Parotid Region and Infratemporal Fossa

Question 1

A 24-year-old man is having problems depressing (opening) his mouth beyond 15 degrees. Which of the following muscles of mastication may not be functioning properly?

A. Temporalis
B. Masseter
C. Medial Pterygoid
D. Lateral Pterygoid

Answer 1

D. Lateral Pterygoid: bilateral: depression and protrusion; unilateral: contralateral movement

A. Temporalis: elevation & retraction (posterior fibers)
B. Masseter: elevation and protrusion (superficial fibers)

C. Medial Pterygoid: (similar to masseter) bilateral: elevation and protrusion; unilateral: contralateral movement

note: all innervated by V3 - mandibular nerve

Question 2

A patient presents to the emergency room after being hit in the head with a baseball at the pterion. Doctors suspect an epidural hematoma. What artery is most likely damaged??

A. Middle meningeal artery
B. Deep temporal artery

C. Superficial temporal artery 
D. Inferior alveolar artery
E. Sphenopalatine artery

Answer 2

A

Question 3

A patient is having surgery on his lower 1st molar. What nerve would the doctor anesthetize?

A. Superior Alveolar Nerve 
B. Inferior Alveolar Nerve 
C. Mental Nerve

D. Chorda Tympani Nerve 
E. Buccal Nerve

Answer 3

B - via inferior alveolar nerve block

problems include injecting into parotid gland, CN VII, or medial pterygoid affecting movements of TMJ

Question 4

The pterygopalatine fossa has six connections through which nerves and vessels travel. Through which of them does a nerve pass carrying preganglionic parasympathetic innervation to the pterygopalatine ganglion?

A. Sphenopalatine foramen 
B. Infraorbital fissure

C. Foramen rotundum

D. Pterygoid canal
E. Greater Palatine canal 
F. Pterygomaxillary fissure

Answer 4

D

Question 5

The secretomotor innervation of the parotid gland is by the glossopharyngeal nerve (CN IX), which synapses in the otic ganglion, but hitchehikes a ride on this nerve before reaching its final destination:

A. Facial nerve

B. Chorda tympani

C. Auriculotemporal nerve 
D. Inferior alveolar nerve 
E. Parotid nerve

Answer 5

C

Question 6

Which of the following branches of the Facial nerve (CN VII) does NOT pierce the parotid gland?

A. Temporal

B. Posterior Auricular

C. Marginal mandibular 
D. Zygomatic
E. Buccal
F. Cervical

Answer 6

B

Facial Nerve: somatic motor to muscles of facial expression + posterior digastric and stylohyoid

Parotid gland innervated by auriculotemporal (V3) n. and great auricular nerve (cervical plexus C2&3)