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Gross Anatomy Facial Netter's Notes UAB
N/A
91
Anatomy
Professional
03/13/2010

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Cards

Term
Frontalis ms
Definition
  • Origin: galea aponeurotica
  • Insertion: skin of eyebrow
  • Fxn: Raises eyebrows (surprise)
  • nerve: temporal branch of CN 7
Term
Occipitalis ms
Definition

Origin: lateral two-thirds of superior nuchal line

Insertion: external occipital protuberance

Fxn: draws scalp posteriorly

Term

Orbicularis oculi ms

 

3 parts

Definition
  1. orbital portion: nasal process of frontal bone
  2. palpebral portion: palpebral ligament
  3. lacrimal portion: lacrimal crest of lacrimal bone

Insertion: circumferentially around orbit meeting in palpebral raphe

3 parts

1) Palpebral part = fxn = closes eyes lightly

2) Orbital part= fxn= closes eyes forcefully

3) lacrimal part= promotes flow of fluid through lacrimal sac

Term

Nasalis ms

2 parts

Definition

1) transverse

2)alar

 

Origin:maxilla

Insertion: nasal

Fxn= dilates the nasal aperture

Inn= buccal branch of CN 7

Term

Orbicularis oris ms

Definition
  • Origin:
    1. alveolar border of maxilla
    2. lateral to midline of mandible
  • Insertion:
    1. circumferentially around mouth
    2. blends with other muscles
  • Fxn:
    1. closes the lips
    2. protrudes the lips
  • Blood: facial artery
  • Nerve: buccal branch of facial nerve
Term
levator labii superioris ms
Definition
  • Origin: medial 1/2 of infraorbital margin
  • Insertion: upper lip muscles
  • Action: elevates the upper lip
  • Blood: facial artery
  • Nerve: buccal branch of facial nerve
Term
Levator labii superioris alaeque nasi ms
Definition
  • Origin: frontal process of maxilla
  • Insertion:
    1. upper lip muscles
    2. nasal cartilage
  • Action:
    1. elevates the upper lip
    2. flares the nostrils
  • Blood: facial artery
  • Nerve: buccal branch of facial nerve
Term

Mentalis ms

Definition

Origin: incisive fossa of mandible

Insertion: integument of the chin

Fxn: protrudes lower lip

 

Term
Buccinator ms
Definition
  • Origin:
    1. posterior alveolar process of maxilla
    2. posterior alveolar process of mandible
    3. along the pterygomandibular raphe
  • Insertion: modiolus
  • Action: compresses the cheek(s) and helps to keep food out of the vestibule
  • Blood: facial artery

Nerve: buccal branch of facial nerve

Term
Platysma ms
Definition
  • Origin: subcutaneous skin over delto-pectoral region
  • Insertion: invests in the skin widely over the mandible
  • Action:
    1. depress mandible and lower lip
    2. tenses the skin over the lower neck
  • Blood: superficial vessels of the neck
  • Nerve: cervical branch of facial nerve (VII cranial)
  • exgends into the supericial neck region (shaving muscle)
Term
Facial nerve embryological origin?
Definition

pharyngeal arch 2

(thus, all SVE)

Term
How does buccal nerve and buccal branch of CN7 differ anatomically?
Definition

The buccal branch of CN7 passes superficial to the masseter ms

 

The buccal nerve (V3) enters the cheek deep to the masseter ms

Term
What branch of CN7 is in surgical danger 20% of the time when accessing the inferior region of the mandible?
Definition
Mandibular branch of CN7, it can dip below its margin in some patients
Term
Foramen by which the facial nerve leaves the cranial cavity?
Definition
Internal acoustic meatus
Term
What two opens do the nerves for muscles of facial expression exit the skull?
Definition
Facial canal and stylomastoid foramen
Term
Bell's palsy and causes
Definition

Definition: facial muscles are paralyzed on one side

 

Causes

  1. inflammation of CN7 inside facial canal
  2. Constriction due to cold exposure of stylomastoid branch of the post auricular artery that supplies CN7
Term
Symptoms of Bell's Palsy
Definition

Varies according to site of compression

  1. superior to stylomastoid foramen = ipsilateral facial paralysis 
  2. proximal to geniculate ganglion = all functions lost including: facial paralysis, dry eye, hyperacusis, ageusia, impaired secretion of salivary glands (submand and subling)
Term
Explain symptoms of Bell's Palsy upon compression of the the CN7 proximal to the geniculate ganglion
Definition
  1. Dry eyes = greater petrosal nerve carrying parasympathetic fibers to lacrimal gland is compromised
  2. hyperacusis =nerve to teh stapedius is paralyzed
  3. ageusia = ant. 2/3 of tongue is paralyzed because of chorda of tympani is compromised
  4. Impaired secretion = parasympathetic fibers in chorda tympani are affected running to the submand and subling glands
Term
Which direction does CN5 branches run in the face?
Definition
Vertically
Term
Which direction do the branches of CN7 run in the face
Definition
Horizontally
Term
Chief sensory nerve of the face?
Definition
CN5
Term
Only part of the facial skin not innervated by CN5?
Definition
Angle of the mandible and parotid gland
Term
Name the branches of CN5 and what area of the face they innervate
Definition

