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Questions and Answers
Which cranial nerve is responsible for innervating the muscles of facial expression?
Which cranial nerve is responsible for innervating the muscles of facial expression?
- Facial Nerve (CN VII) (correct)
- Oculomotor Nerve (CN III)
- Abducent Nerve (CN VI)
- Trigeminal Nerve (CN V)
The pterion is a clinically significant area of the skull because it is the intersection of which bones?
The pterion is a clinically significant area of the skull because it is the intersection of which bones?
- Frontal, Parietal, Temporal, and Sphenoid (correct)
- Parietal, Temporal, Occipital, and Zygomatic
- Frontal, Parietal, Sphenoid, and Ethmoid
- Frontal, Parietal, Occipital, and Temporal
Which of the following describes the action of the orbicularis oris muscle?
Which of the following describes the action of the orbicularis oris muscle?
- Closes the eyelids
- Depresses the corners of the mouth
- Elevates and retracts the upper lip
- Oral sphincter, used in kissing and whistling (correct)
Which of the following is a key function of the trigeminal nerve (CN V)?
Which of the following is a key function of the trigeminal nerve (CN V)?
Which structure does the foramen magnum in the occipital bone transmit?
Which structure does the foramen magnum in the occipital bone transmit?
The temporomandibular joint (TMJ) is formed by the articulation of the:
The temporomandibular joint (TMJ) is formed by the articulation of the:
Which layer of the scalp contains dense connective tissue and blood vessels?
Which layer of the scalp contains dense connective tissue and blood vessels?
Which of the following facial bones contributes to the formation of the hard palate?
Which of the following facial bones contributes to the formation of the hard palate?
Which cranial bone articulates with the mandible?
Which cranial bone articulates with the mandible?
What is the primary function of the Sphenomandibular ligament related to the temporomandibular joint (TMJ)?
What is the primary function of the Sphenomandibular ligament related to the temporomandibular joint (TMJ)?
Which of the following cranial bones articulates with all other cranial bones?
Which of the following cranial bones articulates with all other cranial bones?
A patient presents with difficulty protruding and moving their jaw from side to side. Damage to which muscle is MOST likely the cause?
A patient presents with difficulty protruding and moving their jaw from side to side. Damage to which muscle is MOST likely the cause?
Which layer of the scalp is described as having dense connective tissue?
Which layer of the scalp is described as having dense connective tissue?
A patient has damage to a nerve that affects their ability to wrinkle their forehead and elevate their eyebrows. Which muscle is MOST likely affected?
A patient has damage to a nerve that affects their ability to wrinkle their forehead and elevate their eyebrows. Which muscle is MOST likely affected?
Which of the following is ONLY a sensory branch of the Trigeminal Nerve(CN V)?
Which of the following is ONLY a sensory branch of the Trigeminal Nerve(CN V)?
Which movement does the strong joint capsule NOT allow in the TMJ?
Which movement does the strong joint capsule NOT allow in the TMJ?
Which of the following structures is formed by the temporal process of the zygomatic bone and the zygomatic process of the temporal bone?
Which of the following structures is formed by the temporal process of the zygomatic bone and the zygomatic process of the temporal bone?
If a patient has damage to the trochlear nerve (CN IV), which muscle's function will be MOST affected?
If a patient has damage to the trochlear nerve (CN IV), which muscle's function will be MOST affected?
Which bony element is responsible for creating the forehead region?
Which bony element is responsible for creating the forehead region?
Which of the following muscles associated with facial expression is responsible for compressing the cheeks?
Which of the following muscles associated with facial expression is responsible for compressing the cheeks?
Damage to the cribriform plate of the ethmoid bone would MOST directly affect which of the following?
Damage to the cribriform plate of the ethmoid bone would MOST directly affect which of the following?
Which statement BEST explains the biomechanical function of the articular disc within the temporomandibular joint (TMJ)?
Which statement BEST explains the biomechanical function of the articular disc within the temporomandibular joint (TMJ)?
A patient is diagnosed with damage to the nerve that innervates the lateral rectus muscle. Which cranial nerve is MOST likely affected?
A patient is diagnosed with damage to the nerve that innervates the lateral rectus muscle. Which cranial nerve is MOST likely affected?
A surgeon needs to access the cranial cavity and plans to make an incision along a suture. If they cut along the intersection of the occipital bone and parietal bones, which suture are they incising?
A surgeon needs to access the cranial cavity and plans to make an incision along a suture. If they cut along the intersection of the occipital bone and parietal bones, which suture are they incising?
Damage to the mandibular branch (V3) of the trigeminal nerve would MOST directly affect the function of which muscle?
Damage to the mandibular branch (V3) of the trigeminal nerve would MOST directly affect the function of which muscle?
