tbl 9 cranium scalp face temporal fossa and infratemporal fossa

frontal bone makes up

forehead and superior margin of orbits

nasal bones make up

nose bridge

maxilla bones make up

central face and inferomedial margin or orbits

mandible

jaw

supraorbital foramen

superior margin of orbits

infraorbital foramen

inferior to orbits, in maxilla

mental foramen

in mandible

branches of ____ nerve CN __ pass through the three facial foramen

trigeminal, CN V

zygomatic arch is created by

zygomatic and temporal bones

the trigeminal nerve emerges from the ___ in the cranium

pons

three divisions of the trigeminal nerve

V1 - ophthalmic

V2 - maxillary

V3 - mandibular

carry touch, pain, and temp

ophthalmic, CN V V1 branches into _____, innervates _____, and exits cranium through _____ to enter orbit

supraorbital nerve

scalp anterior to ear

supraorbital foramen

maxillary, CN V V2 branches into _____, innervates _____, and exits cranium through _____ to enter orbit

infraorbital nerve

inferior eyelid, lateral nose, superior lip, and maxillary teeth

infraorbital foramen

mandibular, CN V V3 branches into _____, innervates _____, and exits cranium through _____

buccal and mental nerves

skin over lateral and medial mandible respectively, and inferior lip

mental foramen to join inferior alveolar nerve (sensory nerve for lower/mandibular teeth within mandibular canal)

external carotid artery generates the ____ artery which supplies ____

facial

skin over face and muscles of facial expression

facial artery runs in ____ direction across face, from posterior to anterior. the artery is ____, to ensure it’s not torn with depression of mandible

diagonal

tortuous (curvy)

supraorbital artery exits the orbit through the _____ and supplies the ____

supraorbital foramen

scalp anterior to the ear and skin of most of the forehead

facial vein is a tributary of the ___ and runs parallel to the ____, draining the same structures it supplies

internal jugular vein

facial artery

why is the facial vein less susceptible to rupture than the facial artery?

it runs a straighter course, since it crosses the mandible closer to its angle (posterior to the artery

supraorbital vein runs with the _____ and drains the same structures it supplies. it then enters the _____ to enter the orbit

supraorbital artery

supraorbital foramen

where is pressure best applied to stop the bleeding from a lip laceration?

the facial artery at the mandible where it crosses the face, since its terminal branches directly supply the lips

muscles of facial expression lie within subcutaneous tissue, and thus are _____ muscles

superficial

occipitofrontalis has ___ muscle bellies, which work together to _____

2

elevate brows and wrinkle forehead

orbicularis oculi is innervated by the _____ branch superiorly and the _____ branch inferiorly of the facial nerve

temporal

zygomatic

orbicularis oris is innervated by the _____ branch superiorly and the _____ branch inferiorly of the facial nerve

buccal

marginal mandibular

orbicularis oculi works to

close the eye

orbicularis oris works to

close the mouth and protrude the lips

zygomaticus major and minor are innervated by _____ and work to _____

zygomatic branch of the facial nerve

elevate the angle of the mouth and upper lip for smiling

depressor anguli oris is innervated by _____ and works to _____

marginal mandibular branch of facial nerve

depress the angle of the mouth for frowning

the facial nerve CNVII emerges from the _____ in the cranium, enters the _____ in the posterior cranial fossa to enter the facial canal in the _____. it then exits the cranium via the _____ on its inferior surface to innervate _____

pontomedullary junction

internal acoustic meatus

petrous temporal bone

stylomastoid foramen

parotid salivary gland and muscles of facial expression

why is preoperative CT or MRI used for surgical planning of a parotidectomy?

Preoperative CT or MRI is used before a parotidectomy to determine the size and location of the lesion, and whether it is in the superficial or deep lobe. Imaging also helps assess the lesion’s relationship to the facial nerve, which is crucial for surgical planning and nerve preservation.

why do patients with Bell’s palsy frequently dab the affected eye and corner of the mouth?

why do patients frequently have difficulty chewing?

Inability to close the eyelid and loss of muscle tone causes tearing and drooling.

Paralysis of facial muscles like the buccinator allows food to accumulate in the cheek instead of staying between the teeth.

SCALP

skin

connective tissue

aponeurosis

loose connective tissue

periosteum

the supraorbital nerve innervates _____

the scalp anterior to the ear

the greater occipital nerve, a branch of the _____, innervates the scalp _____

posterior ramus of C2

posterior to the ear

the auriculotemporal nerve, a branch of the _____, innervates the _____

mandibular nerve CN V, V3

lateral scalp

the supraorbital artery supplies the ____

scalp anterior to the ear

the occiptial artery (a branch of the _____) supplies the _____

external carotid artery

scalp posterior to the ear

the external carotid terminally bifurcates into ____ and ____

superficial temporal artery

maxillary artery

the maxillary artery enters ____

infratemporal fossa

the superficial temporal artery supplies the _____

lateral scalp

the supraorbital vein drains the _____

scalp anterior to the ear

the posterior auricular vein, a tributary to the ____, drains the _____

external jugular vein

scalp posterior to the ear

the superficial temporal vein merges with the _____ to form the _____

maxillary vein

retromandibular vein

the retromandibular vein merges with the _____ to form the _____

posterior auricular vein

external jugular vein

the superficial temporal vein drains the _____

lateral scalp

why can scalp infections enter the eyelids?

infections in the loose connective tissue layer of the scalp ("danger area") can spread to the eyelids because this layer is continuous with the eyelids and root of the nose. Blood or pus can flow into the eyelids, causing swelling, especially due to the lack of muscular attachment in the frontalis region

the temporal fossa is where the ____ muscle attaches proximally

temporalis

describe the bony features of the mandible

rami

condyloid process (head and neck)

coronoid process

mandibular notch

mandibular foramina on deep surface of ramus

mental foramen

angle

the infratemporal fossa is located ______ to the temporal fossa. the sphenoid bone has two processes, ____ and _____ ______

inferomedial

medial and lateral pterygoid plates

the infratemporal fossa is bounded superiorly by _____

medially by _____

laterally by _____

anteriorly by _____

infratemporal part of greater wing of the sphenoid

lateral pterygoid plate

ramus of mandible

maxilla

the foramen ovale and the foramen spinosum are in the _____ part of the _____ of the sphenoid bone

infratemporal

greater wing

the ______ nerve innervates the temperomandibular joint. it is a branch of the ____ nerve

auriculotemporal

mandibular