The Face

Question 1

What is the origin of the orbicularis oculi muscle?

Answer 1

Medial palpebral ligament

Question 2

Which part of the orbicularis is responsible for closing the eyelids gently?

Answer 2

Palpebral part

Question 3

Which part of the orbicularis is responsible for closing the eyelids forcefully?

Answer 3

Oribital part

Question 4

Which muscle has both a transverse and alar part which compresses the nasal aperture and draws the cartilage inferiorly and laterally to open the nostril?

Answer 4

Nasalis

Question 5

Which muscle pulls the nose inferiorly?

Answer 5

Depressor septi

Question 6

Which muscles draws down the medial angle of the eyebrows to produce transverse wrinkled over the bridge of the nose?

Answer 6

Procerus

Question 7

What is the name of the muscle which surrounds the mouth and is important in closing the lips?

Answer 7

Orbicularis oris

Question 8

Which muscle presses the cheek against the teeth and compresses the distended cheeks?

Answer 8

Buccinator

Question 9

Which muscle draws the corner of the mouth inferiorly and laterally?

Answer 9

Depressor angel oris

Question 10

Which muscle draws the lower lip downwards?

Answer 10

Depressor labii inferioris

Question 11

Which muscle draws the upper lip upwards?

Answer 11

levator labii superioris

Question 12

Which muscle raises the upper lip and opens the nostril?

Answer 12

Levator labii superioris alaeque nasi

Question 13

Which muscle attaches to the anterior part of the lateral surface of the zygomatic bone?

Answer 13

Zygomaticus minor

Question 14

Which muscle attaches to the posterior part of the lateral surface of the zygomatic bone?

Answer 14

Zygomaticus major

Question 15

Which muscle draws the ear superiorly and anteriorly?

Answer 15

Anterior auricular

Question 16

Which muscle elevates the ear?

Answer 16

Superior auricular

Question 17

Which muscle draws the ear superiorly and posteriorly?

Answer 17

Posterior auricular

Question 18

Which muscle attaches from the skin of the eyebrows to the galae aponeurotic to wrinkle the forehead and raise the eyebrows?

Answer 18

Frontal belly of the occipitofrontalis

Question 19

Which muscle attaches from the lateral part of the superior nuchal line of the occipital bone and mastoid process of temporal bone to the galae aponeurotic to draw the scalp posteriorly?

Answer 19

Occipital belly of the occipitofrontalis

Question 20

What is the name of the common tendon shared by the occipital and frontal bellies of the occipitofrontalis muscle?

Answer 20

Epicranial aponeurosis

Question 21

From which artery does the facial artery arise?

Answer 21

External carotid artery

Question 22

The facial artery runs along the mandible just anterior to the master. T/F?

Answer 22

True

Question 23

Other than the facial artery, what is the terminal branch of the external carotid artery?

Answer 23

Superficial temporal artery

Question 24

From which artery does the transverse facial artery arise?

Answer 24

Superficial temporal artery

Question 25

Along which bone does the transverse facial artery traverse?

Answer 25

Zygomatic bone

Question 26

From where does the CN VII emerge from the cranium?

Answer 26

Stylomastoid foramen

Question 27

Which nerve is immediately given off from CN VII after it emerges from the stylomastoid foramen?

Answer 27

Posterior auriclar nerve

Question 28

Through which gland does the facial nerve travel?

Answer 28

Parotid gland

Question 29

What are the five bundles of terminal branches of the facial nerve?

Answer 29

Temporal, zygomatic, buccal, marginal mandibular and cervical

Question 30

Which branch of the facial nerve crosses the zygomatic arch to supply the auricular superior, frontal belly of the occipitofrontalis and superior part of orbiculares occult?

Answer 30

Temporal branch

Question 31

What muscles are supplied by the zygomatic branch of the facial nerve?

Answer 31

Inferior part of the orbicularis occult and other facial muscles inferior to the orbit

Question 32

Which branch of the facial nerve innervates the buccinator and muscles of the upper lip?

Answer 32

Buccal branch

Question 33

Which branch of the facial nerve innervates the muscles of the lower lip and chin?

Answer 33

Marginal mandibular branch

Question 34

Which branch of the facial nerve innervates the platysma?

Answer 34

Cervical branch

Question 35

How can facial nerve function be examined?

Answer 35

Inspect face for asymmetry, watch for fascinations, ask patient to raise their eyebrows, ask patient to screw their eyes tightly shut and resist you opening them, ask the patient to bare their teeth and ask the patient to blow out their cheeks with their mouth closed

Question 36

How would a unilateral LMN lesion of CNVII present?

Answer 36

Weakness of both upper and lower facial muscles

Question 37

How would a unilateral CNVII UMN lesion present?

Answer 37

Weakness in the lower facial muscles with relative sparing of the upper face

Question 38

What are the three pairs of large salivary glands?

