GA2 Exam 4

How many layers does the scalp have?

5

Skin layer of the scalp has what features?

many sweat and sebaceous glands

abundant arterial, venous and lymphatic drainage

heals quickly due to arterial supply

Connective tissue layer of the scalp has what features?

thick dense, richly vascularized and well innervated

collagen fibers

Aponeurosis(epicranial) layer of the scalp has what features?

serves as attachment for muscles bellies from forehead and occiput

What muscles attaches to epicranial aponeurosis?

occipitofrontalis

Loose areolar tissue layer of the scalp has what features?

sponge like layer with potential spaces

can distend with fluid as result of injury or infection

allows free movement of first three layers

Pericranium layer of the scalp has what features?

firmly attached but can be stripped from crania of living people

dense connective tissue that forms external periosteum

Arterial supply of scalp

supratrochlear

supraorbital

superificial temporal

posterior auricular

occipital

Innervation of scalp, anterior to auricles

Trigeminal nerve (V1-V3)

sensory only

Innervation of scalp, posterior to auricles

spinal cutaneous (C2 and C3) - cervical plexus

sensory only

Venous drainage of scalp

supratrochlear v

supraorbital v

superificial temporal v

posterior auricular v

occipital v

Why do lacerated wounds tend to bleed profusely?

they anastamose

Why does a lacerated wound in the scalp running side to side tend to gape?

due to sheeth being cut against directions of fibers

Face plays important role in what?

In communication

Where do the muscles of facial expression lie within?

superificial fascia of face

Where do muscles of facial expression arise from? Where do insert?

mostly skull bones; insert in skin of face

Which facial expression muscles act as sphincters?

those around orifices (holes)

What pharyngeal arch do muscles of facial expression come from?

2nd

Motor supply for facial muscles is what?

facial nerve CN VII

SVE fibers

Occipitofrontalis occipital belly O and I

O: lateral 2/3 of superior nuchal line

I: epicranial aponeurosis

Occipitofrontalis frontal belly O and I

O: epicranial neurosis

I: skin of subcutaneous tissue of eyebrows and forehead

Occipitofrontalis occipital belly N

posterior auricularbranch of CN VII

Occipitofrontalis frontal belly N

temporal branch of facial n

Occipitofrontalis action

elevates eyebrows and produce transverse wrinkles across forehead

Corrugator Supercilii O and I

O: Medial end of supercilliary arch

I: skin of eyebrow

Corrugator Supercilii N

Temporal branch of facial n

Corrugator Supercilii A

draws eyebrows medially

What is the sphincter muscle of the eye lid?

orbicularis oculi

What are the dilator muscles of eye?

levator palpebrae superioris (not facial expression muscle)

occipitofrontalis

Orbicularis oculi O and I

O: medial palpebral ligament

I: lateral palpebral raphe

Orbicularis oculi has how many parts? What are they

3; Orbital, Palpebral, Lacrimal

Orbicularis oculi N

temporal and zygomatic branches of facial n

Orbicularis oculi A

close eyelids (sphincter muscle)

What is xerophtalmia?

dry eye

What is lagophtlamos?

lid lag; one eye won’t fully close completely and lags

How do you test orbital part of Orbicularis oculi?

Asking patient to close eye while you try to open it

How many parts does nasalis muscle have? What are they?

2; compressor naris, dilator naris

Nasalis O

O: maxilla and frontal process

Nasalis Compressor I

I: crosses bridge of nose to insert on opposite side

Nasalis Dilator I

I: ala of nose

Nasalis N

buccal branch of facial n (SVE)

Nasalis A

compress and dilate nostrils

Procerus O and I

O: arises from nasal bone

I: skin between eyebrows and bridge of nose

Procerus N

Zygomatic branch of facia

Procerus A

pulls down medial end of eyebrow

wrinkles skin of nose

Orbicularis Oris is derived from what muscle?

buccinator muscle

Orbicularis Oris N

buccal and mandibular branches of facial

Orbicularis Oris A

compresses lips together

Dilator muscles of lips arise from what?

bones and fascia around oral orifice

Dilator muscles of lips insertion

I: into subtance of lips

Dilator muscles of lips N

buccal and mandibular branches of facial

Dilator muscles of lips A

Seperate lips

Buccinator muscle is also known as what?

trumpeter’s muscle

Buccinator O and I

O: alveolar margins of maxilla and mandible opposite the molar teeth and from pterygomandibular raphe

I: Upper and lower lips

Buccinator N

buccal branch of facial n

Buccinator A

compresses lips and cheeks against teeth

What pierces the Buccinator muscle?

parotid duct

Facial nerve provides motor supply for what?

facial muscles

Where does facial nerve exit? Where does it run within?

stylomastoid foramen

runs within parotid salivory gland

How many branches does facial nerve give off?

