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What are the 5 layers of the Scalp?
- Connective Tissue (dense)
- Loose Connective Tissue
Which arch of embryo development gives way to the Maxilla
and Mandible and V Trigenminal?
Which arch of embryo development gives way to the Hyoid and VII facial?
What are the 3 Branches of the Trigeminal (V) and where do they innervate?
- V1 – Opthalmic: Frontal, inferior orbit, half of nose
- V2 – Maxillary Nerve: Inferior orbit, upper lip, half of nose
- V3 – Mandibular Nerve: Inferior lip, chin, anterior ear
What are the 6 Branches of the Facial Nerve (VII)?
- Marginal Mandibular
- Posterior Auricular
What are the 6 groups of Muscles of Facial Expression?
What is/are the Muscles of Facial Expression of the Scalp?
Occipitofrontalis, Frontal and Occipital Belly
What is/are the Muscles of Facial Expression of the Orbital Group and their actions?
- Obicularis Occuli – Orbital: forcefully closes
- Palpebral – Gently closes
- Lacrimal – draws lacrimal puncta laterally
- Corrugator Supercilli- furrows brow
What is/are the Muscles of Facial Expression of the Nasal Group and their actions?
- Procerus– Frowning
- Nasalis Transverse – compress nares
- Nasalis Alar – widens nares
- Depressor Septi Nasi – widens nares
What is/are the Muscles of Facial Expression of the Neck and their actions?
Platysma: tenses skin, moves labia inferiorly
What is/are the Muscles of Facial Expression of the Auricular Group and their
- Anterior Auricular – Up and forward
- Superior Auricular – Elevates ear
- Posterior Auricular – Retracts and elevates
What is/are the Muscles of Facial Expression of the main Oral and their actions?
- Orbicularis Oris – purses lips
- Buccinator – Expells air from cheeks
What is/are the Muscles of Facial Expression of the Lower Oral Group and their
- Depressor Anguli Oris – depress corner of mouth
- Depressor Labii Inferioris – depress corner of mouth laterally
- Mentalis – Positions lips
What is/are the Muscles of Facial Expression of the Upper Oral Group and their
- Risorious – grin
- Zygomaticus Major – elevates corner of mouth
- Zygomaticus Minor – elevates upper lip
- Levator Anguli Oris – Levetates angle of mouth
How many Oral Group muscles are there?
What are the 3 Compartments of the Neck and what do they surround?
- Visceral – Trachea, Eosophagus, Thyroid
- Vascular – Int. Jugular, Nerves, Carotid Artery
- Vertebral – Muscles, Vertebral Column
What are the 5 Fascias of the Neck?
- Carotid Sheath
- Superficial Layer
- Investing Layer
- Prevertebral Layer
What is the Danger Space and why is it considered so?
- The Retropharyngeal space as
- - mandibular infection can spread to submental or submandibular spaces, then to
- - Infection here can cause oedema of the larynx
- - Infection can then spread to mediosternum and infect cardiac and respiratory
What are the Muscles of Neck and what are their regions and actions?
- Sternocleidomastoid – draw head forward, tilt and rotate – forms border of Anterior triangle
- Trapezius – rotation of scapula – forms posterior triangle
What are the Anterior Group of Suprahyoid Muscles and their innervations?
- Digastric – V3
- Mylohyoid – V3
- Geniohyoid – C1 (cervical spinal nerve)
What are the Posterior Group of Suprahyoid Muscles and their innervations?
- Posterior Digastric – VII (Facial)
- Stylohyoid – VII
What are the 4 Infrahyoid muscles and their O/I?
- Sternohyoid O – Sternum I- Hyoid
- Sternothyroid O- Sternum I- Thyroid Cartilage
- Thyrohyoid O – continuation of Sternothyroid I - Hyoid
- Omohyoid Lateral and Posterior Belly – Scapula, around Jugular, to tendon, to hyoid
Why do cuts to the head bleed so profusely?
The blood supply to the scalp is a high volume as the brain requires a large amount of blood to function. This blood travels through veins and arteries high in astemosis and pass under skin with very little intervening dermis and hypodermis meaning a small cut can bleed profusely.
