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36 Cards in this Set
- Front
- Back
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face
- define - boundaries |
anterior aspect of head
boundaries: - sup: forehead (superciliary arches - inf: lower edge of mandible - lat: ears |
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scalp
- layers - boundaries |
layers (SCALP)
- skin - CT: thick, dense, lots of blood - aponeurosis: attachment of frontal and occipital bellies of the occipitofrontalis muscle - loose CT: DANGER ZONE spongelike with lots of potential spaces. facilitates movement - pericranium (periosteum of outer surface) SCA considered "scalp proper" boundaries - superior nuchal line of occipital bone - supraorbital margin of frontal bone - zygomatic arches |
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muscles of facial expression
- overview |
- derived from 2nd pharyngeal arch (CN VII)
- located in superficial fascia - origin: bone/fascia - insertion: skin - 3 functional groups: orbital, nasal, oral |
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muscles of facial expression
- orbital group (2) |
- orbicularis oculi: surrounds the orbital oriface and extends into the eyelid (3 parts)
2 major parts: - orbital: close eye tightly, wrinkle forehead - palpebral ("on eyelid"): gently closes eye 1 minor part: lacrimal part: aids in drainage of tears from lateral -> medial of eye - corrugator supercilii: cause vertical wrinkles above nose [WORRY LINES] * from medial superciiliary arch to middle of supraorbital margin |
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most commonly botoxed muscle in face
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corrugator supercilii!
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muscles of facial expression
- nasal group (2) |
- procerus
from nasal bone and upper nasal cartilage to skin of lower forehead - make wrinkles over bridge of nose (DISDAIN) nasalis: 2 opposing parts - transverse: compress nares - alar: open nares |
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muscles of facial expression
- oral group **2 normal **3 lower group **4 upper group ** 2 misc |
normal:
- orbicularis oris - buccinator lower: - depressor anguli oris - depressor labii inferioris - mentalis upper: - zygomatic major - zygomatic minor - levator labii superioris - levator labii superioris alaque nasi misc: - occipitofrontalis - platysma |
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muscles of facial expression
- oral group 2 normal |
- orbicularis oris: completely encircles mouth
origin: maxilla, mandible, corner of mouth insert: mucous membrane of lips A: close mouth, purse lips buccinator: keeps food in oral cavity origin: post mandible, maxilla, pterygomandibular raphe insert: lips and blends with orbicularis oris Action: presses cheek against teeth |
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muscles of facial expression
- oral group **3 lower |
depressor anguli oris
- side of mandible to corner of mouth - depresses corner of mouth depressor labii inferioris - deep to above - mandible to lower lip - LOWERS the lower lip and moves lateral mentalis - mandible to skin of chin - wrinkles chin [POUTING] |
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muscles of facial expression
- oral group **4 upper |
zygomatic major
- lateral zygomatic bone to skin of corner of mouth zygomatic minor - ant zygomatic bone to medial to corner of mouth levator labii superioris - maxilla to skin of upper lip - deepen furrow bw nose and corner of mouth - SADNESS levator labii superioris alaeque nasi - longest name - medial to above - frontal process of maxilla to alar of nose and lip - flare nostrils and raise upper lip - ELVIS PRESLEY |
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muscles of facial expression
- oral group **2 misc |
occipitofrontalis
- attachments: skin of eyebrows -> aponeurosis -> superior nuchal line - action: retract scalp (occipital belly) or raise eyebrows (frontal belly) platysma - below clavicle to mandible and muscles of mouth. - tenses skin of neck (wrinkles) |
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muscles of mastication
- where do they act on - what type of joint - describe the joint |
acts on the TMJ
it is a modified synovial hinge joint formed between the head of mandible and "articular tubercle" and "mandibular fossa" of temporal bone description: - joint is divided into upper/lower parts by articular disc - sup and inf synovial membranes are completely separate - joint capsule is attached to the articular disc |
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movements along TMJ
- which muscles involved |
depression:
- gravity - digastric, geniohyoid, mylohyoid elevation: - temporalis - masseter - medial pterygoid protrusion - lateral pteryoid - assist with medial pterygoid retraction: - post fibers of temporalis - deep masseter - geniohyoid - digastric lateral movements (grinding) |
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muscles of mastication
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- masseter
- temporalis - lateral pteryoid - medial pterygoid |
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masseter muscle
- origin - insertion - nerve - action |
A: elevate mandible
O: zygomatic arch/maxillary process of zygomatic bone I: angle and lateral surface of ramus of mandible N: masseteric nerve of V3 |
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temporalis muscle
- origin - insertion - nerve - action |
A: elevation of mandible
O: temporal fossa/fascia I: coronoid process of mandible and anterior ramus N: deep temporal branch of V3 |
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lateral pterygoid muscle
- origin - insertion - nerve - action |
A: protracts mandible
O: - upper: roof of infratemporal crest of greater wing of sphenoid - lower: lateral surface of lateral pterygoid plate I: joint capsule of TMJ and condyloid process of mandible N: lateral pterygoid n of V3 |
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medial pterygoid muscle
- origin - insertion - nerve - action |
A: elevate mandible (some protrusion)
O: superficial: tuberosity of maxilla deep: medial surface of pterygoid plate I: medial surface of ramus N: medial pterygoid of V3 |
