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Exam 1: DHHD 5002 > Padalecki 5 > Flashcards

Padalecki 5 Flashcards

1
Q

Anterior and Posterior Boundaries of the Parotid Region

A

A. Anterior - anterior border of the mandibular ramus

B. Posterior - mastoid process of temporal bone

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2
Q

Superior and Inferior Boundaries of the Parotid Region

A

C. Superior - zygomatic arch

D. Inferior - posterior belly of the digastric muscle

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3
Q

Medial and Lateral Boundaries of the Parotid Region

A

E. Medial - to the styloid process and beyond

F. Lateral - superficial layer of parotid fascia

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4
Q

Location of the Parotid Gland

A
  1. Inferior and anterior to the auricle
  2. Lateral and posterior to masseter muscle
  3. Lateral, posterior, and medial to the mandibular ramus
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5
Q

Shape of the Parotid Gland

A
  1. Roughly triangular

2. Apex points inferiorly

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6
Q

Parotid gland is sometime described as _______.

A

Bilobate

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7
Q

a. Constricted between _____ and _____.
b. Deep “lobe” expands into the ________.
c. Lobes demarcated by courses of ______; there is fatty tissue between the lobes to allow for movement

A

a. mandible and styloid process
b. lateral pharyngeal space
c. facial nerve branches

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8
Q

Embedded within the parotid from superficial to deep:

A
  1. parotid plexus and branches
  2. retromandibular vein
  3. external carotid artery
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9
Q

The parotid space location is ________.

A

encompasses parotid gland

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10
Q

a. Extension of investing cervical fascia
b. Thick superficial lamina
c. Thin deep lamina - abuts medially on the lateral pharyngeal space
d. Septa penetrate gland

A

Parotid fascia

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11
Q

Attachments of Parotid fascia

A

(1) Superior - zygomatic arch
(2) Inferior - fascia on sternocleidomastoid
(3) Anterior - masseteric fascia

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12
Q
  1. Arises from anterior surface of gland
  2. Course - 1 to 2 cm inferior to zygomatic arch
    a. Curves around anterior border of masseter muscle
    b. Pierces buccinator muscle
  3. Empties into buccal cavity
    a. At parotid papilla
    b. Opposite maxillary second molar tooth
A

Parotid Duct

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13
Q

Arteries are branches of…

A

a. Maxillary artery
b. Superficial temporal artery
c. Transverse facial artery

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14
Q

Veins & location of drainage

A

a. Maxillary vein
b. Superficial temporal vein
c. Transverse facial vein
d. Drain into retromandibular vein

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15
Q

Lymphatics

A

a. Parotid nodes
b. Superficial cervical nodes
c. Superior deep cervical nodes

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16
Q

Afferent fiber innervation

A

a. Great auricular nerve (1) From C2&3
(2) Cell bodies in dorsal root ganglia
b. Auriculotemporal nerve
(1) From V3
(2) Cell bodies in trigeminal ganglion

17
Q

Parasympathetic fiber innervation - Postganglionic

A

(1) Within auriculotemporal branch of V 3
(2) Cell bodies in otic ganglion
(3) Stimulation increases rate of parotid salivary flow
(4) Parotid salivary flow is also stimulated by chewing

18
Q

Parasympathetic fiber innervation - Preganglionic

A

(1) Cell bodies in inferior salivatory nucleus
(2) Peripheral course
(a) Tympanic branch of IX
(b) Tympanic plexus on medial wall of tympanic cavity
(c) Lesser petrosal nerve
(i) Through foramen ovale (ii) To otic ganglion

19
Q

Sympathetic postganglionic fiber innervation

A

a. Through external carotid plexus
b. Cell bodies in superior cervical ganglion
c. Stimulation increases glycoprotein and viscosity of parotid salivary flow

20
Q

Clinical correlates

A
  1. Mumps: viral infection resulting in swelling of the parotid gland; causes severe pain due to the parotid sheath limiting swelling
  2. Parotid tumors
    a. 80% are benign
    b. cancer rare but sometimes in parotid
    c. surgical intervention is risky CN VII.
21
Q

Origin of facial nerve:

  1. From lateral aspect of brainstem at junction of ____ and _____.
  2. This is a complex structure with a peculiar course through the ______.
A
  1. pons and medulla

2. temporal bone

22
Q

In addition to the branchiomeric efferent fibers found in the branches on the face, the facial nerve contains _______ and _______ fibers. The distribution of these fibers within the visceral parts of the head will be considered in detail later.