What are the 6 types of Bone forming the neurocranium?
- Occipital x1
- Fronal x1
- Parietal x2
- Temporal x2
- Sphenoid x1
- Ethmoid x1
What are the 8 types of Bone forming the Viscerocranium?
- Palatine x2
- Vomer x1
- Lacrimal x2
- Nasal x2
- Inf. Nasal Concha x2
- Zygomatic x2
- Maxillary x2
- Mandible x1
What are the 4 sutures of the skull?
- Coronal (frontal and Parietal)
- Saggital (parietals)
- Squamosal (Temporal, parietal, sphenoid)
- Lambdoidal (Occipital, Parietal)
What 7 Bones form the Orbit?
The four surfaces and some features of the maxilla are:
- Nasal – lateral wall of nasal cavity
- Facial – inferior orbital margin, zygomatic process, frontal process, alveolar process
- Orbital – floor of orbit
- Infratemporal – floor of infratemporal fossa
The Zygomatic bone processes and surfaces are:
Temporal process, frontal process, Malar and Temporal Surfaces, Zygomatic foramen
The Suture of the maxilla is called the…
The Mandible articulates with…
The temporal bone and maxillae (through teeth)
Injections are given through the what raphe at what depth?
Through the coronoid notch to the pterygomandibular raphe at 2 to 4cm deep
The main structures of the mandible are the…
Body, Angle, Ramus, Condylar Process, Coronoid Process, Oblique Line, Mental Protuberance, Mandibular foramen, mylohyoid line
The temporomandibular joint is the articulation between the…
Squamous portion of temporal bone (articular disc and eminence) and the condyle of the mandible
The Mandibular condyle has what dimensions?
Football like, Ant/Post 10mm, Med/Lat 20mm
The TMJ consists of the…
Ligament, Articular Disc, Articular fossa of squamous portion of temporal bone, capsule, condyle of the mandible
The articular surface of the TMJ is…
Avascular, with dense fibrous connective tissue
The capsule of the TMJ:
- Completely encloses joint
- Highly Vascular Synovial membrane
- Fibrous connective tissue
- Highly Innervated
The capsule of the TMJ is divided into:
- Inferior Compartment – 0.9 ml rotational movement
- Superior Compartment – 1.2ml translational movement
What does the Synovial fluid do in the TMJ?
Provides lubricant and nutrition for the avascular surfaces
What are the steps in opening the mouth?
- 1.Inferior head of Lateral Pterygoid Muscle rotates condyle 0.9ml into Inferior Compartment
- 2. Hyoid is stabilised by posterior supra and infrahyoid muscles
- 3. When teeth are 20mm separation, TMJ is taut and translation into Superior
- Compartment occurs. Articular Disc and Condyle then slide inferiorly on the articular eminence until at lowest point
What are the 4 pairs and their heads of Muscles of Mastication and their actions?
- Temporalis – Elevates and retrudes mandible
- Masseter Superficial Head – Elevation
- Masseter Deep Head – Elevates and retrudes mandible
- Medial Pterygoid Deep Head – Elevation, protrusion, lateral excursion
- Medial Pterygoid Superficial Head – Elevation, protrusion, lateral excursion
- Lateral Pterygoid Upper Head – Depression, protrusion, lateral excursion
- Lateral Pterygoid Lower Head - Depression, protrusion, lateral excursion
What are the muscles of Mastication associated with Closing the mouth?
- Medial Pterygoid
What are the muscles of Mastication associated with Closing the mouth?
- Lateral Pterygoid
What are the Muscles involved with Mastication?
- Lateral Pterygoid
- Medial Pterygoid
- Suprahyoid (post and ant.)
What are the steps of Closing the Mouth?
- 1.Condyle undergoes reverse process of translation and rotation
- 2. The mandible is retruded and elevated by the masseter, temporalis and medial pterygoid
How does lateral deviation of the mandible occur?
If the mandible laterally deviates to the left, the right lateral pterygoid muscle contracts, moving the condyle forward causing a leftward deviation.
What are the steps of Deglutition?
