Head and Neck Exam Review

• 1. Ascending Palantine Artery
• 2. Tonsillar Artery
• 3. Glandular Branch
• 4. Submental Branch
• 5. Inferior Labial Branch
• 6. Superior Labial Branch
• 7. Labial Nasal Artery
• 8. Angular Artery

• Deep Auricular Artery
• Anterior Tympanic Artery
• Middle Meningeal Artery
• Accessory Meningeal Artery
• Deep Temporal Arteries
• Inferior Alveolar Artery
• Mylohyoid Branch of inf. Alveolar
• Mental artery Branch of inf. Alveolar
• Masseteric Artery
• Pterygoid Branch
• Buccal Artery

• Junction of parietal, frontal, sphenoid, and temporal bones
• Skull fractures are serious in this area
• Middle meningeal artery passes underneath the pterion
• Can cause extradural hematoma

• Anterior Meningeal Artery - crosses pterion
• Middle Meningeal Artery - Branch of maxillary artery, has 2 branches: one enters cranium through foramen spinosum, the other is the accessory meningeal and enters through foramen ovale
• Posterior Meningeal Artery - terminal branch of ascending pharyngeal artery, enters through jugular foramen

Trigeminal nerve, all branches, also cervical nerves

Receives superior cerebral, diploic, and emissary veins, and CSF

A few cerebral veins and falx cerebri

Receives inferior sagittal sinus, great cerebral vein, posterior cerebral veins, superior cerebellar veins, and veins from the falx cerebri

Receives superior sagittal, straight, and occipital sinuses

Drainage from confluence of sinuses: transverse and usually superior sagittal sinuses

Transverse and usually straight sinuses

Cerebral and Ophthalmic veins, sphenoparietal sinus, emissary veins from pterygoid plexus of veins

Most Important: Internal Carotid and Adbucent nerve - aneurism in the carotid here can compress abducent nerve (if patient comes in cross-eyed)

Other things that pass through laterally: Oculomotor nerve [III], trochlear nerve [IV], Ophthalmic nerve [V1], and maxillary nerve [V2]

• Tearing of branches of meningeal artery (could be near pterion)
• Blood collects between dura and calvaria

• Tearing of cerebral veins where they enter superior sagittal sinus
• Blood collects between arachnoid and dura matter

• Caused by significant cerebral trauma - can lead to rupture of aneurism
• Collects within subarachnoid space

• Facial nerve [VII]
• External carotid
• Retromandibular vein

• Temporal
• Zygomatic
• Buccal
• Mandibular
• Cervical

• Medial corner of orbit
• Area of cheek
• Deeper face

Infections here can travel to the brain

• Motor nucleus lesion - ipsilateral weakness of whole face
• Lesion in tract above nucleus - contralateral weakness of lower 1/2 of face

-ipsilateral weakness of whole face, loss of taste on ant. 2/3rds of tongue, loss of lacrimation, some salivation

Occurs because lesion is proximal to greater petrosal nerve and chorda tympani

Ipsilateral weakness of whoel face

• Skin
• Connective Tissue
• Aponeurotic Layer
• Loose Connective Tissue
• Pericranium

Sensory disorder of sensory root of trigeminal nerve.  Typically the pain is in the region of mandibular [V3] and maxillary [V2]

• Levator palpebrae superior muscle (cranial nerve III) - complete ptosis
• Superior toursal muscle (sympathetics) - partial ptosis (horner's syndrome)

• Ciliary: constricts ciliary band, relaxes tension
• Sphincter pupillae: constricts pupil
• Dilator pupillae: dilates pupil, only sympathetic innervation

• 1. Tensor Tympani: Branch of mandibular nerve [V3], contracts pulls handle of malleus medially
• 2. Stapedius: Branch of facial nerve [VII] - contraction of stapes

• Superficial Fascia
• Investing Fascia
• Prevertebral Layer
• Pretracheal Layer
• Carotid Sheath

• 1. Pretracheal Space: between investing layer and pretracheal fascia (infection would spread to superior mediastinum)
• 2. Retropharyngeal Space: between the buccopharyngeal fascia and preverebral fascia
• 3. Third Space: with the preverebral layer covering anterior surface of transverse processes and bodies of cervical vertebrae.