pearls for assessing sensation of the face and head
TRANSCRIPT
![Page 1: Pearls for assessing sensation of the face and head](https://reader034.vdocuments.net/reader034/viewer/2022042723/587c10a51a28ab03768b6801/html5/thumbnails/1.jpg)
SENSORY PEARLS OF FACE AND HEAD INNERVATION
![Page 2: Pearls for assessing sensation of the face and head](https://reader034.vdocuments.net/reader034/viewer/2022042723/587c10a51a28ab03768b6801/html5/thumbnails/2.jpg)
FACIAL SENSATION Trigeminal nerve supplies sensation back to a plane that passes
through the external auditory meatus……MOSTLY
![Page 3: Pearls for assessing sensation of the face and head](https://reader034.vdocuments.net/reader034/viewer/2022042723/587c10a51a28ab03768b6801/html5/thumbnails/3.jpg)
FACIAL SENSATION…PART 2 Angle of the Jaw, earlobe and
Parotid gland Greater Auricular nerve Derived from C2-C3
![Page 4: Pearls for assessing sensation of the face and head](https://reader034.vdocuments.net/reader034/viewer/2022042723/587c10a51a28ab03768b6801/html5/thumbnails/4.jpg)
INNERVATION OF THE PINNA AND EXTERNAL AUDITORY MEATUS
Dense traffic pattern CN V
Auriculotemoral nerve carries most of the sensation
CN VII Auricular branch Concha and osterior wall of the
canal CN X Lesser occipital nerve Greater auricular nerve
Not surprising that lots of pain is referred to the ear
![Page 5: Pearls for assessing sensation of the face and head](https://reader034.vdocuments.net/reader034/viewer/2022042723/587c10a51a28ab03768b6801/html5/thumbnails/5.jpg)
REFERRED EAR PAIN
![Page 6: Pearls for assessing sensation of the face and head](https://reader034.vdocuments.net/reader034/viewer/2022042723/587c10a51a28ab03768b6801/html5/thumbnails/6.jpg)
HITZELBERGER’S SIGN
Decreased sensitivity in the concha corresponding to the sensory distribution of the seventh nerve is suggestive of a space-occupying lesion in the internal auditory canal or cerebellopontine angle.
May be the only sensory loss in early acoustic neuroma
![Page 7: Pearls for assessing sensation of the face and head](https://reader034.vdocuments.net/reader034/viewer/2022042723/587c10a51a28ab03768b6801/html5/thumbnails/7.jpg)
ZOSTER OPHTHALMICUS
![Page 8: Pearls for assessing sensation of the face and head](https://reader034.vdocuments.net/reader034/viewer/2022042723/587c10a51a28ab03768b6801/html5/thumbnails/8.jpg)
HUTCHINSON’S SIGN IN ZOSTER OPHALMICUS
Involvement of the nasociliary nerve of the ophthalmic division of the trigeminal nerve
Predicts involvement of the globe
![Page 9: Pearls for assessing sensation of the face and head](https://reader034.vdocuments.net/reader034/viewer/2022042723/587c10a51a28ab03768b6801/html5/thumbnails/9.jpg)
MENTAL NERVE AND MENTAL NEUROPATHY (NUMB CHIN)
![Page 10: Pearls for assessing sensation of the face and head](https://reader034.vdocuments.net/reader034/viewer/2022042723/587c10a51a28ab03768b6801/html5/thumbnails/10.jpg)
MENTAL NEUROPATHY
Never a trivial symptom and should start a search for occult malignancy
These metastases originate most commonly from: cancers of the breast (20-30%), thyroid gland (15%) kidneys (13%) lungs (12%) prostate (10%) gastrointestinal system (9%), and other organs (11-21%)
![Page 11: Pearls for assessing sensation of the face and head](https://reader034.vdocuments.net/reader034/viewer/2022042723/587c10a51a28ab03768b6801/html5/thumbnails/11.jpg)
SCALP SENSATION AND NON-TRIGEMINAL PAIN
![Page 12: Pearls for assessing sensation of the face and head](https://reader034.vdocuments.net/reader034/viewer/2022042723/587c10a51a28ab03768b6801/html5/thumbnails/12.jpg)
GREATER OCCIPITAL NEURALGIA Palpate! Put you hands where
the patient say it hurts Treatment may help migraine
and cluster Yes…there is controversy.
Such is life.