A
  1. Afferent (mainly taste) fibers

2. Preganglionic parasympathetic (secretomotor) fibers

23
Q

Fiber types of branches of the face

A

a. Efferent to branchiomeric muscle

b. Afferent

24
Q

(1) Muscles derived from second branchial arch
(a) Muscles of facial expression
(b) Three other muscles
(i) Posterior belly of the digastric
(ii) Stylohyoid
(iii) A small muscle of the middle ear (stapedius)
(2) Cell bodies in facial motor nucleus

A

Efferent to branchiomeric muscle

25
Q

(1) To auricular skin

(2) Cell bodies in geniculate ganglion

A

Afferent

26
Q

Course of branches of the face

A

a. Exits skull at stylomastoid foramen

b. Branches within parotid gland (parotid plexus)

27
Q

Peripheral branches

A

a. Two small branches below auricle
b. Temporofacial division
c. Cervicofacial division

28
Q

Two small branches below auricle

A

(1) Posterior auricular

(2) Branch to posterior digastric and stylohyoid muscles

29
Q

Temporofacial division

A

(1) Temporal branches
(2) Zygomatic branches
(3) Buccal branch

30
Q

Cervicofacial division

A

(1) Buccal branch
(2) Marginal mandibular branch
(3) Cervical branch

31
Q

Connections with cutaneous branches of the trigeminal nerve

A

a. Occur in areas of overlap

b. Mechanism to supply afferent fibers to facial muscles

32
Q
  1. Raise the eyebrows
  2. Close both eyelids tightly
  3. Whistle
  4. Smile to show the teeth
  5. Pull down the corners of the mouth and raise (wrinkle) the skin of the neck
A

Test for function of the facial nerve

33
Q

Lesions resulting in facial paralysis

A
  1. Peripheral lesions

2. Central lesions (i.e. stroke)

34
Q

Paralysis of muscles of the lower face only; forehead is usually not affected.

A

Central lesions (i.e. stroke)

35
Q

Peripheral lesions are usually _____.

A

Unilateral

36
Q

(1) Smoothing of wrinkles and folds
(2) Drooping of eyebrow
(3) Sagging of lower eyelid
(4) Sagging of corner of mouth
(5) Deviation of mouth to unaffected side
(6) Interference with normal facial movements (e.g., asymmetry)
(a) Frowning or wrinkling forehead skin
(b) Elevating eyebrow
(c) Closing eye tightly
(d) Pursing lips
(e) Laughing, smiling, or showing teeth
(f) Control of cheek in chewing
(g) Wrinkling skin of neck
(7) Depending on level of lesion, other manifestations may occur (e.g., changes in taste, dry mouth, etc.)

A

Results of peripheral lesions

37
Q
  1. Trauma
  2. Tumor
  3. Inflammatory disorders
  4. Bell’s palsy
A

Etiology of peripheral lesions

38
Q

(a) Parotid neoplasms

b) Acoustic neuroma (benign sheath - cell tumor of VIII

A

Tumors

39
Q

(a) Idiopathic
(b) Often preceded by mild upper respiratory illness
(c) Progresses steadily to affect half of face
(d) Thought to result from ischemic or pressure effects of nerve edema within narrow bony canal
(e) Uncomplicated cases demonstrate some regeneration and varying degrees of functional recovery

A

Bell’s palsy: characteristics

Exam 1: DHHD 5002 (23 decks)

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