The Parotid, Temporal, & Infratemporal Regions & the Temporomandibular Joint Flashcards
the parotid region:
compromises the ___ gland & structures related to it
this gland is the (smallest/largest) of the three paired ___ glands
parotid
largest
salivary
the parotid region:
wedged b/n the ___ & ___ muscle anteriorly, & the ___ muscle posteriorly
overlaps both muscles (superfically/deeply)
ramus of the mandible
masseter muscle
sternoclediomastoid muscle
superficially
the parotid region:
the ___ nerve & its branches pass forward within the parotid gland & divide it into ___ & ___ parts
facial nerve
superficial & deep parts
the parotid region:
the parotid gland is enclosed within a tough connective tissue capsule, the ___, derived from the ___ layer of ___ fascia
a special thickening of this fascia on its deep surface is the ___ ligament which separates the ___ & ___ glands
parotid sheath
investing layer of deep fascia
stylomandibular ligament
parotid & submandibular glands
structures within the parotid gland (superficial to deep) (3)
facial nerve
retromandibular vein
external carotid artery
structures within the parotid gland:
facial nerve:
after entering the parotid gland, the facial nerve typically divides into ___ & ___ trunks (___ & ___ trunks, respectively)
they may pass through the substance of the gland, branching & anastomosing forming the ___ plexus
upper & lower trunks
temporofacial & cervicofacial trunks
parotid plexus
structures within the parotid gland:
facial nerve:
five terminal branches emerge from the ___, ___, & ___ borders of the gland named for the regions they supply (5)
upper
anterior
lower
temporal zygomatic buccal mandibular (marginal mandibular) cervical
structures within the parotid gland:
external carotid artery:
passes into the (superior/inferior) border of the parotid gland, gives off its ___ branch, & then divides behind the ___ into two terminal branches (2)
superior border
posterior auricular branch
neck of the mandible
superficial temporal artery
maxillary artery
structures within the parotid gland:
retromandibular vein:
formed within the substance of the parotid gland by the union of the ___ & ___ veins
usually divides into ___ & ___ branches just below the parotid gland
superficial temporal
maxillary
anterior & posterior
the parotid gland:
the parotid duct:
passes forward over the surface of the ___ muscle approximately a fingerbreadth below the ___ arch
pierces the ___ & ___ muscle
masseter muscle
zygomatic arch
buccal fat pad
buccinator muscle
the parotid gland:
the parotid duct:
opens into the ___ cavity opposite the ___ tooth
the ___ artery (branch of the ___ artery) runs forward above the parotid duct
oral cavity
second upper molar tooth
transverse facial artery
superficial temporal artery
the parotid gland:
innervation:
general sensory innervation to the parotid gland, its sheath, & the overlying skin is provided by the ___ nerve as it ramifies over the surface of the gland
postganglionic parasympathetic fibers reach the gland via the ___ nerve
postganglionic sympathetic innervation is derived from the ___ plexus
great auricular nerve
auriculotemporal nerve
external carotid plexus
the temporal fossa:
borders:
superior: ___ lines
anterior: ___ process of the ___ bone
inferior: ___ arch & ___ crest of the ___ bone
temporal lines
frontal process of the zygomatic bone
zygomatic arch & infratemporal crest of the sphenoid bone
the temporal fossa:
contents:
\_\_\_ muscle & fascia \_\_\_ nerves \_\_\_ arteries \_\_\_ nerve branches \_\_\_ nerve \_\_\_ artery & vein
temporalis muscle & fascia deep temporal nerve deep temporal arteries zygomaticotemporal nerve branches auriculotemporal nerve superficial temporal artery & vein
the temporal fossa:
deep temporal nerves:
pass around the ___ crest of hte __- bone & enter the ___ muscle on its deep surface
infratemporal crest of the sphenoid bone
temporalis muscle
the temporal fossa:
deep temporal arteires:
branches of the ___ artery in the ___ fossa
travel w/ the ___ nerves
maxillary artery
infratemporal fossa
infratemporal nerves
the temporal fossa:
zygomaticotemporal nerve branches:
enter the ___ fossa through one or more small foramina on the ___ fossa surface of the ___ bone
temporal fossa
temporal fossa
zygomatic bone
the temporal fossa:
auriculotemporal nerve & superficial temporal artery & vein:
ascend immediately in front of the ___
ear
the infratemporal fossa:
borders:
anterior: ___ surface of the ___
posterior: ___ process of the ___ bone
medial: ___
lateral: ___
superior: ___
infratemporal surface of the maxilla styloid process of the temporal bone lateral pterygoid plate ramus of the mandible infratemporal crest
