parotid region

Question 1

What are the three pairs of large salivary glands?

Answer 1

Parotid, submandibular, and sublingual glands.

Question 2

Name the minor salivary glands and their locations.

Answer 2

Lingual glands – Tongue
Palatal glands – Palate
Buccal glands – Cheeks
Labial glands – Lips

Question 3

What are the functions of saliva?

Answer 3

Saliva helps in chewing, keeps the mouth moist, and cleans teeth.

Question 4

What are the boundaries of the parotid region?

Answer 4

Anteriorly: Anterior border of masseter
Superiorly: Zygomatic arch
Posteriorly: Mastoid process
Inferiorly: Line joining the angle of mandible to mastoid process

Question 5

What is the largest salivary gland?

Answer 5

Parotid gland.

Question 6

Which nerve passes through the parotid gland?

Answer 6

Facial nerve (extracranial part).

Question 7

Through which foramen does the facial nerve exit the cranial cavity?

Answer 7

Stylomastoid foramen.

Question 8

How many terminal branches does the facial nerve give off from the parotid gland?

Answer 8

Five.

Question 9

From which embryological layer does the parotid gland develop?

Answer 9

Ectoderm.

Question 10

Where is the parotid gland located?

Answer 10

In the retromandibular fossa (parotid bed), posterior to the ramus of the mandible.

Question 11

What are the boundaries of the parotid bed?

Answer 11

Anteriorly: Posterior border of the ramus of mandible
Posteriorly: Mastoid process
Superiorly: External acoustic meatus and posterior TMJ
Medially: Styloid process

Question 12

What forms the parotid capsule?

Answer 12

Tough investing layer of deep cervical fascia.

Question 13

What separates the parotid and submandibular glands?

Answer 13

Stylomandibular ligament.

Question 14

Why is parotid swelling painful in mumps?

Answer 14

The parotid capsule is unyielding, so swelling stretches the capsule, stimulating the great auricular nerve.

Question 15

When does pain due to parotitis increase and decrease?

Answer 15

Increases: At meal times due to gustatory stimulus
Decreases: After meals due to secretion release

Question 16

What is the shape of the parotid gland?

Answer 16

Three-sided pyramid with the apex directed downward.

Question 17

Name the features of the parotid gland.

Answer 17

Apex
Four surfaces: Superior (base), superficial (lateral), anteromedial, and posteromedial
Three borders: Anterior, posterior, and medial

Question 18

What is the most likely diagnosis for the 10-year-old boy with swelling in front of his ears?

Answer 18

Mumps (viral parotitis) – a viral infection of the parotid gland caused by the mumps virus.

Question 19

Why does the pain worsen at meal times in the case of mumps?

Answer 19

Salivary stimulation during meals increases secretion in the inflamed parotid gland, leading to increased pressure within the unyielding parotid capsule, causing pain.

Question 20

Which nerve is responsible for transmitting the pain sensation in mumps?

Answer 20

Great auricular nerve (a branch of the cervical plexus, C2, C3), which supplies sensory innervation to the parotid capsule.

Question 21

Which nerve has likely been damaged in the 45-year-old man after parotid tumor surgery?

Answer 21

Facial nerve (CN VII) – its extracranial part passes through the parotid gland.

Question 22

Through which anatomical structure does the facial nerve pass inside the parotid gland?

Answer 22

The stylomastoid foramen – the facial nerve exits the skull here and enters the parotid gland, where it divides into its five terminal branches.

Question 23

Name the five terminal branches of the facial nerve.

Answer 23

1. Temporal
2. Zygomatic
3. Buccal
4. Marginal mandibular
5. Cervical

Mnemonic: “To Zanzibar By Motor Car”

Question 24

Which salivary glands are affected in Sjogren’s syndrome?

Answer 24

All three major salivary glands – parotid, submandibular, and sublingual, as well as minor salivary glands.

Question 25

What is the primary cause of dry mouth in the patient with Sjogren’s syndrome?

Answer 25

Autoimmune destruction of salivary glands, leading to reduced saliva production (xerostomia).

Question 26

Which other exocrine gland is commonly affected in Sjogren’s syndrome?

Answer 26

Lacrimal glands, causing dry eyes (keratoconjunctivitis sicca).

Question 27

Which structure emerges through the apex of the parotid gland?

Answer 27

Cervical branch of the facial nerve.

Question 28

What are the divisions of the retromandibular vein emerging through the apex of the parotid gland?

Answer 28

Anterior and posterior divisions of the retromandibular vein.

Question 29

The superior surface of the parotid gland is related to which structures?

Answer 29

1. External acoustic meatus 2. Posterior aspect of the temporomandibular joint (TMJ)

Question 30

Which two structures emerge through the superior surface of the parotid gland?

Answer 30

1. Superficial temporal vessels 2. Auriculotemporal nerve

Question 31

The superficial surface of the parotid gland is covered by which layers?

Answer 31

1. Skin 2. Superficial fascia (containing greater auricular nerve branches, preauricular lymph nodes, and platysma) 3. Parotid fascia 4. Deep parotid lymph nodes

Question 32

Which structures are related to the anteromedial surface of the parotid gland?

Answer 32

1. Masseter muscle 2. Medial pterygoid muscle 3. Posterior border of the mandible 4. Lateral aspect of the TMJ

Question 33

The posteromedial surface of the parotid gland is related to which structures?

Answer 33

1. Mastoid process 2. Sternocleidomastoid muscle 3. Posterior belly of digastric muscle 4. Styloid process and its muscles (which separate the gland from major vessels & nerves)

Question 34

Name the three major structures that pass through the parotid gland from superficial to deep.

Answer 34

1. Facial nerve 2. Retromandibular vein 3. External carotid artery

Question 35

What are the structures emerging from the anterior border of the parotid gland?

Answer 35

1. Temporal branch of the facial nerve 2. Zygomatic branch of the facial nerve 3. Transverse facial vessels 4. Upper buccal branch of the facial nerve 5. Parotid duct 6. Lower buccal branch of the facial nerve 7. Marginal mandibular branch of the facial nerve

Question 36

What structures pass through the posterior border of the parotid gland?

Answer 36

1. Posterior auricular vessels 2. Posterior auricular branch of the facial nerve

Question 37

Case: A 35-year-old teacher complains of recurrent swelling and pain in the cheek while eating. Examination shows tenderness over Stensen’s duct but no pus discharge. Q1: What is the most likely cause? Q2: How is the diagnosis confirmed?

Answer 37

Parotid gland obstruction (sialolithiasis) sialography of parotid duct

Question 38

A 45-year-old man undergoes superficial parotidectomy for a benign tumor. A few months later, he notices sweating and redness over his cheek whenever he eats spicy or sour foods. Q1: What is the most likely diagnosis? Q2: Why does this happen after parotid surgery?

Answer 38

Frey's syndrome (gustatory sweating) A: During parotidectomy, the auriculotemporal nerve (which carries parasympathetic fibers to the parotid gland) can be damaged. During healing, these fibers may abnormally reconnect to sweat glands instead of the salivary gland. As a result, eating triggers sweating and flushing of the cheek instead of salivation.