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41 Cards in this Set

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Facial bones
1. nasal bones-2 bones form bridge of nose
2. lacrimal-small bone that contributes to medial wall of orbit
3. zygomatic-bony part of cheek
4. vomer-forms part of nasal septum
5. inferior concha-paired bones that project from lateral wall
6. palatine-forms floor of nasal cavity/roof of mouth
7. maxilla
8. mandible
facial bone-
Maxilla
four sided pyramid lying on its side; four surfaces and four processes
1. base-faces the nasal cavity
2. orbital surface-forms part of floor of orbit
3. facial surface-front
4. infratemporal surface-faces infratemporal fossa
5. frontal process-projects up to articulate with frontal bone
6. zygomatic process-articulates with zygomatic bone
7. alveolar process-tooth socket; maxilla has all sockets of upper teeth
8. palatine process-forms roof of mouth
9. maxillary sinus-large cavity inside of maxilla
facial bone-
Mandible
largest and strongest bone of face;
1. 2 parts
2. process
3. chin
4. foramina
two main parts that meet @ Angle of Mandible
1. horizontal body
2. vertical ramus
Process of mandible
alveolar-contains bottom teeth
Chin
"mental";
1. mental protuberance-@ midline
2. mental tubercles-on either side of protuberance
3. chin is unique to humans
foramina of face
1. supraorbital- in frontal bone
2. infraorbital-in maxilla
3. mental-in mandible; transmit cutaneous sensory nerves, branches of trigeminal nerve
4. zygomatic facial-tiny, contains another branch of trigeminal for skin over bony part of the cheek
Lateral view of mandible
Ramus projects superiorly and ends in 2 processes:
1. coronoid process-attachment of temporalis muscle
2. condyloid process-consists of head and neck; head articulates with temporal bone=TMJ
3. mandibular notch-separates processes
Newborn skull
1. facial skeleton forms 1/8 of volume of skull compared to 1/3 in adults
2. newborns lack teeth-alveolar processes are underdeveloped
3. paranasal sinues are very small or absent @ birth
4. no mastoid process
Adult skull
1. paranasal sinuses-all paired
a. maxillary air sinus-largest; fills up much of body of maxilla; facial, infratemporal, and orbital surface
b. sinuses add resonance to voice
c. lighten skull
d. all sinuses open into nasal cavity
Muscles of facial expression
1. frontalis-raising eyebrows
2. depressor anguli oris-pulling down corner of mouth
3. nasalis-wrinkling of nose
Frontalis
1. associated with scalp
2. originates from epicranial aponeurosis
3. inserts into eyebrows, therefore raises eyebrows
orbicularis oculi
1. orbital part- outer portion
a. quite strong and thick
b. surrounds bony margin of orbit, originates from medial margin of orbit and medial palpebral ligament
c. circles part of orbital surface
d. closes eye forcefully
2. palpebral part-inner portion
a. thinner, more delicate than orbital
b. used in blinking, sleeping, light closure of eyes
c. if can't close eye, the cornea will dry out
Muscles of neck:
Playsma
1. large, very flat, thin
2. easy to remove with skin
3. lies in superficial fascia of neck
4. inserts into corner of mouth and lower vorder of mandible
5. helps draw lower corner of mouth down to express fright
Muscles of mouth
1. orbicularis oris
2. levator labii superioris-elevates upper lip
3. depressor labii inferioris-depresses lower lip
4. levator anguli oris-deep, elevates corner of mouth
5. depressor anguli oris-depresses corner of mouth
6. zygomaticus major and minor-pull up corner of mouth
7. mentalis-protrudes lower lip
8. buccinator
muscle of mouth:
orbicularis oris
1. forms sphincter around oral opening
2. purses lip, protrudes lips when sucking or whistling
3. rest of muscles blend into this muscle
muscle of mouth:
buccinator
1. deeply placed
2. forms soft part of cheek
3. bony origin from alveolar process of maxilla and mandible
4. fibrous origin from pterygomandibular raphe
5. fibers run horizontally forward to insert into lips, blending with fibers of orbicularis oris
