Superficial Face and Scalp Flashcards
What layers make up the scalp proper?
Skin, dense connective tissue, aponeurosis
Parotid Gland Contents
Parotid plexus of the facial nerve (tiny zebra bit my cheek)
Retromandibular vein
ECA
Parotid Gland Innervation
CN IX to otic ganglion, hitch ride on auriculotemporal N ( CN V3)
Parotid Gland Location
from ear to lower mandible, can extend into subnmandibular triangle
on top of masseter M
duct on top of masseter but dives into buccinator M
CN V- Trigeminal (Cutaneous)
Sensory ganglion: trigeminal ganglion
anterior superior scalp and face-same distribution as facial motor to face except sensory
carry postgangliongic parasympathetic fibers via hitch hike onto it by CN IX
CN V- Trigeminal (Motor)
V3 only
Muscles of mastication
CN VII- Facial (Cutaneous)
greater petrosal N–> lacrimal gland
chorda tympani–> taste, submandibular and sublingual glands
CN VII- Facial (Motor)
Exits 1st internal acoustic meatus, exits 2nd through stylomastoid foramen to muscle
Muscles of facial expression (TZBMC)
Muscles of facial expression
PA 2 mesoderm
CN VII
Occipitofrontalis
Orbicularis Oculi
Levator Labii Superioris
Zygomaticus major and
minor
Risorius
BuccinatorBlood Supply to Superficial Face
Mainly branches of ECA:
Facial A
Inferior labial
Superior labial
Lateral nasal
Angular- superior
cheek, inferior eyelid
Occipital A- scalp of
back of head
Posterior Auricular A
Superficial Temporal A
Transverse facial-->
parotid gland and
duct
Branches of ICA:
Supraorbital A- muscles
of skin of forehead
and scalp, superior
conjunctivva
Supratrochlear A
Mental A: facial muscles and skin of chin
Anastomoses of Superficial Face
ICA to ECA
Supraorbital A (ICA) with Superficial temporal A (ECA) above eye/lateral forehead
Angular A (ECA) with Supratrochlear A (ICA) near nose
Veins of Face
Facial, supratrochlear, supraorbital, transverse facial veins
go to cavernous sinus via direct veins or pterygoid venous plexus (from deep veins)
how infections can spread
Cutaneous innervation of scalp and face
Trigeminal
Ophthalmic: superior orbital fissure
- -> Supraorbital (more lateral)
- -> Supratrochlear (more medial)
- –> Lacrimal
- –> Infratrochlear
- –> External nasal
Maxillary: foramen rotundum
- -> Infraorbital
- -> Zygomaticofacial
- -> Zygomaticotemporal
Mandibular: foramen ovale
- -> Auricotemporal (anterior ear)
- -> Buccal
- -> Mental
Cervical plexus:
- -> Great auricular N (skin over angle of lower mandible, inferior lobe of ear, parotid sheath)
- -> Lesser occipital N (scalp posterior to ear)
Cervical Nerves:
–> Posterior rami (C2-C3) innervate posterior scalp and back of neck
Skin
sweat and subaceous glands, hair follicles, vascular supply, lymph drainage
most superficial SCALP
Dense connective tissue
vascularized, cutaneous nerves, hold open arteries when wounded
Aponeurosis
connects occipitofrontalis and temporoparietalis muscles from forehead to occiput and temporal bones
Loose connective tissue
Allows free movement of scalp
What scalp layer can infection spread through quickly?
Loose connective tissue
base of skull to eyes and nose
Pericranium
Forms external periosteum
most deep SCALP
Why do cuts of the scalp bleed profusely?
Highly vascularized, dense CT holds arteries open
What is a detached scalp?
Cut through the aponeurotic layer, muscles on both sides pull opposite sides of wound so it stays open
nerves and BV inferior to superior, so can reattach
What is a non-gaping wound?
Cut up to dense connective tissue
Still held open so will bleed profusely but won’t gape
Lymphatic drainage of head and scalp
Superficial LN of pericervical collar drain the face and scalp
- -> Submental drain lower lip, chin, floor of mouth, tip of tongue, lower incisors
- -> Submandibular follows facial A and drains gums, teeth, tongue, upper lip and lateral lower lip
- -> Parotid drains anterior ear, anterolateral scalp, upper half of face
Drain into deep cervical LN that travel with IJV
- ->Mastoid drains posterolateral half of scalp
- -> Occipital drains posterior scalp and neckDrain into superficial cervical LN that travel with EJV
Which LN drain into deep cervical LN?
Submental, Submandibular, Parotid
Which LN drain into superficial cervical LN?
Mastoid, Occipital
Jugulo-digastric LC
Superior deep cervical LN
C3-C4 near posterior digastic M
Jugulo-omohyoid
Lower deep cervical LN
C6 inferior to omohyoid T
CN VII track
Internal acoustic meatus--> geniculate ganglion (not automatic ganglion)
--> through facial canal posterior to middle ear to give off Stapedius N and Chorda Tympani N
---->Stapedius dampens
sound
--> Chorda tympani goes
to taste anterior 2/3
tongue, parasymp to
submandibular and
sublingual glands
OR --> can go past canal to exit stylomastoid foramen--> muscles of facial expression, platysma, stylohyod, digastric (posterior belly)
Lesions of CN VII at internal acoustic meatus
Bell's palsy No tear production No dampening of sound No taste ant 2/3 No gland inn. of submandibular or sublingual (may not be noticeable)
Lesion of CN VII between Stapedius N and Chorda tympani N
+ tear production
+ normal hearing
no taste ant 2/3
no parasymp.
innervation
Bell’s palsy
Bell’s Palsy
Ipsilateral paralysis of facial muscles at or before stylomastoid foramen
Can’t close eye or blink
Will drool
Can’t pucker lips or suck
on straw
Can be caused by parotid excision if hit CN VII (runs through it)
Le Fort I Fx
maxilla, maxillary alveolar process, possibly pterygoid plates of spehoid
Le Fort II Fx
maxillary sinus, superomedially through infra-orbital foramina, lacrimals, ethmoids, nose, hard palate
Le Fort III Fx
superior orbital fissures, ethmoid, nasal, greater wings of sphenoid, frontozygomatic sutures, zygomatic arches