- 1. Palatopharyngeas, levator veli palatini and uvulae lift soft palate, closing nasopharynx
- 2. Suprahyoid muscles life hyoid bone to allow bolus to pass
- 3. Muscles of pharynx elevate pharynx and larynx, driving food to esophagus
- 4. Epiglottis closes larynx
What nerve innervates the muscles of mastication?
Trigeminal (V) Mandibular Branch (V3)
The palate is formed by…
- Anterior 2/3 – Palatine Process of Maxilla
- Posterior 1/3 – Palatine Bone Horizontal plate
What are the Extrinsic Muscles and their innervations of the tongue?
- Palatoglossus X
- Styloglossus XII
- Genioglossus XII
- Hyoglossus XII
What are the Intrinsic Muscles of the tongue?
- Superior Longitudinal
- Inferior Longitudinal
What is the function of the Soft Palate?
It is a continuation of the hard palate that closes the oropharyngeal isthmus and separates the nasopharynx from the oropharynx
What muscle forms the Palatine Aponeurosis to which all palatal muscles attach?
Tensor Veli Palatini
What are the muscles of the Soft Palate and what are they innervated by?
- Tensor Veli Palatini – Trigeminal Mandibular Branch (V3)
- Levator Veli Palatini – Vagus (X)
- Palatopharyngeus – Vagus (X)
- Palatoglossus – Vagus (X)
- Musculus Uvulae – Vagus (X)
Superior to inferior, what are the sections of the Pharynx and what are they innervated
- Nasopharynx – Trigeminal Maxillary Branch (V2)
- Oropharynx – Glossopharyngeal IX
- Laryngopharynx – Vagus X
- Eosophagus and Trachea
What are the Constrictor Muscles of the Pharynx?
- Middle Constrictor
- Inferior Constrictor
What are the Constrictor Muscles of the Pharynx joined and innervated by?
Posteriorly by Pharyngeal Raphe and Vagus X
What are the 3 unpaired cartilages of the Larynx?
What are the Longitudinal Muscles and their innervations of the Pharynx?
- Stylopharyngeus - Glossopharyngeus IX
- Salpingopharyngeus – Vagus X
- Palatopharyngeus – Vagus X
What forms the vocal chord cartilage?
How does the blood arterially enter the head?
Through Common Carotid lateral to oesophagus and trachea, divides into Internal and External Carotid at superior border of Thyroid Cartilage
Where does the Internal Carotid enter?
Carotid Canal in petrous temporal bone
What are the branches of the External Carotid?
- Superior Thyroid Artery
- Ascending Pharyngeal Artery
- Lingual Artery
- Facial Artery
- Occipital Artery
- Posterior Auricular Artery
- Maxillary Artery
- Superior Temporal Artery
What does the Lingual Artery Supply?
Arises level of Hyoid, supplies suprahyoid muscles, tongue, floor of mouth, sublingual salivary glands and mucosa
What does the Facial Artery Supply?
Runs medially around mandible then upward to canthus of eye, supplying oral, buccal, zygomatic, nasal and infraorbital regions
Where does the Maxillary Artery arise and what does it supply?
- Arises and parotid, source of blood for nasal cavity and ALL
What are the 3 branches of the Maxillary Artery and what do they supply?
- Mandibular – Mandibular teeth
- Pterygoid – Muscles of Mastication
- Pterygopalatine - Maxillary teeth
What sections of the Pterygopalatine branch of the Maxillary Artery supplies what?
- Posterior Superior Alveolar Artery – Molars of Maxilla
- Infraorbital Artery supplies Anterior Superior Artery – Premolars and Anterior Teeth of Maxilla
Why can infection easily spread in cranial veins?
- There are no valves in facial veins so infection can spread
- in either direction
What is the oral venous return path?
Teeth, lips, Oral muscles, post. Nasal cavity, palate -> Pterygoid plexusus of veins-> Maxillary Vein -> Superficial Temporal Vein in Parotid -> Retromandibular Vein
What does the facial Vein collect and drain into?
Collects from scalp, orbits and muscles of facial expression and drains into Internal Jugular