Face, Scalp & Parotid Region

What are the 3 branches of Mandibular n. (V3)?

1. Auriculotemporal n. 2. Buccal n. 3. Mental n.

Postganglionic parasympathetic neurons are located within the parasympathetic ganglia in the head. What are the 4 ganglia?

1. Ciliary (CN III) 2. Otic (CN IX) 3. Pterygopalatine (CN VII) 4. Submandibular (CN VII) Mnemonic: COPS 3977

What are the 4 branches of the external carotid a. that supply the scalp & face?

1. Facial a. (most superficial face) 2. Superficial temporal a. (lateral scalp) 3. Occipital a. (posterior scalp) 4. Posterior auricular a. (ear & scalp posterior to ear)

What are the 4 branches of the facial a. (branch of ECA)?

1. Inferior labial a. 2. Superior labial a. 3. Lateral nasal a. 4. Angular a. (terminal branch)

What are the 5 branches of Ophthalmic n. (V1)?

1. Infratrochlear n. 2. External nasal n. 3. Lacrimal n. 4. Supra-orbital n. 5. Supratrochlear n.

What are the 3 branches of Maxillary n. (V2)?

1.Zygomaticotemporal n. 2. Zygomaticofacial n. 3. Infraorbital n.

The muscles of facial expression arise from the ___ pharyngeal arch and are innervated by _______ n. or CN ____.

2nd; facial; VII

________ vein anastomoses with the inferior & superior ophthalmic veins.

Angular

The danger triangle of the face is called such because ______ veins anastomose with the ______ veins to reach the cavernous sinus, which provides a path for infection to spread into the brain.

Angular; ophthalmic

Idiopathic facial nerve paralysis that usually only occurs on one side is called _______.

Bell's palsy

Craniosynostosis of coronal suture, which results in a tall, flat head is called _______.

Brachycephaly

Preganglionic parasympathetic neurons are located in the _______ & are associated with 4 CNs: _____,_____,______,______

Brainstem 1. Oculomotor n. (CN III) 2. Facial n. (CV VII) 3. Glossopharyngeal n. (CN IX) 4. Vagus n. (CN X)

What smaller branches arise from the cervicofacial branch of facial n (CN VII)?

Buccal, marginal mandibular & cervical branches

__________ is the skullcap or roof of the neurocranium.

Calvaria

Headache, fever, periorbital edema & ophthalmiplegia (paralysis of ocular mm.) indicate what condition?

Cavernous sinus thrombosis

What regions of the face does the Maxillary n. (V2) supply?

Cheeks, lower eyelids, upper lip

_______ ______ is a branch of facial n. (CN VII) that carries taste sensation to anterior 2/3 of tongue.

Chorda tympani

The facial v. and anterior division of retromandibular v. join to form _________ v., which drains into the __________ v.

Common facial v.; IJV

_________ results from premature closure of a suture in an infant, which results in abnormal head shape.

Craniosynostosis

Vessels of the scalp are located within the __________ layer of the scalp.

Dense connective tissue layer

What is the 2nd branch off the facial n. after it exits the stylomastoid foramen? What does it innervate?

Digastric branch; posterior belly of digastric & stylohyoid mm.

The posterior auricular v. and the posterior division of the retromandibular v. join to form the _________ v.

EJV

The "danger area" of the scalp allows infection to spread into the cranial cavity via the _______ ______. This area is found within which layer of the scalp?

Emissary veins; loose connective tissue

_______ vein begins at the medial angle of the eye & drains into the IJV.

Facial

What nerve provides motor innervation to the face?

Facial n. (CN VII)

Mandibular n. (V3) provides sensory & motor innervation to the face and exits the skull by passing through _______ ______.

Foramen ovale

Maxillary n. (V2) is provides only sensory innervation to the face and exits the skull by passing through the ______ ________.

Foramen rotundum

What regions of the face does the Ophthalmic n. (V1) supply?

Forehead, upper eyelids, bridge of nose

What lymph nodes drain the upper lip and lateral parts of the lower lip?

Submandibular nodes

If a patient had skin cancer of the central lower lip, which lymph nodes would it spread to? If a patient had skin cancer of the lateral lower lip, which lymph nodes would it spread to?

Submental Submandibular

What lymph nodes drain the chin & center of the lower lip?

Submental nodes

All lymph from the face drains to the ______ or _____ cervical lymph nodes.

Superficial or deep

Ophthalmic n. (V1) provides only sensory innervation to the face and exits the skull by passing through the ________ _____ ______.

Superior orbital fissure

What are the branches of the internal carotid a. that supply the forehead & anterior scalp?

Supraorbital a. & supratrochlear a.

Pupil dilation, vasoconstriction, contraction of arrector pili m., decreased secretions from salivary & lacrimal glands are all effects of _______ innervation.

Sympathetic

Sympathetic preganglionic neurons are within ______ levels of the spinal cord.

