RCA practical 1

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RCA Practical 1-Face: Skeleton, musculature, blood and nerve supply, and parotid gland
Ashutosh Kumar
Flashcards by Ashutosh Kumar, updated more than 1 year ago
Ashutosh Kumar
Created by Ashutosh Kumar over 7 years ago
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Question Answer
Name Origin: Insertion: Function: Innervation: Orbicularis oculi. This muscle consist of two parts: A palpebral part used for blinking. An orbital part used for closing the eye. Origin: From the medial margin of the orbit and medial palpebral ligament. Insertion: The skin around the margin of the orbit and lateral palpebral raphe. Function: Close the eyelid. Innervation: Temporal branch of the facial nerve (cranial nerve 7).
Name Origin: Insertion: Function: Innervation: Orbicularis oris: Origin: From bone near the median plane of the maxilla and mandible as well as the deep surface of the skin. Insertion: The mucous membranes of the lips. Function: Compresses the lips together and protrudes them (kissing muscle). Innervation: Buccal branch of the facial nerve.
Name Origin: Insertion: Function: Innervation: Buccinator: Origin: Posteriorly from the pterygomandibular raphe, superiorly and inferiorly from the alveolar processes of the maxilla and mandible. Insertion: The angle of the mouth. Function: Compress the inner cheek against the molar teeth aiding in chewing and can compress distended cheeks to cause the expulsion of air from the oral cavity. Innervation: Buccal branch of the facial nerve.
Name Origin: Insertion: Function: Innervation: Frontalis: Origin: From the epicranial aponeurosis. Insertion: The skin of the eyebrows. Function: Raises the eyebrows and wrinkles the forehead. Innervation: Temporal branch of the facial nerve.
Name Origin: Insertion: Function: Innervation: Platysma: Origin: From the superficial pectoral and deltoid fascia. Insertion: Body of the mandible, cheek and orbicularis oris. Function: Tenses the skin of the neck and lower face, as well as depresses the mandible. Innervation: Cervical branch of the facial nerve.
5 layers of the scalp: The scalp consists of 5 layers: Skin. Dense connective tissue (superficial fascia). Aponeurosis (connecting the frontalis and occipitalis muscles) Loose connective tissue. Pericranium (outer periosteum of the bony skull). Most of the blood vessels and nerves run in the connective tissue layer of the scalp, which is dense. Scalp lacerations bleed profusely because the blood vessels are held open by dense connective tissue (2nd layer).
3 branches of the trigeminal nerve: Ophthalmic (V1) Maxillary (V2) Mandibular (V3)
Ophthalmic (V1) Branches (3): Lacrimal nerve Frontal nerve Nasociliary nerve
Lacrimal nerve Origin: Supplies: Origin: Ophthalmic (V1) Supplies: Innervates the lacrimal gland as well as the lateral skin and conjunctiva of the upper eyelid.
Frontal nerve: Origin: Course: Branches (2): Course: Situated on the levator palpebrae superioris muscle Branches: Divides into the supraorbital nerve and supratrochlear nerve.
Supraorbital nerve Origin: Course: Supplies: Origin: Frontal nerve. Course: Exits the orbit via the supraorbital foramen Supplies: The upper eyelid, forehead and scalp.
Nasociliary nerve Origin: Branches (4): Origin: Ophthalmic (V1) Branches: Long ciliary nerves Anterior and posterior ethmoidal nerves Infratrochlear nerve
Long ciliary nerves Origin: Supplies: Origin: Nasociliary nerve Supplies: Carry sensory fibres to cornea and postganglionic sympathetic fibres from the superior cervical ganglion (containing T1 preganglionic axons synapsing) to the dilator pupillae muscles.
Anterior and posterior ethmoidal nerves Origin: Supplies: Branches (1): Origin: Nasociliary Supplies: Enter the respective foramina in the medial wall of the orbit. Branches: Anterior ethmoidal nerve enters the face via the nose as the external nasal nerve.
External nasal nerve Origin: Supplies: Origin: From the anterior ethmoidal nerve. Supplies: The skin over the dorsum of the nose.
Infratrochlear nerve Origin: Origin: Nasociliary nerve
Maxillary nerve (V2) Branches (8): Branches: Greater palatine nerve Lesser palatine nerve Nasopalatine nerve Nasal nerves Pharyngeal nerve Posterior superior alveolar nerve Infraorbital nerve Zygomatic nerve
Greater palatine nerve Origin: Course: Supplies: Origin: Maxillary (V2) Course: Leaves the inferior aspect of the pterygopalatine ganglion and descends through the palatine canal to emerge onto the hard palate Supplies: Sensory to the hard palate.
