Parotid gland

Question 1

boundaries of the parotid bed/retromandibular fossa

Answer 1

Anterior: Mandible ramus posterior border , Masseter (laterally), Medial pterygoid (medially)

Posterior: mastoid process covered by sternocleidomastoid laterally

Superior: external acoustic meatus and posterior part of TMJ

Inferior: line joining angle of mandible to mastoid process

Medially: styloid process with stylohyoid, styloglossus, & stylopharyngeus

Question 2

Extent of parotid gland

Answer 2

Superior; up to external acoustic meatus
Inferior; line joining angle of mandible to mastoid
Anterior; overlaps masseter posterior border
Posterior; overlaps sternocleidomastoid anterior border
Medially; close to pharynx wall (styloid process)

Question 3

Location of accessory parotid gland and from which structure does it emerge?

Answer 3

Located between zygomatic arch superiorly and parotid duct inferiorly
Emerges from anterior aspect of parotid gland

Question 4

Which layer of deep cervical fascia forms the false capsule?

Answer 4

Investing layer

Question 5

The false capsule is also the

Answer 5

parotid fascia

Question 6

Structure formed by deep lamina of parotid fascia and its significance

Answer 6

stylomandibular ligament

separates parotid gland from submandibular gland

Question 7

Relations of the apex of parotid gland

Answer 7

1. retromandibular vein and its divisions
2. cervical branch of facial nerve
3. posterior digastric
4. upper carotid triangle

Question 8

relations of lateral/superficial surface of parotid gland

Answer 8

skin
superficial fascia containing (preauricular/superficial parotid lymph nodes, greater auricular nerve, and platysmaO

parotid fascia superficial lamina
deep parotid lymph nodes

Question 9

Attachments of superficial and deep laminae of parotid fascia

Answer 9

superficial lamina attaches to inferior border of zygomatic arch

deep lamina attaches to styloid process and tympanic plate

Question 10

State relations of the anteromedial surface

Answer 10

Masseter
Mandible ramus
Medial pterygoid
TMJ lateral aspect

Question 11

State the relations of the posteromedial surface

Answer 11

mastoid
sternocleidomastoid 
styloid 
digastric posterior belly
facial nerve 
external carotid artery

Question 12

The parotid gland is separated from which structures by the styloid process and its attachmed muscles

Answer 12

Internal jugular vein
Internal carotid artery
Last 4 cranial nerves

Question 13

Superficial lamina of parotid fascia also called

Answer 13

parotidomasseteric fascia

Question 14

State the structures within the partoid gland from superficial to deep

Answer 14

*MNEMONIC: Not Vlogging Again :(

facial Nerve
retromandibular Vein
external carotid Artery

Question 15

Formation of retromandibular vein

Answer 15

union of maxillary and superficial temporal veins

Question 16

Which part of the parotid gland is affected in Pleomorphic adenoma?

Answer 16

the large superficial part

Question 17

Pleomorphic adenoma is another name for

Answer 17

Mixed parotid tumor

Question 18

clinical significance of patey’s faciovenous plane

Answer 18

the plane between the superficial and deep lobes of parotid gland where the vessels and nerves lie. surgeons cut parallel to the nerve in this plane to avoid damaging it as they remove parotid tumors

Question 19

Parotid duct is also called

Answer 19

Stenson’s duct

Question 20

At which point does Stenson’s duct emerge into the mouth?

Answer 20

opposite crown of upper second molar tooth

Question 21

Course of stenson’s duct

Answer 21

travels forward just anterior to masseter anterior border
bends medially to pierce buccal pad of fat, buccopharyngeal fascia, and buccinator

runs forward between buccinator and buccal mucous membrane

bends medially to pierce buccal mucous membrane to emerge at mouth vestibule opposite crown of upper 2nd molar tooth

Question 22

Importance of tortous course of parotid duct

Answer 22

acts like a valve to prevent the duct from swelling during excessive blowing/whistling

Question 23

surface anatomy of parotid duct

Answer 23

line from tragus to midpoint of line between ala of nose and upper lip

Question 24

Jacobson’s nerve

Answer 24

is the tympanic branch of glossopharyngeal nerve that carries the preganglionic parasympathetic nerve fibers

Question 25

Explain the parasympathetic pathway for parotid gland innervation

Answer 25

Inferior salivatory nucleus –> glossopharyneal nerve –> temporal branch of glossopharyngeal nerve –> lesser petrosal nerve –> otic ganglion

Question 26

Enumerate innervation of parotid gland

Answer 26

Parasympathetic innervation via auriculotemporal nerve - produces water saliva

Sympathetic innervation via superior cervical sympathetic ganglia - produces thick, sticky saliva

Sensory innervation is by auriculotemporal and great auricular nerve (c2 & 3)

Question 27

Frey’s syndrome

Answer 27

damage to auriculotemporal and great auricular nerve causes them to grow back in the same sheath. therefore, signals for salivation signal the sensory nerves for heat, pain, touch.

Person sweats over parotid region during eating.

Question 28

Posterior auricular nerve is given off at

Answer 28

root of styloid process

Question 29

Mumps

Answer 29

swelling of parotid due to inflammation by infection of myxovirus (mumpus virus)

complications in adults include swelling of testes(epididimo-orchitis), inflammation of ovaries(oophoritis), and pancreas (pancreatitis) inflammation

Question 30

Lymphatic drainage of parotid gland

Answer 30

drained by superficial (pre-auricular) and deep parotid lymph nodes which go to drain into deep cervical lymph nodes

Question 31

Parotid gland derived from which embryologic germ layer

Answer 31

ectoderm

Question 32

Embryologic development of parotid gland

Answer 32

Week 6, cord of ectodermal cells at vestibule of primitive mouth grow backwards to form parotid duct

Question 33

Describe Hilton’s method

Answer 33

a method in which cut in the parotid fascia is made horizontal to the facial nerve to avoid injuring it during drainage of abcess