Superficial Face and Parotid Region

Question 1

What pharyngeal arch do the muscles of the face derive from?

Answer 1

The 2nd pharyngeal arch. Associated with Facial Nerve

Question 2

What is the bony protrusion that forms the eyebrow called?

Answer 2

Supercilliary notch of the frontal bone

Question 3

What is the depression between the two supercilliary notches called?

Answer 3

Glabella

Question 4

What is the inferior end of the maxilla, that holds the teeth called?

Answer 4

alveolar process

Question 5

What is the small foramen lateral to the piriform aperture and inferior to the orbits on the maxilla called?

Answer 5

infraorbital foramen

Question 6

Why is blunt trauma to the pterion so severe?

Answer 6

It can rupture the middle meningeal artery and cause death/brain damage

Question 7

What type of nerve fibers innervate the facial muscles and what nerve do they run in?

Answer 7

BE fibers in the facial nerve since they are derived from the 2nd pharyngeal arch

Question 8

What provides cutaneous sensory innervation to face? What type of fibers are these?

Answer 8

Terminal branches of the three division of the trigeminal nerve. GSA
Supraorbital nerve (opthalmic), infraorbital (maxillary), mental (mandibular)

Question 9

What are the actions of the epicranius muscle (occipitofrontalis)?

Answer 9

These muscles of the scalp wrinkle the forehead

Question 10

What does orbicularis oculi do in general?

Answer 10

close the eyelid

Question 11

What does the orbital part of orbicularis oculi do?

Answer 11

tightly contracts the skin around the eye

Question 12

What does the palpebral part of orbicularis oculi do?

Answer 12

palpebral reflex

Question 13

What does the lacrimal part of orbicularis oculi do?

Answer 13

acts on the lacrimal sac

Question 14

What does orbicularis oris do?

Answer 14

closes the mouth

Question 15

What does the buccinator do?

Answer 15

muscle of the cheek important in eating/drinking/playing trumpet/etc

Question 16

What muscles are necessary for smiling?

Answer 16

zygomaticus major, zygomaticus minor, and risorius

Question 17

What does levator labii superioris do?

Answer 17

elevates the upper lip

Question 18

What does levaor labii superioris alaeque nasi do?

Answer 18

elevates upper lip, flares nasal alar cartilages

Question 19

What does levator anguli oris do?

Answer 19

pulls corner of mouth upward

Question 20

What does depressor labii inferioris do?

Answer 20

pulls lower lip down

Question 21

What does depressor anguli oris do?

Answer 21

pulls angle of mouth down

Question 22

What does mentalis do?

Answer 22

pulls skin of chin upward

Question 23

What does the platysma do?

Answer 23

elevates skin of thorax and neck

Question 24

How does CN VII exit the skull?

Answer 24

through the stylomastoid foramen, then passes through the parotid gland

Question 25

What forms the posterior boundary of the parotid bed?

Answer 25

the ear and SCM

Question 26

What forms the anterior border of the parotid bed?

Answer 26

Masseter muscle

Question 27

What forms the superior border of the parotid bed?

Answer 27

Zygomatic Arch

Question 28

At what level in the oral cavity does the parotid duct drain into?

Answer 28

Upper second molar

Question 29

What are the three main neurovascular structures that enter the parotid gland and divide?

Answer 29

CN VII, retromandibular vein, upper part of external carotid artery

Question 30

Does the facial nerve split into its upper and lower trunks in the parotid gland superficial or deep to the external carotid artery? To the Retromandibular vein?

Answer 30

CN VII travels superficial to both the vein and artery. (p 863 grays)

Question 31

List the terminal branches of CN VII from most superior to most inferior:

Answer 31

Temporal, zygomatic, buccal, marginal mandibular, cervical branches

Question 32

Why is it extremely difficult to remove the parotid gland in surgery?

Answer 32

The facial nerve begins branching inside the gland and they must be preserved throughout the removal. Sialiths here can also cause nerve damage

Question 33

What provides sensory innervation to the parotid gland and capsule?

Answer 33

C2-C3 cervical plexus AND Auriculotemproral nerve, a branch of the mandibular nerve (CN V3).

Question 34

Review: Where does the parent branch of the auriculotemporal nerve exit the skull?

Answer 34

Parent branch of the auriculotemproal nerve is CN V3 (the mandibular nerve). This exits through the foramen ovale of the skull.

Question 35

What nerve is associated with the first pharyngeal arch in development?