Lesser palatine nerve Origin: Course: Supplies: Origin: Maxillary (V2) Course: Descends from the pterygopalatine ganglion Supplies: The soft palate.
Nasopalatine nerve Origin: Course: Supplies: Origin: Maxillary (V2) Course: Together with other nasal nerves runs medially from the pterygopalatine ganglion and enters the nasal cavity. Then runs on the nasal septum to emerge through a foramen onto the hard palate Supplies: The anterior part of the hard palate.
Nasal nerves Origin: Course: Supplies: Origin: Maxillary (V2) Course: Enters the nasal cavity through a foramen Supplies: Parts of the lateral wall and septum of the nose.
Pharyngeal nerve Origin: Course: Supplies: Origin: Maxillary (V2) Course: Leaves the posterior aspect of the pterygopalatine ganglion Supplies: The mucous membrane of the nasopharynx.
Posterior superior alveolar nerve Origin: Course: Supplies: Origin: Arise from the maxillary nerve (V2) within the pterygopalatine fossa Course: Descends into a canal Supplies: The molar and premolar teeth.
Anterior superior alveolar nerve Origin: Supplies: Origin: Arises from the infraorbital nerve Supplies: The anterior maxillary teeth.
Infraorbital nerve Origin: Course: Supplies: Branches (1): Origin: Maxillary (V2) Course: Enters the orbit through the infraorbital fissure and runs on the floor of the orbit emerging onto the face through the infraorbital foramen Supplies: The lower eyelid, cheek and upper lip. Branches: to form the anterior superior alveolar nerve.
Zygomatic nerve: Origin: Course: Branches: Supplies: Origin: Maxillary (V2) Course: Enters the orbit through the inferior orbital fissure, runs on the lateral wall of the orbit, divides into two branches, zygomaticofacial and zygomaticotemporal, which emerge onto the face through foramina in the zygomatic bone. Supplies: The skin over the zygomatic bone.
Mandibular (V3) Branches (4): Lingual nerve Inferior alveolar nerve Buccal nerve Auriculotemporal nerve
Lingual nerve Origin: Course: Supplies: Origin: Mandibular (V3) Course: Runs inferiorly between the medial pterygoid muscle and the ramus of the mandible anterior to the inferior alveolar nerve and enters the tongue. Supplies: General sensation to the mucosa of the anterior two thirds of the tongue and floor of the mouth.
Chorda tympani Origin: Course: Supplies: Origin: Branch of the facial nerve (cranial nerve 7) Course: Joins the lingual nerve and runs anteriorly in its sheath. Supplies: Special sensation (taste) to the anterior two thirds of the tongue.
Inferior alveolar nerve Origin: Course: Supplies: Branches (2): Origin: Mandibular (V3) Course: Runs inferiorly between the medial pterygoid muscle and the ramus of the mandible, enters the mandible through the mandibular foramen and runs forward in the mandibular canal Supplies: Sensory to the lower teeth Branches: Mental nerve and mylohyoid nerve
Mental nerve Origin: Supplies: Origin: Is the terminal branch of the inferior alveolar nerve and emerges from the mandibular canal at the mental foramen Supplies: The skin of the chin and lower lip.
Buccal nerve Origin: Supplies: Origin: Mandibular (V3) Supplies: Runs anteriorly to reach the cheek and supply the skin and mucous membranes of the cheek.
Auriculotemporal nerve Origin: Supplies: Origin: Mandibular (V3) Supplies: Runs superiorly together with the superficial temporal vessels to provide sensory supply to skin in the temporal region.
Facial nerve Course: Branches (5): Course: After emerging from the stylomastoid foramen, it immediately enters the parotid gland. The nerve runs superficially within the gland and gives rise to its five terminal branches: Temporal. Zygomatic. Buccal. Mandibular. Cervical. These emerge from superior, anterior and inferior margins of the gland and supply the muscles of facial expression. The highest branch, temporal, crosses the zygomatic bone. The lowest branch, cervical, runs below the angle of the mandible
Parotid gland Size: Secretion: Course of duct: Size: Largest salivary gland. Secretion: Predominantly secretes serous fluid. Course of duct: Drains via the parotid duct into the oral cavity, piercing the buccinator muscle and opens on the inner surface of the cheek just opposite the second maxillary molar.
External carotid artery Branches (8):
Superior thyroid artery Origin: Course: Supplies: Origin: Is either the first or second branch of the external carotid artery. Course: Travels deep to the infrahyoid muscles to supply the superior pole of the thyroid gland.
