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82

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Anatomy

Head and Neck

Question 119 of 180

The skin over the tip of the nose is primarily supplied by which of the following nerves:

Answer:

The external nasal nerve, branch of the ophthalmic nerve, innervates the anterior part of the nose.

Cutaneous Innervation of Face

The trigeminal nerve divides into three major divisions: the ophthalmic (V1), maxillary (V2) and mandibular (V3) nerves which supply the skin of the face.

By Patrick J. Lynch, medical illustrator (Patrick J. Lynch, medical illustrator) [CC BY 2.5], via Wikimedia Commons

Cutaneous Innervation of the Head. (Image by Patrick J. Lynch, medical illustrator [CC BY 2.5], via Wikimedia Commons)

Ophthalmic Nerve

The ophthalmic nerve exits the skull through the superior orbital fissure to enter the orbit. It gives rise to five cutaneous branches that supply the face:

  • the supraorbital nerve (innervating skin of the upper eyelid and conjunctiva and the skin of the upper forehead extending back to the middle of the scalp)
  • the supratrochlear nerve (innervating skin of the lower central part of the forehead and conjunctiva and skin of the upper eyelid)
  • the infratrochlear nerve (innervating the medial half of the upper eyelid and the skin in the area of the medial angle and the bridge of the nose)
  • the lacrimal nerve (innervating the lateral half of the upper eyelid and the skin in the area of the lateral angle)
  • the external nasal nerve (innervating the anterior lower half of the nose).

Maxillary Nerve

The maxillary nerve exits the skull through the foramen rotundum and gives rise to three cutaneous branches that supply the face:

  • the zygomaticotemporal nerve (innervating a small area of the anterior temple above the zygomatic arch)
  • the zygomaticofacial nerve (innervating a small area of skin over the zygomatic bone)
  • the infraorbital nerve (innervating the lower eyelid, the cheek, the side of the nose and the upper lip).

Mandibular Nerve

The mandibular nerve exits the skull through the foramen ovale and gives rise to three cutaneous branches that supply the face:

  • the auriculotemporal nerve (innervating the external acoustic meatus, the surface of the tympanic membrane and a large area of the temple)
  • the buccal nerve (innervating the cheek)
  • the mental nerve (innervating the skin and mucous membranes of the lower lip and the skin of the chin).

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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