Face and Parotid

Question 1

SCALP acronym

Answer 1

5 layers
Skin
Connective tissue (dense)
Aponeurotic layer
Loose connective tissue
Pericranium

Question 2

What is the pericranium continuous with?

Answer 2

The periosteal layer and the periorbital fascia

Question 3

What is the role of the dense connective tissue in the scalp

Answer 3

Contains neurovascular structures

Question 4

What is the role of the loose connective tissue in the scalp

Answer 4

Facilitates movement of the scalp over the calvaria

Infection tends to localise and spread through this layer

Question 5

Blood vessels in the scalp

Answer 5

Branches of the external carotid and ophthalmic artery

Question 6

Innervation of the scalp

Answer 6

Trigeminal nerve and cervical nerves

Question 7

Occipitofrontalis

Answer 7

Muscle of facial expression innervated by facial nerve

Question 8

Innervation of parotid gland

Answer 8

Sensory of parotid fascia: C2
Sensory of parotid itself: CN V3
(auriculotemporal nerve)
Motor: CN V3 and CN IX

Question 9

Auricularis muscles

Answer 9

Anterior, superior and posterior

Innervated by facial nerve

Question 10

Parotid gland

Answer 10

Largest of 3 salivary glands and wrapped around the mandible anterior to and below the ear
The parotid duct leaves the anterior border of the gland and crosses the face in a transverse course over the masseter. At the anterior border of the masseter the duct pierces the buccinator and opens into the oral cavity.

Question 11

Obicularis oris

Answer 11

Upper and lower lip muscles

Damage to one area results in lip pulling in that direction

Question 12

Porion line

Answer 12

Intersection between the supraorbital meatal line and the infraorbital meatal line
One of the three anatomical points used to identify the Frankfurt plane
Easy to palpate therefore identifiable and accurate

Question 13

Zygomatic sutural line

Answer 13

Intersection between frontozygomatic and temporozygomatic sutures

Question 14

Course of the facial nerve

Answer 14

Exits the skull through the stylomastoid foramen and immediately gives off the posterior auricular nerve which passes back and up to supply the occipital part of occipitofrontalis
The next branch supplies the posterior belly of digastric and stylohyoid muscles
The facial nerve enters the posteromedial surface of the parotid gland and divides into temperozygomatic and lower cervicofacial branches

Question 15

5 branches of the facial nerve

Answer 15

Temporal, zygomatic, buccal, marginal mandibular and cervical

Question 16

Danger zone

Answer 16

Region between porion line and zygomatic sutural line where facial nerve runs

Question 17

Pitanguys line

Answer 17

Old way of identifying temporal branch course, but based on soft tissue landmarks and very variable
Alternative landmark should be intersection of porion and zygomatic sutural lines

Question 18

Temporal branch innervation

Answer 18

Anterior and superior auricularis muscles

Frontalis

Question 19

Zygomatic branch innervation

Answer 19

Frontalis
Obicularis oculi
Muscles below eye

Question 20

Buccal branch innervation

Answer 20

Buccinator and muscles of upper lip

Question 21

Marginal mandibular innervation

Answer 21

Muscles of lower lip

Question 22

Cervical branch innervation

Answer 22

Platysma

Question 23

Close relations to the facial nerve

Answer 23

Parotid gland
Retromandibular vein
External carotid artery
Masseter muscle

Question 24

How to guess position of parotid duct

Answer 24

Draw a line on the side of the face between the corner of the mouth and the tragus
Find the middle third and draw a box 1.5 cm above and below
93% of people have the parotid gland here

Question 25

The parotid gland is divided into superficial and deep parts by the:

Answer 25

Facial nerve