Face anatomy

Question 1

intracranial course of facial nerve

Answer 1

origin between pons and medulla

internal acoutstic meatus

facial canal in the petroud part of the temporal bone

exit through the stylomastoid foramen

Question 2

branches of facial nerve in the face

Answer 2

the zebra buggered my cat

divides into 5 branches as it enters the parotid

temporal
zygomatic
buccal
marginal mandibular
cervical

Question 3

cranial nerves that transmit parasympathetic fibers

Answer 3

occulomotor
facial
glossopharyngeal
vagus

Question 4

surface anatomy of the parotid gland

Answer 4

tragus, mandible, middle of mastoid

duct = middle 1/3 of line from intertrgaic notch to philtrum

Question 5

what is the opening of the parotid gland

Answer 5

stensen’s duct
adjacent to the upper 2nd molar

Question 6

path of parotid duct

Answer 6

crosses the masseter, pierces buccinator

opens next to 2nd molar

Question 7

structures passing through parotid gland

Answer 7

facial nerve - most superficial

ECA

Retromandibular vein

auriculotemporal nerve (branch of V3)

deep parotid LNs

Question 8

relations to the parotid gland

Answer 8

anterior - masseter, medial pterygoid, superfiial termportal and maxillary arteries, facial nerve, stylomandibualr ligament

posterio - posterio belly digastric, SCM, stylohypod, ICA, matoid process, styloid process.

Question 9

arterial supply to the parotid

Answer 9

ECA

Question 10

venous drainage of parotid

Answer 10

retromandibular = union of superficial temporal and maxillary

Question 11

lymphatic drainage parotid

Answer 11

deepa d superficial partid nodes - upper deep cervical

Question 12

nerve innervation of parotid

Answer 12

parasympathetic - secretomotor from otic ganglion

sympathetic - superficial cervical ganglion

sensory - greater auricular nerve

Question 13

types of parotid gland secretion

Answer 13

serous

parasymptathetic - watery
sympathetic - low-volume, enzme rich

Question 14

differentials of a parotid lump

Answer 14

infection - parotiditis, mumps

obstructed duct - internal or external comression

neoplasm - pleomorphic adenoma warthin’s tumour

deep parotid LNs

Question 15

frey syndrome

Answer 15

damage to the parasympathetic fibres from the auricolotemporal nerve resulting in excessive gustatory sweatingin response to salivary stimulus

Question 16

where to palpate the facial artery

Answer 16

as it crosses the inferior border of the mandible adjacent to the anterior border f the masseter

Question 17

what artery is the temporal pulse

Answer 17

superficial temporal

Question 18

where does the submandibular duct open

Answer 18

floor of the mouth, either side of the frenulum

Question 19

submandibular gland secretion

Answer 19

mucous and serous

Question 20

nerves at ris of injury in submandibular gland excision

Answer 20

marginal mandibular (branch of facial)
lingual
hypoglossal

Question 21

difference between UMN and LMN facial palsy

Answer 21

UMN lesion upper part fo the faci will be spared

LMN both the upper an dlower part of the face is affected

Question 22

regions drained by the pre-auricular LNs

Answer 22

upper half of the face
temporal region
auricle and external acoustic meatus
gums

Question 23

what do melanoma mets look like microscopically

Answer 23

pigmented cells

Question 24

nerve supply to the tongue

Answer 24

all of the motor innervation from the hypoglossal nerve (except palatoglossus - vagus)

posterior 1/3 - sensory and taste = glossopharyngeal

anterior 1/3 - taste = chorda tympani (VII), sensation = lingual (mandibular V3)

Question 25

extrinsic muscles of the tongue

Answer 25

genioglossus, hypglossus, styloglossus supplied by hypoglossal nerve palatoglossus suplied by vagus

Question 26

muscle retracting the tongue

Answer 26

sttyloglossus

Question 27

what makes up the roof of the middle ear

Answer 27

tegmen tympani

Question 28

how do middle ear infections cross the skull?

Answer 28

direct erosion of tegmen tympani may also spread throug mastoid air cells causing mastoidiitis

Question 29

clinical picture of meningism

Answer 29

photophobia, neck stiffness, fever

Question 30

identify internal auditory meatus

Answer 30

temporal bone between posterior cranial fossa and middle ear

Question 31

structures passing through IAM

Answer 31

facial nerve vestibulocochlear nerve 7 and 8

Question 32

what can make irreversible damage to the vestibulocochlear nerve

Answer 32

acoustic neruoma

Question 33

why does a patient with an acoustic neuroma hear loud noises on the affected side?

Answer 33

facial nerve involvement with paralysis of the nerve to stapedius

Question 34

relations of the middle ear

Answer 34

roof - tegmen tympani floor - thin bone between tympanic cavity and INjternal juglular vein anterior - thinbone between tympanic cavity and ICA posyerior wall - mastoid medial mall - inner ear lateral wall - tympanic membrane

Question 35

parasympathetic ganglion occulomotor nerve

Answer 35

target organ: pupil (constriction) ciliary ganglion

Question 36

parasympathetic ganglion facial nerve

Answer 36

target organ: Lacrimal glands, nasal mucosa, submandibular and sublingual salivary glands pterygopalatine ganglion submandibular ganglion

Question 37

parasympathetic ganglion glossopharyngeal

Answer 37

target organ: parotid otic ganglion

Question 38

vagus parasympathetic ganglions

Answer 38

thoracic and abdomianl viscera diffuse ganglions

Question 39

cranial nerves and sympathetic nerves

Answer 39

no cranial nerve carries originating sympathetic fibres Preganglionic sympathetic fibers: Originate from T1-T3 spinal cord levels → ascend to superior cervical ganglion. Postganglionic sympathetic fibers: Travel on carotid arteries (internal/external). Hitchhike on branches of CNs V1 (ophthalmic), V2 (maxillary), V3 (mandibular) to reach their targets. Influence pupil dilation (dilator pupillae muscle), sweating, vasoconstriction, eyelid elevation (minorly via Müller's muscle). disruption anywhere along chain results in horners syndrome