A patient presents with paralysis of the muscles of facial expression. Which nerve is MOST likely affected?
A patient presents with paralysis of the muscles of facial expression. Which nerve is MOST likely affected?
If a patient is experiencing impaired function related to the 'H'-shaped intersection of the frontal, parietal, temporal, and sphenoid bones, which cranial landmark is potentially involved?
If a patient is experiencing impaired function related to the 'H'-shaped intersection of the frontal, parietal, temporal, and sphenoid bones, which cranial landmark is potentially involved?
An elderly patient displays a notable decrease in cheek prominence. Which of the following facial bones is MOST likely undergoing age-related resorption?
An elderly patient displays a notable decrease in cheek prominence. Which of the following facial bones is MOST likely undergoing age-related resorption?
A patient is undergoing a procedure that requires ligating the chief artery of the face for hemostasis. Which vessel is MOST likely being targeted?
A patient is undergoing a procedure that requires ligating the chief artery of the face for hemostasis. Which vessel is MOST likely being targeted?
During a physical exam, a physician palpates the pulse of an artery against the mandible's inferior border. Which artery is MOST likely being assessed?
During a physical exam, a physician palpates the pulse of an artery against the mandible's inferior border. Which artery is MOST likely being assessed?
A patient has difficulty elevating the angle of their mouth, which is essential for smiling. Which muscle is MOST likely affected?
A patient has difficulty elevating the angle of their mouth, which is essential for smiling. Which muscle is MOST likely affected?
If a patient has a compromised ability to wrinkle their forehead, which muscle is MOST likely affected?
If a patient has a compromised ability to wrinkle their forehead, which muscle is MOST likely affected?
A lesion affecting the superior orbital fissure would MOST likely impact the function of which muscle of the orbit?
A lesion affecting the superior orbital fissure would MOST likely impact the function of which muscle of the orbit?
A patient has lost the ability to flare their nostrils. Which muscle is MOST likely affected?
A patient has lost the ability to flare their nostrils. Which muscle is MOST likely affected?
Which of the following ligaments is thought to have a possible role in the prevention of inferior dislocation of the temporomandibular joint (TMJ)?
Which of the following ligaments is thought to have a possible role in the prevention of inferior dislocation of the temporomandibular joint (TMJ)?
Which action is PRIMARILY associated with the 'swing rope' mechanism of the sphenomandibular ligament?
Which action is PRIMARILY associated with the 'swing rope' mechanism of the sphenomandibular ligament?
A patient has an injury that severs the ascending branch of the external carotid artery. Which artery is MOST at risk due to its origin from the external carotid's ascending branch?
A patient has an injury that severs the ascending branch of the external carotid artery. Which artery is MOST at risk due to its origin from the external carotid's ascending branch?
A patient CANNOT move their eyeball laterally. Assuming nerve damage, which of the following cranial nerves has MOST likely been damaged?
A patient CANNOT move their eyeball laterally. Assuming nerve damage, which of the following cranial nerves has MOST likely been damaged?
When describing the anatomical relationship of the skin to the pericranium, which term is MOST accurate?
When describing the anatomical relationship of the skin to the pericranium, which term is MOST accurate?
A patient is experiencing impaired elevation and retraction of the tongue. A deficit in muscles innervated by which cranial nerve could MOST likely cause this?
A patient is experiencing impaired elevation and retraction of the tongue. A deficit in muscles innervated by which cranial nerve could MOST likely cause this?
If the external acoustic meatus is located on the temporal bone, which bone landmark can also be found on the temporal bone?
If the external acoustic meatus is located on the temporal bone, which bone landmark can also be found on the temporal bone?
Why might the zygomatic arch, created by the temporal process of the zygomatic bone, undergo reconstruction following a traumatic injury?
Why might the zygomatic arch, created by the temporal process of the zygomatic bone, undergo reconstruction following a traumatic injury?
A patient with trigeminal neuralgia affecting the ophthalmic nerve (V1) would MOST likely experience pain in which area?
A patient with trigeminal neuralgia affecting the ophthalmic nerve (V1) would MOST likely experience pain in which area?
A patient's difficulty with the motor control of mastication is attributed to damage along the mandibular branch (V3) of the trigeminal nerve. Which muscle action would be MOST compromised?
A patient's difficulty with the motor control of mastication is attributed to damage along the mandibular branch (V3) of the trigeminal nerve. Which muscle action would be MOST compromised?
Following a traumatic injury, a patient undergoes a surgical procedure. Postoperatively, they exhibit impaired sensation of the upper lip and cheek. Which nerve was MOST likely affected during the procedure?
Following a traumatic injury, a patient undergoes a surgical procedure. Postoperatively, they exhibit impaired sensation of the upper lip and cheek. Which nerve was MOST likely affected during the procedure?
