Parotid Bed

Question 1

Parotid Gland

Answer 1

Largest of salivary glands, Triangular or wedge-shaped structure, Located anterior, inferior and posterior to the ear in an area known as the parotid bed, Wedged between the ramus of mandible and the mastoid process

Question 2

Parotid Capsule

Answer 2

Sheath. Investing layer of the deep cervical fascia goes on both side of the gland. Strong fascia enclosing entire gland. Continuous with the deep fascia of the neck.

Question 3

Parotid Duct

Answer 3

About two inches long and ¼ inches in diameter, Leaves the anterior edge of the gland, Courses to the masseter muscle and pierces buccinator muscle to enter oral cavity. Oblique passsage of duct through muscle acts like a valve. Opens in the oral cavity opposite 2nd maxillary molar at Parotid Papilla

Question 4

Parotid Papilla

Answer 4

Opening of duct into oral cavity by 2nd molar. Can become infected/inflamed causing backup and pain

Question 5

Accessory Parotid Gland

Answer 5

Part of the parotid gland separate from the main mass and immediately superior to the parotid duct

Question 6

Facial Nerve (CNVII)

Answer 6

Enters the posteriomedial part of the gland after exiting the stylomastoid foramen. Facial nerve is the most superficial structure in the parotid gland. It forms a plexus in the gland from which 5 branches are given off to them (muscles of facial expression, TZBMC). The nerve gives off two branches before entering the gland: posterior auricular and Motor nerve to the posterior belly of digastric and stylohyoid muscles (muscles of the 2nd arch)

Question 7

Posterior Auricular Branch

Answer 7

Branch of facial nerve before entering parotid. Innervates some muscles of the ear, if you can wiggle your ears, these muscles are involved

Question 8

Motor Nerve branch of Facial Nerve

Answer 8

Branch of Facial nerve before entering parotid. Innervates posterior belly of digastric muscle and stylohyoid muscle.

Question 9

Temporal Branches of Facial Nerve

Answer 9

Branches of Facial Nerve going to muscles in temporal region

Question 10

Zygomatic Branches of Facial Nerve

Answer 10

Branches of Facial Nerve going to muscles in zygomatic region

Question 11

Buccal Branches of Facial Nerve

Answer 11

Branches of Facial Nerve going to muscles in buccal region

Question 12

(Marginal) Mandibular Branches of Facial Nerve

Answer 12

Branches of Facial Nerve going to muscles in mandibular region

Question 13

Cervical Branches of Facial Nerve

Answer 13

Branches of Facial Nerve going to muscles in cervical region

Question 14

Retromandibular Vein

Answer 14

lies deeper to the CN VII, Formed in the substance of the parotid gland. Superficial temporal vein coming down and joins up with maxillary vein to become retromandibular vein. While in the gland the retromandibular vein divides into an anterior and a posterior part (division).The posterior part joins with the posterior auricular vein to form the external jugular vein. The anterior part joins with the facial vein to drain into the internal jugular vein. Small veins from the parotid drain into the retromandibular vein

Question 15

Superficial Temporal Vein

Answer 15

Joins with maxillary vein to form retromandibular vein

Question 16

Maxillary vein

Answer 16

Joins with superficial temporal vein to form retromandibular vein. Gathers blood from maxilae region.

Question 17

Posterior portion of retromandibular vein

Answer 17

Joins posterior auricular vein, forms external jugular

Question 18

Posterior auricular vein

Answer 18

Joins posterior portion of retromandibular vein to form the external jugular

Question 19

Anterior Portion of retromandibular vein

Answer 19

Meets with Facial Vein to form internal jugular

Question 20

Facial Vein

Answer 20

Meets with anterior portion of retromandibular vein to form internal jugular

Question 21

Internal Jugular

Answer 21

Formed by junction of anterior portion of retromandibular vein and facial vein

Question 22

External Jugular

Answer 22

Formed by junction of posterior portion of retromandibular vein and posterior auricular vein

Question 23

External Carotid Artery

Answer 23

Lies deeper than jugular vein. The external carotid enters the gland from its inferior. It terminates in the parotid gland by giving off two terminal branches: Maxillary artery and Superficial Temporal Artery

Question 24

Maxillary Artery

Answer 24

Proceeds Anteriorly into the infratemporal fossa

Question 25

Superficial Temporal Artery

Answer 25

Proceeds superiorly to supply the scalp

Question 26

Sympathetic Nerve Supply to Parotid

Answer 26

Postganglionic sympathetic fibers destined for the parotid gland are derived from the superior cervical ganglion of the sympathetic chain and travel to the parotid gland with the external carotid artery. Stimulation of the gland by the sympathetic system produces thick saliva

Question 27

Superior cervical ganglion of sympathetic chain

Answer 27

Sends postganglion sympathetic fibers to the parotid gland along the external carotid artery. Stimulate production of thick saliva

Question 28

Parasympathetic Nerve Supply to Parotid

Answer 28

Starts in brain. Branches of the CN IX, tympanic nerve (ear) and lesser petrosal nerve, bring preganglionic fibers to the otic ganglion (located in deep face). Postganglionic fibers go from the otic ganglion to the parotid gland with the auriculotemporal nerve (branch of the mandibular division of CN V). Stimulation of these fibers produces a thin watery saliva

Question 29

Summary of Parasympathetic and Sympathetic Nerve Supply to Parotid

Answer 29

Slide

Question 30

Lymphatic Drainage

Answer 30

gland is mainly drained into the preauricular or parotid lymph nodes which ultimately drain to the deep cervical chain

Question 31

Infection of the Parotid Gland

Answer 31

Mumps – acute, communicable viral infection of salivary glands (mainly the parotid) Gland swells causing severe pain because of the sheath of the gland

Question 32

Tumors of the Parotid

Answer 32

80% of the salivary gland tumors occur in the parotid