Parotid Gland Flashcards
1
Q
Type
A
Largest salivary gland
2
Q
Shape
A
Wedge shaped
3
Q
Site
A
Lies in depression between mandible ramus and mastoid process
4
Q
Extent
A
- Forwards: over masseter
- Backwards: over part of sternomastoid
- Upwards: external auditory meatus
- Downwards: 2cm below and behind mandible angle
5
Q
Parotid fascia
A
Capsule of deep cervical fascia enclosing gland
6
Q
Parts
A
- Main superficial part
- Deep part
- Small accessory part
7
Q
Main superficial part
A
Wedged between
1. Anterior: mandible ramus
2. Posterior: mastoid process and sternomastoid
8
Q
Deep part
A
Deep to mandible
9
Q
Small accessory part
A
Above parotid duct on masseter
10
Q
Surfaces
A
- Lateral surface
- Anteromedial surface
- Posteromedial surface
11
Q
Lateral surface contents
A
- Skin
- Fascia
- Great auricular nerve
- Superficial parotid lymph nodes
12
Q
Anteromedial surface contents and shape
A
Extremely concave
1. Ramus of mandible
2. Masseter muscle
3. Medial pterygoid muscle
13
Q
Posteromedial surface processes (2)
A
- Matoid
- Styloid
14
Q
Posteromedial surface muscles attached to mastoid process (2)
A
- Superficially: Sternomastoid
- Deeply: posterior belly digastric
15
Q
Posteromedial surface attached to styloid process
A
3 muscles and 2 ligaments
16
Q
Posteromedial surface blood vessels (2)
A
- ICA
- IJV
With last 4 cranial nerves in between
17
Q
2 structures enter Posteromedial surface
A
- Facial nerve
- ECA
18
Q
Ends
A
- Upper end
- Lower end
19
Q
Upper end shape and relation
A
Concave
Related to external auditory meatus
20
Q
Upper end contents (3)
A
- Superficial temporal artery
- Superficial temporal vein
- Auriculotemporal nerve
21
Q
Lower end site
A
2cm below and behind angle mandible overlapping posterior belly digastric
22
Q
Structures leaving lower end (2)
A
- Cervical branch of facial nerve
- Anterior and posterior divisions of posterior facial (retromandibular) vein
23
Q
Borders
A
Anterior border
24
Q
Structures leaving anterior border
A
- Parotid duct: with accessory part above it
- Transverse facial artery: above duct
- Temporal branch facial nerve: above duct
- Zygomatic branch facial nerve: above duct
- Buccal branch facial nerve: below duct
- Mandibular branch facial nerve: below duct
25
Surface anatomy: upper end
1. Concave upwards around external auditory meatus
2. Line from auricle tragus (mandible head) to middle mastoid process
26
Surface anatomy: anterior border
Line from
1. Tragus
Downwards and forwards to
2. Middle of masseter
Downwards and backwards to point 2cm below and behind
3. Mandible angle
27
Surface anatomy: posterior border
Line from
1. Mastoid process
Point 2cm below and behind
2. Mandible angle
Running along
3. Anterior sternomastoid border
28
Parotid duct
Thick walled with narrow lumen 5cm long
29
Parotid duct site
Gland anterior border passing horizontally on Masseter below zygomatic arch
30
Parotid duct: structures pierced
At Masseter anterior border
It pierces:
1. Buccal pad of fat
2. Buccopharyngeal facia
3 . Buccinator
4. Buccal mucosa
It then opens in vestibule opposite 2nd molar
31
Parotid duct surface anatomy
Middle 1/3 of line from tragus to point midway between nose ala and red margin of upper lip
32
Structures within the parotid gland (5)
1. Facial nerve
2. Posterior facial vein
3. ECA
4. Deep parotid lymph node
5. Auriculotemporal nerve
33
Facial nerve relation to parotid gland
1. Enters Posteromedial surface close to stulomastoid foramen
2. Runs as most superficial structure
3. End by dividing into 5 terminal branches
34
Facial nerve terminal branches in parotid gland
1. Temporal
2. Zygomatic
3. Buccal
4. Mandibular
5. Cervical
35
Posterior facial vein relation in parotid gland
1. Formed inside gland behind mandible neck by union of maxillary and superficial temporal veins
2. Descends between facial nerve and ECA
3. Leaves gland through its lower end as anterior and posterior divisions
36
ECA relation to parotid gland
1. Passes deep to gland lower end entering gland through its Posteromedial surface
2. Run as deepest structure
3. Ends opposite mandible neck by dividing into 2 terminals
37
ECA terminal branches in parotid gland (2)
1. Maxillary artery
2. Superficial temporal artery
38
Deep parotid lymph node site in parotid gland
In gland substance around blood vessels
39
Auriculotemporal nerve in parotid gland
Runs a short course
40
Parotid gland nerve supply
1. Sensory
2. Sympathetic
3. Parasympathetic
41
Sensory nerve supply in parotid gland
1. Auriculotemporal nerve
42
Sympathetic nerve supply in parotid gland
Plexus around ECA and MMA
43
Parasympathetic nerve supply in parotid gland
Glossopharyngeal nerve
44
Glossopharyngeal nerve course and origin
1. Preganglionic fibers arise from inferior salivary nucleus of medulla
2. Pass with tympanic branch of Glossopharyngeal nerve
3. Enter middle ear
4. From tympanic plexus
5. Gives lesser superficial petrosal nerve
45
Lesser superficial petrosal nerve course and relay
1. Leaves skull via foramen ovale
2. Relay in Otic ganglion
3. Posterior ganglionic fibers join Auriculotemporal nerve to reach gland
46
Parotid gland blood supply
1. Atrial: superficial temporal artery
2. Venous:
- posterior facial (retromandibular) vein
- external jugular vein
47
Lymph drainage parotid gland
1. Superficial parotid node
2. Deep parotid node
Drain in deep cervical nodes
48
Applied anatomy: inflammation of gland (parotitis)
Infection reaches gland from mouth through duct or blood stream.
Patient complains of:
1. Parotid swelling
2. Raised or everted auricle lobule
3. Severe pain (due to stretch of tight parotid capsule)
Increases during mastication (due to close relation of gland to TMJ
49
Applied anatomy: parotid tumors
Affects gland superficial to facial nerve branches
Benign: will not affect nerve
Malignant: compresses and invade the nerve leading to facial nerve paralysis
