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Anatomy > The Face > Flashcards

The Face Flashcards

1
Q

how many different categories of emotion can we signal by selective contraction and relaxation of facial muscles

A

more than 20

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2
Q

how are human faces distinctly different from our nearest living relatives

A

face relatively small
cranium large
remainder of the skull is more vertical in profile
our faces are tucked under the anterior aspect of the brain case (apes = brain more posterior to their face)

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3
Q

how many bones make up the facial skeleton

A

14

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4
Q

what 4 systems does the complex of facial bones house parts of

A

digestive
respiratory
visual
olfactory (smell)

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5
Q

how are the soft tissues of the face arranged

A

series of layers (nature of these layers varies in different parts of the face)

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6
Q

what are soft tissue layers connected together and to the underlying facial skeleton by

A

retaining ligaments (bundles of fibrous connective tissue)

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7
Q

what happens to soft tissues of the face with age

A

begin to sag and so retaining ligaments cause lines / creases to develop

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8
Q

how do the movements of the soft tissue cause wrinkles

A

retaining ligaments retain og length (relatively unchanged)

tissues around them get saggy bulging around the retaining ligament

bc the retaining ligament doesnt change a crease develops where it is as soft tissue bulges out

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9
Q

so what do facial creases indicate

A

position of retaining ligaments which are holding the face onto the skull

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10
Q

what can the soft tissues of the face be considered as

A

a single unit structure (called a FLAP in surgical context)

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11
Q

what does the face being a single unit structure enable in surgical terms

A

face transplant operations

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12
Q

how does face transplant work

A

soft tissues removed as single piece (flap) and transplanted onto reconstructed facial skeleton of the recipient

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13
Q

what can the outcomes of face transplants be

A

v acceptable cosmetic result

patients gain movement (motor function) and sensation in new face

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14
Q

what are the general layers of soft tissue

A

1) skin (most superficial)
2) subcutaneous tissue - fatty connective tissues
3) layer consisting of muscles and fibrous connective tissue (most deep)

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15
Q

what is the layer containing muscles of facial expression mixed with fibrous connective tissue that covers the whole of the face called

A

superficial musculoaponeurotic system (SMAS)

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16
Q

what are muscle parts of the SMAS examples of

A

muscles of facial expression (series of interconnected muscles which are ALL in this layer)

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17
Q

what do we know about the components of the SMAS

A

exact nature of distribution is disputed
muscles it contains are well known
fibrous tissue in it is intertwined w and connects muscles of facial expression

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18
Q

as an anatomical structure what is the SMAS

A

controversial

some people think it doesnt exist but its a key concept in modern plastic surgery esp facelifts)

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19
Q

why is “aponeurotic” included in the SMAS

A

an aponeurosis = flat tendon of muscle

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20
Q

what are the muscles encircling the eyes called

A

obicularis oculi

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21
Q

what is the muscle of the cheek called and where does it run

A

the buccinator

in the cheek attaching to the maxilla superiorly and mandible inferiorly (more substantial than most muscles of facial expression)

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22
Q

what is the name for the muscles encircling the corners of the mouth and where do they insert into

A

oral commisures

the modiolus lateral to them

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23
Q

what is dramatic at the oral commissures and why

A

difficulty of telling where one muscle ends and next one starts because they tend to blend together

because just lateral to each commissure several muscles of facial expression blend together.

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24
Q

which muscle encircles the opening of / orbits the mouth and what does it act as

A

obicularis oris

a sphincter (of the mouth) - purses lips

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25
Q

what is the name for a hub region where many muscles of facial expression merge together and WHY

where is this found

A

modiolus (pl; modioli, latin for wheel hub)

vaguely resembles wheel hub (hub of muscles with spokes sticking out)

lateral to corners of mouth

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26
Q

why are modioli important

A

in relation to functional movements of the oral sphincter

in facial development

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27
Q

what is the function of the frontalis muscle

A

pulls eyebrows upwards when you raise them in surprise

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28
Q

which 3 muscles alter the position of the oral commisures by moving the modiolus

A

1) depressor anguli oris
2) levator anguli oris
3) zygomatic major

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29
Q

which muscle/s pulls the commissure downwards when it/they contract/s

A

depressor anguli oris (because it is fixed at the bottom)

