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Anatomy Gi > Anatomy L2 > Flashcards

Anatomy L2 Flashcards

1
Q

Covering of parotid gland?

A

Splitting of investing layer that comes from deep cervical facia
= superfacial (parotidmasster fascia)
=deep(stylomandibular ligament)

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2
Q

Postero-medial surface of parotid gland is related to?

A

We have mastoid and styloid processes

SCM
Posterior belly of digastric

stylohyoid
styloglossus
stylopharyngeus

Also EC enters the parotid gland at this level

This surface is also related to deeper structure like internal
carotid artery, internal jugular vein, deep to the styloid
apparatus.

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3
Q

The pain produced by the MUMPS is mistaken for toothache,

the parotid swellings are painful WHY?

A

Due to unyielding nature of this fascia (parotid)

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4
Q

Structures that emerge from BASE of parotid gland?

A 
SETTA  
Superficial temporal vessels
External acoustic meatus
Temporal facial nerve
TMJ 
Auricotemporal nerve
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5
Q

Parotid gland APEX structures?

Structures that emerge from apex of parotid?

A

RMV

Cervical facial nerve

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6
Q

The significance of the BASE of the parotid gland is ?

A

a tumor affecting this are a can obstruct the TMJ

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7
Q

Superficial or lateral surface of parotid gland structures?

A 
Skin
Platysma
Superficial parotid ln
Parotid fascia 
Great aurical nerve(supplying skin over fascia)
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8
Q

Antero-medial surface of parotid gland is related to?

A

MRM

Masseter muscle (outside)
Ramus of mandible
Medial pterygoid muscle (inside)

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9
Q

The superficial lamella (parotid fascia) of the fascia is very strong and attached to?

A

Lower Zygomatic bone arch + epimysium of the masseter muscle.

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10
Q

Lymphatic drainage of parotid gland?

A

pre auricular/ superficial parotid LN فوق القلاند

deep parotid LN داخل القلاند

Then into deep cervical LN

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11
Q

Structures that emerge from ANTERIOR border of parotid gland?

A
  1. transverse facial arterty
  2. zygomatic facial nerve
  3. upper AND lower buccal facial nerves
  4. marginal mandibular nerves
  5. parotid duct
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12
Q

which nerve is likely to be injured during the removal of a tumor in the parotid salivary gland ?

A

The facial nerve and its branches cuz its most superficial

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13
Q

Structures inside the parotid gland (outside to inside) ?

Ya3ni tarteeb min most superficial to deepest

A

1- facial nerve and its branches
2- RMV
3-EC and its branches (superficial temporal art. + maxillary art.)

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14
Q

What forms the RMV at the apex?

A

union of superficial temporal + maxillary veins

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15
Q

Where does the EC terminate ?

A

Neck of mandible

Then it gives the maxillary art. and superficial temporal art. (Which gives the transverse facial art.)

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16
Q

Where does the parotid duct open?

A

In the vestibule opposite to the 2nd upper maxillary molar tooth

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17
Q

A bad oral hygiene can cause?

A

bacterial parotitis (infection spread through parotid duct) resulting in slight swelling of the gland and usually produces an abscess.

The skin over the swelling shows redness. It is extremely painful due to unyielding nature of the parotid fascia

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18
Q

Preganglionic secretomotor parasympathetic fibers are derived from? And carried by?

A

Inf salivary nuclei in medulla

Carried by glossopharyngeal n.

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19
Q

The secretomotor fibers leave the glossopharyngeal nerve at JAGULAR FORAMEN through its branch called?

A

Tympanic nerve

It inters the tympanic cavity and middle ear thro tympanic canaliculi at the jugular foramen. Then forms tympanic plexus in middle ear,

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20
Q

What does tympanic plexus supply?

A

Mucousa of middle ear

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21
Q

What arises from these tympanic plexus?

A

The lesser petrosal nerve, having preganglionic parasympathetic that emerge through foramen ovale and ends in otic ganglion.

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22
Q

The postganglionic fibers from OTIC GANGLION join what nerve?

A

join the auriculotemporal nerve to supply the parotid gland.

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23
Q

Post ganglionic SYMPATHETIC fibers arise from what ganglion?

A

arise from “superior cervical sympathetic ganglion”, then form plexus around external carotid artery and its branch middle meningeal branch to supply parotid gland

24
Q

What is Frey’s syndrome? And why does it happen?

A

When patient eats beads of sweat appear on the skin covering
the parotid gland.

Cause: This is due to union of auriculotemporal nerve & great auricular
nerve (supply skin over the parotid gland including sweat glands) within the parotid gland during wound healing process.

25
Q

What is crocodile tears syndrome?

A

Spontaneous tearing in parallel with the normal salivation of eating.

Why? often following facial paralysis when nerve fibers destined for a salivary gland are damaged and by mistake regrow into a tear gland. (t the fascial nerve branches are in relation wi th the lacrimal nerve)

26
Q

1)A slow growing benign tumor in the parotid usually does not show facial nerve involvement

2)A rapidly growing carcinoma of the gland can show the
involvement of facial nerve.

Which is true?

A

Both accurate

27
Q

Patient with parotid tumor is presented with inability to close their eyes, which nerve is affected?

A

Facial nerve

28
Q

Patient with parotid tumor is presented with lots of food in their vestibule, which branch of facial nerve is affected?

A

Buccal facial nerve; it supplies the buccinator muscle that cleans the vestibule and doesn’t allow food to accumulate in there.