6. parotid duct pierces buccinator so that secretions empty into vestibule of mouth
7. compresses the cheek, used in blowing, whistling, and smiling
8. used in eating-tone keeps bolus of food between occlusal surfaces of teeth
Nerves of face:
Facial Nerve (CN VII)
1. motor nerve of face
2. innervates all facial muscles
3. leaves brain from posterior cranial fossa and enters the opening in the temporal bone called the Internal Auditory Meatus; then emerges on base of skull in stylomastoid foramen
branches of Facial Nerve
(CN VII)
gives off 2 small branches as it emerges:
1. posterior auricular-innervates occipitalis and auricular muscles
2. nerve to stylohyoid and digastric muscles-muscles of neck
3. facial nerve sinks into parotid and divides into 5 branches
a. temporal-innervates frontalis and superior part of orbicularis oculi
b. zygomatic-cross zygomatic arch, innervates lower part of o. oculi and zygomatic muscles
c. buccal-run superficial to masseter, go to oral area and innervate buccinator and o. oris
d. marginal mandibular-run along margin of mandible, innervate muscles of lower lip and chin
e. cervical-innervate playsma
Bell's Palsy
1. facial muscles on one side are paralyzed
2. sudden onset
3. corner droops, levator anguli oris and zygomatic major paralyzed
4. buccinator cannot keep food out of vestibule
5. can't chew properly
6. constantly drooling
7. can't close eyes
8. tears spill out on face
9. might be caused by inflammation as the nerve transverses the temporal bone
branches of Facial Nerve (CN VII) within the facial canal
1. greater petrosal-presynaptic parasympathetic fibers that supply lacrimal gland, in the orbit
2. nerve to stapedius-tiny muscle in inner ear; functions to keep stapes from moving too much and protects from sudden loud sounds (reflex); paralysis leads to hyperacousis
3. chorda tympani-comes off just proximal to stylomastoid foramen; carries taste fibers from anterior 2/3 of tongue
Trigeminal Nerve (CN V)
chief sensory nerve of face and head; 3 major branches:
1. ophthalmic-V1
2. maxillary-V2
3. mandibular-V3
All have sensory fibers (GSA), fibers which supply skin and certain mucus membranes of nasal and oral cavity
**Only mandibular has efferent fibers (SVE)-supply muscles of mastication
ganglion of trigeminal nerve
1. swelling that lies in middle cranial fossa and is much like a dorsal root ganglia of spinal nerve-contains cell bodies of psedounipolar neurons and strictly a sensory ganglion
2. peripheral processes pass out of V1-V3
3. All return signals to brain
Trigeminal nerve (CN V): V1
skin of forehead, upper eyelid and dorsum, some of sides and tip of nose
CN V: V2
lower eyelid, upper lip, side of nose and area in from of temple
CN V: V3
reverse L-shaped region, lower lip, chin, lower part of cheek, part of ear, auricle, and temple
**only area of facial skin trigeminal nerve doesn't get is over Angle of Mandible
Facial artery
terminal branch of ECA;
1. only branch that gives off branches of its own
2. appear on face first at lower border of mandible
3. tortuous course to angle of eye
4. branches:
a. inferior and superior labial
b. lateral nasal
c. angular-near medial angle of eye, terminal branch
Ophthalmic artery
off the ICA, branches into:
1. supraorbital
2. supratrochlear
3. dorsal nasal
venous drainage:
facial vein
parallels facial artery, but posterior; usually unites with retromandibular vein; jnctn of anterior division of retromandibular and facial veins is common facial vein, which drains into IJV
communications of facial vein between deeper veins
superior and inferior ophthalmic veins which connect the upper part of facial vein, angular vein, with the cavernous venous sinus inside skull
clinical correlations of venous infection spread
1. valveless veins; should infection get into facial vein in area near the angular vein, it could travel posteriorly into sinus, inside skull
2. deep facial vein, lies in soft part of cheek that connects facial vein to pterygoid plexus of veins, which is connected to caverous sinus by little veins at base of skull
