parotid region and facial nerve

Question 1

boundaries of parotid region

Answer 1

• zygomatic arch superiorly
• external ear and anterior border of sternocleidomastoid posteriorly
• ramus of mandible medially
• anterior border of masseter anteriorly
• angle and inferior border of mandible inferiorly

Question 2

what’s in the parotid region?

Answer 2

• parotid gland and duct
• parotid plexus of facial nerve
• retromandibular vein
• external carotid artery
• masseter muscle

Question 3

what’s the largest salivary gland?

Answer 3

parotid

Question 4

the parotid gland is enclosed within the ______ part of the ______

Answer 4

enclosed within the parotid sheath (capsule) part of the superficial musculoaponeurotic system (SMAS)

Question 5

deep relation of parotid gland

Answer 5

• anteromedial surface covers–> masseter and mand

- posteromedial surface covers–> mastoid process, styloid process, and last 4 CN posteriorly

Question 6

contents of parotid gland from superficial to deep

Answer 6

• parotid plexus of facial nerve
• retromandibular vein
• external carotid artery

Question 7

_____ splits the parotid gland into 2 distinct surgical lobes –the superficial and deep lobes

Answer 7

facial nerve

Question 8

parotid duct

Answer 8

• penetrates the buccinator and buccal mucosa before it opens into the vestibule of the mouth opposite the upper second molar
• corresponds to the middle 1/3 of a line extends from tragus of ear to angle of mouth

Question 9

parasympathetic supply of parotid gland

Answer 9

• glossopharyngeal nerve (CN IX) increases gland secretion
• Parasymp. fibers carried by the lesser superficial petrosal branch of the CN IX that relays in the otic ganglion, then postganglionic fibers carried by auriculotemporal nerve to gland

Question 10

sensory supply of parotid gland

Answer 10

auriculotemporal (V3) and great auricular nerves

Question 11

sympathetic supply of parotid gland

Answer 11

cervical ganglia through the external carotid plexus

*vasomotor reduces the gland secretion

Question 12

any gland in head is supplied by ___ except ____

Answer 12

facial nerve except parotid

Question 13

course of parasympathetic fibers to parotid gland

Answer 13

1. glossopharyngeal nerve (superior salivatory nucleus)
2. tympanic branch
3. tympanic plexus
4. lesser petrosal nerve (preganglionic)
5. otic ganglion
6. auriculotemporal nerve (postganglionic)
7. parotid gland

Question 14

parasympathetic cranial nerves

Answer 14

III, IV, IX, X

Question 15

what is the major concern during parotidectomy?

Answer 15

injury of facial nerve

Question 16

why parotid gland infection or diseases causes pain in the auricle, temporal region and TMJ?

Answer 16

these areas receive nerve supply from same nerve supplying the parotid fascia and skin (auriculotemporal and great auricular nerves)

Question 17

origin of facial nerve

Answer 17

pontine portion of brainstem

Question 18

exit of facial nerve

Answer 18

stylomastoid foramen

Question 19

3 roots of facial nerve

Answer 19

1. motor–facial muscles
2. sensory–skin of auricle
3. parasympathetic–lacrimal gland, nasal glands, and all salivary glands except the parotid and through the Greater Superficial Petrosal and chorda tympani branches

Question 20

facial motor/terminal branches

Answer 20

temporal
zygomatic
buccal
mandibular (marginal)
cervical

Question 21

extratympanic part of facial nerve

Answer 21

nerve to digastric
nerve to stylohyoid
posterior auricular branch
facial motor branches

Question 22

first branch that arises after exiting the stylomastoid foramen is the ______ that supplies the _______

Answer 22

posterior auricular nerve that supplies the occipitalis muscle

Question 23

posterior auricular nerve supplies

Answer 23

occipital belly

auricularis posterior

Question 24

cervical branch supplies

Answer 24

platysma

Question 25

mandibular branch of facial nerve supplies

Answer 25

muscles of lower lip (orbic. oris, depressor labii, depressor anguli, mentalis, risorius

Question 26

buccal branch of facial nerve supplies

Answer 26

buccinator, levator labii, zygomaticus, and part of orbicularis oris

Question 27

zygomatic branch of facial nerve supplies

Answer 27

lower part of orbicularis oculi
levator labi alaque nasi
procerus
levator labii and anguli

Question 28

temporal branch of facial nerve supplies

Answer 28

frontalis, auricularis anterior and superior and upper part of orbicularis oculi

Question 29

marginal mandibular branch

Answer 29

• supplies lower lip muscles
• along mandible and over mandibular body anterior to facial artery
• very susceptible to damage
• communicates with buccal branch in only 10% of pts–> damage can lead to perm disfiguring

Question 30

cervical branch of facial nerve divides to form _____

Answer 30

descending and anterior branches

Question 31

descending branch of cervical branch of facial nerve

Answer 31

innervates platysma and communicates with the anterior cutaneous nerve of the neck

Question 32

anterior branch of cervical

Answer 32

• crosses the mandible superficial to facial artery and vein
• joins the mandibular branch to contribute to the innervation of the muscles of the lower lip

Question 33

A patient with marginal mandibular nerve damage cannot do what?

Answer 33

form a symmetric smile

-can’t pull ipsilateral lower lip down and laterally or revert the corresponding vermilion border

Question 34

bell’s palsy

Answer 34

facial nerve paralysis in one side of face for no clear cause

Question 35

symptoms of bell’s palsy

Answer 35

• sudden weakness or paralysis on one side of face
• weak closure of eye
• eye problems, like excessive tearing or dry eye
• drooling
• accumulation of food in mouth
• loss of ability to taste
• increased sensitivity to sound