Face & Parotid Gland

Question 1

Muscles of face: name + innervation

Answer 1

Orbiularis oculi
Orbicularis oris
Buccinator
Platysma
Innervated by branches of facial n.

Question 2

Blood supply of face: name

Answer 2

Ophthalmic (ICA):

• Zygomaticotemporal
• Zygomaticofacial
• Dorsal nasal
• Supra-orbital
• Supra-trochlear

Sup. temporal (ECA):
Transverse facial

Maxillary (ECA):

• Infra-orbital
• Mental = from inf. alveolar
• Buccal

Facial (ECA):

• Superior labial
• Inferior labial
• Lateral nasal
• Angular

Question 3

Facial artery: origin, course + branches

Answer 3

Superficial
Branch of ECA
Through deep structures neck, inf. border of mandible, curves around, ant. to masseter (pulse)
Upwards + medially, along side of nose
Terminates as angular = med. corner eye
Branches:
*sup. labial
*inf. labial
*lat. nasal

Question 4

Transverse facial artery: origin, course + branches

Answer 4

Superficial
Branch of sup. temp. a. = terminal br. of ECA
Arises in substance of parotid, crosses face

Question 5

Maxillary artery: origin, position + supply

Answer 5

Deep
Terminal br. ECA
Supplies:
*nasal cavity
*lat. walls + roof oral cavity
*teeth
*dura in cranium
*infratemporal fossa
Starts neck mandible + ends pterygopalatine fossa
3 parts by lat. pterygoid

Question 6

Maxillary artery: 1st part

Answer 6

Mandibular part
Post. + inf. lat. pterygoid
Branches:
*deep auricular
*ant. tympanic
*middle meningeal
*inf. alveolar
*acc. middle meningeal

Question 7

Maxillary artery: 2nd part

Answer 7

Pterygoid part - on muscle
Branches:
*masseteric
*deep temporal
*pterygoid
*buccal

Question 8

Maxillary artery: 3rd part

Answer 8

Pterygopalatine part - in fosssa
Branches:
*post. sup. alveolar
*sphenopalatine
*infra-orbital
*pharyngeal
*artery to pterygoid canal
*palatine (descending)

Question 9

Maxillary artery: mnemonic

Answer 9

DAM I AM Deeply Pained But Pretty Soon I’ll Possess A Phd

Question 10

Inferior alveolar artery: course + branches

Answer 10

Descends + enter mandibular foramen
Mylohyoid br.= in groove of ramus
Mental br. = terminal - supply chin

Question 11

Venous drainage of face: name

Answer 11

Facial v.
Transverse facial v.
Pterygoid venous plexus

Question 12

Facial vein: origin, course, tributaries + termination

Answer 12

Supratrochlear + supraorbital form angular = med. corner orbit
Angular becomes facial
Descends across with a. until inf. border mandible
Terminates IJV
Many tributaries = veins accompanying various br. of facial a.

Question 13

Transverse facial vein: course + termination

Answer 13

Accompanies a.
Drains into superficial temporal v.
Terminates in retromandibular v. with maxillary v.

Question 14

Pterygoid venous plexus: location + connections

Answer 14

Btw. lat. + med. pterygoids
Connections:
*retromandibular v. via maxillary
*facial v. via deep facial
*cavernous sinus via emissary veins

Question 15

Facial vein: connections + significance

Answer 15

Connects with:
*ophthalmic v. - med. corner orbit
*infra-orbital v. - cheek
*pterygoid venous plexus via deep v.
Pterygoid = connected with cavernous sinus
Interconnections, infections handled with care, prevent spread of infectious material to brain
Danger triangle = corners mouth to bridge of nose, inc. nose + maxilla

Question 16

Motor innervation of face: origin, course + types of fibres

Answer 16

Muscles of face = 2nd pharyngeal arch = facial n.
Facial n. exits post. cranial cavity, int. acoustic meatus
Through temporal + emerges from base via stylomastoid foramen
Motor + sensory
SVE = muscles of pharyngeal arches = facial expression + digastric
GVE = smooth, cardiac + glands = submandibular, sublingual + lacrimal

Question 17

Sensory innervation of face: origin + division

Answer 17

Cutaneous innervation = trigeminal n. - 1st pharyngeal arch

3 divisions = ophthalamic, maxillary + mandibular

Question 18

Branches of facial nerve

Answer 18

Branches as it leaves skull:

• post. auricular = up + back of ear - ear + scalp
• br. to post. belly digastric

Enters parotid + main stem divides:

• temporofacial br.
• cervicofacial br.

5 terminal groups of branches:

• temporal = temple, scalp + supra-orbital area
• zygomatic = infra-orbital area, side nose + upper lip
• buccal = upper lip, cheek + corners mouth
• marginal mandibular = chin + lower lip
• cervical = platysma

Question 19

V1 division of trigeminal nerve

Answer 19

Ophthalmic:

• SOF
• Supratrochlear + orbital = upper eyelid, forehead + scalp
• infratrochlear = med. upper eyelid, medial angle + side nose
• lacrimal = lat. upper eyelid + lat. angle
• ext. nasal = ant. nose

Question 20

V2 division of trigeminal nerve

Answer 20

Maxillary:

• foramen rotundum
• zygomaticotemporal = ant. temple above arch
• zygomaticofacial = skin over bone
• infra-orbital = lower eyelid, cheek, side nose + upper lip

Question 21

V3 division of trigeminal nerve

Answer 21

Mandibular:

• foramen ovale
• auricolotemporal = ext. meatus, tympanic membrane
• buccal = cheek
• mental = lower lip + chin

Question 22

Parotid bed: structures

Answer 22

Post. belly digastric m.
Stylohyoid m.
Med. pterygoid m.
Ramus
Masseter m.

Question 23

Parotid gland: relations

Answer 23

Ant. + below lower half of ear
Superficial, post. + deep ramus
Lower border mandible to zygomatic arch
Post. = SCM
Extends superficially + ant. across masseter

Question 24

Structures passing through parotid substance

Answer 24

EJV
Facial nerve
Retromandibular vein

Question 25

Parotid gland: blood supply + innervation (name)

Answer 25

Blood = br. ECA
Innervation:
*sensory/GVA = auricolutemp. n. from V3
*parasympathetic/secretomotor/GVE = lesser petrosal = br. of glossopharyngeal

Question 26

Secretomotor supply of parotid gland

Answer 26

CN = glossopharyngeal (IX)
Preganglionic fibres from IX = carried by lesser pretrosal n.
Ganglion = otic - fibres synapes
Postganglionic fibres exit ganglion + hitchhike on auricolotemporal n.
Leave skull via foramen ovale

Question 27

Parotid duct: course

Answer 27

Leave ant. edge gland
Cross masseter ant.
Turns deeply into buccal fat pad + pierces buccinator
Exits buccinator + enter oral cavity