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Stapedius muscle has its nerve supply from:

# Stapedius muscle has its nerve supply from:

A. Trigeminal nerve

B. Facial nerve

C. Glossopharyngeal nerve

D. Stato-acoustic nerve

The correct answer is: B. Facial nerve

Stapedius muscle along with the tensor tympani are muscles of ossicles of middle ear. Stapedius is supplied by facial nerve, whereas tensor tympani is supplied by mandibular nerve. Stapedius and tensor tympani both act simultaneously to damp down the intensity of high pitched sound waves, thus protecting the internal ear. In paralysis of the muscle even normal sounds appear too loud, which is known as "hyperacusis".

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Lower one third of pinna is supplied by:

# The lower one-third of pinna is supplied by:

A. Auriculotemporal nerve

B. Great auricular nerve

C. Lesser occipital nerve

D. Vagus nerve

The correct answer is: B. Great Auricular Nerve.

Greater auricular nerve supplies lower one third of both lateral and medial surface of pinna. Auriculotemporal nerve supplies upper 2/3rds of lateral surface of pinna. Lesser occipital supplies upper 2/3rds of medial surface of pinna. Vagus nerve supplies root of the pinna. Facial nerve supplies muscles of pinna.

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Dangerous area of the face

# Which of the following areas are regarded as the ‘dangerous area’ of the face?

A. Chin and lower lips

B. Lower and upper lips

C. Upper lip and lower part of the nose

D. Upper part of nose and forehead

The correct answer is C. Upper lip and lower part of the nose.

The dangerous area of the face is drained by the facial vein. Deep connections of the facial vein with cavernous sinus includes:

i. A communication between the supraorbital and superior ophthalmic veins.

ii. Another with the pterygoid plexus through the deep facial vein which passes backwards over the buccinator. The pterygoid venous plexus in turn communicate with the cavernous sinus through an emissary vein. The veins of the dangerous area of face are valveless. Movements of the facial muscles and absence of valves in the facial vein might facilitate retrograde flow of blood. This allows retrograde infection, which is carried by facial, angular and nasofrontal veins and superior ophthalmic veins into cavernous sinus. This can lead to spread of septic emboli from the dangerous area of the face and can cause cavernous sinus thrombosis with serious complications.

Eagleton criteria for diagnosis of cavernous sinus thrombosis are:

- Known site of infection

- Paralysis of 3,4,6 nerves

- Proptosis of eye due to increased pressure in superior and inferior veins of the orbit.

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Branch of facial artery that crosses the submandibular region:

# The branch of facial artery that crosses the submandibular region, runs anteriorly over mylohyoid muscle and divides into two branches, a deep branch and a superficial branch, is:

A. Submental artery

B. Tonsillar artery

C. Superior labial artery

D. Retromandibular artery

The correct answer is A. Submental artery.

Submental artery: The largest cervical branch, it arises as the facial artery emerges out from the submandibular gland, turning forwards on the mylohyoid below the mandible. It supplies the surrounding muscles and anastomoses with a sublingual branch of the lingual and mylohyoid branch of the inferior alveolar arteries; at the chin it ascends the mandible, dividing into superficial and deep branches, which anastomose with the inferior labial and mental arteries, supplying the chin and lower lip.

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