Ascending pharyngeal artery Origin: Course: Supplies: Origin: Is either the first or second branch of the external carotid artery. Course: Arises from the medial aspect and runs up the pharynx giving branches to the pharynx and prevertebral muscles.
Lingual artery Origin: Course: Supplies: Origin: External carotid artery, 2nd anterior branch. Course: Arches supero anteriorly, deep to the hypoglossal nerve and disappears deep to the hyoglossus muscle of the tongue. Supplies: Tongue
Facial artery Origin: Course: Supplies: Origin: Arises in common with the lingual artery or immediately superior from the external carotid artery. Course: Ascends deep to the submandibular gland and travels along the inferior border of the mandible, enters the face just anterior to the masseter and travels to the medial angle (canthus) of the eye. Supplies: Gives off branches to supply the lower and upper lips and the side of the nose.
Occipital artery Origin: Course: Supplies: Origin: Arises from the posterior aspect of the external carotid artery. Course: Runs on the posterior aspect of the posterior belly of the digastric muscle to supply the posterior scalp.
Posterior auricular artery Origin: Course: Supplies: Origin: From the external carotid artery. Course: A small branch that ascends posterior to the external auditory meatus and supplies the adjacent region.
Maxillary artery Origin: Course: Branches (2 main): Origin: One of the two terminal branches of the external carotid artery. Course: To enter the infratemporal fossa, It crosses superficially to the lateral pterygoid muscle, but in some cases it passes deep to the muscle. Branches: To form the middle meningeal artery and inferior alveolar artery (other branches follow V2 and V3) in the infratemporal fossa.
Superficial temporal artery Origin: Course: Supplies: Origin: One of the two terminal branches of the external carotid artery. Course: Emerges on the face in between the temporomandibular joint (TMJ) and ear to the temporal region. Supplies: The skin and facial muscles of frontal and temporal regions.
Internal carotid artery: Origin: Course: Branches from cavernous sinus (1): Origin: Common carotid artery. Course: Found in the carotid sheath. Does not have any branches in the neck. Runs in the cavernous sinus along with cranial nerve 3,4,6,V1 and V2. Branches: Emerges from the cavernous sinus to give off the ophthalmic artery.
Ophthalmic artery Origin: Course: Supplies: Origin: Arises from the internal carotid artery as it emerges from the cavernous sinus. It passes through the optic foramen together with the optic nerve and runs anteriorly close to the superomedial wall of the orbit. Supplies/branches: It gives off branches to structures in the orbit similar to the nasociliary nerve, including the central retinal artery and ends as the supraorbital artery.
Central retinal artery Origin: Course: Supplies: Origin: Ophthalmic artery. Course: Runs in the optic nerve to supply the retina.
Supraorbital artery Origin: Course: Supplies: Origin: A terminal branch of the ophthalmic artery. Course: It passes superiorly from the supraorbital foramen Supplies: Distributes to the muscles and skin of the forehead and scalp.
Facial vein Origin: Course: Communicates with: Origin: Provides the major venous drainage of the face. Course: Begins at the medial canthus of the eye and runs posterior to the artery and at the inferior margin of the mandible is joined by the anterior branch of the retromandibular vein and drains into the internal jugular vein. The facial vein communicates with the superior ophthalmic vein at the medial canthus and pterygoid plexus via the deep facial vein.
Ophthalmic veins Origin: Course: Drains into: Origin: Venous drainage of the orbit is though superior and inferior ophthalmic veins. Course: Pass through the superior orbital fissure and enter the cavernous sinus. The superior ophthalmic vein communicates with the facial vein at the medial canthus of the eye
Pterygoid plexus of veins Pterygoid plexus of veins: A network of small veins around the lateral pterygoid muscle and communicates with the cavernous sinus by emissary veins passing through the foramen ovale. Because of interconnections between the veins, infections of the face (dange area) can spread intracranially (cavernous sinus).
Internal jugular vein Course: Tributaries: Drainage of inferior thyroid veins: Course: Drains blood from the brain and superficial parts of the face and neck. It commences at the jugular foramen and runs inferiorly through the neck in the carotid sheath, and unites with the subclavian vein. Tributaries: The facial, lingual, pharyngeal, superior and middle thyroid veins. The inferior thyroid veins drains into the brachiocephalic veins.
External jugular vein Origin: Tributaries and course: Origin: Begins near the angle of the mandible by the union of the posterior division of retromandibular vein and posterior auricular vein. Course: It cross the sternomastoid and pierces the investing layer of cervical fascia and terminates in the subclavian vein.
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