Parotid gland and face (Clinical case questions)

Question 1

Loss of sensation from the temporal region and loss of secretory function of the parotid gland would be caused by interruption of which nerve?  
 A. Auriculotemporal 
 B. Chorda tympani 
 C. Deep temporal, posterior 
 D. Facial  
 E. Great auricular

Answer 1

A. Auriculotemporal

Question 2

An elderly man presented with severe pain beneath the left eye, radiating into the lower eyelid, lateral side of the nose and upper lip. What nerve was involved?  
 A. Buccal 
 B. Infraorbital 
 C. Mental 
 D. Supratrochlear 
 E. Zygomatic

Answer 2

B. Infraorbital

Question 3

During a face lift operation on a 48-year-old woman, the plastic surgeon inadvertently cut the marginal mandibular branch of the facial nerve. Which of the following muscles would be paralyzed because of the injury?  
 A. Buccinator 
 B. Depressor anguli oris 
 C. Levator anguli oris 
 D. Levator labii superioris 
 E. Stylohyoid

Answer 3

B. Depressor anguli oris

Question 4

As a result of a face lift operation, a 46-year-old woman noticed an asymmetry of the inferior lip and could not fully depress the angle of her mouth on the right side. Which of the following nerves was most likely damaged during the surgery?  
 A. zygomatic (VII) 
 B. buccal (VII) 
 C. mental (V3) 
 D. marginal mandibular (VII) 
 E. infraorbital (V2)

Answer 4

D. marginal mandibular (VII)

Question 5

An elderly woman complained of a severe pain, felt above the right eye radiating to the upper eyelid, side of the nose and forehead. Branches of which of the following nerves convey pain sensations from areas of the skin described?  
 A. maxillary (V2) 
 B. greater auricular nerve 
 C. ophthalmic (V1) 
 D. mandibular (V3) 
 E. facial (VII)

Answer 5

C. ophthalmic (V1)

Question 6

Due to multiple salivary calculi (stones) in the submandibular duct, the submandibular gland of a 45-year-old individual was surgically removed. What major artery directly related to the gland was of special concern to the surgeon?  
 A. lingual 
 B. superior thyroid 
 C. facial 
 D. ascending pharyngeal 
 E. maxillary

Answer 6

C. facial

Question 7

To study the compensatory response of selective suprahyoid muscles in elevating the hyoid bone, an experiment was designed in which the posterior belly of the digastric and stylohyoid muscles were paralyzed by drugs. The muscular branches of which of the following nerves must be chemically interrupted to produce paralysis in both muscles?  
 A. inferior alveolar  
 B. facial 
 C. hypoglossal 
 D. glossopharyngeal 
 E. lingual

Answer 7

B. facial

Question 8

Which nerve provides motor innervation to the buccinator muscle?  
 A. Auriculotemporal nerve 
 B. Buccal branches of CN VII 
 C. Buccal nerve 
 D. Mandibular division of CN V 
 E. Marginal mandibular nerve

Answer 8

B. Buccal branches of CN VII

Question 9

Which nerve provides cutaneous innervation to the skin of the angle of the mandible?  
 A. Auriculotemporal nerve 
 B. Lesser petrosal nerve 
 C. Buccal branches of VII 
 D. Marginal mandibular nerve 
 E. Great auricular nerve

Answer 9

E. Great auricular nerve

Question 10

Which nerve carries postganglionic parasympathetic fibers to the parotid gland? 
 A. Auriculotemporal nerve 
 B. Lesser petrosal nerve 
 C. Glossopharyngeal nerve 
 D. Great auricular nerve 
 E. Marginal mandibular nerve

Answer 10

A. Auriculotemporal nerve

Question 11

A patient is unable to wink; what muscle is affected?  
 A. frontalis 
 B. levator palpebrae superioris 
 C. orbicularis oculi 
 D. superior tarsal  
 E. zygomaticus major

