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Neurosciences > Week 2 Anatomy of the Face and orbit, eyelids, CN III, IV, VI > Flashcards

Week 2 Anatomy of the Face and orbit, eyelids, CN III, IV, VI Flashcards

1
Q

List the muscles of facial expression and their functions

A
  1. Frontalis muscle: “surprise” wrinkle forehead and raises eyebrows
  2. Orbicularis oculi: around orbital margin and eyelids. Close eyelids “blink/wink”
  3. Orbicularis oris: encircles and inserts into lips. pursing lips, protruding them, and compressing them against teeth. speech production. “whistling/kissing”
  4. Buccinator: inserts at angle of mouth and into orbicularis oris. keeps cheeks taut and keeps food away from cheek pouches and from entering vestibule of mouth
  5. Zygomaticus major: elevate labial commissure and used in “smiling”
  6. Platysma: depress mandible and tense skin of lower face and neck against resistance “grimace”
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2
Q

Describe the peripheral distribution of CN VII, the facial nerve

A

Exits from stylomastoid foramen

  • divides into temporal, zygomatic, buccal, mandibular, cervical branches, (nerve to stylohyoid muscle, nerve to posterior belly of digastric), posterior auricular nerve
  • Tiny zebra bite my clit please
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3
Q

Describe the clinical features of Bell’s palsy

A

site of lesion: below the stylomastoid foramen, where CNVII exits the skull

symptoms: ipsilateral
- drooping of mouth, drooling (orbicularis iris)
- drooping of eyelid and eversion (dry eye and tearing) (orbicularis oculi)
- accumulation of food between cheek and teeth when chewing (buccinator and orbicularis iris)
- inability to close eye or wrinkle forehead (frontalis and orbicularis oculi)

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4
Q

Describe the anatomical relationships of the parotid gland and the parotid duct

A
  • parotid gland: antero-inferior to external auditory meatus
  • parotid duct: passes horizontally over masseter muscle and pierces buccinator muscle. Enters oral cavity near 2nd maxillary molar
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5
Q

Describe the innervation of the parotid gland

A

Inferior salivatory nucleus (para/pre cell bodies)–>travel with CN IX (lesser petrosal nerve)–>exits through foramen oval, synapse in otic ganglion–>travel with CN V3 (auriculotemporal nerve).

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6
Q

Describe the peripheral distribution of the three division of CN V, trigeminal nerve

A 
CN V1 (ophthalmic): supraorbital nerve exits supraorbital notch on forehead
CN V2 (maxillary): infraorbital nerve goes through infraorbital foramen- cheek, skin and conjunctiva of lower eyelid, skin and mucus membrane of upper lip, upper teeth and gums, nasal mucosa
CN V3 (mandibular): mental nerve-exits mental formaen
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7
Q

Describe the clinical features of trigeminal neuralgia

A
  • can affect single or multiple divisions of CN V (V2 or V3 usually)
  • episodes of intense pain lasting a few seconds to a few minutes
  • cause unknown, related to compression of trigeminal nerve by adjacent vessel
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8
Q

Trace the course of the facial artery and facial vein

A
  • Facial artery: branch of external carotid artery-winds way to inferior border of mandible, crosses superficially. crosses over buccinator and maxilla and takes diagonal course toward medial angle of eye. Tortorous
  • Facial vein: begins near medial angle of eye, runs inferoposteriorly through face, posterior to facial artery. Joined by retromandibular vein and drains into Internal jugular
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9
Q

list the neighboring anatomical regions and structures related to each wall of the orbit

A
  1. superior: frontal sinus and frontal lobes of brain in anterior cranial fossa
  2. posterior: temporal lobes of brain in middle cranial fossa
  3. apex: cavernous venous sinus and sphenoid sinus
  4. medial: ethmoid air cells
  5. inferior: maxillary sinus
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10
Q

List the fascial structures of the orbit and their function.

A
  1. periorbital: periosteum that lines orbit walls
  2. orbital septum: closes off orbital opening anteriorly where it extends from orbital margin to tarsal plates
  3. tarsal plates (superior and inferior): dense connective tissue within upper and lower eyelid. connected to orbital septum. joined medial and laterally by palpebral ligaments
  4. optic sheath: continuation of meningeal layer of dura around optic nerve
  5. sclera: touch whitish outer layer of eyeball that extra ocular muscles are attached to.
  6. bulbar sheath: thin membranous fascia that separates eyeball and extra ocular muscles
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11
Q

What are the five structural layers of the eyelids?

