1. Skull, Scalp, Superficial Face and Neck
Terms
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- What's the cranium?
- the skull - skeleton of the head
- Calvaria
- dome of cranium
- neurocranium
- calvaria + cranial base
- viscerocranium
- facial skeleton
- Neurocranium bones
- Frontal, parietal, temporal, occipital, sphenoid, ethmoid
- condyloid process
- on the mandible, extends to the head which articulates with the mandibular fossae of temporal bone - TMJ
- coronoid processes
- insertion of the temporalis muscle; extends up right behind the back teeth, where it hides behind the zygomatic arch when the mouth is closed; the insertion of pterygoid muscle
- facial bones
-
14
2 zygomatic, 2 maxilla, 2 palatine, 2 lacrimal, 2 nasal, 2 inferior nasal concha; 1 vomer and 1 mandible. - Sutures of the skull
- coronal, sagittal, lambdoidal, squamosal
- 8 craniometric points:
-
1. Nasion
2. Glabella
3. Pterion
4. Bregma
5. Vertex
6. Lambda
7. Asterion
8. Inion - Where is the nasion?
- At the bridge of teh nose
- what is the glabella?
- The smooth point above the nasion
- where is the pterion?
- at the point where 4 cranial bones meet - at the level of the greater wing of the sphenoid.
- What artery courses under the pterion?
- The middle meningeal artery
- Where is the bregma located?
- Where the 2 parietal bones meet the frontal.
- where is the vertex?
- at the vertex
- where is the lambda?
- At the junction of the sagittal and lambdoid sutures
- where is the asterion?
- at the junction of the squamous and lambdoid sutures.
- where is the inion?
- protuberance at the back of the head
- What 2 age-related skull changes occur?
-
1. Fontanelles in newborns
2. Mandibular recession in elderly - What are the layers of the scalp?
-
S-skin
C-connective tissue
A-aponeurosis
L-loose connective tissue
P-pericranium - What is characteristic about the scalp connective tissue?
- Highly supplied w/ neurovascular structures
- What is the aponeurosis called?
- Galea aponeurotica
- what is the galea aponeurotica?
- A helmet like piece of tissue that connects the bellies of the occipitofrontalis and epicranius muscles.
- What innervates galea aponeurot?
- Facial nerve - CN VII
- What are the 2 layers of the pericranium?
-
-Epicranium
-Endocranium - How do the pericranial layers connect?
- Through skull sutures - pass from within to without.
- Where are the epi/endocranium layers found?
-
Epi = top of cranium (external)
Endo = inside cranium (internal) - What 2 considerations are important to remember when treating scalp lacerations?
-
1. Profuse bleeding
2. Gaping wounds if aponeurosis is cut - What is the proper scalp composed of?
- SCAL -> all stays together as one thick layer
-
What are the first 6 of the 16 muscles of facial expression?
(BCDDLL) -
-Buccinator
-Corrigator supercilii
-Depressor anguli oris
-Depressor labii inferioris
-Levator labii superioris
-Levator labii alaeque nasi -
What are the last 10 of the 16 muscles of facial expression?
(MNOOOPPRZZ) -
-Mentalis
-Nasalis
-Orbicularis oculi/oris
-Occipitofrontalis
-Platysma
-Procerus
-Risorius
-Zygomaticus major/minor - What layer are these facial muscles derived from in devo?
- Pharyngeal arches
- What are the 2 general functions of orbicularis oculi?
-
1. Help control light entering eye
2. Distribute tears - 2 portions of orbicularis oculi:
-
1. Palpebral portion
2. Orbital portion - What does the palpebral portion of orbic oculi do?
- Closes eyelids voluntarily or involintarily (blinking)
- What does the orbital portion of orbic oculi do?
- closes lids voluntarily
- What is the function of orbicularis oris?
- lip movements
- What is the function of zygomaticus major?
- draws angle of mouth upward
- what is the function of zygomaticus minor?
- elevates upper lip exposing maxillary teeth
- what is the function of levator labii superioris?
- raises upper lip
- what is the function of levator labii superioris alaeque nasi?
- dilates nostril
- what is the function of nasalis?
- Affects nasal aperture during deep inspiration
- What is the function of procerus?
- draws medial angle of eyebrows inferiorly
- What is the function of Corrigator supercilii?
- Draws eyebrows medially and downward as in frowning or shielidng eyes from brite lite.
- What is the function of the Buccinator?
-
Compresses the cheeks against the teeth and gums;
Attaches to pharyngeal muscles posteriorly - what is significant about the buccinator in infants?
- the buccal fat pad keeps cheeks from collapsing inward during suckling.
- what is the function of risorius?
- participates in many facial actions
- What is the function of depressor anguli oris?
- draws angle of mouth down/lateral
- what is the function of depressor labii inferioris?
- draws lower lip downward
- what does mentalis do?
- raises/protrudes lower lip - drinking or pouting
- what does platysma do?
- produces tension in neck skin; labial part draws down lower lip
- what is function of occipitofrontalis?
- raises eyebrows/wrinkles forehead
- What gives motor innervation to muscles of facial expression?
- Facial nerve - CN VII
- 5 branches of CN VII
-
1. Temporal
2. Zygomatic
3. Buccal
4. Marginal mandibular
5. Cervical - As it enters the viscerocranium, what does the facial nerve plunge into?
- The parotid gland
- What is the posteriorly headed branch of CN VII? How does it get there?
- Posterior Auricular branch; passes through the stylomastoid foramen
- What does the posterior auricular branch of CN VII innervate?
- Occipitalis
- What branch of CN VII innervates frontalis?