T1-L2 (no sympathetic preganglionic neurons in cervical region)

What lymph nodes drain the posterior scalp?

Occipital & mastoid nodes

_________ veins drain into the cavernous sinus.

Ophthalmic

Herpes zoster of trigeminal n. accounts for ~20% of cases. Which division of the nerve is most commonly affected?

Opthalmic n.

In Bell's palsy, pt's often can't close one of their eyes. This is due to paralysis of ______ m.

Orbicularis oculi

In Bell's palsy, pt's often have difficulty eating & drinking. This is due to paralysis of ________ & _______ muscles.

Orbicularis oris (holds lips together) Buccinator (holds food b/t teeth)

What smaller branches arise from the temporofacial branch of facial n (CN VII)?

Temporal & zygomatic branches

The parotid plexus contains which branches of facial n (CN VII)?

Temporal, Zygomatic, Buccal, Marginal mandibular & cervical

What are the 2 major branches of facial n. or CN VII?

Temporofacial & cervicofacial branches

Pupil constriction, contraction of ciliary m. & stimulation of lacrimal and salivary gland secretion are effects of _______ innervation.

Parasympathetic

What lymph nodes drain the lateral face & scalp including eyelids?

Parotid nodes

______ is the largest salivary gland. It is enclosed within the _______ sheath that is continuous with the investing layer of deep cervical fascia.

Parotid; parotid

The pericranium covers the _____ of the skull.

Periosteum

Craniosynostosis of coronal or lambdoid suture on one side only, which results in a asymmetrical/twisted head is called _______

Plagiocephaly

Herpes zoster oticus may effect the external ear via ______ n.

Posterior auricular n.

What is the 1st branch off the facial n. after it exits the stylomastoid foramen? What does it innervate?

Posterior auricular n. ; auricular & occipitalis mm.

What nerves carries preganglionic and postganglionic parasympathetic fibers to the parotid gland?

Preganglionic fibers = lesser petrosal n. (branch of the glossopharyngeal n; CN IX) Postganglionic fibers = auriculotemporal n. (branch of mandibular n; CN V3)

The superficial temporal v. & maxillary v. join to form the ________ v. that descends through the parotid gland and divides into anterior & posterior branches.

Retromandibular v.

What are the 5 layers of the scalp?

S = skin C= connective tissue A = apopneurosis L= =loose connective tissue P = pericrainum

Craniosynostosis of sagittal suture that results in a narrow, elongated head is called ________.

Scaphalocephaly

Sensory cell bodies of trigeminal n. are located in the trigeminal ganglion, which is also called the _______ ganglion.

Semilunar

What artery arises from superficial temporal a. (branch of ECA)?

Transverse facial a.

What artery travels with the parotid duct & supplies the parotid gland?

Transverse facial a.

Postganglionic parasympathetic fibers are distributed by branches of the ________ n.

Trigeminal (CN V)

What nerve provides the main sensory innervation to the face? What are the 3 divisions?

Trigeminal n. (CN V) 1. Ophthalmic n. (V1) 2. Maxillary n. (V2) 3. Mandibular n. (V3)

________ ______ ("Tic douloureux") is a sensory disorder of CN V that causes sudden attacks of excruciating facial pain. Treatment: Anti-convulsive drugs, percutaneous glycerol injection or microvascular decompression surgery

Trigeminal neuralgia

Veins of the face lack _____ and form an anastomosing network capable of retrograde flow.

Valves

Herpes zoster oticus may cause vertigo or hearing loss by affecting the _______ n., which is in close proximity to facial n.

Vestibulocochlear n. (CN VIII)

What 2 sources provide blood supply to the scalp & face?

Internal carotid artery (ICA) & external carotid artery (ECA)

Pterygoid plexus of veins is located within the ______ _____ and drains deep structures of the face. It anastomoses with the ________ v. & ______ sinus.

Intratemporal fossa; facial & cavernous

What regions of the face does the Mandibular n. (V3) supply?

Lateral sides of head, lower lip, chin

Describe the path of the parotid duct: Cross superficial to _________ m. --> pierces ______ m. ---> opens into oral cavity opposite ____ maxillary molar

Masseter; buccinator; 2nd

In trigeminal neuralgia, which divisions are most and least commonly affected?

Most = Maxillary n. (V2) Least = Ophthalmic (V1)

What is the name of the aponeurosis of the scalp? What 2 muscles does it connect?

Galea aponeurotica; frontalis m. & occipitalis m.

_______ is the site of the geniculate ganglion, a L-shaped collection of fibers and pseudo-unipolar sensory neurons.

Geniculum

Sympathetic postganglionic neurons enter the cervical spinal nerves via _____ ____ and follow arteries to structures in the head/neck.

Gray rami

_______ ______ n. is a parasymphathetic branch of facial n.

Greater petrosal n.

Reactivation of varicella zoster virus along sensory distribution of facial n. is a condition called ______ _____ _____.

Herpes zoster oticus