Podcast
Questions and Answers
Which lymph nodes are responsible for draining the anterior scalp?
Which lymph nodes are responsible for draining the anterior scalp?
Which cranial nerve supplies the muscles of facial expression?
Which cranial nerve supplies the muscles of facial expression?
What is the primary function of the orbicularis oris muscle?
What is the primary function of the orbicularis oris muscle?
Which of the following muscles is primarily responsible for squinting?
Which of the following muscles is primarily responsible for squinting?
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What characteristic of facial skin distinguishes it from other areas?
What characteristic of facial skin distinguishes it from other areas?
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Which muscle is located in the superficial fascia of the neck and plays a role in facial expression?
Which muscle is located in the superficial fascia of the neck and plays a role in facial expression?
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What type of connective tissue connects the skin of the face to the underlying bones?
What type of connective tissue connects the skin of the face to the underlying bones?
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Which muscle acts as a sphincter around the nostrils?
Which muscle acts as a sphincter around the nostrils?
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What is the primary reason for the profuse bleeding from scalp wounds?
What is the primary reason for the profuse bleeding from scalp wounds?
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Which layer of the scalp is considered the 'dangerous layer'?
Which layer of the scalp is considered the 'dangerous layer'?
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What anatomical structure primarily consists of a tendinous sheet in the scalp?
What anatomical structure primarily consists of a tendinous sheet in the scalp?
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Which arteries specifically supply blood to the scalp?
Which arteries specifically supply blood to the scalp?
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How do veins of the scalp facilitate the spread of infection?
How do veins of the scalp facilitate the spread of infection?
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Which clinical condition is most often indicated by a 'black eye'?
Which clinical condition is most often indicated by a 'black eye'?
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What role do emissary veins play in the venous drainage of the scalp?
What role do emissary veins play in the venous drainage of the scalp?
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Which statement about the layers of the scalp is incorrect?
Which statement about the layers of the scalp is incorrect?
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What is the primary function of the platysma muscle?
What is the primary function of the platysma muscle?
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Which branch of the facial nerve innervates the frontalis muscle?
Which branch of the facial nerve innervates the frontalis muscle?
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Which muscle is involved in the act of pushing food from the vestibule of the mouth into the oral cavity?
Which muscle is involved in the act of pushing food from the vestibule of the mouth into the oral cavity?
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Which of the following muscles is NOT considered a muscle of mastication?
Which of the following muscles is NOT considered a muscle of mastication?
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What percentage of saliva is secreted by the parotid salivary gland?
What percentage of saliva is secreted by the parotid salivary gland?
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Which muscle contributes to the facial expression of shock and disbelief?
Which muscle contributes to the facial expression of shock and disbelief?
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Which nerve supplies the muscles responsible for mastication?
Which nerve supplies the muscles responsible for mastication?
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What covers the parotid salivary gland?
What covers the parotid salivary gland?
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What structure lies deep within the parotid gland and divides into maxillary and superficial temporal arteries?
What structure lies deep within the parotid gland and divides into maxillary and superficial temporal arteries?
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Which of the following describes the route of the parotid duct (Stensen duct)?
Which of the following describes the route of the parotid duct (Stensen duct)?
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Which nerve runs superficial to the retromandibular vein within the parotid gland?
Which nerve runs superficial to the retromandibular vein within the parotid gland?
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What is the length of the parotid duct?
What is the length of the parotid duct?
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Which structure is formed by the union of maxillary and superficial temporal veins within the parotid gland?
Which structure is formed by the union of maxillary and superficial temporal veins within the parotid gland?
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Which of the following branches corresponds to the anterior division of the retromandibular vein?
Which of the following branches corresponds to the anterior division of the retromandibular vein?
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Which type of parotid lymph nodes are typically classified as superficial within the gland?
Which type of parotid lymph nodes are typically classified as superficial within the gland?
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What condition may occur due to inflammation of the parotid gland?
What condition may occur due to inflammation of the parotid gland?
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What is the main characteristic symptom of Frey's syndrome?
What is the main characteristic symptom of Frey's syndrome?
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Which artery supplies the palatine tonsil as one of its branches?
Which artery supplies the palatine tonsil as one of its branches?
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At what anatomical location does the facial artery arise?
At what anatomical location does the facial artery arise?
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Which artery is responsible for supplying the upper lip?
Which artery is responsible for supplying the upper lip?
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Which of the following arteries is NOT a branch of the external carotid artery?
Which of the following arteries is NOT a branch of the external carotid artery?
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What triggers the symptoms associated with Frey's syndrome?
What triggers the symptoms associated with Frey's syndrome?
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Which artery runs forwards to supply the chin and lower lip?
Which artery runs forwards to supply the chin and lower lip?
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What is one of the deeper surface branches of the external carotid artery?
What is one of the deeper surface branches of the external carotid artery?
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Which branch of the facial nerve is responsible for conveying taste fibers from the anterior two-thirds of the tongue?
Which branch of the facial nerve is responsible for conveying taste fibers from the anterior two-thirds of the tongue?
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What is the primary function of the facial nerve?
What is the primary function of the facial nerve?
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Where is the facial nerve attached in the brain?
Where is the facial nerve attached in the brain?
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What type of lesion is associated with Bell's palsy?
What type of lesion is associated with Bell's palsy?
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What is the role of the nerve to Stapedius?
What is the role of the nerve to Stapedius?
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Which part of the facial nerve gets divided by the stylomastoid foramen?
Which part of the facial nerve gets divided by the stylomastoid foramen?