Which intersection is characterized as the junction of the lambdoid and sagittal sutures?
Which intersection is characterized as the junction of the lambdoid and sagittal sutures?
The frontal bone contributes to several key anatomical landmarks. Which of the following is a structure formed by the frontal bone?
The frontal bone contributes to several key anatomical landmarks. Which of the following is a structure formed by the frontal bone?
A stroke patient's MRI reveals localized damage primarily affecting the right frontal lobe. Which cranial bone is MOST directly associated with this impacted brain region?
A stroke patient's MRI reveals localized damage primarily affecting the right frontal lobe. Which cranial bone is MOST directly associated with this impacted brain region?
If a pathologist is examining a skull and identifies the largest and strongest facial bone, which bone is the pathologist MOST likely examining?
If a pathologist is examining a skull and identifies the largest and strongest facial bone, which bone is the pathologist MOST likely examining?
Surgical access to the pituitary gland often involves traversing a bone located at the anteromedial base of the cranium. Which bone is this?
Surgical access to the pituitary gland often involves traversing a bone located at the anteromedial base of the cranium. Which bone is this?
While studying cranial sutures, a student is trying to differentiate the sagittal and coronal sutures. Which statement BEST describes the orientation of the sagittal suture?
While studying cranial sutures, a student is trying to differentiate the sagittal and coronal sutures. Which statement BEST describes the orientation of the sagittal suture?
A patient presents with diminished sense of smell due to damage of the cribriform plate requires the surgeon to discuss the risk associated with the bone. Where is this bone located on the scull?
A patient presents with diminished sense of smell due to damage of the cribriform plate requires the surgeon to discuss the risk associated with the bone. Where is this bone located on the scull?
A person exhibiting deep worry/concern has action in which of the following muscles?
A person exhibiting deep worry/concern has action in which of the following muscles?
When considering the bony structure of the cranium, the calvaria is synonymous with which anatomical region?
When considering the bony structure of the cranium, the calvaria is synonymous with which anatomical region?
Which nerve innervates skin of posterior head.?
Which nerve innervates skin of posterior head.?
What structures do the occipital condyles articulate with?
What structures do the occipital condyles articulate with?
Why are the muscles of facial expression crucial?
Why are the muscles of facial expression crucial?
Which of the following does NOT occur in the inferior articular cavity?
Which of the following does NOT occur in the inferior articular cavity?
If a patient required reconstruction of hard palate which paired bone MOST likely needs reconstruction?
If a patient required reconstruction of hard palate which paired bone MOST likely needs reconstruction?
A structure creates the Zygomatic arch with Temporal process of Zygomatic Bone, which structure is it?
A structure creates the Zygomatic arch with Temporal process of Zygomatic Bone, which structure is it?
Flashcards
Neurocranium
Neurocranium
Bony casing of the brain, consisting of the calvaria (skullcap) and cranial base.
Coronal Suture
Coronal Suture
Sutures join the frontal bone with both parietal bones.
Sagittal Suture
Sagittal Suture
Sutures join the right and left parietal bones together.
Lambdoid Suture
Lambdoid Suture
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Squamous Suture
Squamous Suture
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Lambda
Lambda
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Pterion
Pterion
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Superficial Face
Superficial Face
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Orbicularis Oris
Orbicularis Oris
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Occipitofrontalis
Occipitofrontalis
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Study Notes
- Layers of the scalp include skin, connective tissue, aponeurotic tissue, loose connective tissue, and pericranium.
- The cranium has two divisions.
- Important landmarks of each cranial and facial bone should be identified.
- Sutures of the cranium should be described.
- The formation of the Lambda, Bregma, and Pterion intersections of the cranium should be described.
- Muscles of the face and orbit including actions and Innervations, should be identified.
- The articulations, joint type, ligaments, and movements of the TMJ should be identified.
- Actions and Innervations of the muscles of mastication should be identified.
- The innervation and vasculature of the face should be described.
Head
- Contains the Cranial Cavity, Ears (2), Orbits (2), Nasal Cavities (2), and Oral Cavity.
- The cranial cavity contains the brain and coverings, including the cranium and meninges.
- The oral cavity contains the Temporomandibular Joint (TMJ) and Muscles of Mastication.
Superficial Regions
- The scalp covers the superior, posterior, and lateral regions and consists of 5 layers: skin, connective tissue, aponeurotic tissue, loose connective tissue, and pericranium.
- The face covers the anterior aspect of head and contains the Muscles of Fascial Expression.
Cranium (Skull)
- The skeleton of the head is also known as the Neurocranium; the bony casing of the brain.
- Regions of the Neurocranium include:
- Roof: calvaria (skullcap)
- Floor: Cranial Base
- Bones of the Neurocranium include:
- Frontal Bone: Creates forehead with supra-orbital margin and glabella
- Parietal (paired): Superior and lateral aspect of the skull with superior and inferior temporal lines.
