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Scalp, Face and Facial Nerve
LECOM Yr 1
76
Anatomy
Graduate
09/22/2011

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Cards

Term
where is the scalp located specifically?
Definition
extends from the superciliary arches to the occipital protuberance and zygomatic arches laterally
Term
what are the layers of the scalp?
Definition
Skin has the large amount of the hair follicles

Connective tissue (dense) contains vessels and nerves.

Aponeurotic layer has occipito-frontal muscle

Loose connective tissue separates aponeurotic layer

Pericranium is the deepest layer (periosteum)
Term
what is found in the skin of the scalp?
Definition
large amount of hair follicles
Term
what is found in the connective tissue of the scalp?
Definition
vessels and nerves
Term
which muscle is located in the aponeurotic layer of the scalp?
Definition
occipito-frontal muscle
Term
loose connective tissue of the scalp separates which layer?
Definition
the aponeurotic layer
Term
what is the deepest layer of the scalp?
Definition
pericranium
Term
describe the nerve innervation to the anterior portion of the scalp? (to the ears and vertex)
Definition
all three divisions of CN V

ophthalmic- supratrochlear, supraorbital

maxillary- zygomaticotemporal

mandibular- auriculotemporal
Term
describe the nerve innervation to the posterior region of the scalp? (to the ears and vertex)
Definition
dorsal and ventral rami of C2 and C3 (cervical plexus)
Term
is the skull innervated by sensory nerves or motor nerves?
Definition
sensory nerves
Term
which cranial nerve is the main sensory nerve of the head?
Definition
CN V
Term
what are the 2 branches of the maxillary nerve?
Definition
zygomaticotemporal and zygomaticofacial
Term
is deep suturing needed for superficial scalp wounds?
Definition
no, superficial wounds do not gape because of the aponeurosis
Term
do scalp injuries heal well?
Definition
yes, scalp has intensive anastomoses and good healing

arteries do not supply bones
Term
why is bleeding from scalp wounds profuse?
Definition
since arterial walls of arteries of the scalp are firmly attached to the dense connective tissue in which they are embedded, limiting their ability to constrict when cut, bleeding from scalp wounds is profuse
Term
for internal bleeding, what are the 3 components that must be present?
Definition
content, source and space
Term
where does scalp infection occur?
Definition
in the 4th layer of loose connective tissue

emissary veins are pathways for intracranial infection. Cannot spread to the neck and lateral face because of direct attachment of the occipitofrontalis to the occipital and temporal bones, and continuation of aponeurosis is temporal fascia.
Term
what are the 2 major groups of muscles of the face?
Definition
muscles of mastication

muscles of facial expression
Term
the muscles of facial expression are derived from where and are innervated by branches of what nerve?
Definition
derived from the second pharyngeal arch and innervated by branches of the facial nerve (CN VII)
Term
what is the function of the muscles of the face?
Definition
Muscles act on the skin of the face to change expression and work as sphincters and dilators around facial orifices (look sad, smile, smirk, frown, etc.)
Term
which are 3 important muscles of the face?
Definition
orbicularis oculi
buccinator
orbicularis oris
Term
what is the function of the orbicularis oculi muscle?
Definition
shuts the eye
Term
what is the function of the buccinator muscle?
Definition
presses cheek against molars, keeps food between occlusal surface out of oral vestibule when chewing
Term
what is the function of the orbicularis oris muscle?
Definition
closes lips

related to buccinator muscle
Term
do the muscle of the face have thick fascia?
Definition
no
Term
what are the parts of the orbicularis oculi muscle?
Definition
has two major parts:

palpebral part (closes lids gently) and orbital part (closes lids tightly)

small lacrimal part (deep, medial, attaches to lacrimal sac)
Term
what nerve innervates the buccinator muscle?
Definition
innervated by the buccal branch of CN VII
Term
the mucosa inside the cheek and the skin overlying the cheek are innervated by what nerve?
Definition
the buccal branch of CN V3
Term
partial insertion of the buccinator muscle is into what muscle?
Definition
orbicularis oris; crossing fibers

works together with vestibular of the mouth
Term
where does the platysma muscle attach and what is its function?
Definition
attaches to the base of mandible and
subcutaneous tissue of supra- and infraclavicular regions; depresses mandible and tenses the skin of
inferior face and neck
Term
what nerves innervate the platysma muscle?
Definition
CN VII (motor)