- Temporal branch
- what innervates orbicularis oculi?
-
temporal branch (superiorly) &
zygomatic branch (inferiorly) - Which branch of the CN VII (facial) innervates the platysma?
- Cervical branch
- What term denotes a peripheral lesion of the facial nerve?
- Bells Palsy
- What are the 4 characteristics of bells palsy to take note of?
-
1. Facial muscle paralysis
2. Can't close eyelids
3. Mouth angle droops
4. Forehead doesn't wrinkle - Recap; what connective tissue connects frontalis and occipitalis mucles?
- Epicranial aponeurosis (galea)
- What 3 nerves recieve sensory information from the face and scalp?
-
1. Trigeminal V
2. Cervical n. 2
3. Cervical n. 3 - In general what is CN V responsible for?
-
-Motor innervation of muscles of mastication
-Sensation of the face - Where does the sensory info recieved by CN V branches get sent to?
- trigeminal ganglion; then to the sensory root.
- What are the divisions of CN V?
-
1. Opthalmic (sensory only)
2. Maxillary (sensory only)
3. Mandibular (mixed) - In what part of the face does V1 provide sensation?
-
-Top of skull in line w/ ear
-Tip of nose just above opening
-from corner of nose to corner of eye to high up on temporals. - In what part of the face does V2 provide sensation?
-
-High up on temporals peak
-Down around corner of eye to tip of nose above nostril
-upper lip to mid cheek then back up to the peak - In waht part of the face does V3 provide sensation?
-
-Where V1 stops high up on temporals
-Where V2 peaks on temporals
-Just under chin, along jaw, up to ear adn very front of it. Back up to top of temporal in line with ear. - What nerve provides sense info from the back of the skull?
- Dorsal rami of C2 and C3
- What nerve provides sensory info from the ear, just behind the ears, and sides of the neck?
- Ventral rami of C2 and C3
- What problem is usually seen with CN V?
- Trigeminal neuralgia - intermittent excruciating pain is felt; usually assoc. w/ V2
- What 2 main arteries give vascular supply to the face?
-
1. External carotid
2. Internal carotid - How many branches of ext. carotid feed the face? acronym?
- 6: FASTPO
- What are the 6 branches of external carotid?
-
1. Facial a (which ends in)
2. Angular a
3. Sup/inf labial aa.
4. Transverse facial
5. Posterior auricular
6. Occipital - which are branches of the facial artery?
-
Angular
Sup/inf labial - What is the transverse facial artery a branch of?
- Superficial temporal a - just another branch of the ext. carotid.
- What 2 branches does the internal carotid supply to the face?
-
1. Supratrochlear (from opthalm)
2. Supraorbital (from opthalmic) - Where is the facial artery?
- in the jaw region
- Where is teh angular artery?
- in the corner of the eye
- Where are the superior/inferior labial arteries?
- above/below the lips
- What do the supratrochlear and supraorbital veins drain into?
- Combine to join w/ angular vein
- What/where is the retromandibular vein?
- The union of the maxillary vein and superficial temporal vein; exits the face just under ear.
- What happens to the retromandibular vein?
- Splits to send blood to both internal and external jugulars.
- What does retromandibular v. send to external jugular vein?
-
-Posterior retromandib branch
-Posterior auricular vein - What does retromandibular v. send to internal jugular vein?
-
-Anterior retromandib branch
-Facial vein - What separates the internal and external jugular veins?
- Sternocleidomastoid
- What is thrombophlebitis of the facial vein?
- Spread of infection via facial vein communication w/ opthalmic vein and cavernous sinus - spreads superficial infections to the brain.
- What are the 2 types of facial lymphatic drainage to consider?
-
-Deep
-Superficial - What is the flow of superficial lymphatic drainage?
-
-Lymph from superfic face/scalp collects in vessels
-Vessels drain into superfic nodes at head/neck junction
-Lymphs flows to deep cervical lymph nodes - What is the flow of deep lymphatic drainage?
-
-Tongue & tonsils drain to deep cervical lmph nodes
-Deep lymph nodes located around IJV - What are the 8 structures of the outer ear?
-
LASHCAT
Lobule
Antihelix
Scaphoid fossa
Helix
Concha
Antitragus
Tragus - what are 2 alternate names for the outer ear?
- auricle or pinna
- what is the tragus?
- the little flap above the opening to the ear
- what is the antitragus?
- the flap across from the tragus
- what is the concha?
- the flatbed of the ear opening
- where is the lobule?
- the ear lobe; did u really need this flashcard?
- not really but im bored
- ok then
- where are the helix/antihelix?
-
Helix = top part of ear
Antihelix = skin just inside helix - What separates the helix and antihelix?
- Scaphoid fossa
- What is the external acoustic meatus?
- The canal extending from the superficial ear down to the middle ear
- What separates the outer/middle ear?
- Tympanic membrane
- What are the 3 main features of the middle ear?
-
-Auditory ossicles
-Muscles
-Eustachian tube - What are the 3 auditory ossicles?
-
1. Malleus
2. Incus
3. Stapes - What is the function of the auditory ossicles?
- To mechanically transfer acoustic energy from the tympanic membrane to the inner ear oval window.
- What are the muscles of the middle ear and their innervations?
-
-Stapedius - CN VII
-Tensor tympani - V3 - What is the purpose of having middle ear muscles?
- To dampen particularly loud sounds.
- Where does sound go after passing through the ear?
- To the inner ear auditory canal.
- What are 2 extra names for the auditory canal?
-
-Eustachian tube
-Pharyngotympanic tube - What is the auditory canal's function?
- To equalize middle ear pressure w/ atmospheric pressure.