External nose
Bony and cartilaginous:
1. nasal bones on frontal process of maxilla and frontal bone contribute to bony framework
2. lower part of nose has cartilaginous framework, including septal cartilage in midline and lateral expansions on either side called lateral nasal cartilages or processes of septal cartilages
3. U-shaped cartilage, which bonds the external nostril called greater alar cartilage
5 layers of eyelid
1. skin
2. subcutaneous
3. palpebral part of orbicularis oculi-part that gently closes eye
4. tarsal fascia layer
5. conjunctiva
More:
Tarsal fascia layer
2 parts:
1. dense thickening of connective tissue in both upper and lower eyelids know as tarsal plates which stiffen the lid
2. fascia-orbital septum or palpebral fascia
3. together form sheet of tissue from bony margin of orbit to margin of lid
More:
Conjunctiva
**mucus membrane which lines the inner surface of eyelid
1.palpebral part
2. bulbar part-at upper part of eyelid, conjunctiva is reflected onto upper part of eyeball (same for lower lid)
3. points of reflection where palpebral and bulbar conjunctiva are continuous are called fornices
4. conjunctiva sac is space between the two
5. tears are secreted into superior fornix of sac
6. tarsal glands embedded in the tarsal plates-have oily secretion; glands open on margins of lid an dkeep lids from sticking together and waterproof the lids
8. tarsal plates bound to orbital margins by medial and lateral palpebral ligaments
9. lacrimal sac lies just posterior to medial palpebral lig
Lacrimal apparatus
1. gland lies in upper lateral corner of orbit
2. ducts are tiny and open to superior fornix; about 12 ducts secrete into sac and blinking draws lids medially and spreads fluid
3. lacrimal papilla
4. lacrimal punctum-tiny opening on summit of papilla
5. lacrimal canaliculis-tube
**excess lacrimal fluid is suctioned into punctum with capillary action into canaliculi which drain into sac, which lies in medial margin of orbit; sac drains inferiorly into nasal cavity via nasolacrimal duct (sniffing when cry)
autonomic innervation
1. lacrimal gland- secretomotor fibers are parasympathetic
2. CN VII (facial nerve) controls lacrimation and so presynaptic fibers leave brain with this nerve (via temporal bone, Greater Petrosal nerve)
3. greater petrosal nerve joins the deep petrosal nerve (postsynaptic sympathetic-cell bodies lie in neck and cervical ganglion)
4. the joining of these 2 nerves makes the nerve of the pterygoid canal (bony canal in sphenoid bone)
AI: pterygoid canal
**canal leads to space in skull called pterygopalatine fossa where pterygopalatine ganglion lies
1. synapse occurs for parasympathetic fibers
2. pterygopalatine ganglia lies in wedge-shaped space on side of skull (fossa)
2. postsynaptic fibers run up and connect with maxillary nerve and travel in now what is the zygomatic nerve to enter orbit
3. run up to lacrimal nerve, which is branch of V1, and leads to lacrimal gland
5 layers:
SCALP
1. Skin
2. dense Connective tissue-contains vessels and nerve to scalp
3. Aponeurosis-epicranial aponeurosis where frontalis originates
**first 3 layers are very closely bound together, move together as unit on fourth layer
4. Loose connective tissue-danger layer b/c infections can spread quite rapidly; emissary veins-little valveless veins that connect veins outside to inside skull; infection can spread into intradural venous sinuses
5. Pericranium-outer connective tissue of skull
Blood and Nerve supply to SCALP
Nerves:
1. All 3 divisions of trigeminal nerve have cutaneous brs
2. more posteriorly, cervial nerves, Greater and Lesser occipital nerves
Blood:
* 3 direct branches of ECA:
1. Superficial temporal
2. posterior auricular
3. occipital
**all anastomose
* 2 indirect branches off ICA:
1. supraorbital
2. supratrochlear
**these anastomose
CC: laceration to head
1. most common head injury requiring surgical intervention
2. heavy bleeding due to anastomoses
3. arteries are in dense Connective tissue, therefore remain open