Answer 35

CN V (trigeminal)

Question 36

What provides sensory innervation to the face?

Answer 36

The three branches of CN V (1,2,and 3: opthalmic, maxillary, mandibular)

Question 37

What passes through the supraorbital, infraorbital, and mental foramina?

Answer 37

``` Supraorbital nerve (a branch of the opthalmic CN V1) Infraorbital nerve (a branch of maxilary CN V2) Mental nerve (a branch of mandibular CN V3) ```

Question 38

What muscle allows you to gently blink?

Answer 38

palpebral part of orbicularis occuli

Question 39

Is zygomaticus major medial or lateral to zygomaticus minor?

Answer 39

lateral

Question 40

Where does buccinator muscle originate? What muscle will share its origin?

Answer 40

pterygomandibular raphe. | Superior pharyngeal constrictor

Question 41

What covers and protects the parotid gland/region? What is it a continuation of?

Answer 41

parotid fascia or capsule. It is a superior continuation of the cervical or deep investing fascia of neck

Question 42

Where do zygomaticus major and minor originate? Where to they insert?

Answer 42

origin: Zygomatic bone insert: skin at corner of mouth

Question 43

What innervates masseter?

Answer 43

Mandibular division of trigeminal nerve (CN V3) muscle of mastication

Question 44

Does parotid duct cross the masseter superficially or deep?

Answer 44

superficially

Question 45

What muscle does the parotid gland penetrate to reach the oral cavity?

Answer 45

buccinator muscle

Question 46

What two muscles does the facial nerve innervate BEFORE it reaches parotid gland to divide into upper and lower trunks?

Answer 46

stylohyoid and posterior digastric (neither are muscles of facial expression)

Question 47

What three muscles are associated with the styloid process?

Answer 47

Stylohyoid, styloglossus, stylopharyngeus

Question 48

How could an infection spread from the jaw to the mediastinum?

Answer 48

through the lateral pharyngeal space to the retropharyngeal space then down to the mediastinum

Question 49

Rank from most superficial to deep: retromandibular vein, parotid gland, external carotid artery, CN VII

Answer 49

parotid gland, CN VII, retromandibular vein, external carotid artery

Question 50

What provides motor innervation to the parotid gland? What ganglion do the fibers come from?

Answer 50

GVE parasympathetics from CN IX (glossopharyngeal nerve). | Otic ganglion. (p937 grays for great diagram)

Question 51

What innervates the skin around the ear and the superior tip of the parotid gland?

Answer 51

auriculotemporal nerve (branch of CN V3)

Question 52

What artery supplies blood to the anterior face?

Answer 52

Facial artery

Question 53

Does the facial artery travel deep or superficial to zygomaticus major?

Answer 53

deep

Question 54

What structure does posterior auricular artery seem to follow?

Answer 54

stylohyoid muscle.

Question 55

The area around the eyebrows receives blood from an artery besides the superficial temporal. What is it?

Answer 55

Opthalmic artery (A branch of the ICA) passes through the orbit and supplies that area as well, forming heavy anastomoses with the superficial temporal and ECA system

Question 56

What major vessel does venous drainage from the anterior face dump into? Lateral face and temple?

Answer 56

Facial vein will cover front of face and merge into the internal jugular vein. The superficial temporal vein will drain the temple and lateral face and merge with the retromandibular vein, which then dumps into the external jugular vein

Question 57

What two tributaries make up retromandibular vein?

Answer 57

maxillary vein and superficial temporal vein

Question 58

What merges with the retromandibular vein to form the external jugular vein?

Answer 58

posterior auricular vein

Question 59

Where is the buccal fat pad found?

Answer 59

anterior margin of masseter, superficial to the buccinator. It often has parotid duct and buccal branches of CN VII crossing it

Question 60

Where is lymph of the face likely to drain to?

Answer 60

Deep cervical nodes that encircle the neck

Question 61

What is the most common cause of facial nerve paralysis?

Answer 61

Bell's palsy. The cause of the condition is not well known but it is thought to follow exposure to cold temperatures and possibly viral infections in the face.

Question 62

Where is the buccal fat pad found?

Answer 62

anterior margin of masseter, right under the cheek bone

Question 63

Where is lymph of the face likely to drain to?

Answer 63

Deep cervical nodes that encircle the neck

Question 64

What is the most common cause of facial nerve paralysis?

Answer 64

Bell's palsy. The cause of the condition is not well known but it is thought to follow exposure to cold temperatures and possibly viral infections in the face.