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Neuro Week 1 > ICL 11.0: Muscles of the Face & Infratemporal > Flashcards

ICL 11.0: Muscles of the Face & Infratemporal Flashcards

1
Q

what are the 5 groups of muscles of the face?

A
  1. epicranial group
  2. circumorbital and palpebral group
  3. auricular group
  4. nasal group
  5. buccolabial group
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2
Q

which muscles are in the epicranial group?

A
  1. epicranius aka occipitofrontalis

2. temporoparietalis

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3
Q

which muscles are in the circumorbital and palpebral group?

A
  1. orbicularis oculi
  2. levator palpebrae superioris
  3. corrugator supercilii
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4
Q

which muscles are in the auricular group?

A
  1. auricularis anterior
  2. auricularis superior
  3. auricularis posterior
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5
Q

which muscles are in the nasal group?

A
  1. procerus
  2. nasalis
  3. depressor septi
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6
Q

which muscles are the buccolabial group?

A
  1. orbicularis oris
  2. levator labii superioris
  3. levator Labii superioris alaeque nasi
  4. risorius
  5. zygomaticus major
  6. zygomaticus minor
  7. mentalis
  8. levator anguli oris
  9. depressor labii inferioris
  10. depressor anguli oris
  11. buccinator
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7
Q

where do facial muscles originate and attach too?

A

they arise from the facial bones and attached to the skin or encircle facial orifices

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8
Q

what is the innvervation of the facial muscles?

A

all of them are innervated by the facial nerve

EXCEPT levator palpebrae superiors which is innervated by the oculomotor nerve

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9
Q

what is the route of the facial nerve?

A

it leaves the skull through stylomastoid foramen, and soon pierces the parotid gland

within the parotid gland, it ramifies into terminal branches which leave the parotid gland from the different borders and run in the superficial fascia of the face to reach their target muscles

this is very close to the TMJ so it is at risk if there is a fracture/dislocation of TMJ

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10
Q

what are the 7 branches of the facial nerve?

A
  1. greater petrosal nerve
  2. nerve to the stapedius
  3. chorda tympani
  4. osterior auricular
  5. nerve to posterior belly of digastric muscle
  6. nerve to stylohyoid
  7. five terminal branches for the muscles of facial expression
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11
Q

what are the 5 terminal branches of the facial nerve?

A
  1. temporal
  2. zygomatic
  3. buccal
  4. marginal mandibular
  5. cervical

“To Zanzibar By Motor Car”

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12
Q

what is facial palsy?

A

aka Bell’s Palsy

it is a type of facial paralysis that results in an inability to control the facial muscles on the affected side

symptoms may include include muscle twitching, weakness, or total loss of the ability to move one or rarely both sides of the face, drooping of the eyelid, a change in taste, pain around the ear, and increased sensitivity to sound

cause is unknown

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13
Q

what are the symptoms of Bell’s palsy?

A
  1. paralysis of the orbiculares oculi which leads to an inability to close the eye –> serious issue because it leads to eye dryness and corneal ulceration
  2. paralysis of the orbicularis oris = angle of the mouth sags in the affected side, and there may be drooling in that side
  3. paralysis of the buccinator = accumulation of food between the cheek and the teeth on the affected side; flattened nasolabial fold on effected side
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14
Q

what is the arterial supply of the face? what is the route that is takes?

A
  1. facial artery

2. superficial temporal artery

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15
Q

what is the route of the facial artery?

A

its a branch of the external carotid artery

it runs part of its course in the digastric triangle and reach the face at the lower anterior angle of the masseter where its pulse can be palpated

it kind of travels through the mouth up the nose to the eye where it ends near the medial angle of the orbit by becoming the angular artery

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16
Q

what are the branches of the facial artery?

A
  1. ascending palatine
  2. tonsillar
  3. inferior labial*
  4. superior labial*
  5. lateral nasal*
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17
Q

what is the route of the superficial temporal artery?

A

it’s one of the terminal branches of the external carotid artery (the other is the maxillary artery)

it arises inside the parotid gland near the neck of mandible, runs upward and crosses the zygomatic arch and runs in the superficial fascia of the face, supply the skin of face and part of the scalp

it basically runs up the side of the face infant of the ear

you can feel its pulse at the tragus

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18
Q

what are the branches of the superficial temporal artery?