A
  1. Skin
  2. subcutaneous layer: eyelashes and sebaceous glands
  3. muscular layer: made of lavatory palpebrae superiors inserting into superior tarsal plate and interdigitating with orbicular is oculi
  4. tarsofascial layer: orbital septum inserting into tarsal plates. tarsal glands in plates.
  5. palpebral conjunctiva: thin moist transparent epithelium covering inside of lid
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12
Q

What is the superior tarsal muscle (mueller’s muscle)?

A

-smooth muscle arising from legator palpebrae superiors and inserting into tarsal plate. maintains elevated position of upper eyelid against gravity. innervated by symp/post from cervical sympathetic trunk ganglion

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13
Q

List the innervation and anatomical function of each extraocular muscle.

A
  1. superior rectus muscle: oculomotor nerve, elevates and adducts (medial)
  2. inferior rectus muscle: oculomotor nerve, depresses and adducts
  3. medial rectus muscle: oculomotor nerve, adducts
  4. lateral rectus muscle: abducent nerve, abducts
  5. superior oblique muscle: trochlear nerve, depresses and abducts
  6. inferior oblique muscle: oculomotor nerve, elevates and abducts
    MULTIFUNCTIONAL MUSCLES: pass medial to vertical axis
    -inferior and superior rectus: pull posteriorly
    -inferior and superior oblique: pull anteriorly
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14
Q

Trace the pathway of parasympathetic innervation to the eye.

A

edinger-westphal nucleus (para/pre cell bodies)–>via CN III–>ciliary ganglion (para/post cell bodies)–>ciliary nerves–>sclera on the back of the eyeball–>through walls around circumference of eyeball–>ciliary body (accommodation or focusing)+sphincter pupillae muscle (constriction)

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15
Q

What do the motor components of the oculomoter nerve (CNIII) supply?

A

levator palpebrae superioris, superior rectus, inferior rectus, medial rectus, inferior oblique muscles

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16
Q

Trace the pathway of the oculomotor nerve.

A

middle cranial fossa–>wall of cavernous sinus–>superior orbital fissure–>orbit–>upper and lower divisions that supply muscles above and below level of optic nerve

17
Q

What nerve and nerve component is responsible for innervating the smooth muscles related to the constriction of the pupil and accommodation and focus?

A

parasympathetic component of oculomotor (CNIII). Via ciliary nerves.

18
Q

Trace the pathway of the trochlear nerve. What nerve components are there?

A

trochler nucleus–>middle cranial fossa–>wall of the cavernous sinus–>superior orbital fissure–>orbit–>superior oblique muscle

-motor only

19
Q

Trace the pathway of the abducent nerve. What nerve components are there?

A

abducent nucleus–>posterior cranial fossa–>cavernous sinus–>superior orbital fissure–> orbit–>lateral rectus muscle only (motor only)

20
Q

What is innervated by the ophthalmic nerve (CNV1) with respect to the eyes, orbit, eyelids?

A
  • upper eyelid: conjuctiva and outside skin (branches include nasociliary)
  • bulbar conjunctiva covering eyeball
  • cornea reflex: afferent is SS via opththalmic nerve and efferent is SM via facial nerve contracting obicularis oculi
21
Q

What is innervated by the maxillary nerve (CN V2) with respect to the eye, orbit, eyelids?

A

-lower eyelid: inside and outside

22
Q

What component of the facial nerve innervates the lacrimal gland. Trace the pathway of the facial nerve to the lacrimal gland.

A

-Parasympathetic pathway
superior salvatory nucleus–>facial nerve–>geniculate ganglion–>greater petrosal nerve–>nerve of pterygoid canal–>pterygopalatine ganglion (para/post)–>branches of maxillary and ophthalmic nerves–>orbit–>lacrimal gland

23
Q

What do the sympathetic innervations of the eyeball innervate?

