Topic 8 - Anatomy of the Face and Scalp Flashcards

1
Q

Describe the vasculature of the parotid gland

A
  • Arterial - posteior auricular and superficial temporal arteries
  • Venous - retromandibular vein
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2
Q

Describe the attachments of the medial pterygoid

A
  • Deep and superficial parts
  • Attachments
    • Deep - lateral pterygoid plate of sphenoid bone
    • Superficial - maxillary tuberosity and palatine bone
    • Both - ramus of mandible
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3
Q

Describe the function of the depressor labii inferioris

A

Lowers bottom lip

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4
Q

Describe the attachment and function of the frontalis muscle

A
  • Attached to the epicranial aponeurosis
  • Function = raise eyebrows/wrinkle forehead
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5
Q

List the branches of the facial artery

A

Cervical branches:

  • Ascending pharyngeal artery
  • Tonsillar artery
  • Submental artery
  • Glandular artery

Facial branches

  • Inferior labial artery
  • Superior labial artery
  • Lateral nasal branch
  • Angular artery (terminal branch)
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6
Q

Describe the venous drainage of the face

A
  • Angular vein runs down side of nose, forms the facial vein
  • Facial vein drains most of face, drains to internal jugular vein
  • Other veins
    • Maxillary vein (follows artery)
    • Superficial temporal vein - drains forehead and scalp
  • Superficial temporal + maxillary = retromandibular vein
  • Posterior auricular vein + retromandibular vein = external jugular vein
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7
Q

Describe the location and structure of the masseter

A
  • Most superficial
  • Deep and superficial parts
  • Attachment:
    • Deep - zygomatic arch
    • Superficial - maxillary process of zygomatic bone
    • Both - ramus of mandible
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8
Q

Describe the arterial supply of the scalp

A
  • Branches of the external carotid artery - superficial temporal, posterior auricular and occipital arteries
  • Ophthalmic artery (branch of internal carotid) - supraorbital and supratrochlear
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9
Q

Describe the function of levator anguli oris

A

Elevates angle of mouth medially

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10
Q

Describe the venous drainage of the scalp

A
  • Superficial - follows arteries
    • Superficial temporal, occipital, posterior auricular, supraorbital, supratrochlear
  • Deep - pterygoid venous plexus, between temporalis and later pterygoid muscles, drains to maxillary veins
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11
Q

Describe the function of levator labii superioris alaque nasi

A

Elevates upper lip and wing of nose

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12
Q

Describe the function of orbicularis oris

A

Purses lips

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13
Q

Describe the positions of the medial and lateral pterygoids

A

Medial is inferior, lateral is superior

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14
Q

Describe the attachements of the lateral pterygoid muscle

A
  • Superior and inferior heads
  • Attachements
    • Superior - greater wing of sphenoid bone
    • Inferior - lateral pterygoid plate of sphenoid bone
    • Both - neck of mandible
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15
Q

Describe the embryological origin of the muscles of mastication

A

1st pharyngeal arch

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16
Q

Describe the embryological origin of the muscles of facial expression

A

2nd pharyngeal arch

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17
Q

Describe the location of the sublingual glands

A
  • On floor of oral cavity, under tongue
  • Borded laterally by mandible, medially by genioglossus muscle
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18
Q

Why is the aponeurosis clinically significant?

A

In scalp wounds, if the aponeurosis is torn through (especially in coronal plane due to pull of occipitalis and frontalis muscles) the wound will gape

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19
Q

Describe the parasympathetic innervation of the sublingual gland

A
  • Superior salivatory nucleus from chorda tympani
  • Synapses at submandibular ganglion
  • Increases salivation through secretomotor and vasodilator fibres
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20
Q

How are superficial scalp wounds usually treated?

A

Don’t gape, easily treated e.g. with glue

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21
Q

Describe the sensory innervation of the parotid gland

A

Auriculotemporal and great auricular nerves

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22
Q

What is the action of the temporalis muscle?

A

Elevates and retracts mandible

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23
Q

Which nerve innervates the muscles of mastication?

A

Mandibular division of the trigeminal nerve

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24
Q

Describe the parasympathetic innervation of the submandibular gland

A
  • Superior salivatory nucleus from chorda tympani
  • Follows lingual branch of mandibular nerve to submandibular ganglion
  • Increases salivation through secretomotor and vasodilator fibres
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25
Q

What is the function of the muscles of mastication?

A

Move the temporomandibular joint

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26
Q

List the structures which pass through the parotid gland

A
  1. Facial nerve - splits to give 5 terminal branches in the parotid gland
  2. External carotid artery - gives off posterior auricular artery and splits into terminal branches (maxillary and superficial temporal arteries)
  3. External Jugular - formed by retromandibular and posterior auricular veins in parotid gland
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27
Q

Describe the function of platysma

A

Draws the cornes of the mouth down and out, lifts the skin of the neck up

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28
Q

List the salivary glands

A
  1. Parotid
  2. Submandibular
  3. Sublingual
29
Q

Describe the parasympathetic innervation of the parotid gland

A
  • Glossopharyngeal nerve
  • Synapses with otic ganglion
  • Auriculotemporal nerve carries fibres to parotid gland
  • Increases saliva production
30
Q

Describe the loose areolar connective tissue of the scalp

A
  • Separates outer layers and pericardium - allows them to move independently
  • Scalping injuries = scalp torn off through this layer
  • Randomly arranged type 1 and 2 collagen bundles
31
Q

Describe the sympathetic innervation of the submandibular gland

A
  • Superior cervical ganglion
  • Follows carotid plexus to travel with facial artery
  • Then follows submental artery to gland
  • Decreases blood flow, decreases secretions
32
Q

Describe the drainage of the parotid gland

A

Parotid duct

33
Q

Why are scalp wounds often severe?