A
  1. transverse facial (it goes and anatomoses with the facial artery)
  2. frontal (anterior branch)
  3. parietal (posterior branch)
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19
Q

which veins drain the face?

A

facial vein

the supraorbital and supratrochlear veins form the angular vein at the root of the nose –> the angular vein descend over the medial side of orbit to become the facial vein at the lower side of the medial margin of the orbit

then the facial veins descends and in the digastric triangle it joins the anterior division of the retromandibular vein to form the common facial vein

the common facial vein then drains into the internal jugular vein

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20
Q

how does the facial vein communicate with the cavernous sinus?

A

the facial vein communicates with cavernous sinus through two routes

  1. superior and inferior ophthalmic veins connect the angular vein in the orbital region to the cavernous sinus
  2. the deep facial veins between the nose and mouth connect the facial vein to the pterygoid plexus of veins which, in turn, connects to the cavernous sinus
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21
Q

what is cavernous sinus thrombophlebitis?

A

the dangerous triangle of the face = the triangle formed by the nose and mouth

face infections in the area of the dangerous triangle could cause facial vein phlebitis with secondary thrombophlebitis (blood clot) in the internal jugular vein

infected thrombi may reach to cavernous sinus, causing thrombophlebitis of cavernous sinus which may lead to:

  1. exophthalmos = bulging eyeball
  2. diplopia/ophthalmoplegia = double vision
  3. mydriasis and loss of near vision reflexes
  4. pain, paresthesia or loss of sensation in the distribution of ophthalmic or maxillary divisions of trigeminal nerve
  5. death
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22
Q

what are the 3 pairs of salivary glands?

A
  1. parotid
  2. submandibular
  3. sublingual
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23
Q

which salivary gland is the largest?

A

parotid

the parotid glad is surrounded by a tough capsule (parotid sheath), derived from the investing layer of the deep cervical fascia

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24
Q

what is the function of the parotid gland?

A

it’s a salivary gland drains saliva through the parotid duct

it’s located under the ear and anterior to the sternocleidomastoid

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25
Q

what is sialadentis?

A

inflammation of the parotid gland

associated with pain, tenderness, redness, and gradual, localized swelling of the affected area

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26
Q

where is the parotid duct located?

A

the parotid ducts emerges from the anterior border of parotid

it runs over the masseter muscle and pierces the buccinator muscle to reach the oral cavity

the parotid ducts opens in the buccal mucosa opposite the maxillary 2nd molar tooth

occasionally, there is extension of the glandular tissue of the parotid over the parotid duct called accessory parotid gland

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27
Q

what are sialoliths?

A

stones in the parotid duct

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28
Q

what is sialography?

A

imaging the parotid after injecting radiographic contrast medium

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29
Q

what are the borders of the parotid gland?

A

the parotid gland extends from external auditory meatus superiorly to the angle of the mandible inferiorly, and from the ramus of the mandible anteriorly to the mastoid process posteriorly –> it’s wedge shaped

it has 3 surfaces = lateral, anteromedial and posteromedial

it has 3 borders = anterior, posterior and medial borders

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30
Q

what is the parotid bed?

A

a group of structures related to the medial border of the parotid gland

  1. styloid process
  2. stylohyoid muscle
  3. internal carotid
  4. vagus nerve
  5. glossopharyngeal nerve
  6. lateral wall of the pharynx
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31
Q

which structures are at risk during surgery on the parotid gland?

A
  1. facial nerve
  2. retromandibular vein
  3. external carotid artery

these 3 structures run within the parotid gland and they could be damaged during surgery

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32
Q

which muscles surround the parotid?

A

posteromedial:
1. posterior belly of the digastric

  1. sternocleidomastoid
  2. mastoid process

anteromedial surface:
1. masseter

  1. medial pterygoid muscle
  2. ramus of the mandible
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33
Q

how is the parotid gland parasympatheticlly innervated?

A

glossopharyngeal nerve –> tympanic branch –> lesser petrosal nerve –> otic ganglion –> postganglionic and parasympathetic which run in the auricolotemporal nerve –> parotid gland

most important!

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34
Q

how is the parotid gland sympathetically innervated?

A

sympathetic postganglionic fibers are derived from superior cervical ganglion, reaching the gland through sympathetic plexus around external carotid artery

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35
Q

what is the sensory innervation of the parotid gland?

