Face

Question 1

Where are the boundaries of the face

Where are the 9 facial subregions

Answer 1

Superior border => forehead
Inferior border => chin
Lateral border => ears

Orbital => around eyes
Infra orbital => under eyes
Buccal => next to mouth
Parotid => inferolateral to cheeks
Zygomatic => bony ridge of cheeks
Nasal => nose
Oral => around mouth
Mental => chin

Question 2

What is the function of the face

What is found in the face

Answer 2

Identity, expression, communication

Facial bones
Musculature
Special senses

Question 3

Name the 14 bones that make up the viscerocranium
-which ones give the face its shape

What else gives the face its shape

Answer 3

Inf nasal concha
Lacrimal
Palatine
Vomer

Maxilla
Mandible
Nasal
Zygomatic

Fat

Question 4

What is special about the muscles of the face

How would you group the facial muscles

Answer 4

Very superficial
-lack of fat or tissue between skin and skull

Originate on bone => insert into skin

Scalp, forehead, eyebrows
Mouth, lips, cheeks
Orbital opening

Question 5

What are the muscles of the

-scalp, forehead, eyebrows

Answer 5

Epicranius (frontalis, occipitalis)

• cranial aponeurosis to eyebrows
• raise eyebrows

Question 6

What are the muscles of the

-mouth, lips, cheeks

Answer 6

Orbicularis oris

• multiple layers (extrinsic-originate from other muscles)
• intersects at the corners of the mouth

Buccinator (cheek muscle)

• mandible, maxilla to orbicularis oris
• presses cheek against teeth => food against molars,suckling

Zygomaticus (smiling)

• zygomatic => orbicularis oris and levator anguli oris
• smiling grinning

Platysma (depress mandible)

• clavicle => mandible
• tense skin, depress mandible

Question 7

What are the muscles of the

-orbital opening

Answer 7

Orbicularis oculi

• frontal, maxilla, lacrimal around orbit
• blinking

Question 8

Describe the arterial supply to the face

Answer 8

ECA gives off many branches

• facial branch => skin and muscles
• transverse facial => parotid, masseter
• lateral nasal => nose
• labial (superior, inferior) => lips

Question 9

Describe the venous supply of the face

Answer 9

Parallel path to equivalent name sarteries

Superficial
-drained from plexus at the surface that drain at anterior scalp => facial vein => int jugular vein

Deep

• deep facial vein => facial vein
• retromandibular divides to drain into the facial vein or external jugular

Question 10

Describe the innervation of the face and facial muscles

Answer 10

Trigeminal

• sensory of face, scalp
• motor for mastication

Facial
-motor for facial muscles

Question 11

Describe the route of the opthalmic nerve

-what does it innervate

Answer 11

Opthalmic nerve
Pseudopolar neurone in trigeminal ganglion
SOF

Branches into

• Frontal => supraorbital and supratrochlear branches
• Nasociliary => intratrochlear and anterior ethmoidal branches (anterior ethmoidal => ext nasal)
• Lacrimal

Top of head
Upper eyelid
Medial surface of nose

Question 12

Describe the route of the maxillary nerve

-what does it innervate

Answer 12

Maxillary nerve
Pseudopolar neruone in trigeminal ganglion
Foramen rotundum

Branches into

• Zygomatic => zygomaticofacial via zygomaticofacial foramen (cheek), zygomaticotemporal via zygomaticotemporal foramen (anterior temporal scalp
• Infraorbital via infraorbital foramen

Lower eyelid
Lateral nose
Upper lip
Mucosa of maxillary sinus
Top teeth

Question 13

Describe the route of the mandibular nerve

• what does it innervate
  
  • sensory

Answer 13

Mandibular nerve
Pseudopolar neurone in trigeminal ganglion
Foramen ovale

Branches into

• auriculotemporal => skin in front of ear
• lingual => ant 2/3 tongue
• buccal => skin, oral mucosa
• inferior alveolar => mandibular foramen => inferior dental plexus => mental nerve

Lateral temporal
Anterior ear
Mandible

Question 14

Describe the route of the mandibular nerve

• what does it innervate
  
  • motor

Answer 14

Mandibular nerve
Joins sensory component distal to trigeminal ganglion

Branches to masticators

• masseter
• medial, lateral pterygoids
• temporalis

Branches also to other muscles involved in eating

• tensor tympani
• tensor veli palatini
• anterior belly of digastric
• mylohyoid

Question 15

What is trigeminal neuralgia

Answer 15

Chronic facial pain

• hyperalgesia and allodynia
• unilateral, electric shock-like

-female prevalence, increases with age

Often due to the basilar artery compressing the nerve root

Often treated with anticonvulsants like carbemazepine (reduce nervous transmission)
If unaffective, can be operated on with the risk of hearing and sensory loss

Question 16

Describe the route of the facial nerve

• what does it innervate
• special sensory

Answer 16

Facial nerve
IAM in petrous

Greater petrosal
Stapedius
Chorda tympani => hitchhiked with lingual nerve => ant 2/3 tongue

Stylomastoid foramen

Posterior auricular nerve
Posterior belly of digastric nerve
Stylohyoid nerve
Parotid gland => upper and lower branches

Muscles of facial expression:
Upper bilateral control => temporal, zygomatic branches
Lower contralateral control => buccal, mandibular branches

Question 17

Describe the route of the facial nerve

• what does it innervate
  
  • PNS

Answer 17

Facial nerve
IAM
Greater petrosal nerve branch => MCF => pterygopalatine ganglion => mucous and lacrimal glands

Stapedius nerve branch => MOTOR

Chorda tympani branch => combine with lingual nerve => submandibular ganglion => submandibular, sublingual glands

Stylomastoid foramen

ALL MOTOR
Post auricular
Post digastric
Stylohyoid

Question 18

Describe the route of the facial nerve

• what does it innervate
  
  • motor

Answer 18

Facial nerve
IAM
Greater petrosal nerve => PNS
Stapedius nerve => stapedius muscle in inner ear
Chorda tympani => PNS

Stylomastoid foramen

Posterior auricular branch=> intrinsic, extrinsic outer ear muscles
Posterior belly of digastric branch=> elevate hyoid
Stylohyoid branch=>  elevate hyoid
(facial expression
Within parotid => 5 terminal branches 
-temporal
-zygomatic
-buccal
-mandibular
-cervical

Question 19

Describe the structure of the parotid gland

Answer 19

Tightly enclosed in fascia (causes pain in mumps)

Branches within the gland

• Facial nerve plexuses
• ECA divides into maxillary and superficial temporal branches

Parotid duct lies on masseter, pierces buccanator => opens into oral cavity on the buccal side

Saliva production stimulated by IX

Question 20

What muscles attach to the superior nuchal line

Answer 20

Trapezius
Splenius capitus
Occipitalis

Question 21

What muscles attach to the mastoid process

-what movements are possible

Answer 21

Sternocleidomastoid

• bilateral => head extension
• unilateral => lateral flexion
• unilateral rotation