A
  • Because the blood vessels of the scalp are secured to the fibrous tissue of the superficial fascial layer if they are severed the cut ends don’t easily retract - bleed profusely
  • Loose connective tissue acts as space blood can collect in, small injury can produce large contusion
  • Veins from connective tissue drain into cranial cavity, infection from surface can spread intracranially
34
Q

Describe the blood supply of the submandibular glands

A
  • Arterial - submental artery from facial artery
  • Venous - submental vein, drains to facial vein
35
Q

Describe the appearance of the parotid glands

A

Irregular, lobular

36
Q

Describe the function of the procerus muscle

A

Furrows brow

37
Q

List the muscles of facial expression

A
  • Frontalis
  • Procerus
  • Orbicularis oculi
  • Levator labii superioris alaque nasi
  • Orbicularis oris
  • Risorius
  • Buccinator
  • Levator labii superioris
  • Depressor labii inferioris
  • Levator anguli oris
  • Depressor anguli oris
  • Platysma
  • Zygomaticus major and minor
38
Q

Describe the innervation of the scalp

A
  • Branches of the trigeminal and cervical nerves (C2/3)
    • Supratrochlear, supraorbital, zygomaticotemporal, auriculotemporal
39
Q

Describe the sympathetic innervation of the sublingual gland

A
  • Superior cervical ganglion
  • Plexus on carotid artery
  • Travels with facial artery branches to sublingual gland
  • Decreases salivation via vasoconstriction
40
Q

Where do the secretions of the submandibular salivary glands drain?

A
  • Secretions enter oral cavity via submandibular (Wharton’s) duct
  • 1-3 openings at base of lingual frenulum
41
Q

Describe the connective tissue of the scalp

A
  • Dense subcutaneous layer of fat and fibrous tissue
  • Contains nerves and vessels
42
Q

Describe the function of the buccinator muscle

A

Accessory muscle of mastication - pushes food between teeth

43
Q

List the layers of the scalp

A
  1. Skin
  2. Connective tissue
  3. Aponeurosis (galea)
  4. Loose areolar connective tissue
  5. Pericranium
44
Q

Describe the secretions of the sublingual glands

A

Mucous secretions

45
Q

Describe the aponeurosis of the scalp

A

Dense fibrous tissue, from frontalis muscle (anterior) to occipitalis muscle (posterior)

46
Q

Describe the course of the facial artery

A

Tortuous course - winding, allows for movement of the jaw without occlusion

47
Q

Describe the location of the parotid gland

A

In the parotid region:

  • Lateral border - sternocleidomastoid muscle
  • Medial border - masseter muscle
  • Superior border - zygomatic arch
  • Inferior border - inferior border of mandible
48
Q

Describe the function of zygomaticus minor

A

Elevates upper lip

49
Q

Describe the drainage of the sublingual glands

A

Secretions drain into oral cavity by minor sublingual ducts (of Rivinus), 8-20 per gland

50
Q

Describe the attachments of the temporalis muscle

A

Temporal fossa to coronoid process of mandible

51
Q

List the muscles of mastication

A
  1. Masseter
  2. Temporalis
  3. Medial pterygoid
  4. Lateral pterygoid
52
Q

Describe the function of depressor anguli oris

A

Pulls angle of mouth down

53
Q

Describe the location of the submandibular gland

A
  • Boundaries
    • Superior - inferior body of mandible
    • Anterior - anterior belly of digastric muscle
    • Posterior - posterior belly of digastric muscle
  • Hook shaped around mylohyoid muscle
54
Q

Where does the facial artery originate?

A

Branch of external carotid artery, arises in the carotid triangle

55
Q

List the branches of the external carotid artery involved in the blood supply of the face

A
  1. Facial artery
  2. Occipital artery
  3. Posterior auriclar artery
  4. Maxillary artery
  5. Superficial temporal artery
56
Q

Describe the function of zygomaticus major

A

Draws angle of mouth superior and posteriorly

57
Q

Describe the vasculature of the sublingual glands

A
  • Arterial - sublingual and submental arteries (from facial artery)
  • Venous - sublingual and submental veins (drain into facial vein)
58
Q

Which nerve supplies the muscles of facial expression

A

Facial nerve

59
Q

Describe the pericranium of the scalp

A
  • Periosteum of skull
  • Provides nutrition to bone and capacity for repair
60
Q

Describe the function of risorius

A

Draws the angle of the mouth backwards

61
Q

What is the action of the lateral pterygoid?

A
  • Depresses mandible
  • Bilaterally - protracts
  • Unilateral - moves laterally
62
Q

What is the function of the masseter muscle

A

Elevates the mandible

63
Q

Why is the temporalis muscle relevant in ENT surgery?

A

Covered by a tough fascia - can be harvested surgically to repair a perforated tympanic membrane

64
Q

Describe the function of levator labii superioris

A

Elevates upper lip

65
Q

Describe the structure and function of the orbicularis oculi muscle

A
  • Orbital and palpebral parts
  • Attached to median palpebral fissure medially
  • Orbital part function - tightly closes eye
  • Palpebral part function - blinking
66
Q

What is the action of the medial pterygoid?

A

Elevate the mandible

67
Q

Describe the sympathetic innervation of the parotid gland

A
  • Superior cervical ganglion, travels on carotid plexus
  • Decreases saliva production
68
Q

Describe the dermatomes of the head and neck

A
  • Branches of the trigeminal nerve supply the face
    • Ophthalmic - forehead, centre of nose, upper eyelids
    • Maxillary - cheeks, lower eyelids, upper lip
    • Mandibular - jaw, lower lip
  • C2 - side of jaw, ears, superior part of scalp
  • C3 - bottom of scalp, top of neck (under jaw)
  • C4/5/6 - continues down neck