A

great auricular nerve and auriculotemporal nerve

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36
Q

what is Frey’s syndrome?

A

a rare neurological disorder resulting from damage to or near the parotid glands responsible for making saliva, and from damage to the
*auriculotemporal nerve often from surgery

when the nerves heal they get all criss crossed between the parasympathetic, sympathetic and sensory innervation so when you smell something good instead of salivating you start sweating

symptoms include sweating and flushing on the cheek or temple, or near the ear, particularly when eating foods with more-intense flavors, such as sour, spicy, or salty foods

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37
Q

what are the boundaries of the temporal fossa?

A

temporal lines to the zygomatic process of the frontal bone to the zygomatic arch and then loops back around to the temporal lines

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38
Q

what are the contents of the temporal fossa?

A

the temporalis muscle along with its blood and nerve supply = deep temporal arteries and nerves

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39
Q

what is the infratemporal fossa?

A

an irregular area on the lateral surface of the skull deep below the zygomatic arch and deep to the ramus of the mandible

it goes from the ramus of the mandible to the lateral pterygoid plate to the posterior surface of the maxilla to the mastoid/styloid process of the temporal one

it goes from the infratemporal surface of the greater wing of the sphenoid down to the medial pterygoid attachment o the angle of the mandible

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40
Q

what are the contents of the infratemporal fossa?

A

MUSCLES
1. Medial Pterygoid

  1. Lateral Pterygoid
  2. Temporalis muscle tendon

BLOOD VESSELS
1. Maxillary artery and some of its branches

  1. Pterygoid plexus of veins
  2. Maxillary vein and its tributaries

NERVES
1. Mandibular nerve and its branches

  1. Otic ganglion
  2. Posterior superior alveolar nerve (branch of maxillary nerve)
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41
Q

which 4 muscles are responsible for chewing?

A
  1. masseter
  2. temporalis
  3. medial pterygoid muscle
  4. lateral pterygoid muscle
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42
Q

what innervates the muscles involved in mastication?

A

the mandibular division of the trigeminal nerve

  1. masseter
  2. temporalis
  3. medial pterygoid muscle
  4. lateral pterygoid muscle
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43
Q

where is the masseter located? what is its action?

A

ocated in the face over the lateral surface of the ramus of the mandible – it basically covers the ramus

it goes from the zygomatic arch to the angle of the mandible

muscle is overlapped by the parotid gland posteriorly, and crossed by parotid duct, branches of facial nerve

it’s a powerful elevator of the mandible to occlude the teeth, the muscle provides minimal protrusion

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44
Q

what is the innvervation of the masseter?

A

V3 = mandibular division of trigeminal nerve

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45
Q

where is the temporalis located? what is its action?

A

Temporalis muscle is located in the temporal fossa, occupying all the temporal fossa, and it is tendon is in the infratemporal fossa

so it goes from the interior temporal line and takes up the whole floor of the temporal fossa down to the coronoid process of the mandible

elevates and retrudes the mandible to close the mouth

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46
Q

what is the innervation of the temporalis

A

deep temporal branches of the mandibular nerve

47
Q

what clinically significant thing is related to the temporalis?

A

the temporalis muscle is covered by tough double-layered temporal fascia commonly used as a graft tissue for tympanoplasty

48
Q

where is the lateral pterygoid located?

A

upper head attaches from the infratemporal surface of the greater wing of the sphenoid

lower head attaches to the lateral surface of the lateral pterygoid plate

then they both insert at the neck of the mandible like at the condylar process

49
Q

what is the innervation of the lateral pterygoid muscle?

A

mandibular nerve

50
Q

what is the action of the lateral pterygoid muscle?

A
  1. protrusion of the mandible
  2. depresses the mandible (opening
  3. with ipsilateral medial pterygoid, they rotate the mandible to the contralateral side
51
Q

what is the location of the medial pterygoid muscle? what is it innervated by?

A

it originates from the medial surface of the lateral pterygoid plate & tuberosity of maxilla

it then attaches into the medial surface of the angle of the mandible

so it’s like on the inside of your jaw from the inside of your mandible to the inside of the maxilla

it’s innervated by the mandibular nerve

52
Q

what is the action of the medial pterygoid muscle?

