• Origin: galea aponeurotica
• Insertion: skin of eyebrow
• Fxn: Raises eyebrows (surprise)
• nerve: temporal branch of CN 7

Origin: lateral two-thirds of superior nuchal line

Insertion: external occipital protuberance

Fxn: draws scalp posteriorly

Orbicularis oculi ms

3 parts

1. orbital portion: nasal process of frontal bone
2. palpebral portion: palpebral ligament
3. lacrimal portion: lacrimal crest of lacrimal bone

Insertion: circumferentially around orbit meeting in palpebral raphe

3 parts

1) Palpebral part = fxn = closes eyes lightly

2) Orbital part= fxn= closes eyes forcefully

3) lacrimal part= promotes flow of fluid through lacrimal sac

Nasalis ms

2 parts

1) transverse

2)alar

Origin:maxilla

Insertion: nasal

Fxn= dilates the nasal aperture

Inn= buccal branch of CN 7

Orbicularis oris ms

• Origin:
  1. alveolar border of maxilla
  2. lateral to midline of mandible
• Insertion:
  1. circumferentially around mouth
  2. blends with other muscles
• Fxn:
  1. closes the lips
  2. protrudes the lips
• Blood: facial artery
• Nerve: buccal branch of facial nerve

• Origin: medial 1/2 of infraorbital margin
  
• Insertion: upper lip muscles
• Action: elevates the upper lip
• Blood: facial artery
• Nerve: buccal branch of facial nerve

• Origin: frontal process of maxilla
• Insertion:
  1. upper lip muscles
  2. nasal cartilage
• Action:
  1. elevates the upper lip
  2. flares the nostrils
• Blood: facial artery
• Nerve: buccal branch of facial nerve

Mentalis ms

Origin: incisive fossa of mandible

Insertion: integument of the chin

Fxn: protrudes lower lip

• Origin:
  1. posterior alveolar process of maxilla
  2. posterior alveolar process of mandible
  3. along the pterygomandibular raphe
• Insertion: modiolus
• Action: compresses the cheek(s) and helps to keep food out of the vestibule
  
• Blood: facial artery

Nerve: buccal branch of facial nerve

• Origin: subcutaneous skin over delto-pectoral region
• Insertion: invests in the skin widely over the mandible
• Action:
  1. depress mandible and lower lip
  2. tenses the skin over the lower neck
• Blood: superficial vessels of the neck
• Nerve: cervical branch of facial nerve (VII cranial)
• exgends into the supericial neck region (shaving muscle)

pharyngeal arch 2

(thus, all SVE)

The buccal branch of CN7 passes superficial to the masseter ms

The buccal nerve (V3) enters the cheek deep to the masseter ms

Definition: facial muscles are paralyzed on one side

Causes

1. inflammation of CN7 inside facial canal
2. Constriction due to cold exposure of stylomastoid branch of the post auricular artery that supplies CN7

Varies according to site of compression

1. superior to stylomastoid foramen = ipsilateral facial paralysis 
2. proximal to geniculate ganglion = all functions lost including: facial paralysis, dry eye, hyperacusis, ageusia, impaired secretion of salivary glands (submand and subling)

1. Dry eyes = greater petrosal nerve carrying parasympathetic fibers to lacrimal gland is compromised
2. hyperacusis =nerve to teh stapedius is paralyzed
3. ageusia = ant. 2/3 of tongue is paralyzed because of chorda of tympani is compromised
4. Impaired secretion = parasympathetic fibers in chorda tympani are affected running to the submand and subling glands

V1 = forehead, upper eyelids, dorsum of nose

V2 = lower eyelid, upper lip and side of the nose

V3 = L-shaped stirp of skin including lip and chin, lower cheek, part of the external ear and temple

V1 nerves and  (need to list distributions sometime)

1. Supraorbital nerve
2. Supratrochlear nerve
3. Palpebral branch of lacimal nerve
4. infratrochlear nerve
5. external nasal branch of anterior ethmodial nerve

1. Infraorbital nerve
2. Zygomaticofacial nerve
3. Zygomaticotemporal nerve

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

• Severe stabbing pain in the region of V2 most frequently, in V3 less frequently, and V1 least frequently.
• Most common older women (suicide?)