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Which symptom would NOT typically indicate facial nerve paralysis?
Which symptom would NOT typically indicate facial nerve paralysis?
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Which branch supplies the muscles around the auricle?
Which branch supplies the muscles around the auricle?
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Study Notes
Scalp, Face & Parotid - Learning Outcomes
- List the layers of the scalp, its blood supply, and bleeding from the scalp
- Describe the superficial temporal artery and the facial artery
- Describe the veins of the face and temporal region
- Identify the major muscles of the face and jaw
- Describe the seventh cranial nerve: its relations, lesions, and testing
- Describe the parotid gland and its duct, their relations and clinical conditions and its secretomotor innervation
- Describe the anatomy of the ophthalmic division of the trigeminal nerve, including how their integrity is tested clinically
The Scalp
- Layers: Skin, Dense connective tissue, Aponeurotic layer, Pericranium, Loose connective tissue
- Skin: Thin except in the occipital region, abundant sweat, sebaceous glands, and hair follicles. Abundant arterial supply, good venous and lymphatic drainage.
- Connective tissue layer/sub-cutaneous tissue: Consists of numerous blood vessels and nerves. Wounds bleed profusely as blood vessels are prevented from retraction by fibrous tissue.
- Aponeurosis: Tendinous sheet of occipitofrontalis, loose connective tissue, dangerous layer of scalp.
- Periosteum: Cephalhaematoma
Internal Scalp Bleeding
- Clinical Application: Cephalohematoma, subgaleal hemorrhage
Facial Structures
- Anterior aspect of head: From forehead to chin and from one ear to the other
- Skin: Elastic, vascular (bleeds then heals rapidly), consists of numerous sweat and sebaceous glands, connected to underlying bones by loose connective tissue (contain muscle of facial expression)
- Superficial fascia: Contains facial muscles, blood vessels and nerves, fat tissues (absent in eye lids)
- No deep fascia in the face: Except over...?
Muscles of the Face
- Called muscles of facial expression: Lie in superficial fascia. They take origin from facial bones and are inserted in the skin.
- Embryologically: Develop from mesoderm of the 2nd pharyngeal arch, therefore supplied by facial nerve.
- Facial muscles: Serve as sphincters and dilators of orifices of the face (orbit, nose, and mouth)
Parotid Gland
- Largest salivary gland: Composed mostly of serous acini, enclosed by thick parotid fascia derived from investing layer of deep cervical fascia.
- Secretes 25% of saliva: Serous (watery secretions)
- Clinical application: Parotid gland tumour, Parotitis (inflammation- infective i.e. stone in duct, bacterial, viral (mumps))
- Frey's syndrome: A rare condition following trauma to the auriculotemporal nerve in the parotid area. Patients complain of redness and sweating on the cheek and temporal area whenever they eat or think about food
Parotid Duct (Stensen Duct)
- Thick-walled duct (~5cm long): Emerges from the middle of the anterior border of the gland.
- Runs forward on masseter: With the transverse facial artery and upper buccal above and lower buccal branch of facial nerve below
- Opens into the vestibule of the mouth opposite the crown of the upper 2nd molar tooth
Parasympathetic Innervation to the Gland
- Parasympathetics leave the brain with the glossopharyngeal nerve (IX)
- IX exits the skull through the jugular foramen, tympanic nerve ascends into the inferior tympanic canaliculus, and joins the tympanic plexus
- The lesser petrosal nerve comes out of the tympanic plexus and exits the petrous temporal bone via the foramen for the lesser petrosal
- The lesser petrosal nerve leaves the middle cranial fossa via the foramen ovale. It synapses in the otic ganglion, under the foramen ovale.
Structures within the Parotid Gland
- The external carotid artery lies deep within the gland, and divides into the maxillary and superficial temporal arteries
- The retromandibular vein forms from the maxillary and superficial temporal veins. It divides into anterior and posterior divisions within the gland.
- The facial nerve runs forward, dividing into five terminal branches: temporal, zygomatic, buccal, mandibular, and cervical.
- A few parotid lymph nodes (superficial and deep) also lie within the gland.
Jaw Muscles
- These are the muscles that move the lower jaw (mandible). The upper jaw (maxilla) is fixed to the base of the skull.
- Four principal muscles: masseter, temporalis, medial pterygoid, lateral pterygoid.
- Some authorities add a fifth, the digastric. Innervated by motor fibres from the trigeminal nerve.
Facial Nerve
- Introduction: Mixed nerve – contains sensory (nervus intermedius) and motor roots, has parasympathetic function, attached to the lower border of the pons
- Course of the facial nerve: Divided by the stylomastoid foramen into intracranial and extracranial part
- Branches: Temporal, zygomatic, buccal, mandibular, cervical
- Clinical application: Facial nerve paralysis: lesion at different levels : supranuclear, nuclear & infra-nuclear : Bell's palsy (lesion in the internal acoustic meatus, genu (geniculate ganglion), distal to the genu or below stylomastoid foramen).
Testing Motor Function of the Facial Nerve
- Tell the patient to: look upwards, raise eyebrows, wrinkle forehead, close eyes tightly, puff out cheeks, grin and show teeth, contract platysma
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Description
Explore the intricate anatomy of the scalp, face, and parotid gland through this comprehensive quiz. Delve into the layers of the scalp, vascular supply, major facial muscles, and the seventh cranial nerve. Test your knowledge on clinical conditions related to the parotid gland and the trigeminal nerve's anatomy.
