?
chamber of the eye between iris/pupil and lens
What is the iris?
pigmented (gives each person their eye color) and is capable of constricting to control how much light enters the pupil
What is the dilator pupillae m?
muscle of the iris that dilates the iris under sympathetic control
What is the sphincter pupillae m?
Muscle of the iris that constricts the iris; under parasympathetic control
In the absence of nerve stimulation the ciliary muscle is relaxed causing the lens to do what?
Since the zonular fibers are under tension, it causes the lens to stretch thin to refract light for distant vision
In the presence of parasympathetic stimulation, the ciliary muscle is contracted causing the lens to do what?
Since the zonular fibers are now more relaxed, the lens has internal tension and becomes more spherical to refract light for near vision
What is the optic portion of the retina?
Visual portion: sensitive to light and has a pigmented layer (reduces scattering of light) and a neural layer (light receptive)
What is the nonvisual portion of the retina?
An anterior continuation of pigmented layer associated with iris and ciliary body
Where does the retina receive its blood from?
Central artery of the retina (from opthalmic a)
The back of the eye contains a distinct circular area called what?
optic disc
Where are the sensory nerve endings of the optic nerve concentrated?
optic disc
What is lateral to the optic disc and functions in visual acuity?
macula lutea
What is another name for extrinsic eye muscles?
extraocular muscles
What is the function of the extrinsic eye muscles?
moves the eyeball
Why are the eye muscles called extrinsic?
because they originate within the orbit and insert onto the sclera (2 intrinsic mm)
What are the six extrinsic eye muscles?
rectus m
medial, lateral, inferior, superior
oblique m
inferior, superior
What is the function and innervation of the medial rectus m?
moves eyeball medially (adducts)
CN III
What is the function and innervation of the lateral recuts m?
laterally (abducts)
CN VI
What is the function and innervation of the inferior rectus m?
inferiorly (depresses eye) and medially (adducts)
CNIII
What is the function and innervation of the superior rectus m?
Superiorly and medially
CNIII
What is the function and innervation of the inferior oblique m?
Moves eye superiorly and laterally
CNIII
What is the function and innervation of the superior oblique m?
Inferiorly and laterally
CN IV
What causes strabismus?
a lack of coordination between the eyes. They eyes look in different directions and do not focus at the same time on a single point
What happens to the non-dominant eye with strabismus?
lazy eye becomes weaker over time and loses visual acquity (amblyopia)
What can lead to strabismus?
birth injuries, diseases localized to eye or orbit, improper muscle attachment, heredity
What is external strabismus?
damage to CN III (knocks out medial rectus) pulls eye laterally
What is internal strabismus?
damage to abducens nerve which knocks out lateral rectus. eye pulled medially
What is the general rule for cranial nerves and spinal nerves?
Cranial nerves innervate anterior head and face, while spinal nerves innervate posterior head and scalp
What is the somatosensory for the anterior face?
Trigeminal Nerve V
What is the somatosensory for the posterior head?
Greater, lesser occipital nerve and greater auricular nerve (C2, C3)
What is the somatomotor for the anterior face?
Facial nerve VII
What does the CN V1 innervate?
Supra-orbital, supratrochlear, lacrimal, infratrochlear, and external nasal (opthalamic division)
What does the CN V2 innervate?
Infra-orbital, zygomaticofacial and zygomaticotemporal (maxillary divison)
What does the CN V3 innervate?
Mental, buccal, auriculotemporal (mandibular divison)
