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Flashcards in Parotid Bed Deck (32):
1

Parotid Gland

Largest of salivary glands, Triangular or wedge-shaped structure, Located anterior, inferior and posterior to the ear in an area known as the parotid bed, Wedged between the ramus of mandible and the mastoid process

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2

Parotid Capsule

Sheath. Investing layer of the deep cervical fascia goes on both side of the gland. Strong fascia enclosing entire gland. Continuous with the deep fascia of the neck.

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3

Parotid Duct

About two inches long and ¼ inches in diameter, Leaves the anterior edge of the gland, Courses to the masseter muscle and pierces buccinator muscle to enter oral cavity. Oblique passsage of duct through muscle acts like a valve. Opens in the oral cavity opposite 2nd maxillary molar at Parotid Papilla

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4

Parotid Papilla

Opening of duct into oral cavity by 2nd molar. Can become infected/inflamed causing backup and pain

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5

Accessory Parotid Gland

Part of the parotid gland separate from the main mass and immediately superior to the parotid duct

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6

Facial Nerve (CNVII)

Enters the posteriomedial part of the gland after exiting the stylomastoid foramen. Facial nerve is the most superficial structure in the parotid gland. It forms a plexus in the gland from which 5 branches are given off to them (muscles of facial expression, TZBMC). The nerve gives off two branches before entering the gland: posterior auricular and Motor nerve to the posterior belly of digastric and stylohyoid muscles (muscles of the 2nd arch)

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7

Posterior Auricular Branch

Branch of facial nerve before entering parotid. Innervates some muscles of the ear, if you can wiggle your ears, these muscles are involved

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Motor Nerve branch of Facial Nerve

Branch of Facial nerve before entering parotid. Innervates posterior belly of digastric muscle and stylohyoid muscle.

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9

Temporal Branches of Facial Nerve

Branches of Facial Nerve going to muscles in temporal region

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10

Zygomatic Branches of Facial Nerve

Branches of Facial Nerve going to muscles in zygomatic region

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11

Buccal Branches of Facial Nerve

Branches of Facial Nerve going to muscles in buccal region

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12

(Marginal) Mandibular Branches of Facial Nerve

Branches of Facial Nerve going to muscles in mandibular region

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13

Cervical Branches of Facial Nerve

Branches of Facial Nerve going to muscles in cervical region

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14

Retromandibular Vein

lies deeper to the CN VII, Formed in the substance of the parotid gland. Superficial temporal vein coming down and joins up with maxillary vein to become retromandibular vein. While in the gland the retromandibular vein divides into an anterior and a posterior part (division).The posterior part joins with the posterior auricular vein to form the external jugular vein. The anterior part joins with the facial vein to drain into the internal jugular vein. Small veins from the parotid drain into the retromandibular vein

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15

Superficial Temporal Vein

Joins with maxillary vein to form retromandibular vein

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16

Maxillary vein

Joins with superficial temporal vein to form retromandibular vein. Gathers blood from maxilae region.

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17

Posterior portion of retromandibular vein

Joins posterior auricular vein, forms external jugular

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18

Posterior auricular vein

Joins posterior portion of retromandibular vein to form the external jugular

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19

Anterior Portion of retromandibular vein

Meets with Facial Vein to form internal jugular

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20

Facial Vein

Meets with anterior portion of retromandibular vein to form internal jugular

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21

Internal Jugular

Formed by junction of anterior portion of retromandibular vein and facial vein

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22

External Jugular

Formed by junction of posterior portion of retromandibular vein and posterior auricular vein

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23

External Carotid Artery

Lies deeper than jugular vein. The external carotid enters the gland from its inferior. It terminates in the parotid gland by giving off two terminal branches: Maxillary artery and Superficial Temporal Artery

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24

Maxillary Artery

Proceeds Anteriorly into the infratemporal fossa

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25

Superficial Temporal Artery

Proceeds superiorly to supply the scalp

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26

Sympathetic Nerve Supply to Parotid

Postganglionic sympathetic fibers destined for the parotid gland are derived from the superior cervical ganglion of the sympathetic chain and travel to the parotid gland with the external carotid artery. Stimulation of the gland by the sympathetic system produces thick saliva

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27

Superior cervical ganglion of sympathetic chain

Sends postganglion sympathetic fibers to the parotid gland along the external carotid artery. Stimulate production of thick saliva

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28

Parasympathetic Nerve Supply to Parotid

Starts in brain. Branches of the CN IX, tympanic nerve (ear) and lesser petrosal nerve, bring preganglionic fibers to the otic ganglion (located in deep face). Postganglionic fibers go from the otic ganglion to the parotid gland with the auriculotemporal nerve (branch of the mandibular division of CN V). Stimulation of these fibers produces a thin watery saliva

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29

Summary of Parasympathetic and Sympathetic Nerve Supply to Parotid

Slide

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30

Lymphatic Drainage

gland is mainly drained into the preauricular or parotid lymph nodes which ultimately drain to the deep cervical chain

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31

Infection of the Parotid Gland

Mumps – acute, communicable viral infection of salivary glands (mainly the parotid) Gland swells causing severe pain because of the sheath of the gland

32

Tumors of the Parotid

80% of the salivary gland tumors occur in the parotid