Answer 38

Parotid, submandibular and sublingual

Question 39

Which muscle does the parotid gland penetrate to open into the oral cavity?

Answer 39

Buccinator muscle

Question 40

Where do the parotid glands lie?

Answer 40

Shallow triangular shaped trench formed by the sternocleidomastoid muscle behind, the rams of the mandible in front and the external acoustic meatus and posterior aspect of the zygomatic arch.

Question 41

Which salivary glands are the largest?

Answer 41

Parotid glands

Question 42

Which salivary gland opens into the small sublingual papilla?

Answer 42

Submandibular glands

Question 43

Which salivary glands are the smallest of the salivary glands?

Answer 43

Sublingual glands

Question 44

The sublingual gland drains into the oral cavity via several small ducts which open onto...?

Answer 44

The crest of the sublingual fold

Question 45

There is hormonal control of salivary secretion. T/F?

Answer 45

False

Question 46

An increase in blood flow to the salivary glands causes an increase in saliva secretion. How is this mediated?

Answer 46

Increased parasympathetic neural activity

Question 47

The superior and inferior labial branches and the lateral nasal branch are branches of which artery?

Answer 47

The facial artery

Question 48

From which artery do the infraorbital artery, mental artery and buccal artery arise?

Answer 48

Maxillary artery

Question 49

Which branch of the maxillary artery supplies the chin?

Answer 49

Mental artery

Question 50

Which branch of the maxillary artery supplies the lower eyelid, upper lip and area between these structures?

Answer 50

Infraorbital artery

Question 51

Via which branch does the internal carotid artery supply the face?

Answer 51

Ophthalamic artery

Question 52

The facial vein drains the majority of blood from the face. Where does this vein drain to?

Answer 52

Internal jugular vein

Question 53

The transverse facial vein follows the course fo the transverse facial artery. Where does this vein drain?

Answer 53

Into the superficial temporal vein

Question 54

There are connections between the facial vein and the deeper intracranial veins. Why is this clinically relevant?

Answer 54

Infections of the face, particularly above the mouth, may spread in an intracranial direction via these anastomoses

Question 55

What are the three terminal branches of CN V?

Answer 55

ophthalmic nerve maxillary nerve mandibular nerve

Question 56

Which of the three terminal branches of CN V carries both sensory afferents and motor efferents?

Answer 56

Mandibular nerve

Question 57

The ophthalmic division of the trigeminal nerve carries sensory information from which structures?

Answer 57

Eyes, conjunctiva, lacrimal glands, nasal cavity, frontal sinus, fall cerebri, upper eyelid and dorsal of the nose

Question 58

The maxillary division of the trigeminal nerve carries sensory information from which structures?

Answer 58

Nasopahrynx, palate, nasal cavity, teeth of the upper jaw, maxillary sinus and skin covering the side of the nose, lower eyelid, cheek and upper lips

Question 59

The mandibular division of the trigeminal nerve carries sensory information from which structures?

Answer 59

lower lip, anterior part of the external ear, external acoustic meatus, anterior two third of the tongue and teeth of the lower jaw

Question 60

Which muscles are innervated by the mandibular portion of the trigeminal nerve?

Answer 60

Muscles of mastication - temporals, master, medial and lateral pterygoids tensor tympani muscle tensor veli palatini muscle anterior belly of the digastric muscle

Question 61

Describe the histology of the salivary glands?

Answer 61

Consists of lobules surrounded by a fibrous capsule Ech lobule/acinus is made up of acing cells which are drained by ductules that join up to from larger ducts which lead into the mouth myoepithelial cells extent over surface of acing

Question 62

Salivary secretion is under hormonal control. T/F?

Answer 62

False - it is under nervous control only

Question 63

What are the main constituents of parotid gland secretions?

Answer 63

Alpha amylase and IgA

Question 64

Which salivary gland has the largest output volume?

Answer 64

Submandibular glands

Question 65

The primary salivary secretions are isotonic as sodium is transported actively by the sodium/potassium pump and this allows secondary active transport of other electrolytes alongside the passive movement of water through what channels?

Answer 65

Aquaporin 5 channels

Question 66

Why is the final salivary secretions hypotonic?

Answer 66

Because in secondary modification of the salivary secretion there is movement of ions without concomitant water movement

Question 67

Why does the pH of saliva increase from 6.2 to 7.4 when salivary secretion rates are increased?

Answer 67

Increased salivary secretion rate allows less time for reabsorption resulting in saliva with increased sodium, bicarbonate and chloride content In particular, the increase bicarbonate results in increased pH

Question 68

What is a salivary mucocele?

Answer 68

A cyst which arises in connection with minor salivary glands

Question 69

What is the appearance of salivary mucoceles?

Answer 69

Blue/translucent swelling under the lining of the mouth

Question 70

How are salivary mucoceles treated?

Answer 70

Surgical removal