week 2- NV Flashcards
veins/lymph
what are the important structures in the face that can allow for the spread of infection
lymph nodes
- submental nodes
- submandibular nodes
- parotid/pre-auricular nodes
Venous
- The cavernous sinus
Infection from the face can spread through the facial vein into the orbit, or through the pterygoid venous plexus, eventually reaching the cavernous sinus. Septicemia can lead to meningitis or cavernous sinus thrombosis.
veins/lymph
Outline the superficial venous flow of the face
superficial temporal –> maxillary = retromandibular –> posterior –> posterior auricular –> external jugular
superficial temporal –> maxillary = retromandibular –> anterior –> facial –> common facial –> internal jugular
veins/lymph
ID the lymph nodes of the face and where they drain into
They all drain into the deep cervical nodes
veins/lymph
ID these veins
- deep facial
- facial
- pterygoid plexus
- internal and external jugular
- Retromandibular vein
- maxillary
- superficial temporal
ID the arteries involved with these brain regions
what is the general course of the facial artery
how to control facial bleeding caused by trauma to this vessel
main supply to the face
From: external carotid
branches:
- angular
- inf/sup labial
- submental
- ascending palantine artery
Compressing the facial artery on the inferior border of the mandible anterior to the masseter (at arrow) controls facial bleeding
what arteries supply the face
- facial most of the face
- Superficial temporal
- transverse facial a
- (Internal) Maxillary a
what fractures bleed perfusely in PT with midface injuries
The facial artery and its branches, as well as the terminal branches of the ophthalmic artery (the dorsal nasal artery) are important clinically since they often bleed profusely in patients with midfacial fractures
where is the superficial temporal artery located and what nerve does it run with
runs along the ear vertically
auriculotemporal nerve
name the branches of the maxillary artery
- mandibular
pterygod
pterygopalatine
what does the maxillary artery branch off of
what fossas do it run through (2)
what muscle does it run lateral to
external carotid
infratemporal fossa & pterygopalatine fossa
lateral pterygoid muscle
what is the first part of the maxillary artery and its 5 branches
what region does it supply blood to
what muscle does it run under
what structure does it run with
DAM I AM
Mandibular
- Deep auricular
- Anterior tympanic
3.Middle meningeal
- Inferior alveolar
- (accessory meningeal)
supplies: mandible; teeth & gums; gingiva; dura and cranial vault
muscle: lateral pterygoid muscle
structure: inferior and parallel to the auriculotemporalnerve
what is the second part of the maxillary artery and its 5 branches
what region does it supply blood to
what muscle does it run under
what structure does it run with
Pterygoid
‘Mad Porn And Pills bottles dont tempt a B***’
- Masseteric ( supplies masseter)
- Pterygoid branches (supplies Lateral and medial pterygoids)
- Anterior and
- Posterior branches of deep temporal artery (supplies temporalis)
- Buccal branch (supplies buccinator)
supplies: muscles of mastication
muscle: usually passing between the heads of the lateral pterygoid
structure: deep to the ramus of the mandible
what is the third part of the maxillary artery and its 3/6 important branches
what region does it supply blood to
Pterygopalatine
- Posterior superior alveolar
- Infra-orbital
- Sphenopalatine (terminal branch)
supplies: nasal wall & septum, paranasal sinuses; inferior eyelid, lacrimal sac, side of nose, upper lip; maxillary teeth, gingiva & sinus; hard & soft palate
where do 90% of nose bleeds originate from
The sphenopalatine artery is often called the “artery of epistaxis”. may need ESPAL (Endoscopic Sphenopalatine Artery Ligation).
It supplies most of the blood to the inferior and posterior aspects of the nasal cavity and will anastomose with the anterior and posterior ethmoidal, greater palatine and (septal branch of the) superior labial aa in plexus called Kiesselbach’s area (Kiesselbach’splexus).
LEGS:
- superior Labial
- Ethmoids (anterior and posterior)
- Greater palatine
- Sphenopalatine
what areas do the trigemmenal and facial nerve supply
what foramen does each it pass through
trigemmenal: facial structures derived from the first pharyngeal arch & cutaneous innervation to the skin
Facial: facial structures derived from the second pharyngeal arch
exits through the: foramen ovale (V) stylomastoid foramen (VII)
what are the branches of the V3 and their functions
1. Meningeal branch (nervus spinosus)
2. Auriculo temporal n*
Sensory from ear and TMJ
Also carries PSNS from tympanic nerve (of CNIX) to parotid
3. Lingual n*
general sensory to tongue; the chorda tympani from CN VII and PSNS to the submandibular and sublingual glands join this nerve
4. Inferior alveolar n
Mylohyoid branches from the inferior alveolar.
The inferior alveolar terminates as the mental nerve.
5. (Long) Buccal nerve
sensory from skin of cheek and molar teeth
6.Branchiomotor branches from anterior division:
- Masseteric
- Deep temporal
- Nerves to lateral and medial ptyergoids
- Nerve to tensor velipalatini
- Nerve to tensor tympani
where does the auriculotemporal nerve run posterior to
condylar head
what is the path of the facial nerve
The facial nerve exits the posterior cranial fossa through the internalacousticmeatus. It passes through the temporal bone and emerges from the base of the skull through the stylomastoid foramen and enters the parotid gland BUT DOES NOT INNERVATE IT
name the 6 branches of the facial nerve
name the parotid plexus gives branches
•Temporofacialbr=>
temporal, zygomatic, some buccal branches
•Cervicofacial br=>
buccal, marginal mandibular, and cervical branch
what nerve can be damaged during birth when using forceps to retrieve the baby
Due to the underdeveloped mastoid process of newborns, CNVII may be injured during forceps delivery
The pathway of parasympathetics to the salivary glands
Parasympathetic innervation to the parotid gland has a complex path. A branch of CNV, the auriculotemporalnerve,carries postganglionic PSNS from CNIX and the otic ganglion to the parotid gland through the following pathway:
- The preganglionic parasympathetic component of CNIX travels through the tympanic cavity as the tympanic nerve
- This preganglionic fiber exits the tympanic plexus and joins the lesser (superficial) petrosal nerve.
- The lesser petrosal nerve synapses in the otic ganglia
- Postganglionic fibers of CNIX are conveyed to the parotid gland by the auriculotemporal nerve(a branch of CNV3).
The pathway chorda tympani
The function of chorda tympani
The function of the lingual nerve
The chordatympani, a branch of CNVII, travels through the middle ear between the malleus and the incus, exits the skull through the petrotympanic fissure, then joins the lingua lnerve.
The chorda tympani carries taste from the anterior 2/3 of the tongue and parasympathetics to the submandibular and sublingual glands.
The lingual nerve carries general sensory information from the anterior 2/3 of the tongue.
The function of the lingual nerve
A 30-year-old man had a pleomorphic adenoma removed from his left parotid gland. His postoperative course was uncomplicated. Two months later, he noted that his left cheek became wet while he was eating. Believing that saliva was being discharged from the parotidectomy scar, he went to the emergency department. An examination revealed that the wound had healed well: there were no signs of a fistula (arrow, Panel A). Frey’s syndrome was suspected, and the lemon test was performed. As soon as the patient ate a lemon wedge, his left auricular and parotic regions became flushed and sweaty
Gustatory sweating, or Frey’s syndrome, can develop after a variety of insults to the autonomic nervous system, such as trauma or radiation therapy, but is most commonly encountered as a complication of parotidectomy
The most widely accepted mechanism is aberrant neuronal regeneration resulting in parasympathetic cholinergic innervation of cutaneous sympathetic receptors