• GSA = skin, mucosa, and teeth
• SVE = muscles of mastication

• Not always known
• Sometimes from inflammation of petrous temporal bone
• Compression of the sensory root by aberrant artery
• Pathological change in spinal trigeminal nucleus

• Chin
• Lips
• nose

• near the angle of the eye
• angular artery

• supratrochlear vein
• supraorbital vein

• anterior division of retromandibular vein
• facial vein

• It is valveless, thus able to transmit infection
• Connected to pterygoid plexus
• Connected to cavernous sinus

• nasal
• frontal
• [image]
• maxilla[image]
• [image]

• septal
• lateral nasal
• greater alar

• The medial and lateral meeting fo the eyelids

• triangular area bonded by two lids and the Plica semilunaris (semilunar fold)

• fold of conjunctiva which intercepts foreign bodies of the eye

• small mound of modified skin containing fine hair cells and sebaceous/sweat glands

• On medial aspect of eyelid
• Has lacrimal punctum

• Tiny opeing on the medial aspect of the eyelid
• Functions as part of the drainage apparatus for lacrimal gland

1. skin
2. subcutaneous tissue
3. muscular
4. tarsofascial
5. palpebral part of conjunctiva

• it is loose, thus fluid can accumulate after trauma to the eyelid

• palpebral part of the orbicularis oculi

• tarsal plates and orbital septum

• Made of connective tissue that strengthens the eyelid

• Posterior surfaces of tarsal glands
• Oily secretions waterproofs the eyelids and prevents them from sticking together

• membrane that stretches margins of the orbit to the tarsal plates

• deepest layer of the eyelid
• vascular and examined in suspected cases of anemia

• Outermost part of the eyeball

• Bulbar conjunctiva
• Palpebral conjunctiva

• Junctions of the bulbar and palprebral conjunctiva
• Seen when the eyelid is reflected

1. levator palpebrae superioris ms
2. superior tarsal ms

Function = elevate the upper eyelid

• Origin: inferior aspect of the lesser wing of sphenoid (adjacent to the common annular tendon)
• Insertion:
  1. medial and lateral walls of the orbit
  2. superior tarsus
• Action: elevates the eyelid
• Blood: branches of ophthalmic artery
• Nerve: oculomotor nerve (III cranial)
• ptosis if injured

• smooth muscle
• involuntary
• innervation = post-synaptic sympathetic fibers from the superior cervical ganglion
• if injured = ptosis

• function to attach the tarsal plates to the margins of the orbit
• **To access the lacrimal sac, the medial palpebral ligament must be cut**

• Lacrimal gland
• lacrimal ducts
• into the superior fornix of the conjuctival sac
• Into the lacrimal lake
• lacrimal punctum
• lacrimal canaliculus
• lacrimal sac
• nasolacrimal duct
• inferior meatus of the nasal cavity

• Upon contraction it physically pushes on the lacrimal gland causing tear flow

• inflammation of the lacrimal sac

• Afferent = CN5
• Efferent = CN7

• tears falling onto the face

• Protective corneal reflex is lost
• Eye remains open, suspect to drying out and ulceration
• epiphora due to the lower eyelid sagging

• Maxillary
• Lacrimal

• Leave brain in CN7 via facial canal
• branch off to form greater petrosal nerve
• joins another nerve to form the nerve of pterygoid canal
• goes to pterygopalatine ganglion(presyn) in pterygopalatine fossa
• postsyn fibers join V2
• Leave through V2 zygomatic branch
• Enter orbit
• Zygomatic nerve communicates with the lacrimal nerve (V1)

• Superior cervical ganglion
• inhibits secretion

1. Skin
2. connective tissue
3. aponeurosis
4. loose subaponeurotic tisse
5. pericranium

• Fourth layer (loose subaponeurotic tissue)
• Because infections can readily spread through it
• Veins of the scalp are connected to the superior sagittal sinus via emissary veins

• Yes, but the external is direct and internal indirectly

• Anterior/posterior because of the galea aponeurotica would keep the left/right cut open

What are the arteries of the scalp the major blood supply to the crainal bones?

1. nasal
2. lacrimal
3. zygomatic
4. maxilla
5. mandible
6. vomer
7. inferior nasal concha
8. palatine

1. Frontal
2. zygomatic
3. alveolar
4. palatine

1. mental tubercle
2. Anterior border of the ramus