7

Skin of face is supplied by how many divisions of trigeminal n.?

3

What is the division of trigemnial known as V1?

Opthalmic

What is the division of trigemnial known as V2?

Maxillary

What is the division of trigemnial known as V3?

Mandibular

What nerves are in maxillary division of trigeminal?

Zygomaticofacial, zygomaticotemporal, infraorbital

What nerves are in mandibular division of trigeminal?

auriculotemporal, buccal and mental

2 z’s and in front of orbit stands for what?

2nd division

Zygomaticofacial

zygomaticotermporal

infraorbital

After beating 3 men stands for what?

3rd division of trigeminal n

Auriculotemporal

Buccal

Mental

Superior and inferior boundaries of parotid region?

Superior: zygomatic arch

inferior: angle and inferior border of mandible

Medial and posterior boundary of parotid region?

Medial: ramus of mandible

Posterior: external ear and anterior border of SCM

anterior boundaries of parotid region?

Anterior: anterior border of masseter

Parotid sheath is what? Resists what?

tough fibrous capsule

resists expansion/swelling

Where does parotid gland open into?

lateral to upper second molar tooth (on each side of mouth)

Parotid gland is responsible for how much saliva generation?

30%

Sensory nerve supply to parotid gland?

Auriculotemporal and great auricular n (C2, C3)

Parasympathetic nerve supply to parotid gland?

Preganglionic fibers through CN IX (glosso)

Postganglionic fibers through auriculotemporal n

Where do the pregg PS fibers synapse?

otic ganglia

Sympathetic nerve supply to parotid gland?

Preganglionic fibers from T1-T2

Postganglionic fibers from external carotid plexus

Where do the pregg SP fibers synapse?

superior cervical ganglion

Frey’s syndrome/gustatory sweating is what?

instead of salivating, sweating occurs on side with no parotid gland

First 3 branches of facial nerve are what?

temporal, zygomatic, buccal

Other 3 branches of facial nerve are what?

marginal mandibular, cervical, posterior auricular

Final branch of facial n is what?

Branch to posterior belly of digastric and stylohyoid

temporal branch supplies what muscles?

anterior and superior auricular

frontal belly occiptofrontalis

orbicularis oculi

corrugator supercili

zygomatic branch supplies what muscles?

orbicularis oculi

muscles inferior to orbit

buccal branch supplies what muscles?

buccinator

upper lip and nostril muscles

marginal mandibular branch supplies what muscles?

risorius and other lower lip muscles

cervical branch supplies what muscles?

platysma

posterior auricular branch supplies what muscles?

superior and posterior auricular m

occipital belly of occipitofrontalis

Injury to facial nerve may do what?

produce paralysis of some or all facial muscles

Tramautic injury of facial nerve may occur due to what?

complication of parotid gland surgery

Nontramautic injury of facial nerve may occur due to what?

inflammation of facial n in stylomastoid foramen due to infection

produces edema and compression of n

Idiopathic of facial nerve may occur due to what?

no known cause but follows cold exposure

(formerly known as bell’s palsy)

Herpes zoster oticus may occur due to what?

uncommon manifestation of herpes zoster that affects CN 8 ganglia and geniculate ganglia of 7th n

What is the arterial supply to the face?

facial artery

superficial temporal

maxillary

ophthalmic

facial artery gives off what branches?

submental, inferior and superior labal, lateral nasal, angular

LISSA

superficial temporal artery gives off what branches?

transverse facial

frontal

parietal

Maxillary artery gives off what branches?

mental and infraorbital

Ophthalmic artery gives off what branches?

Supraorbital, supratrochlear, dorsal nasal

Face is drained by what vein? What location is it formed?

facial vein; medial angle of eye