C2, C3 (sensory)
Term
describe the parotid gland
Definition
Largest salivary gland of irregular shape

Superficial & deep parts

Tough fascial sheath

Investing fascia

Painful with bacterial and viral inflammation

CNVII only passes through
Term
which nerve runs through the parotid gland?
Definition
the facial nerve
Term
just behind the parotid gland is what nerve?
Definition
the retromandibular nerve
Term
the external carotid artery is embedded in the parotid gland and terminates to give off what 2 branches?
Definition
superficial temporal branch- innervates parotid gland from superior border

maxillary artery- emerges from anteromedial border
Term
what does the parotid gland lie anteroinferior to?
Definition
the external acoustic meatus where it is wedged between rami of mandible and mastoid process
Term
describe the path of the parotid duct
Definition
exits anterior surface of gland, crosses masseter, pierces buccinator and opens in oral vestibule opposite second upper molar
Term
what structures lie in the parotid bed? (structures deep to the parotid gland)
Definition
Mastoid process, styloid process, stylomastoid foramen (exit of CN VII), posterior belly of digastric, carotid sheath
Term
which structures pass through the parotid gland?
Definition
Facial nerve, retromandibular vein, external carotid artery (superficial temporal and transverse facial)

Lymphatic vessels: superficial &
deep parotid nodes (on sheath & within gland)
Auriculotemporal nerve (carrying postganglionic parasympathetic fibers)
Term
which nerves provide sensory innervation to the parotid gland?
Definition
great auricular (C2, C3) fascia and skin

auriculotemporal (CNV3)
Term
which nerves provide vasomotor innervation to the parotid gland?
Definition
sympathetic fibers via the external
carotid plexus; nerve cell bodies are located in the superior cervical ganglion
Term
which nerves account for secretion of the parotid gland?
Definition
parasympathetic fibers from CN IX
Term
what is the great auricular nerve?
Definition
a branch of the cervical plexus and provides sensory inner to parotid sheath, gland, and overlying skin
Term
which nerve is chief cutaneous nerve of the face?
Definition
CN V is the chief cutaneous nerve of the face.
All three divisions of CN V innervate the skin of the face; nerve cell bodies are in trigeminal (semilunar) ganglion
Term
what regions of the face does the ophthalmic nerve innervate?
Definition
(from trigeminal ganglion as sensory nerve, enters the orbit through superior orbital fissure)

Frontal - forehead and scalp (supraorbital and supratrochlear)

Nasociliary - skin of external nose and medial eyelid (infratrochlear)

Lacrimal - lateral superior eyelid (carries secretomotor fibers from pterygopalatine ganglion to lacrimal gland)
Term
describe the mandibular nerve (CN V3) and its branches
Definition
motor and sensory. Leaves the craniun through foramen ovale

Auriculotemporal – skin posterior to auricle and over the temporal region, external acoustic meatus, tympanic membrane

Buccal – cheek

Mental – chin
Term
from which artery does the facial artery arise?
Definition
arises from external carotid artery and branches into interior and superior labial, lateral nasal, and angular a.s
Term
from which artery does the occipital and posterior auricular arteries arise?
Definition
external carotid artery
Term
the superficial temporal artery arises from which artery?
Definition
temporal arises as a smaller terminal branch of external carotid and branches into transverse facial and is within parotid gland
Term
the mental artery arises from which artery?
Definition
inferior alveolar artery
Term
the supraorbital and supratrochlear arteries are terminal branches of which artery?
Definition
the opthalmic artery (a branch of the internal carotid artery
Term
which artery is the major vessel supplying the face?
Definition
facial artery
Term
what are the branches of the facial artery?
Definition
Facial artery is a branch of external carotid that arises in the neck (carotid triangle)