A
  1. elevation of the mandible
  2. protrudes the mandible
  3. with ipsilateral lateral pterygoid, they rotate the mandible to the contralateral side
53
Q

which muscles allow you to grind your jaw side to side?

A

the lateral and medial pterygoid muscles

so when the left medial and lateral pterygoid muscles contract they move the jaw to the right

54
Q

which muscles help elevate the mandible? aka close the mouth

A
  1. temporalis
  2. masseter
  3. medial pterygoid
55
Q

which muscles help depress the mandible? aka open the mouth

A

lateral pterygoid

  1. supra hyoid and infra hyoid muscle groups

gravity

56
Q

which muscles help with protrusion of the mandible?

A
  1. lateral pterygoid
  2. medial pterygoid
  3. masseter
57
Q

which muscles with recursion of the mandible?

A

temporalis

58
Q

what are the articulating processes of the TMJ?

A

from the skull it’s the mandibular fossa and articular tubercle (part of the temporal bone)

from the mandible the head of the mandible aka the condylar process articulates with the skull

the articular surfaces are covered by fibrocartilage, but predominantly fibrous

59
Q

what are the extrinsic and intrinsic ligaments of the TMJ?

A

the lateral temporomandibular ligament attaches from the zygomatic arch to the condylar process

the extrinsic ligaments are the stylomandibular ligament and the sphenomandibular ligament

60
Q

what is the function of the articular disc of the TMJ?

A

the TMJ has an articular disc that’s attached to the joint capsule and divides the joint cavity into an upper and lower compartment

the upper compartment has a loos capsule which permits forward and backward gliding movements of the mandibular head and the articular disc as a unit

the lower compartment has a slightly tenser capsule which allows a hinge-like downward and upward rotation of the mandibular head within the articular disc

61
Q

what happens when you open your mouth?

A

forward and downward gliding of the mandibular head and articular disc over the articular tubercle in the upper compartment of the joint

there’s also hinge-like downward rotation of the mandibular head in the lower compartment, i.e., within the articular disc around a horizontal axis

62
Q

what happens when you close your mouth?

A

upward and backward gliding movement of the mandibular head and articular disc in the upper compartment

there’s also hinge-like upward rotation of the mandibular head in the lower compartment, i.e., within the articular disc around a horizontal axis

63
Q

what happens when you grind your mouth to the right?

A

forward and downward gliding of the left mandibular head and the articular disc while the right mandibular head stays in the occlusal position and spins rightward around its vertical axis

64
Q

what happens when you grind your mouth to the right?

A

forward and downward gliding of the right mandibular head and the articular disc while the left mandibular head stays in the occlusal position and spins leftward around its vertical axis

65
Q

what happens when the TMJ is dislocated?

A

it always happens anteriorly due to lack of bony congruence of the articular process during opening of the mouth

usually due to excessive yawning, opening of the mouth, violent contractions of the lateral pterygoid or receiving a blow to the mandible with the mouth open

NO posterior dislocation due to congruence of the articular surfaces and the presence of the postglenoid tubercle

66
Q

what happens if you get punched in the jaw with your mouth closed?

A

in a direct blow to the mandible from front, with the mouth closed, the neck of the mandible will break before dislocation

if you get punched with your mouth open, the TMJ will dislocate anteriorly

67
Q

if you’re surgically repairing the TMJ, which nerves do you need to watch out for?

A
  1. acial nerve

2. auriculotemporal nerve

68
Q

what is the route of the maxillary artery?

A

the maxillary artery is the larger of the two terminal branches of external carotid artery

it arises opposite the neck of the mandible, runs most of its course through the infratemporal fossa

then it dives into the pterygomaxillary fissure to reach pterygopalatine fossa where it divides into two terminal branch; infraorbital and sphenopalatine arteries

69
Q

what are the branches of the maxillary artery?

A
  1. deep auricular
  2. anterior tympanic
  3. inferior alveolar
  4. deep temporal
  5. buccal
  6. posterior superior alveolar
  7. middle meningeal (the most important**)
  8. accessory meningeal
  9. muscular branches
70
Q

what is the route of the middle meningeal artery?

A

it’s a branch of the maxillary artery that ascends upward deep to the lateral pterygoid muscle

it accesses the cranial cavity through the foramen spinosum and then splits into a larger anterior frontal branch and a posterior parietal branch

71
Q

what is the origin of the mandibular nerve?