Answer 11

C. orbicularis oculi

Question 12

What structure lies deepest in the parotid gland?  
 A. External carotid artery 
 B. External jugular vein 
 C. Facial artery 
 D. Facial nerve 
 E. Retromandibular vein

Answer 12

A. External carotid artery

Question 13

A deep laceration of the face in the middle of the parotid gland could affect the:  
 A. External jugular vein 
 B. Facial nerve 
 C. Glossopharyngeal nerve 
 D. Hypoglossal nerve 
 E. Lingual artery

Answer 13

B. Facial nerve

Question 14

Pain elicited from an infected facial wound is primarily conveyed by what nerve?  
 A. Facial 
 B. Great auricular 
 C. Hypoglossal 
 D. Transverse cervical 
 E. Trigeminal

Answer 14

E. Trigeminal

Question 15

Inability to close the lips relates to the action of which muscle?  
 A. Anterior belly of the digastric 
 B. Mylohyoid 
 C. Orbicularis oris 
 D. Platysma 
 E. Zygomaticus major

Answer 15

C. Orbicularis oris

Question 16

Which muscle will not be affected when the mandibular division of the trigeminal nerve (V3) is anesthetized?  
 A. Anterior belly of digastric 
 B. Buccinator 
 C. Medial pterygoid 
 D. Mylohyoid 
 E. Temporalis

Answer 16

B. Buccinator

Question 17

A 38-year-old female patient complained of parotid pain that increased while eating. Intraoral examination detected some pus oozing from the parotid duct opening. What was the most likely anatomical reference that the physician considered to locate the parotid duct opening?
A. Mucosa of the sublingual caruncle behind the central incisor teeth
B. Mucosa of the cheek across the 2nd upper (maxillary) molar tooth
C. Mucosa of the floor of the mouth along the sublingual fold
D. Mucosa of the cheek across the 2nd lower (mandibular) molar tooth

Answer 17

B. Mucosa of the cheek across the 2nd upper (maxillary) molar tooth

Question 18

While recovering from a right facial paralysis, a 36-year-old female patient complained that food accumulated between the teeth and the cheek mucosa when chewing. The deficiency of which muscle was most likely the cause of the chewing problem?  
 A. Zygomaticus major 
 B. Orbicularis oris 
 C. Buccinator  
 D. Levator labii superioris

Answer 18

C. Buccinator

Question 19

The parotid space contains all EXCEPT:  
 A. External carotid artery 
 B. Facial nerve 
 C. Intraparotid lymph nodes 
 D. Medial pterygoid muscle 
 E. Retromandibular vein

Answer 19

D. Medial pterygoid muscle

Question 20

As a result of meningitis, a patient develops Bell's palsy. One of the symptoms was hyperacusis. What nerve was involved?  
 A. Facial 
 B. Glossopharyngeal 
 C. Oculomotor 
 D. Trigeminal 
 E. Vagus

Answer 20

A. Facial

Question 21

Frey's Syndrome is marked by profuse sweating over one cheek, temple, and surrounding areas of the face, precipitated by eating. The condition may be idiopathic, but often follows parotid surgery. The condition is attributable to abberant reinnervation, the redirection of autonomic fibers normally going to salivary glands being redirected to sweat glands. What is the source of the nerve fibers involved?  
 A. Facial 
 B. Glossopharyngeal 
 C. Oculomotor 
 D. Trigeminal 
 E. Vagus

Answer 21

D. Trigeminal

Question 22

While recovering from multiple dental extractions, an elderly man experienced a radiating pain affecting the lower eyelid, lateral side of the nose, upper lip and over the zygomatic and temporal areas on the left side. Which nerve is involved in the patient’s perception of pain?

Answer 22

Maxillary division of trigeminal

Question 23

The facial muscle most responsible for moving the lips both upward and laterally to produce a smile is:  
 A. Buccinator 
 B. Levator anguli oris 
 C. Levator labii superioris 
 D. Platysma 
 E. Zygomaticus major

Answer 23

E. Zygomaticus major