NBDE Quiz # 67
The facial nerve, is the nerve of facial expression. The pathways of the facial nerve are different, and knowledge of the key intratemporal and extratemporal landmarks is essential for accurate physical diagnosis and safe and effective surgical intervention in the head and neck.
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NBDE Quiz # 67
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1. Question
The cervical branch of the facial nerve is tran-sected during parotidectomy. Which of the fol-lowing functions is most likely to be affected?
CorrectThe correct answer is D. Transection of the cervical branch of the facial nerve would re¬sult in loss of function of the platysma muscle, which acts to retract and depress the mandible. This muscle lies in a superficial position within the anterior neck and attaches to the superfi¬cial fascia of the pectoralis major and deltoid muscles as well as to the mandible and the skin and subcutaneous tissue of the lower face. With these multiple attachments, it acts in a synchronous motion with the other muscles of the lower lip to draw the oral commissure and lower lip downward. The marginal mandibu¬lar branch of the facial nerve innervates the lip depressor muscle. Because the lip depressor muscle compensates for the loss of function of the platysma muscle, weakened depression of the lower lip would only be a temporary find¬ing. Forward flexion of the neck involves re¬laxation of the posterior muscles of the neck with the patient in the upright position or ac¬tion of the sternocleidomastoid muscles bilat¬erally with the patient in the supine position. Muscles that contribute to lateral neck flexion include the sternocleidomastoid, splenius, and inferior obliquus capitis. Upward movement of the hyoid bone is accomplished through the action of the digastric, stylohyoid, mylohyoid, and geniohyoid muscles; the sternohyoid, ster-nothyroid, thyrohyoid, and omohyoid muscles are used for downward movement. Pursing the lips is a function of the orbicularis oris muscle.
IncorrectThe correct answer is D. Transection of the cervical branch of the facial nerve would re¬sult in loss of function of the platysma muscle, which acts to retract and depress the mandible. This muscle lies in a superficial position within the anterior neck and attaches to the superfi¬cial fascia of the pectoralis major and deltoid muscles as well as to the mandible and the skin and subcutaneous tissue of the lower face. With these multiple attachments, it acts in a synchronous motion with the other muscles of the lower lip to draw the oral commissure and lower lip downward. The marginal mandibu¬lar branch of the facial nerve innervates the lip depressor muscle. Because the lip depressor muscle compensates for the loss of function of the platysma muscle, weakened depression of the lower lip would only be a temporary find¬ing. Forward flexion of the neck involves re¬laxation of the posterior muscles of the neck with the patient in the upright position or ac¬tion of the sternocleidomastoid muscles bilat¬erally with the patient in the supine position. Muscles that contribute to lateral neck flexion include the sternocleidomastoid, splenius, and inferior obliquus capitis. Upward movement of the hyoid bone is accomplished through the action of the digastric, stylohyoid, mylohyoid, and geniohyoid muscles; the sternohyoid, ster-nothyroid, thyrohyoid, and omohyoid muscles are used for downward movement. Pursing the lips is a function of the orbicularis oris muscle.