A

it’s one of the three branches of the trigeminal nerve

V3

72
Q

what is the route of the mandibular nerve?

A

It leaves the skull through foramen ovale to reach the infratemporal fossa

it then divides into anterior and posterior trunks from which multiple branches emerge

when it comes out of the foramen ovale it branches behind the lateral pterygoid muscle

73
Q

what’s special about the mandibular nerve?

A

mandibular nerve is the only division of the trigeminal nerve which is mixed nerve, carrying motor fibers for the muscles of mastication, tensor veli palatini, mylohyoid, and anterior belly of digastric, and sensory fibers supplying part of the skin of the face and oral cavity

74
Q

what are the branches of the mandibular nerve?

A

from the posterior trunk:
1. auriculotemporal nerve

2, inferior alveolar nerve

  1. lingual nerve

from the anterior trunk:
1. deep temporal nerves

  1. nerve to masseter
  2. nerve to lateral pterygoid
  3. nerve to medial pterygoid
  4. buccal nerve –> sensory; do NOT confuse with buccal branch of the facial nerve which is motor
75
Q

what is the route of the aurticulotemporal nerve?

A

arises from the mandibular nerve by two roots which encircle the middle meningeal artery

it passes deep to the lateral pterygoid muscle and the neck of the condylar process of mandible

it’s at risk in fracture of the neck of the mandible or during surgical repair of dislocated temporomandibular joint

76
Q

what does the auritculotemporal nerve innervate?

A

sensory fibers to:

  1. skin of the temple
  2. auricle of the ear
  3. external auditory canal
  4. parotid gland
  5. TMJ

it also carries postganglionic parasympathetic fibers from the otic ganglion to the parotid gland

77
Q

in what location would you perform a mandibular nerve block?

A

through the mandibular notch

it’s literally a straight shot at the mandibular nerve

78
Q

what is the route of the inferior alveolar nerve?

A

it’s a branch of the mandibular nerve that enters the mandible through the mandibular foramen and runs in the mandibular canal

it emerges from the mental foramen as the mental nerve

79
Q

what does the inferior alveolar nerve innervate?

A

it supplies all the mandibular teeth and area of the skin over the chin and lower lip

also, before it enters the mandibular foramen the inferior alveolar nerve gives its nerve to mylohyoid branch which supplies mylohyoid and anterior belly of digastric

80
Q

in what location would you do an interior alveolar nerve block?

A

from inside of the oral cavity, midway between the anterior and posterior border of the ramus of the mandible and 1 cm above the occlusal surface of the third mandibular molar tooth

81
Q

what is the route of the lingual nerve?

A

it’s a branch of the mandibular nerve and it emerges in the infratemporal fossa below the lower border of the lateral pterygoid and runs over the medial pterygoid on its way to the tongue

it reaches the oral cavity between the mylohyoid and hyoglossus muscle

it ends by supplying general sensation to the anterior 2/3 of the tongue

it basically runs down your mandible

the lingual nerve is joined by the chorda tympanic branches of facial nerve

82
Q

what is the function of the chorda tympanic nerve?

A

the lingual nerve is joined by the chorda tympanic branches of facial nerve

the chorda tympanic nerve carries preganglionic parasympathetic fibers to the submandibular ganglion from which postganglionic secretomotor fibers innervates submandibular and sublingual salivary glands

83
Q

during what procedure could the lingual nerve be damaged?

A

the lingual nerve enters the oral cavity very close to the mandibular 3rd molar and is at risk during its extraction aka your wisdom teeth!

84
Q

what is the route of the buccal nerve?

A

it’s a branch of the mandibular nerve that emerges between the two heads of lateral pterygoid

it runs over the lower head of the lateral pterygoid, medial pterygoid and buccinator and supplies the skin of the cheek and buccal mucosa

85
Q

where would you perform a buccal nerve block?

A

inside the oral cavity, injection is made in the retromolar fossa which is posterior and superior to the mandibular 3rd molar

86
Q

what is the sensor distribution of the mandibular nerve?

A

the mandibular nerve is V3 so it’s the lower part of the face

the auriculotemporal nerve innervates the ear to the middle temple

the buccal nerve innervates the lateral cheek

the mental nerve innervates the chin and lower lip

87
Q

what is the pterygomaxillary fissure?