V1 = forehead, upper eyelids, dorsum of nose

V2 = lower eyelid, upper lip and side of the nose

V3 = L-shaped stirp of skin including lip and chin, lower cheek, part of the external ear and temple

Term
Functional component(s) of CN5?
Definition
GSA and SVE
Term
Name the muscular derivatives of pharnygeal arch 5 in man.
Definition
None. it is vestigial
Term

V1 nerves and  (need to list distributions sometime)

 

Definition
  1. Supraorbital nerve
  2. Supratrochlear nerve
  3. Palpebral branch of lacimal nerve
  4. infratrochlear nerve
  5. external nasal branch of anterior ethmodial nerve
Term
V2 nerves (list of distributions needed)
Definition
  1. Infraorbital nerve
  2. Zygomaticofacial nerve
  3. Zygomaticotemporal nerve
Term
V3 branches and distributions (need)
Definition
  1. Buccal n
  2. Mental n
  3. Auriculotemporal n
Term
Tic douloureux (trigeminal neuralgia)
Definition
  • Severe stabbing pain in the region of V2 most frequently, in V3 less frequently, and V1 least frequently.
  • Most common older women (suicide?)
Term
Trigeminal nerve functional components
Definition
  • GSA = skin, mucosa, and teeth
  • SVE = muscles of mastication
Term
Location of the trigeminal ganglion
Definition
depression on the apex of the petrous temoral bone
Term
Trigeminal neuralgia causes
Definition
  • Not always known
  • Sometimes from inflammation of petrous temporal bone
  • Compression of the sensory root by aberrant artery
  • Pathological change in spinal trigeminal nucleus
Term
Major arterial supply to the face?
Definition
Facial artery
Term
Lacerations of the face bleed profusely, why?
Definition
The facial arteries anastomose together and with the opposite side
Term
Where does the facial artery arise from?
Definition
External carotid artery
Term
Where does the facial artery enter the face?
Definition
Inferior border of the mandible
Term
Facial artery supplies what cutaneous areas?
Definition
  • Chin
  • Lips
  • nose
Term
Where does the facial artery end and what vessel does it form?
Definition
  • near the angle of the eye
  • angular artery
Term
What veins form the angular vein?
Definition
  • supratrochlear vein
  • supraorbital vein
Term
Does the facial vein lie posterior or anterior to the facial artery?
Definition
Posterior
Term
What forms the common facial vein?
Definition
  • anterior division of retromandibular vein
  • facial vein
Term
What is a clinically important fact about the facial vein? (infection)
Definition
  • It is valveless, thus able to transmit infection
  • Connected to pterygoid plexus
  • Connected to cavernous sinus
Term
Bones of the external nose
Definition
  • nasal
  • frontal
  • [image]
  • maxilla[image]
  • [image]
Term
Cartilages of the external nose
Definition
  • septal
  • lateral nasal
  • greater alar
Term
Angles (Canthi)
Definition
  • The medial and lateral meeting fo the eyelids
Term
Lacrimal lake
Definition
  • triangular area bonded by two lids and the Plica semilunaris (semilunar fold)
Term
Plica semilunaris
Definition
  • fold of conjunctiva which intercepts foreign bodies of the eye
Term
Lacrimal caruncle
Definition
  • small mound of modified skin containing fine hair cells and sebaceous/sweat glands
Term
Lacrimal papilla
Definition
  • On medial aspect of eyelid
  • Has lacrimal punctum
Term
Lacrimal punctum
Definition
  • Tiny opeing on the medial aspect of the eyelid
  • Functions as part of the drainage apparatus for lacrimal gland
Term
Five layers of the eyelids
Definition
  1. skin
  2. subcutaneous tissue
  3. muscular
  4. tarsofascial
  5. palpebral part of conjunctiva
Term
Clinical importance of the subcutaneous tissue of the eyelid?
Definition
  • it is loose, thus fluid can accumulate after trauma to the eyelid
Term
What makes up the muscular layer of the eyelid?
Definition
  • palpebral part of the orbicularis oculi
Term
Components of the tarsofacial layer of the eyelid?
Definition
  • tarsal plates and orbital septum
Term
Function of the superior and inferior tarsal plates?
Definition
  • Made of connective tissue that strengthens the eyelid
Term
Where are the tarsal glands and what are their function?
Definition
  • Posterior surfaces of tarsal glands
  • Oily secretions waterproofs the eyelids and prevents them from sticking together
Term
Orbital septum
Definition
  • membrane that stretches margins of the orbit to the tarsal plates
Term
Palpebral part of the conjuctiva and its clinical relevance?
Definition
  • deepest layer of the eyelid
  • vascular and examined in suspected cases of anemia
Term
Bulbar conjunctiva
Definition
  • Outermost part of the eyeball
Term
What makes the borders of the conjunctival sac?
Definition
  • Bulbar conjunctiva
  • Palpebral conjunctiva
Term
Superior and inferior conjuctial fornices (fornix)
Definition
  • Junctions of the bulbar and palprebral conjunctiva
  • Seen when the eyelid is reflected
Term
What are the two muscles that insert into the superior tarsal plate? Function?
Definition
  1. levator palpebrae superioris ms
  2. superior tarsal ms