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30
Q

which muscle/s pull the commissure upwards when it/they contract/s

A

levator anguli oris

zygomatic major (also pulls it slightly BACKWARDS)

31
Q

which 3 muscles act to elevate or depress upper or lower lips

A

1) depressor labii inferioris
2) levator labii superioris
3) zygomaticus minor

32
Q

which muscle/s inserts into and acts to depress the lower lip

A

depressor labii inferioris

33
Q

which muscle/s act to elevate the upper lip

A

levator labii superioris

zygomaticus minor

34
Q

what is the ‘sulking’ muscle and what does it do / how does it work

A

the mentalis (mentum; latin for chin)

when these fibres are made shorter the soft tissue is moved up so lower lip moves up and so out (curls it out)

35
Q

what does the buccinator play important roles in

A

suckling (survival of babies)

controlling the bolus of food during chewing

36
Q

which band of fibrous connective tissue defines the posterior boundary of the buccinator

A

the pterygomandibular raphe

37
Q

which muscle is posterior to the pterygomandibular raphe + attaches to it

A

the superior constrictor of the pharynx

38
Q

how is the pterygomandibular raphe used clinically and why

A

landmark in IA nerve block procedure because IA nerve goes through mandibular foramen into mandible to supply lower teeth + many of associated gingivi

39
Q

what is the oxypatalis

A

connected to the frontalis by tendenous layer (epicranial aponeurosis)

40
Q

what is the risorius

A

pulls the modiolus laterally (backwards)

41
Q

where does the zygomaticus major run

A

rises from the zygomatic bone that also elevates the corner of the mouth

runs from the mastoid process downwards to blend into the modiolus

42
Q

where does the depressor angulie oris run

A

up from below (attached to the mandible)

no superior bony attachment it just ends

has muscular attachment as blends with other muscles at the modiolus

43
Q

where do the mentalis muscles run

A

attach superiorly

run downwards and medially

insert into soft tissue of lower lip / chin (mental region)

44
Q

where does the buccinator run

A

attached superiorly to the maxilla and INferiorly to the mandible

it is embedded in the cheek

45
Q

where does the pterygomandibular raphe run

A

between part of sphenoid bone (one of pterygoid plates) and the mandible

46
Q

a duct of which salivary gland pierces the buccinator to get into the mouth

A

parotid gland

47
Q

branches of which nerve run anteriorly across the face to supply motor function to all the muscles of facial expression

A

the facial nerve

48
Q

what type of nerve is the facial nerve

A

cranial nerve VII (we have 12 cranial nerves emerging from each side of our brain)

so it emerges directly from the brain

49
Q

how do branches of the facial nerve leave the skull

A

via foramina and fissures (gaps between bones)

emerge from the skull by travelling through a canal in the petrous part of the temporal bone - come out through a foramen in base of skull that lies just medial just on outside of the mastoid process

50
Q

what does motor branch of the facial nerve do once its emerged from the skull

A

almost immediately passes into and through (does NOT supply) the parotid gland which lies on the side of the face just anterior to the ear

in here it breaks up into a series of branches which emerge and run in different directions

51
Q

what is the correlation between facial nerves running through the parotid gland and IA nerve blocks

A

if administer it incorrectly

deposit anaethetic solution into the gland + block motor branches of the facial nerve running through it

temporarily paralysing that side of the patient’s face (FACIAL HEMI-PARALYSIS) BUT the teeth are not anaesthetised

52
Q

describe the branches of the facial nerve supplying the muscles of facial expression

A

purely motor = all nerves passing along these branches are motor nerve fibres

do nothing else but supply the muscles of facial expression

NO SENSORY FIBRES IN THIS PART OF FACIAL NERVE AT ALL

53
Q

what 5 groups are the branches of the facial nerve innervating the muscles of facial expression classified into
(hint = depends on region they supply)

