Presentation on theme: "Vessels and nerves of the face: Part of the head and neck file."— Presentation transcript:
1 Vessels and nerves of the face: Part of the head and neck file. Dr. SamsamPictures from: Platzer atlas and textbook of human anatomy
2 Big vessels in the neck: Hypoglossal nerveExternal Carotid A.CommonCarotid A.internal Jugular V.Vagus N.Subclavian A.Brachial plexusCommon facial V.Superior cervicalsympathetic ganglion
3 Anterior Facial Regions: First of all, the blood supply of the face ismostly by ext. carotid and partly by int. carotid.Facial artery (2) from ext. carotid passesit anastomose with dorsal nasal A. (4) comingfrom Ophthalmic A.Forehead is supplied by supratrochlear A. (8)and supraorbital (9) A., both from ophthalmic A.Facial vein (10) anastomoses via Angularvein (11) With dorsal nasal vein.***This anastomoses is extremely importantsince this allows a direct connection toCavernous sinus, through which, infectionseg: from a furuncle on the lip, may get into skull.All mimetic muscles are innervated by branchesof facial N: 13- temporal branch, 14- zygomatic15- buccal branch and 16- marginal mandibular.
4 Anterior Facial Regions: Sensory innervation to the face:Is derived from branches ofTrigeminal (V) nerve: Ophthalmic (V/1),Maxillary (V/2) and mandibular (V/3) nerves.Ophthalmic nerve: supplies the forehead:Supratrochlear N (17) and supraorbital (18).Maxillary nerve: supplies lower eyelid,Cheek, lateral nasal, upper lip and anteriorTemporal regions by Infraorbital N. (22).Mandibular N: lower lip over mandible(not angle) and chin by mental N (23).Auriculotemporal N (24) supplies skin onMandible ramus, concha of auricle andMost part of ext. layer of tympanic memb.Sensitivity of the 3 branches of trigeminal Ncan be tested by pressing nerves 18, 22 and 23.This is a vertical line, 2-3 cm lateral to midline.***Trigeminal Neuralgia.
5 Trigeminal neuralgia (Tic Douloureux) A disorder of unknown etiology (cause) associated with intractable pain along the 3branches of trigeminal nerve but especially along maxillary and mandibularnerves. A simple trigger such as touch, cold or hot can start the pain.Therapy: Carbamazepine, radiofrequency destruction of thebranches involved.Alcohol or Glycerin injection around the trigeminal ganglion.Transection of the sensory root.Vascular decompression of the trigeminal ganglion.