Function = elevate the upper eyelid

Term
Levator palpebrae superioris ms
Definition
  • Origin: inferior aspect of the lesser wing of sphenoid (adjacent to the common annular tendon)
  • Insertion:
    1. medial and lateral walls of the orbit
    2. superior tarsus
  • Action: elevates the eyelid
  • Blood: branches of ophthalmic artery
  • Nerve: oculomotor nerve (III cranial)
  • ptosis if injured
Term
Superior tarsal ms
Definition
  • smooth muscle
  • involuntary
  • innervation = post-synaptic sympathetic fibers from the superior cervical ganglion
  • if injured = ptosis
Term
Medial and lateral palpebral ligaments
Definition
  • function to attach the tarsal plates to the margins of the orbit
  • **To access the lacrimal sac, the medial palpebral ligament must be cut**
Term
Tract of tears
Definition
  • Lacrimal gland
  • lacrimal ducts
  • into the superior fornix of the conjuctival sac
  • Into the lacrimal lake
  • lacrimal punctum
  • lacrimal canaliculus
  • lacrimal sac
  • nasolacrimal duct
  • inferior meatus of the nasal cavity
Term
What functional role does the obicularis oculi ms (palpebral) have in tear secretion?
Definition
  • Upon contraction it physically pushes on the lacrimal gland causing tear flow
Term
Dacryocystitis
Definition
  • inflammation of the lacrimal sac
Term
What nerves allow the corneal reflex?
Definition
  • Afferent = CN5
  • Efferent = CN7
Term
What is epiphora?
Definition
  • tears falling onto the face
Term
Paralysis of the orbicularis oculi has what symptoms?
Definition
  • Protective corneal reflex is lost
  • Eye remains open, suspect to drying out and ulceration
  • epiphora due to the lower eyelid sagging
Term
What bones form the fossa for the lacrimal sac?
Definition
  • Maxillary
  • Lacrimal
Term
Tract of parasympathetic fibers to lacrimal gland
Definition
  • Leave brain in CN7 via facial canal
  • branch off to form greater petrosal nerve
  • joins another nerve to form the nerve of pterygoid canal
  • goes to pterygopalatine ganglion(presyn) in pterygopalatine fossa
  • postsyn fibers join V2
  • Leave through V2 zygomatic branch
  • Enter orbit
  • Zygomatic nerve communicates with the lacrimal nerve (V1)
Term
What is the origin of the sympathetic fibers to the lacrimal gland and how do they affect the gland?
Definition
  • Superior cervical ganglion
  • inhibits secretion
Term
What are the five layers of the scalp?
Definition
  1. Skin
  2. connective tissue
  3. aponeurosis
  4. loose subaponeurotic tisse
  5. pericranium
Term
What is the danger level in the scalp? Why?
Definition
  • Fourth layer (loose subaponeurotic tissue)
  • Because infections can readily spread through it
  • Veins of the scalp are connected to the superior sagittal sinus via emissary veins
Term
Do both the external and internal carotid artery supply the scalp?
Definition
  • Yes, but the external is direct and internal indirectly
Term
Is it better to have a cut in the scalp going in the anterior/posterior or left/right direction?
Definition
  • Anterior/posterior because of the galea aponeurotica would keep the left/right cut open
Term
What are the most common head injury requiring surgical care?
Definition
Scalp injuries
Term

What are the arteries of the scalp the major blood supply to the crainal bones?

 

Definition
No.  The middle meningeal artery supplies the cranium
Term
What are the facial bones?
Definition
  1. nasal
  2. lacrimal
  3. zygomatic
  4. maxilla
  5. mandible
  6. vomer
  7. inferior nasal concha
  8. palatine
Term
What are the bones of the face derived from?
Definition
Mesenchyme, except for inferior nasal concha
Term
What are the four processes of the maxilla?
Definition
  1. Frontal
  2. zygomatic
  3. alveolar
  4. palatine
Term
The buccal shelf of the mandible marks what nerve?
Definition
Buccal nerve
Term
What are the two landmarks that the external oblique line connects?
Definition
  1. mental tubercle
  2. Anterior border of the ramus
Term
What type of ANS fibers does the greater petrosal nerve carry?
Definition
Parasympathetic from CN7
Term
What type of ANS fibers does the deep petrosal nerve carry?
Definition
Sympathetic
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