the infratemporal fossa:
contents:
\_\_\_ ligament \_\_\_ division of the \_\_\_ nerve \_\_\_ artery (1st & 2nd parts) \_\_\_ plexus \_\_\_ \_\_\_ ganglion \_\_\_ & \_\_\_ muscles
sphenomandibular ligament mandibular division of the trigeminal nerve maxillary artery pterygoid venous plexus chorda tympani otic ganglion medial & lateral pterygoid muscles
the infratmpoeral fossa:
pterygoid plexus:
network of ___ within the infratemporal fossa
the important point to remember is that none of these veins posses ___ so blood can potentially flow in ___
infections can spread from the pterygoid plexus in ___ to areas communication w/ the pterygoid plexus
for example, infections can spread from the ___ to the ___ cavity & ___ sinus resulting in ___ & ___
veins
valves
any direction
any direction
teeth cranial cavity cavernous sinus cavernous sinus thrombosis cranial meningitis
muscles of mastication:
temporalis muscle:
(small/large), ___-shaped muscle
nerve: ___ division of the ___ nerve
action:
- powerful (elevator/depressor) of the mandible closing the ___ & approximating the ___
- posterior fibers (protract/retract) the ___ after it has been protruded
- the muscle also contributes to side-to-side ___ movements
large, fan-shaped
mandibular division of the trigeminal nerve
elevator
mouth
teeth
retract
mandible
grinding
muscles of mastication (4)
temporalis muscle
masseter muscle
lateral pterygoid muscle
medial pterygoid muscle
muscles of mastication:
masseter muscle:
nerve: ___ division of the ___ nerve
action:
- (elevates/depresses) mandible to occlude the ___ in mastication
- has a small effect in side-to-side ___, ___, & ___
mandibular division of the trigeminal nerve
elevates
teeth
movements
protraction
retraction
muscles of mastication:
lateral pterygoid muscle:
nerve: ___ division of the ___ nerve
action:
- acting together, the lateral pterygoid muscles pull the ___ discs & head of the mandible forward, (protruding/retracting) the mandible
- when the lateral & medial pterygoids contract on side only, the mandible is moved laterally to the (same/opposite) side
mandibular division of the trigeminal nerve
auricular discs
protruding
opposite
muscles of mastication:
medial pterygoid muscle:
nerve: ___ division of the ___ nerve
action:
- primary action: (elevate/depress) the mandible
- assists the lateral pterygoid in (protruding/retracting) the mandible
mandibular division of the trigeminal nerve
elevate
protruding
the temporomandibular joint (tmj):
articulation: the ___ process of the mandible articulates w/ part of the ___ fossa & ___ tubercle of the ___ bone
condylar process
mandibular fossa
articular tubercle
temporal bone
the temporomandibular joint (tmj):
modified ___ joint
allows opening & closing via a ___ action around a central axis passing through the ___ as well as anterior/posterior sliding (___) movements & side-to-side movement
hinge
hinge action
mandibular condyles
translation
the temporomandibular joint (tmj):
unlike most other ___ joints where the articular surfaces are covered by hyaline cartilage, those of the tmj are covered by ___
the ___ disc is predominantly composed of dense ___ tissue & some ___
synovial
fibrocartilage
articular disc
connective tissue
fibrocartilage
the temporomandibular joint (tmj):
the entire joint is ___
the joint is completely separated into two parts by the ___ disc (2)
avascular
articular disc
lower part
upper part
the temporomandibular joint (tmj):
lower part: allows mainly the hinge-like ___ & ___
upper part: allows the head of the mandible to slide (___) forward (___) onto the articular tubercle & backward (___) into the articular fossa
depression & elevation
translate
protrusion
retraction
the temporomandibular joint (tmj):
___ membrane lines all of the non-articular surfaces of the upper & lower compartments of the joint & is attached to the margins of the ___ discs
synovial membrane
articular discs
the temporomandibular joint (tmj):
synovial membrane & joint capsule:
the upper portion of the joint capsule above the attachment of the disc is (lax/taut) & allows for ___ & ___ movements
the lower portion of the joint capsule below the disc is (lax/taut), but allows the ___ movement
lax
forward (protrusion) & backward (retraction) translational movements
taut
rotatory (hinge)
the temporomandibular joint (tmj):
articular disc:
the disc completely separates the joint into ___ compartments
the disc attaches to the circumference of the ___ capsule at about its middle
the articular disc moves forward & backward w/ the ___
two compartments
fibrous capsule
condyle
accessory ligaments of the tmj:
stylomandibular ligament:
consists of a specialized thickening of the ___ layer of ___ fascia located (anterior/posterior) to the tmj
