Parotid, Temporal and Infratemporal Region Flashcards by Geno Sadaya

TRUE of parotid gland

a. 50% found in stylomandibular
b. secretion is serous and mucus
c. produce 2/3 of saliva in one day
D. not discreetly palpable in parotid bed

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True for tumors of the parotid gland

a. benign tumors are often found in the deep lobe
b. malignant tumors don’t affect the facial nerve and does not cause paralysis
c. deep lobe tumors may manifest as a parapharnygeal mass
d. small parotid tumors are not malignant

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Structure that is easily cut when exposing ITF using blunt chisel and mallet

A. Inferior alveolar artery
B. Inferior alveolar nerve
C. lingual nerve
D. internal maxillary artery

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The parotid gland is encapsulated by which fascia?

Superficial /investing layer of the deep cervical fascia

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Not true of the stylomandibular tunnel

A. contains 20% of the parotid gland
B. Bounded anteriorly by the posterior border of the ramus
C. Bounded posteriorly by the stylomandibular ligament
D. Contains the deep lobe of the parotid gland

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Parasympathetic stimulation of the parotid gland?

a. Auriculotemporal nerve
b. Lesser petrossal nerve
c. Greater petrossal nerve
d. Otic ganglion

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Found on the inferior border of the parotid gland?

a. Transverse facial artery and vein
b. Superficial temporal artery
c. Great auricular nerve
d. Retromandibular vein

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Which of the following is NOT TRUE about the pterygoid muscle?

a. The lateral pterygoid muscle opens and protrudes the jaw
b. The superior head of the medial pterygoid muscle is bigger than the lower head
c. The medial pterygoid is oriented vertically

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The lower head of the lateral pterygoid is attached to the:

a. Fovea of the condyle
b. TMJ ligament
c. TMJ capsule
d. Coronoid process

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Attachment for buccinators and superior constrictor?

a. Sphenomandibular ligament
b. Pterygomandibular raphe
c. Stylomandibular ligament
d. Pharyngeal raphe

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This ligament prevents condylar dislocation posteriorly

A. temporomandibular ligament
B. sphenomandibular ligament
C. stylomandibular ligament

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Fracture of the mandible usually involves

A. three fractures
B. four fractures
C. just one fracture
D. two fractures

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Enlarged if you have a small cell carcinoma at chin

A. deep cervical lymph nodes
B. superficial cervical lymph nodes
C. submental lymph nodes

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What artery supplies the buccinator?

A. pterygopalatine part of the maxillary artery
B. mandibular part of the maxillary artery
C. pterygoid part of the maxillary artery

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TRUE of parotid deep lobe tumor

A. usually malignant
B. usually benign
C. does not affect the facial nerve
D. none of the above

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Which is an inferior border of the parotid gland?

A. tip of mastoid
B. upper border of the posterior belly of digastric
C. retromandibular vein
D. sternocleidomastoid

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Which is not true of retromandibular vein?

A. branch of external jugular vein
B. outside the parotid sheath
C. lateral to the ECA
D. superior to deep cervical lymph nodes

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Medial boundary of parotid gland

A. masseter
B. buccinators
C. lateral pterygoid
D. medial pterygoid

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Roof/Superior border of infratemporal fossa

A. zygomatic bone
B. frontal bone
C. inferior surface of the greater wing of sphenoid
D. mandible

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Not true about lateral pterygoid

A. developed from the first pharyngeal arch
B. one of the muscles of mastication
C. long and thick
D. involved in depression of mouth

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Which is the incorrect pairing?

A. lateral pterygoid : horizontal orientation
B. medial pterygoid : horizontal orientation

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Which is not a branch of the second part of the maxillary artery?

A. deep temporal arteries
B. buccal artery
C. infraorbital artery
D. pterygoid branches

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Which is not an infratemporal vessel?

A. deep auricular artery
B. sphenopalatine artery
C. buccal artery
D. internal carotid artery

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Cranial nerve V3 that connects with CN IX via the otic ganglion to supply ____ parasympathetic to the parotid gland.

A. buccal, presynaptic
B. buccal, postsynaptic
C. auriculo-temporal, postsynaptic
D. auriculo-temporal, presynaptic

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Fracture of the left TMJ will result to A. Condylar protrusion of the left side of the mandible B. Retraction of the left condyle of the mandible C. Paralysis of the left side of the mandible D. Numbness of the left side of the mandible

What separates the parotid gland from the submandibular gland?

Sylomandibular ligament

Exception in the mnemonic PS(-m) am (-b) A. Mylohyoid is not posterior B. Buccal is not anterior C. Buccal is not sensory D. Mylohyoid is not sensory

Which of the following is true? A. The maxillary vein forms the cavernous plexus. B. The superficial temporal and maxillary veins join to form the external jugular vein. C. The internal maxillary artery is not enveloped by the maxillary vein and plexus. D. The pterygoid plexus is connected to the face and cavernous sinus.