A

it’s a v-shaped space between the posterior surface of maxilla and the lateral pterygoid process

it connects the infratemporal fossa with the pterygopalatine fossa

88
Q

what passes through the pterygomaxillary fissure?

A

the 3rd part of the maxillary artery

it dives through the fissure to reach to the pterygopalatine fossa

89
Q

what are the contents of the pterygopalatine fossa?

A
  1. part of the maxillary nerve
  2. pterygopalatine ganglion and the beginning parts of its branches
  3. the 3rd part of the maxillary artery and the beginning parts of its branches
90
Q

what does the pterygopalatine fossa communicate with?

A

Oral cavity through the palatine canal

Orbits through the inferior orbital fissure

Middle crania fossa through foramen rotundum

Nasal cavity through sphenopalatine foramen

Pharynx through pharyngeal canal

Infratemporal fossa through pterygomaxillary fissure

Base of the skull through pterygoid canal

91
Q

where does the maxillary nerve originate from?

A

it’s V2

the maxillary nerve is the second branch of trigeminal nerve

it is a PURE sensory nerve

92
Q

what is the route of the maxillary nerve?

A

it leaves the middle cranial fossa where it is located in the lateral wall of cavernous sinus through the foramen rotundum to reach the pterygopalatine fossa

it runs within the pterygopalatine fossa and leaves it through the inferior orbital fissure to reach the infraorbital canal where it becomes infraorbital nerve

the infraorbital nerve exits the infraorbital canal through infraorbital foramen where it supplies areas of the face, nose, and lower eye lids and upper lip

93
Q

what are the branches of the maxillary nerve?

A
  1. zygomatic nerve (ends in the face as zygomaticotemporal and zygomatic facial)
  2. posterior superior alveolar nerve
  3. two sensory roots to the pterygopalatine ganglion
94
Q

what is the pterygopalatine ganglion?

A

the pterygopalatine ganglion is a parasympathetic ganglion topographically related to maxillary nerve but functional related to facial nerve through its greater petrosal nerve

95
Q

what are the roots that contribute to the pterygopalatine ganglion?

A

2-3 sensory roots from the maxillary nerve

the motor root of the greater petrosal nerve

the sympathetic root of the deep petrosal nerve from the plexus around the internal carotid artery

96
Q

which nerves contribute to the pterygoid canal?

A

deep petrosal nerve and the motor root of the greater petrosal nerve

97
Q

what are the branches of the ophthalmic nerve?

A

top
1. supraorbital

  1. supratrochlear
  2. infratrochlear
  3. external nasal
    bottom
98
Q

which nerves supply the sensory innervation of the face?

A

sensory innervation of the face is derived from the three divisions of the trigeminal nerve; ophthalmic, maxillary and mandibular

***the exception is the skin over the angle of the mandible is supplied by great auricular nerve (C2,3)

99
Q

what is trigeminal neuralgia?

A

a painful condition affecting areas of the face supplied by trigeminal nerve

very rare though and the cause is unknown

effects 50-70 year olds and more women

the patient suffers from sudden episode of agonizing or excruciating pain which is described as stabbing, burning, piercing-Shock-like or lightening

100
Q

a patient suffering from agonizing pain under the nose as a result of trigeminal neuralgia. Which of the following nerves is most likely affected?

A. Ophthalmic

B. Maxillary

C. Mandibular

D. Auriculotemporal

E. Facial

A

B. Maxillary

101
Q

to extract the mandibular 3rd molar tooth, which nerve of the following should be anesthetized?

A. Buccal nerve

B. Posterior superior alveolar nerve

C. Auriculotemporal

D. Inferior alveolar

E. None of the above

A

D. Inferior alveolar

102
Q

a patient who squeezes a pimple on his upper lip is at risk of cavernous sinus thrombophlebitis due to retrograde spread of infection into the cavernous sinus though which of the following venous routes?

A. Superficial temporal vein

B. Pterygoid plexus of veins

C. Retromandibular vein

D. Common facial vein

E. Internal jugular vein

A

B. Pterygoid plexus of veins

103
Q

during chewing of food, which muscle of the following will move the mandible to the left side?