- Temporal (paired): Includes external acoustic meatus, mastoid process, and styloid process.
- Sphenoid (wedge): Anteromedial base of skull with medial and lateral pterygoid processes.
- Occipital: Base of posterior aspect of skull (occiput), containing foramen magnum that transmits spinal cord and vertebral arteries, occipital condyles, and external occipital protuberance.
Sutures
- Flat and irregular bones of the skull are interlocked by sutures, which are fibrous joints.
- Coronal Suture: Joins frontal bone with both parietal bones.
- Sagittal Suture: Joins the right and left parietal bones together.
- Lambdoid Suture: Joins occipital bone with both parietal bones.
- Squamous (2) Sutures: Joins parietal bone with temporal bone.
- Other Intersections include:
- Lambda: Junction of lambdoid and sagittal sutures.
- Bregma: Junction of sagittal and coronal sutures.
- Pterion: "H" shaped intersection of frontal, parietal, temporal, and sphenoid bone.
Viscerocranium
- The Viscerocranium (Facial Bones) consists of 15 bones in total.
- Mandible: The skeleton of the lower jaw, largest and strongest facial bone, has 2 parts: horizontal part (body) and 2 vertical rami (superior part of ramus) with condyle (head and neck), coronoid process (anterior), angle, and mental protuberance (chin).
- Ethmoid contributes to oral and nasal cavity formation.
- Vomer: Forms part of bony nasal septum with the ethmoid.
- Maxilla (paired): upper jaw between mouth and eyes.
- Inferior nasal conchae (paired): Bony plate in the lateral wall of the nasal cavity.
- Zygomatic (paired): Forms prominence of cheeks and anterolateral rims of infraorbital margins of orbits and creates zygomatic arch with temporal bone.
- Palatine (paired): Creates the hard palate with maxillae.
- Nasal (paired): Creates the bridge of the nose.
- Lacrimal (paired): Creates medial wall of orbit, associated with passage of tears.
Superficial Face
- The anterior aspect of the head between the forehead and chin.
- Fascial shape is determined by underlying bones.
Nerves of the Face
- Cervical Spinal Nerves C2 and C3 innervate the skin of the posterior head.
- The Trigeminal Nerve (CN V) is sensory to the face, motor to muscles of mastication (chewing), and has 3 branches: Ophthalmic (CN V1): sensory, Maxillary (CN V2): sensory, and Mandibular (CN V3): motor supply to muscles of mastication.
- The Facial Nerve (CN VII) supplies muscles of facial expression, auricular muscles (around the ear), and scalp muscles.
Arteries of the Face
- Facial A: Branch of External Carotid A, Chief artery of the face, palpable at inferior border of mandible.
- Superficial Temporal A: Small branch of external carotid artery, palpable anterior to external ear.
Veins of the Face
- Facial V: Major venous drainage of face, drains into internal jugular vein.
- Superficial Temporal V: Drains into external jugular vein.
Muscles of the Face (bolded)
- Present in subcutaneous tissue and attached to skin and surround facial orifices.
- Innervated by CN VII (facial).
- Muscles of Forehead:
- Occipitofrontalis: elevates eyebrows, wrinkles forehead.
- Muscles around the mouth:
- Orbicularis oris: oral sphincter, kissing, whistling.
- Platysma: depresses mandible, tenses skin of inferior face and neck.
- Buccinator: holds food between teeth and cheeks, resists distension (when blowing).
- Muscles around the eye:
- Orbicularis oculi: orbital sphincter, closes eyelids.
- Corrugator supercilia: draws eyebrow medially and inferiorly (concern/worry).
- Muscles around the nose:
- Nasalis: opens nostrils.
Muscles of the Orbit
- The muscles that move the eye: 4 Recti (Superior, Inferior, Medial, and Lateral) and 2 Oblique (Superior, Inferior).
Temporomandibular Joint (TMJ)
- Articulation: head of the mandible with mandibular fossa of the temporal bone.
- Joint type: Modified hinge-type synovial joint, separated by articular disc into superior and inferior articular cavities.
- Ligamentous Supports: strong joint capsule, lateral, stylomandibular, and sphenomandibular ligaments.
- Movements: Gliding and pivoting, protrusion, elevation/depression, and lateral movements.
Muscles of Mastication
- These muscles are innervated by the Mandibular Division (CN V3) of CN V (Trigeminal).
- The muscles include: Temporalis, Masseter, Lateral pterygoid, and Medial pterygoid.
Clinical Pearls
- Plagio- and Brachycephaly.
- Pterion and Skull Fractures.
- Bell's Palsy.
- TMJ Dysfunction.
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