The Parotid, Temporal, & Infratemporal Regions & the Temporomandibular Joint

Question 1

the parotid region:

compromises the ___ gland & structures related to it

this gland is the (smallest/largest) of the three paired ___ glands

Answer 1

parotid

largest
salivary

Question 2

the parotid region:

wedged b/n the ___ & ___ muscle anteriorly, & the ___ muscle posteriorly

overlaps both muscles (superfically/deeply)

Answer 2

ramus of the mandible
masseter muscle

sternoclediomastoid muscle

superficially

Question 3

the parotid region:

the ___ nerve & its branches pass forward within the parotid gland & divide it into ___ & ___ parts

Answer 3

facial nerve

superficial & deep parts

Question 4

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

Answer 4

parotid sheath
investing layer of deep fascia

stylomandibular ligament
parotid & submandibular glands

Question 5

structures within the parotid gland (superficial to deep) (3)

Answer 5

facial nerve
retromandibular vein
external carotid artery

Question 6

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

Answer 6

upper & lower trunks
temporofacial & cervicofacial trunks

parotid plexus

Question 7

structures within the parotid gland:
facial nerve:

five terminal branches emerge from the ___, ___, & ___ borders of the gland named for the regions they supply (5)

Answer 7

upper
anterior
lower

temporal
zygomatic
buccal
mandibular (marginal mandibular)
cervical

Question 8

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)

Answer 8

superior border
posterior auricular branch
neck of the mandible

superficial temporal artery
maxillary artery

Question 9

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

Answer 9

superficial temporal
maxillary

anterior & posterior

Question 10

the parotid gland:
the parotid duct:

passes forward over the surface of the ___ muscle approximately a fingerbreadth below the ___ arch

pierces the ___ & ___ muscle

Answer 10

masseter muscle
zygomatic arch

buccal fat pad
buccinator muscle

Question 11

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

Answer 11

oral cavity
second upper molar tooth

transverse facial artery
superficial temporal artery

Question 12

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

Answer 12

great auricular nerve

auriculotemporal nerve

external carotid plexus

Question 13

the temporal fossa:
borders:

superior: ___ lines
anterior: ___ process of the ___ bone
inferior: ___ arch & ___ crest of the ___ bone

Answer 13

temporal lines

frontal process of the zygomatic bone

zygomatic arch & infratemporal crest of the sphenoid bone

Question 14

the temporal fossa:
contents:

\_\_\_ muscle & fascia
\_\_\_ nerves
\_\_\_ arteries
\_\_\_ nerve branches
\_\_\_ nerve
\_\_\_ artery & vein

Answer 14

temporalis muscle & fascia
deep temporal nerve
deep temporal arteries
zygomaticotemporal nerve branches
auriculotemporal nerve
superficial temporal artery & vein

Question 15

the temporal fossa:
deep temporal nerves:

pass around the ___ crest of hte __- bone & enter the ___ muscle on its deep surface

Answer 15

infratemporal crest of the sphenoid bone

temporalis muscle

Question 16

the temporal fossa:
deep temporal arteires:

branches of the ___ artery in the ___ fossa

travel w/ the ___ nerves

Answer 16

maxillary artery
infratemporal fossa

infratemporal nerves

Question 17

the temporal fossa:
zygomaticotemporal nerve branches:

enter the ___ fossa through one or more small foramina on the ___ fossa surface of the ___ bone

Answer 17

temporal fossa
temporal fossa
zygomatic bone

Question 18

the temporal fossa:
auriculotemporal nerve & superficial temporal artery & vein:

ascend immediately in front of the ___

Answer 18

ear

Question 19

the infratemporal fossa:
borders:

anterior: ___ surface of the ___
posterior: ___ process of the ___ bone
medial: ___
lateral: ___
superior: ___

Answer 19

infratemporal surface of the maxilla
styloid process of the temporal bone
lateral pterygoid plate
ramus of the mandible
infratemporal crest

Question 20

the infratemporal fossa:
contents:

\_\_\_ ligament
\_\_\_ division of the \_\_\_ nerve
\_\_\_ artery (1st & 2nd parts)
\_\_\_ plexus
\_\_\_
\_\_\_ ganglion
\_\_\_ & \_\_\_ muscles

Answer 20

sphenomandibular ligament
mandibular division of the trigeminal nerve
maxillary artery
pterygoid venous plexus
chorda tympani
otic ganglion
medial & lateral pterygoid muscles