A
  1. superior tarsal muscle=smooth muscle between legator palpebrae superiors and superior tarsal plate that maintains position of upper eyelid against gravity
  2. Dilatory pupillae muscle=smooth muscle in iris responsible for enlarging pupil
24
Q

Trace the pathway of the sympathetic nerves to the eyeball.

A

lateral gray horn of T1-4/5–>ventral roots–>spinal nerve–>white rami–>sympathetic trunk–>superior cervical sympathetic ganglion–>jump onto internal carotid artery as carotid plexus–>hitchhike onto CN 3,4,5,6 to eye muscles

25
Q

What are the symptoms of Horner’s Syndrome? What are these symptoms due to?

A
  1. Ptosis due to paralyzed superior tarsal muscle-mild
  2. Miosis due to paralyzed dilator pupillae muscle
  3. Anhydrosis-dry skin due to lack of sweating
    -sweat glands of face and forehead denervated
  4. Vasodilation-paralysis of smooth vasoconstrictor musculature of vessels
    Caused by interrupted SYMPATHETIC innervation to the head
26
Q

What do the motor components of the oculomoter nerve (CNIII) supply?

A

levator palpebrae superioris, superior rectus, inferior rectus, medial rectus, inferior oblique muscles

27
Q

Trace the pathway of the oculomotor nerve.

A

middle cranial fossa–>wall of cavernous sinus–>superior orbital fissure–>orbit–>upper and lower divisions that supply muscles above and below level of optic nerve

28
Q

What nerve and nerve component is responsible for innervating the smooth muscles related to the constriction of the pupil and accommodation and focus?

A

parasympathetic component of oculomotor (CNIII). Via ciliary nerves.

29
Q

Trace the pathway of the trochlear nerve. What nerve components are there?

A

trochler nucleus–>middle cranial fossa–>wall of the cavernous sinus–>superior orbital fissure–>orbit–>superior oblique muscle

-motor only

30
Q

Trace the pathway of the abducent nerve. What nerve components are there?

A

abducent nucleus–>posterior cranial fossa–>cavernous sinus–>superior orbital fissure–> orbit–>lateral rectus muscle only (motor only)

31
Q

What is innervated by the ophthalmic nerve (CNV1) with respect to the eyes, orbit, eyelids?

A
  • upper eyelid: conjuctiva and outside skin (branches include nasociliary)
  • bulbar conjunctiva covering eyeball
  • cornea reflex: afferent is SS via opththalmic nerve and efferent is SM via facial nerve contracting obicularis oculi
32
Q

What is innervated by the maxillary nerve (CN V2) with respect to the eye, orbit, eyelids?

A

-lower eyelid: inside and outside

33
Q

What component of the facial nerve innervates the lacrimal gland. Trace the pathway of the facial nerve to the lacrimal gland.

A

-Parasympathetic pathway
superior salvatory nucleus–>facial nerve–>geniculate ganglion–>greater petrosal nerve–>nerve of pterygoid canal–>pterygopalatine ganglion (para/post)–>branches of maxillary and ophthalmic nerves–>orbit–>lacrimal gland

34
Q

What do the sympathetic innervations of the eyeball innervate?

A
  1. superior tarsal muscle=smooth muscle between legator palpebrae superiors and superior tarsal plate that maintains position of upper eyelid against gravity
  2. Dilatory pupillae muscle=smooth muscle in iris responsible for enlarging pupil
35
Q

Trace the pathway of the sympathetic nerves to the eyeball.

A

lateral gray horn of T1-4/5–>ventral roots–>spinal nerve–>white rami–>sympathetic trunk–>superior cervical sympathetic ganglion–>jump onto internal carotid artery as carotid plexus–>hitchhike onto CN 3,4,5,6 to eye muscles

36
Q

What are the symptoms of Horner’s Syndrome? What are these symptoms due to?

A
  1. Ptosis due to paralyzed superior tarsal muscle-mild
  2. Miosis due to paralyzed dilator pupillae muscle
  3. Anhydrosis-dry skin due to lack of sweating
    -sweat glands of face and forehead denervated
  4. Vasodilation-paralysis of smooth vasoconstrictor musculature of vessels
    Caused by interrupted SYMPATHETIC innervation to the head

Neurosciences (59 decks)

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