Facial artery has several branches
-angular artery
-inferior and superior labial arteries
-lateral nasal artery
Term
the facial vein is the continuation of which vein?
Definition
the angular vein; has no valves
Term
what 2 veins unify to form the angular vein?
Definition
the supraorbital and supratrochlear veins
Term
what 2 veins unify to form the retromandibular vein?
Definition
the union of superficial temporal and maxillary veins

descends within the parotid gland
Term
true or false: infection of the skin may be a source of intracranial infection
Definition
true
Term
does the facial vein have valves?
Definition
no

blood flow can go in 2 different directions, inside and outside cranial
Term
where does the facial vein terminate?
Definition
into the internal jugular vein
Term
with which vein does the facial vein communicate?
Definition
the superior ophthalmic vein, which drains into the cavernous sinus

facial vein communicates:
With orbit via superior ophthalmic vein

With dural venous sinuses via pterygoid plexus
Term
are there lymphatic nodes in the scalp?
Definition
no

lymph drained to superficial LN’s: occipital, mastoid, pre-auricular and parotid (superficial with veins, deep with arteries)
Term
lymph from the lateral part of the face and scalp drains where?
Definition
to superficial parotid lymph nodes
Term
lymph from the upper lip and lateral parts of the lower lip drains where?
Definition
into submandibular lymph nodes
Term
lymph from the chin and central part of the lower lip drains where?
Definition
into submental lymph nodes
Term
what are the 4 components of the facial nerve?
Definition
1. Somatic (brachial) motor
2. Visceral (parasympathetic) motor
3. Special sensory (special
afferent).
4. General sensory (general somatic afferent)
Term
the somatic component of the facial nerve supplies what?
Definition
Supplies the muscles of facial expression; posterior belly of digastric, stylohyoid, and stapedius.
Term
the visceral motor component of the facial nerve supplies what?
Definition
presynaptic to pterygopalatine ganglion to the lacrimal, submandibular,
sublingual glands, mucous membranes of hard and soft palate, nasopharynx.
Term
the special sensory component of the facial nerve innervates what?
Definition
Taste sensation from the anterior 2/3 of tongue; hard and soft palates (from chorda tympani to lingual nerve).
Term
the somatic (general) sensory component of the facial nerve supplies what?
Definition
General sensation from the skin
of the concha of the auricle and
from a small area behind the ear
Term
what occurs if there is a central lesion to the facial nerve?
Definition
paralysis of muscles on contralateral side.

Forehead is spared due to double innervation
Term
motor paralysis of the facial nerve causes what?
Definition
ipsilateral Bell's palsy
Term
lesion of CN VII near origin of the nerve of near the geniculate ganglion results in what?
Definition
loss of motor, taste, and autonomic function
Term
can a motor neuron lesion be a bell's palsy?
Definition
no
Term
upper motor neuron lesions cause what?
Definition
facial asymmetry

atrophy of muscles of lower portion of the face on affected side

no eyebrow droop

intact folds on forehead

intact conjunctival reflex

smoothing of nasolabial folds on affected side

lips cannot be held tightly together or pursed

difficulty keeping food in mouth while chewing on affected side
Term
lower motor neuron lesions cause what?
Definition
marked facial asymmetry

atrophy of facial muscles

eyebrow droop

smoothing out of forehead and nasolabial folds

uncontrolled tearing and loss of efferent limb of conjunctival reflex

drooping of the mouth corner

lips cannot be held tightly together or pursed

difficulty keeping food in mouth while chewing on the affected side
Term
which muscle is responsible for keeping food in the mouth?
Definition
the buccinator muscle
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