T4: Face and Scalp

Question 1

Lymphatic drainage of the forehead follows which artery? (MG)
A. Frontal artery
B. Maxillary artery
C. Facial artery
D. Opthalmic artery

Answer 1

C. Facial artery

The submandibular nodes drain the forehead and follow the facial artery

Question 2

Man is in a cave and scraps his head posterior to the vertex on stalactite. To which lymphatic node will the infection drain.

A. Upper Deep Cervical Nodes
B. Preauricular Nodes
C. Parotid Nodes
D. Submandibular Nodes

RFA

Answer 2

Ans. A- Upper Deep Cervical-drains posterior to the vertex

B & C- Drain Anterior to the vertex

D. Drains the forehead

Question 3

Boxer takes punch to the head causing lacerations. After a few weeks it is found a infection has spread to deep intracranial venous structures. Which of these veins or sinuses is not possibly responsible for the spread of the infection to the deep intracranial venous structures?

A. Infraorbital vein 
B. Ophthalmic veins
C. Cavernous Sinus
D. Pterygoid plexus
E Supratrochlear Vein

RFA

Answer 3

E. Supratrochlear

Question 4

Lebron James dunks over Draymond Green to seal a finals victory for the Cavs. As he leaves the court. He grins victoriously. Which muscle is used for this action?

A. Levator anguli oris
B. Mentalis
C. Risorius
D. Orbicularis Oris
E. Zygomaticus maj/min
F.  Frontalis 
G. Platysma

RFA

Answer 4

Ans. C Risorius = grinning

A. Levator anguli oris- elevates corners of mouth

B. Mentalis- positions lips when drinking from a cup

D. Orbicularis oris

E. Zygomaticus Maj/min=smiling

F. Frontalis= move scalp. wrinkle the forehead

G. Platysma= embedded in to superficial cervical fascia

Question 5

A 55 year old man comes to your office with a lump just posterior to the tip of his chin. Upon imaging and later biopsy, the lump is identified to be a malignant tumor. Assuming metastasis, which lymph nodes would the cancer spread to first from the tumor site? (MG)
A. Submandibular nodes
B. Submental nodes
C. Pre-auricular nodes
D. Parotid nodes

Answer 5

B. Submental nodes

Submental nodes drain the chin and medial lower lip.

Submandibular nodes drain medial corner of orbit, external nose, medial cheek, upper lip, and lateral part of lower lip

Pre-auricular and parotid nodes drain eyelids, external nose, and lateral cheek

Question 6

Which of the following structures pass through the parotid gland? (MG)
A. CN VII
B. External carotid artery
C. Retromandibular vein
D. Superficial temporal vein
E. Maxillary vein
F. Transverse facial artery
G. A,B,C
H. D,E,F
I. All of the above

Answer 6

I. all of the above

Maxillary vein and superficial temporary vein are branches of the retromandibular vein and all pass through the parotid gland.

Transverse facial artery is one of several ECA branches and pass with it through the parotid.

Question 7

The Glossopharyngeal must synapse where ____ to innervate the parotid gland? (mm)

A) The Parotid Gland
B) Edinger Westphal
C) Auriculotemporal
D) Otic Ganglia 
E) Geniculate

Answer 7

Answer D

IX sends pregang pns to the otic ganglia where is then synapses and innervates the parotid via V3

Question 8

The Facial nerve component responsible for PNS is the?

mm

Answer 8

Answer: Nervous intermedius - err’thang except motor

Motor component = facial nerve proper

Question 9

Upon walking into the exam room you hear your patient whistling with his eyes closed. The patient complains that he’s been having difficulty in his opening his mouth lately and has been having extreme facial pain. You suspect the patient has a facial nerve injury. Is this a correct diagnosis?
(mm)

Yes?
No?

Answer 9

No this isn’t a correct diagnosis. The patient is able to close his eyes and whistle which are two major indications that his facial muscles and nerve is intact. Trouble opening the mouth is due to V3 w/ ur lateral pterygoid. The extreme pain is most likely trigeminal neuralgia

Question 10

A young brown boy named Ahmed wants to fit in with all the even weirder brown guys and decides to get a nose ring. As they puncture the lower right corner of his nose to insert the diamond encrusted jewel he screams in agonizing pain. Which of the following nerves are responsible for the sensation from that area? (mm)

A) Supratrochlear
B) Lacrimal
C) Infraorbital
D) External Nasal
E) Infratrochlear

Answer 10

Answer: C

D- anterior nose