Lecture 12 & 13: Face and Parotid

Question 1

What does SCALP stand for?

Answer 1

S -> Skin
C -> Connective tissue (dense)
A -> Aponeurotic layer
L -> Loose connective tissue
P -> Pericranium

Question 2

What innervates the ant. aspect of the cranium?

Answer 2

Supratrochlear and supra-orbital nerves (Ant->Post)

Question 3

What innervates the lateral aspect of the cranium?

Answer 3

Zygomaticotemporal n.
Auriculotemporal n.

Question 4

What innervates the post. aspect of the cranium?

Answer 4

Greater occipital nerve (post->ant direction)

Question 5

What are the muscles of facial expression?

Answer 5

Platysma
Occipitofrontalis
Auricularis muscles
Orbicularis occuli
Buccinator
Oribicularis oris

Question 6

What two groups of muscles work together to ensure the lips are angulated?

Answer 6

Levator anguli oris
Depressor anguli oris

Question 7

Where does the parotid gland sit?

Answer 7

• Sits lateral aspect inferior to ear.
• Sometimes extends below the mandible
• Sits on ramus of mandible, on top of masseter muscle

Question 8

Describe the innervation of the parotid:

Answer 8

Sensory: V3 (Gland), C2 (parotid fascia (investing fascaia) (thus pain location changes)

Secretomotor; PSNS fibres: CN IX mainly & V3

SNS: Superior cervical ganglion vi ECA and MMA

Question 9

Describe the location of the parotid duct:

Answer 9

Parotid duct:
- Leaves ant. border, travels over masster, bends 90 Degrees, penetrating buccinator and opens next to second molar

Question 10

Why is the facial nerve important when it comes to the parotid gland?

Answer 10

Facial nerve exits via styloid mastoid foramen then leaves to parotid gland before branching.

Surgery / trauma can severely damage it

Question 11

Describe the branches of the facial nerve:

Answer 11

Branches:

Temporozygomatic:

• > Temporal (if damaged cant shut eyes)
• > Zygomatic
• > Buccal

Cervicofacial

• > Marginal mandibular (if damaged lower lip droops) (bells palsy)
• > Cervical

Temporal and marginal mandibular are very superficial

Question 12

Whats superficial and deep to the facial nerve?

Answer 12

Superficial:
- Parotid gland

Deep:

• Ext. carotid art
• Retromandibular vein
• Styloid

Facial nerve exits between styloid and mastoid before travelling through parotid gland

Question 13

Using surface anatomy where approximately would the parotid duct be?

Answer 13

Line between concha of ear and corner of mouth ~1/2 way

Question 14

What drains the ant. aspect of the head?

Answer 14

Submental and submandibular nodes

Question 15

What drains the lateral aspect of the head?

Answer 15

Pre-auricular and parotid nodes

Question 16

What drains the posterior aspect of the head?

Answer 16

• Mastoid nodes
• Occipital nodes

Both of which drain into the upper cervical nodes

Question 17

Whys it important to know the trigeminal branches?

Answer 17

Because skin cancer is common in NZ and can travel up these nerves:

• V1 = Upper face
• V2 = Middleface
• V3 = Lower face and lateral temporal aspect

Question 18

Answer 18

Question 19

Answer 19

Question 20

Answer 20

Question 21

Answer 21

Question 22

Answer 22

Question 23

Answer 23

1. Orbiularis occuli
2. Auricularis (Sup)
3. Occipitofrontalis muscle
4. Platysma

Question 24

Answer 24

1. Orbicularis oris
2. Masseter
3. Buccinator

Question 25

Answer 25

Question 26

Answer 26

Question 27

Answer 27

Question 28

Answer 28

Question 29

Answer 29

Question 30

Answer 30

1. Temporalzygomatic Branch 2. Cervicofacial Branch A. Temporal B. Zygomatic C. Buccal D. Marginal Mandibular E. Cervical

Question 31

Describe the relation of the facial nerve to the structures in and around the parotid gland:

Answer 31

Question 32

What are the borders of the parotid gland?

Answer 32

Ant: Masseter and ramus of mandible Post: Mastoid process, sternocleidomastoid Sup: Zygomatic arch Medial: Stylohyloid, stylopharyngeas, styloglossus muscle, external carotid branches: Superficial temporal art & maxillary art.

Question 33

What are the five divisions of the facial nerve once it leaves the parotid gland:

Answer 33

Temporal branch: (muscles of facial expression of eye) Zygomatic branch (obicularis occuli) Buccal branch : (Facial expression below orbit, above chin) Marginal mandibular branches: Risorious muscle (smiling) + lower lip and chin. Cervical branch: Platysma of neck

Question 34

What artery runs with the parotid duct?

Answer 34

Transverse facial artery (branch of superficial temporal artery)

Question 35

Describe the blood supply of the parotid gland:

Answer 35

Branch of the internal carotid: - Superificial temporal artery -\>Transverse facial artery Supplys the gland and duct) - Maxillary artery (draw diagram)

Question 36

What is freys syndrome?

Answer 36

Damage to the auriculotemporal nerve that results in uncontrolled sweating (of the head) when eating spicy food

Question 37

What infection causes swelling of the partoid gland?

Answer 37

Mumps