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nerves of face and scalp
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- since face is derived from first and second pharyngeal arch, CN V and VII
- CN V: cutaneous innervation of face and motor muscles of mastication - CN VII: motor to muscles of facial expression - SCALP innervated by CN and cervical nerves |
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path of CN VII
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- exits post cranial fossa via INTERNAL ACOUSTIC MEATUS
- pass through temporal bone, give branches in cranial cavity - exit skull through STYLOMASTOID FORAMEN - enters parotid gland and divides into: UPPER TEMPOROFACIAL BR LOWER CERVICOFACIAL BR - the two branches form: parotid plexus - 5 terminal branches of the plexus |
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5 terminal branches of CN VII
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Two Zebras Bit My Coccyx
(T and Z above parotid duct) (B and M below parotid duct) (C below mandible) - temporal: temple forehead, supraorbital region - zygomatic: infraorbital, lateral nasal - buccal: cheek, upper lip, corner mouth - marginal mandibular: lower lip, chin - cervical: platysma |
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bells palsy
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- injury to CN VII that causes ipsilateral muscle weakness to facial expression
- unknown etiology can be shingles - sudden onset, variable prognosis |
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sensory innervation to the face and scalp
- general plan - specific nerves |
FACE: all sensory innervation is provided by CN V
SCALP: - anterior to vertex: CN V - posterior to vertex: cervical nerves **note: occipitofrontalis is innervated by CN VII** specific: ANTERIOR - supratrochlear (V1) - supra-orbital (V1) - zygomaticotemporal (V2) - auriculotemporal (V3) POSTERIOR (C2-3) - great auricular - lesser occipital - greater occipital - 3rd occipital |
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branches of CN V and their innervation type
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V1: ophthalmic
- sensory only V2: maxillary - sensory only V3: mandibular - sensory - motor to 4 mastication muscles |
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arterial supply of face
- ECA (9) |
PRIMARY SOURCE
- facial artery is major vessel. - facial a terminates as angular artery at medial eye - other facial artery branches: *inferior labial a *superior labial a *lateral nasal a - transverse facial artery [br off superficial temporal artery; terminal branch of ECA] - maxillary artery branches *infra-orbital: enters through infraorbital foramen *buccal *mental: through mental foramen |
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arterial supply of face
- ICA (5) |
SECONDARY SOURCE
branches of ophthalmic artery - zygomaticofacial - zygomaticotemporal - dorsal nasal - supra-orbital - supratrochlear |
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arterial supply of scalp
- imp clinical concept with blood supply |
ECA:
- superficial temporal - post. auricular - occipital ICA - supratrochlear - supraorbital IMPORTANT - arteries anastamose ipsilaterally and contralaterally |
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parotid gland
- location - where does duct exit - what is its path |
location:
- ant: extends halfway across masseter - post: covers SCM and masseter - sup: zygomatic arch - inf: lower border of mandible duct exit - ant aspect of gland halfway bw zygomatic arch and corner of mouth duct path - pierces buccinator muscle - enters oral cavity @ second upper molar |
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structures that enter or pass through/deep to parotid gland
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- CN VII
- ECA and branches - retromandibular vein *this is formed IN THE PAROTID gland by the union of: - superficial temporal v - maxillary v |
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innervation of the parotid gland
- sensory - PSNS - SNS |
sensory (gland/parotid sheath/skin):
- auriculotemporal (V3) - great auricular (C2-3) PSNS (stimulate secretion) - presynapse: CN IX - synapse: otic ganglia - postsynapse: auriculotemporal (V3) SNS (reduce secretion) - cervical ganglia via ECA plexus |
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boundaries of temporal fossa
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- posterior/superior: sup/inf temporal lines
- anterior: frontal/zygomatic bones - laterally: zygomatic arch - inferior: infratemporal crest - floor: parietal/frontal/temporal/sphenoid - roof: temporal fascia |
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contents of temporal fascia (5)
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- temporalis muscle/fascia
- deep temporal n (V3) - zygomaticotemporal n (V2) - deep temporal a [br of maxillary] - middle temporal a [br of superficial temporal a] |
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boundaries of infratemporal fossa
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- lateral: ramus of the mandible
- medially: lateral pterygoid plate - ant: post maxilla - post: tympanic plate/mastoid process/styloid process - sup: inf surface of greater wing of sphenoid - inf: attchment of medial pterygoid to mandible |
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contents of infratemporal fossa (8)
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- inferior temporalis
- sphenomandibular ligament - medial pterygoid muscle - lateral pterygoid muscle - maxillary a and branches - pterygoid plexus (venous) - mandibular V3 - buccal n (branch of V3) |
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sphenomandibular ligament
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ligament that attaches the spine of sphenoid bone to lingula of mandible
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difference bw buccal n and buccal branch
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- buccal nerve: a branch of V3
deep/medial to masseter - buccal branch: a branch of CN VII superficial/lateral to masseter |