A

1) temporal branches
2) zygomatic branches
3) buccal branches
4) mandibular branches
5) cervical branches

54
Q

where do the temporal branches run

A

uowards towards region of the temple (covered by temporalis muscle)

55
Q

where do the zygomatic branches run

A

parallel to zygomatic arch

56
Q

where do the buccal branches run

A

across cheek

a lot of these as a lot of muscles in the area

57
Q

where do the mandibular branches run

A

along inferior border of mandible and just underneath it

58
Q

where do the cervical branches run

A

some come down into neck (cervical relates to neck)

59
Q

what condition results in facial hemi-paralysis and why

A

bell’s palsy

facial nerve branches going to muscles of facial expressed get screwed up whilst travelleling through the petrous part of temple bone.
while running through this part the nerve gets affected by (in many cases) a virus resulting in this condition

60
Q

what is the difference between paralysis caused by bells palsy and messing up an IA nerve block

A

bells palsy lasts for a long time (often weeks) usually spontaneously resolving in most people BUT not all AND even if it does it tends to come back

IA block = resolves after a few hours

61
Q

what nerve supplies sensory function to the skin covering the face

A

the trigeminal nerve (cranial nerve V) - theres a right and a left one

(it innervates the oral cavity AND is main sensory nerve for entire face, including all skin covering it and most of cavities within it)

62
Q

what is present just after the trigeminal nerve leaves the brain

A

trigeminal ganglion

63
Q

what is the trigeminal ganglion

A

where all the cell bodies of the sensory nerve fibres travelling in the nerve are found

64
Q

which 3 nerves does the trigeminal ganglion give rise to

A

1) V1 = opthalmic nerve
2) V2 = maxillary nerve
3) V3 = mandibular nerve

(1st, 2nd + 3rd divisions of the trigeminal nerve)
labelled using V because trigeminal nerve is cranial nerve V

65
Q

why is the trigeminal nerve relevant

A

branches of it = targets of dental local anaesthetic procedures

when a nerve has been anaesthetised = specific region of the facial skin will become numb (ie lower lip with IA nerve block)

66
Q

where does its branches run and what part of the facial skin does the V1 opthalmic division of the trigeminal nerve provides sensory innervation to

A

1) through the orbits

some branches come out of orbit and over forehead passing backwards on the scalp to supply sensation

2) SO forhead and parts of scalp

67
Q

where does its branches run and what part of the facial skin does the V2 maxillary division of the trigeminal nerve provides sensory innervation to

A

1) forward underneath orbit and passes under it becoming the infraorbital nerve which then comes out through the infraorbital foramen

2) upper teeth + associated gingivi
infraorbital nerve supplies skin on middle part of anterior aspect of face

68
Q

where does its branches run and what part of the facial skin does the V3 mandibular division of the trigeminal nerve provides sensory innervation to

A

1) IA nerve runs inside canal in mandible + divides into 2 nerves at chin one of which being the mental nerve (comes out through mental foramen)

2) skin over lower part of face (lower lip and mucosa on inside of it)
skin infront of and above the ears

69
Q

what is the significance of the mental nerve given off by the IA nerve

A

if carry out IA nerve block successfully just as its going in through the mandibular foramen we will anaesthetise some of the associated gingivi and areas supplied by the mental nerve

70
Q

what does each nerve fibre have on it due to their thinness

A

a cell body with a nucleus in middle

71
Q

where are the cell bodies of all sensory nerve fibres running along branches of the trigeminal nerve

A

trigeminal ganglion (swelling to accomodate all the sensory cell bodies as when theyre collected together they take up a lot of room)

72
Q

what does ganglion mean when related to a nerve

A

swelling (where there are cell bodies associated with the nerves)

73
Q

which other type of nerve supplies some structures in the head and neck and where do these come from

A

spinal nerves

they emerge from the spinal cord (supply everything else in the body not supplied by the cranial nerves)

Anatomy (7 decks)

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