29
Q

Patient with parotid tumor is presented with trouble whistling and blowing, which branch of facial is affected?

A

Buccal facial n. Which supplies the buccinator muscle

30
Q

when u ask the patient to smile and the angle of the mouth won’t be widened nor depressed, which branch of facial is affected?

A

marginal mandibular branch

31
Q

The parotid duct may be blocked by a ? And pain due to this can be worsened by ? Because saliva builds us

A

Calculus
Eating

A radiopaque fluid can be injected into the duct system through a cannula inserted through the orifice of the parotid duct and the radiograph is taken. This procedure is called sialography
(sialo=saliva).

32
Q

The enlargement of the parotid glands and multiple dental caries are common in?

A

Bulimic people (binge and purge)

33
Q

Where is the submandibular gland situated ?

A

Submandibular fossa in the mandible

34
Q

Submandibular glad is intended by?

A

Mylohyoid muscle. (-

35
Q

Superficial part of submandibular gland: الفص اللي برا

What are the structures in the inferior surface?

A 
Skin
Platysma 
Deep fascia
Cervical facial n.
Facial vein
Submandibular LN
36
Q

Superficial part of submandibular gland:

Lateral surface structures?

A

Facial artery

Submandibular fossa

37
Q

which structure is most likely to be injured during surgical removal of the superficial part of the sub mandibular salivary gland ?

A

Facial artery imp

38
Q

Relations of the superficial part of submandibular gland - Medial surface

A

Anterior part:

  • mylohyoid and its vessels
  • submental art.

Middle part:

  • hyoglossus muscle
  • lingual n. (superficial to hyoglossus)
  • hypoglossal n. (superficial to hyoglossus)
  • submandibular ganglion

Posterior part (deep to hyoglossus muscle):

  • lingual art.
  • glossopharyngeal n.
39
Q

Relations of deep part of submandibular gland? (Lateral, medial, above, and below)

A 
Lateral= mylohyoid
Medial= hyoglossus
Above= lingual n. + submandibular ganglion
Below= hypoglossal n.
40
Q

Submandibular salivary gland is removed in cases of tumor in it. During surgery, care must be taken to avoid injury to which structures?

A

facial nerve, facial artery, lingual nerve and hypoglossal nerve.

*ركزي لو قال removal of superficial part of submandibular الاجابة تكون facial artery *

41
Q

Submandibular duct location

A

in the floor of the mouth- sublingual papillae - by the side of
the lingual frenulum.

42
Q

Sublingual salivary gland location?

A

Located below the tongue, in the floor of the mouth between the mucous membrane and mylohyoid muscle.

43
Q

Sublingual salivary gland duct opening?

A

Summit of sublingual fold

44
Q

if you are removing a stone from the submandibular salivary gland DUCT which nerve may be injured?

A

Lingual nerve
Because the DUCT has triple relation with the lingual nerve (lingual nerve is related to lateral, inferior & medial side of the duct).

45
Q

which nerve carries taste sensation from the anterior end of the tounge?

A

Chorda tympani branch if facial n

Lingual n

46
Q

Preganglionic parasympathetic secretomotor pathway for submandibular and sublingual glands?

A 
Superior salivatory nucleus of pons
 ⬇️
Facial nerve (VII) 
⬇️
Chorda tympani nerve + joins w lingual n. (Branch of mandibular n.)
⬇️
Submandibular ganglion
⬇️
Submandibular & Sublingual gland (Some of the postganglionic fibers join the lingual nerve and supplies sublingual salivary gland)j
47
Q

Salivary glands are:
1- compound tubuloalveolar glands
2-simple tubular
3-compound tubular

A

1- compound tubuloalveolar glands

48
Q
  1. Serous salivary gland
A

Not a question

49
Q

Saliva function?

A

-moistens food
-lubricates the digestive tract
-digestion of carbohydrates
-excrete certain salts and protect against bacterial invasion by
releasing lysosome and IgA into the saliva

50
Q

Where does the parotid duct open?

A

In the vestibule opposite to the 2nd upper maxillary molar tooth

51
Q

Describe serous acini

A 
Smaller
Smaller lumen
Circular
Circular round nucleus at base
Pyramidal cells
Produce protein rich watery secretion
52
Q

Describe mucous acini

A 
Oval 
Larger
Larger lumen
Columnar cells
Flat nucleus at base
Produce thick glycosaminoglycan-rich secretion (mucus)
53
Q

What are parotid gland sections (it’s serous salivary gland)?
serous gland secretions are watery and rich w protein

A

25% of the total salivary volume
amylase, maltase, sialomucin
enzyme resistant secretory IgA

54
Q

Why cells of mucous acini (like sublingual) appear empty when stained?

A

Cells of mucous acini contain large numbers of mucinogen granules in the apical part . This mucinogen is lost in H&E stained paraffin sections, hence appear empty

55
Q

Submandibular gland secretions

A

produce approximately 70% of the salivary volume, contain both mucous and serous (mostly serous) acini.
-The serous secretion contain sialomucin and have weak amylase activity
-The mucous acinus may be capped by serous demilunes composed of several lysozyme-secreting
serous cells

56
Q

Cells of serous acini show basal basophilic (hematoxylin) because of rough ER and free ribosomes.

The apical part of the acinar cell is eosinophilic (eosin) stain because of secretary granules

A

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Anatomy Gi (2 decks)

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