Question 21

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 ___ & ___

Answer 21

veins

valves
any direction

any direction

teeth
cranial cavity
cavernous sinus
cavernous sinus thrombosis
cranial meningitis

Question 22

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

Answer 22

large, fan-shaped

mandibular division of the trigeminal nerve

elevator
mouth
teeth

retract
mandible

grinding

Question 23

muscles of mastication (4)

Answer 23

temporalis muscle
masseter muscle
lateral pterygoid muscle
medial pterygoid muscle

Question 24

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 ___, ___, & ___

Answer 24

mandibular division of the trigeminal nerve

elevates
teeth

movements
protraction
retraction

Question 25

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

Answer 25

mandibular division of the trigeminal nerve auricular discs protruding opposite

Question 26

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

Answer 26

mandibular division of the trigeminal nerve elevate protruding

Question 27

the temporomandibular joint (tmj): articulation: the ___ process of the mandible articulates w/ part of the ___ fossa & ___ tubercle of the ___ bone

Answer 27

condylar process mandibular fossa articular tubercle temporal bone

Question 28

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

Answer 28

hinge hinge action mandibular condyles translation

Question 29

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 ___

Answer 29

synovial fibrocartilage articular disc connective tissue fibrocartilage

Question 30

the temporomandibular joint (tmj): the entire joint is ___ the joint is completely separated into two parts by the ___ disc (2)

Answer 30

avascular articular disc lower part upper part

Question 31

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

Answer 31

depression & elevation translate protrusion retraction

Question 32

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

Answer 32

synovial membrane | articular discs

Question 33

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

Answer 33

lax forward (protrusion) & backward (retraction) translational movements taut rotatory (hinge)

Question 34

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 ___

Answer 34

two compartments fibrous capsule condyle

Question 35

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 ___

Answer 35

investing layer ofdeep cervical fascia posterior capsule of the parotid gland styloid process ramus of the mandible

Question 36

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 ___

Answer 36

lateral pterygoid muscle vascular tissue laminae

Question 37

accessory ligaments of the tmj (3)

Answer 37

temporomandibular (lateral) ligament stylomandibular ligament sphenomandibular ligament

Question 38

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 ___

Answer 38

artiuclar tubercle zygomatic process temporal bone neck of the mandibular condyle

Question 39

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 ___

Answer 39

downward & backward condyle

Question 40

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

Answer 40

protrusion of the mandible open protrusion joint

Question 41

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

Answer 41

capsule spine of the sphenoid bone lingual of the mandible mandibular foramen

Question 42

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, ___

Answer 42

closed opened - lateral pterygoid muscle, auriculotemporal nerve, maxillary artery - medial pterygoid muscle, chorda tympani

Question 43

the temporomandibular joint: jaw movement: opening the mouth: opening the mouth involves both (elevation/depression) & (protrusion/retraction) of the mandible

Answer 43

depression | protrusion

Question 44

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 ___

Answer 44

angle of the mandible neck (e.g., parotid & sternocleidomastoid) articular tubercle

Question 45

the temporomandibular joint: jaw movement: closing the mouth: involves the reverse of ___ (protrusion/retraction) & (elevation/depression) of the mandible

Answer 45

opening the mouth retraction elevation

Question 46

the temporomandibular joint: typical dissection of the region (superficial to deep): ``` ___ ___ & relations ___ muscle ___ of mandible & ___ muscle ___ artery & branches ___ muscle ___ nerve & branches ___ muscle ```

Answer 46

``` skin parotid & relations masseter muscle ramus of mandible & temporalis muscle maxillary artery & branches lateral pterygoid muscle mandibular nerve & branches medial pterygoid muscle ```

Question 47

the temporomandibular joint: jaw movement: movements & muscles responsible: depression: three muscles (3) elevation: three muscles (3)

Answer 47

digastric muscle geniohyoid muscle mylohyoid muscle temporalis muscle masseter muscle medial pterygoid muscle

Question 48

the temporomandibular joint: jaw movement: movements & muscles responsible: protrusion (protraction): one prime & two assisting muscles (3) retrusion (retraction): one prime & two assisting muscles (3)

Answer 48

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

Question 49

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

Answer 49

no nerve supply postganglionic sympathetic fibers external carotid plexus

Question 50

the temporomandibular joint: | nerve supply: one main & two others (3)

Answer 50

main: - auriculotemproal nerve others: - posterior deep temporal nerve - masseteric nerve

Question 51

artery between stylomandibular ligament & neck of mandible

Answer 51

maxillary artery