A. Right masseter

B. Left temporalis

C. Right medial pterygoid

D. Left lateral pterygoid

E. Left Medial pterygoid

A

C. Right medial pterygoid

104
Q

a 45-year old female patient with left-sided facial palsy affecting all the muscles of facial expressions and she is additionally complaining of decreased tolerance to loud sounds. Lacrimation was normal in the left eye. you locate the lesion of the facial nerve at:

A. parotid gland

B. distal end of the facial canal in the mastoid part of temporal bone

C. proximal end of the facial canal

E. the stylomastoid foramen

F. the internal auditory canal

A

C. proximal end of the facial canal

105
Q

a patient with rhabdomyosarcoma ( a malignant tumor of the muscle) in the medial pterygoid may cause pressure symptoms in which of the following nerves?

A. Auriculotemporal nerve

B. Lingual nerve

C. Posterior superior
alveolar nerve

D. Maxillary nerve

E. Deep temporal nerve

A

B. Lingual nerve

106
Q

a patient with facial palsy is more likely to complain of:

A. Loss of sensation in the left side in the buccal mucosa and skin of the cheek on the left side

B. Loss of general sensation from the anterior 2/3 of the tongue on the left side

C. Loss of taste sensation in the posterior 1/3 of the tongue on the left side

D. Decreased salivation from the left parotid gland

E. None of the above

A

E. None of the above

107
Q

a 22-year old male came to the Emergency Department after an altercation in which he received a blow to the chin that fractured the neck of the mandible as evidenced by x-ray. Which of the following nerve is at risk and should be evaluated?

A. Inferior alveolar nerve

B. Auriculotemporal nerve

C. Lingual nerve

D. Buccal nerve

E. Deep temporal nerve

A

B. Auriculotemporal nerve

108
Q
  1. A patient with rhabdomyosarcoma ( a malignant tumor of the muscle) in the lateral pterygoid my cause pressure symptoms in which of the following nerves?

A. Auriculotemporal nerve

B. Lingual nerve

C. Inferior alveolar nerve

D. Deep temporal nerve

E. All of the above

A

A. Auriculotemporal nerve

B. Lingual nerve

C. Inferior alveolar nerve

D. Deep temporal nerve

E. All of the above

109
Q

a fracture in the middle of the ramus of the mandible will result in sensory loss in which of the following areas of the face?

A. Upper lip

B. Cheek

C. Over the surface of the parotid

D. Skin of the chin and lower lip

E. Auricle of the ear

A

D. Skin of the chin and lower lip

110
Q

trigeminal neuralgia affecting the mandibular division of the trigeminal nerve suffers from pain in the following area of the face except:

A. Lower lip

B. The skin of the cheek

C. The skin of the chin

D. The skin over angle of the mandible

E. Skin of the temple region

A

D. The skin over angle of the mandible

111
Q

postganglionic parasympathetic fibers from the otic ganglion to the parotid gland are carried to the parotid gland through which of the following nerves?

A. Deep auricular nerve

B. Inferior alveolar nerve

C. Lingual nerve

D. Auriculotemporal nerve

E. Chorda tympani nerve

A

D. Auriculotemporal nerve

112
Q

Preganglionic parasympathetic fibers to the pterygopalatine ganglion are derived from which of the following cranial nerve?

A. Oculomotor nerve

B. Abducens nerve

C. Facial nerve

D. Glossopharyngeal nerve

E. Maxillary division of trigeminal nerve

A

C. Facial nerve

113
Q

Pterygopalatine ganglion supplies post-ganglionic secretomotor fibers to which of the following glands?

A. Parotid gland

B. Sublingual gland

C. Lacrimal gland

D. Submandibular gland

E. None of the above

A

C. Lacrimal gland

114
Q

Pressure on the lingual nerve by Schwannoma (largely benign tumor of Schwann cells) at its origin from the mandibular nerve may result in:

A. Loss of general sensation of the anterior 2/3 of the tongue

B. Loss of taste sensation from the anterior 2/3 of the tongue

C. Combined loss of taste and general sensation of the anterior 2/3 of the tongue

D. Loss of saliva secretion from the submandibular and sublingual salivary gland

E. Loss of saliva secretion from parotid gland

A

A. Loss of general sensation of the anterior 2/3 of the tongue

Neuro Week 1 (9 decks)

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