also consists of thickening of the posterior part of the ___ of the ___
attaches superiorly to the ___ process & inferiorly to the ___
investing layer ofdeep cervical fascia
posterior
capsule of the parotid gland
styloid process
ramus of the mandible
the temporomandibular joint (tmj):
articular disc:
anteriorly, the disc is attached to the tendon of the ___ muscle
posteriorly, the disc is continuous w/ a layer of loose ___ tissue (sometimesconsidered a continuation of the disc) which splits into two ___
lateral pterygoid muscle
vascular tissue
laminae
accessory ligaments of the tmj (3)
temporomandibular (lateral) ligament
stylomandibular ligament
sphenomandibular ligament
accessory ligaments of the tmj:
temporomandibular (lateral) ligament:
this broad ligament is attached above to the ___ tubercle on the root of the ___ process of the ___ bone & below to the lateral surface & posterior border of the ___
artiuclar tubercle
zygomatic process
temporal bone
neck of the mandibular condyle
accessory ligaments of the tmj:
temporomandibular (lateral) ligament:
its fibers pass (upward/downward) & (forward/backward)
it functions as a check ligament to prevent downward & backward displacement of the ___
downward & backward
condyle
accessory ligaments of the tmj:
stylomandibular ligament:
it functions as a check ligament in (protrusion/retraction) of the mandible
this ligament is relaxed when the mouth is (open/closed) & only becomes taut during extreme (protrusion/retraction)
thus, it does not limit ___ movement to any appreciative extent
protrusion of the mandible
open
protrusion
joint
accessory ligaments of the tmj:
sphenomandibular ligament:
located medial to the ___ of the joint
attaches superiorly to the ___ of the ___ bone & expands inferiorly to attach to the ___ of the ___ & the posterior margin of the ___ foramen
capsule
spine of the sphenoid bone
lingual of the mandible
mandibular foramen
accessory ligaments of the tmj:
sphenomandibular ligament:
it functions as a check ligament & is relaxed when the jaw is (open/closed) & becomes tense as the jaw is (opened/closed)
relations:
- lateral: ___ muscle, ___ nerve, ___ artery
- medial: ___ muscle, ___
closed
opened
- lateral pterygoid muscle, auriculotemporal nerve, maxillary artery
- medial pterygoid muscle, chorda tympani
the temporomandibular joint:
jaw movement:
opening the mouth:
opening the mouth involves both (elevation/depression) & (protrusion/retraction) of the mandible
depression
protrusion
the temporomandibular joint:
jaw movement:
opening the mouth:
the forward or protrusive movement allows greater depression of the mandible by preventing backward movement of the ___ of the ___ into structures in the ___ (e.g., ___ & ___)
full protrusion, the articular disc lies under the ___
angle of the mandible
neck (e.g., parotid & sternocleidomastoid)
articular tubercle
the temporomandibular joint:
jaw movement:
closing the mouth:
involves the reverse of ___
(protrusion/retraction) & (elevation/depression) of the mandible
opening the mouth
retraction
elevation
the temporomandibular joint:
typical dissection of the region (superficial to deep):
\_\_\_ \_\_\_ & relations \_\_\_ muscle \_\_\_ of mandible & \_\_\_ muscle \_\_\_ artery & branches \_\_\_ muscle \_\_\_ nerve & branches \_\_\_ muscle
skin parotid & relations masseter muscle ramus of mandible & temporalis muscle maxillary artery & branches lateral pterygoid muscle mandibular nerve & branches medial pterygoid muscle
the temporomandibular joint:
jaw movement:
movements & muscles responsible:
depression: three muscles (3)
elevation: three muscles (3)
digastric muscle
geniohyoid muscle
mylohyoid muscle
temporalis muscle
masseter muscle
medial pterygoid muscle
the temporomandibular joint:
jaw movement:
movements & muscles responsible:
protrusion (protraction): one prime & two assisting muscles (3)
retrusion (retraction): one prime & two assisting muscles (3)
prime:
- lateral pterygoid muscle
assisting:
- superficial heads of the masseter
- medial pterygoid
prime:
- posterior fibers of the temporalis muscle
assisting:
- deep head of the masseter
- digastric
the temporomandibular joint:
nerve supply:
the articular & the dense part of the articular disc have ___
(pre/postgang) (symp/parasymp) fibers from the ___ plexus innervate the same regions of the joint
no nerve supply
postganglionic sympathetic fibers
external carotid plexus
the temporomandibular joint:
nerve supply: one main & two others (3)
main:
- auriculotemproal nerve
others:
- posterior deep temporal nerve
- masseteric nerve
artery between stylomandibular ligament & neck of mandible
maxillary artery