Branch of the third part of the internal maxillary A. Deep auricular B. Inferior alveolar C. Anterior tympanic D. Sphenopalatine

Which is not part of the medial wall of the infratemporal fossa? a. Levator veli palatini b. Tensor veli palatini c. Styloid process d. Superior pharyngeal constriction

Which is not true? a. The maxillary veins forms the pterygoid plexus b. The superior temporal vein joins the maxillary vein to form the retromandibular vein c. The maxillary artery is not surrounded by the maxillary vein and plexus d. The pterygoid connects to the cavernous sinus

Largest salivary gland

Parotid gland

The area occupied by the parotid gland

Parotid bed

The apex of the parotid gland is posterior the angle of the mandible. T/F

The duct of the parotid gland pierces which muscle?

Buccinator

The duct of the parotid gland lies on which muscle before it pierces the buccinator?

Masseter

The parotid duct enters the oral cavity through which opening?

A small orifice opposite the second maxillary molar tooth

What are embedded within the parotid gland?

Parotid plexus of CN VII, retromandibular vein, external carotid artery, and the parotid sheath with parotid lymph nodes

CN VII provides innervation to the parotid gland. T/F

F The parotid gland receive innervation from the auriculotemporal nerve which is a branch of V3, and the greater auricular nerve which is a branch of the cervical plexus

Structure dividing the superficial and deep lobes of the parotid gland

Facial nerve

Type of secretion of the parotid gland

Serous (watery)

Duct of the parotid gland

Stensen's duct

Which muscle primarily occupies the temporal fossa

Temporalis muscle

Lateral border of the temporal fossa

Zygomatic arch

Posterior and superior border of the temporal fossa

Temporal lines

Inferior border of the temporal fossa

Infratemporal crest

Lateral border of the infratemporal fossa

Ramus of the mandible

Medial border of the infratemporal fossa

Lateral pterygoid plate

Anterior border of the infratemporal fossa

Posterior aspect of the maxilla

Inferior border of the infratemporal fossa

Attachment of the medial pterygoid

Contents of the infratemporal fossa

Muscles: fnferior part of temporalis muscle, pterygoid muscles, Arteries: maxillary artery, Veins: pterygoid venous plexus, Nerves: mandibular, inferior alveolar, lingual, buccal and chorda tympani nerves, otic ganglion

Articular surfaces involved in the TMJ

Mandibular fossa, articular tubercle of the temporal bone (superiorly), and the head of the mandible (inferiorly)

The two bony articular surfaces of the TMJ are completely separated by which structure?

Articular disc of the TMJ

Compartments formed by the articular disc of the TMJ

Superior articular compartment, inferior articular compartment

Protrusion and retrusion of the jaw occur between the temporal bone and the articular disc (superior cavity). T/F

Depression and elevation of the jaw and the rotational or pivoting movements occur in the inferior compartment. T/F

Which structure strengthens the TMJ laterally?

Lateral ligament of the TMJ

The lateral ligament of the TMJ is an extrinsic ligament of the TMJ. T/F

F It is intrinsic, a thickened part of the joint capsule.

The stylomandibular ligament and the sphenomandibular ligament are intrinsic ligaments of the TMJ.

F They are extrinsic. Stylomandibular ligament is from the fibrous capsule of the parotid gland.

The stylomandibular ligament does not add strength to the TMJ. T/F

The stylomandibular ligament attaches onto which structures?

Styloid process to the angle of the mandible.

The sphenomandibular ligament attaches onto which structures?

Spine of sphenoid to lingula of the mandible

The primary passive support of the mandible

Sphenomandibular ligament

To open the mouth, the head of the mandible and the articular disc must move posteriorly on the articular surface until the head lies inferior to the articular tubercle. T/F

F They must move anteriorly.

The four muscles of mastication arise from which embryological structure?

Mesoderm of the first pharyngeal arch

Muscles of mastication

Temporal, masseter, medial and lateral pterygoid muscles

The nerve that innervates the muscles of mastication

Mandibular nerve (V3) motor root

Actions of the temporalis

Elevates and retrudes mandible, moves mandible ipsilaterally

The right temporalis muscle moves the mandible to the left. T/F

F Movement of the mandible to one side is caused by the ipsilateral temporalis muscle.

Actions of the masseter

Elevates, retrudes and protrudes mandible, moves mandible laterally

Actions of the medial pterygoid

Elevates and protrudes mandible, moves mandible contralaterally

Actions of lateral pterygoid

Depresses mandible (against resistance) in assistance to gravity, protrudes mandible, moves mandible contralaterally

The main protruder of the chin

Lateral pterygoid

The main depressor of the mandible

Gravity

Muscles that protrudes the chin

Lateral pterygoid, masseter, medial pterygoid

Muscles that open the mouth

Lateral pterygoid, suprahyoid, infrahyoid

Muscles that close the mouth

Temporalis, masseter, medial pterygoid

Muscles that retrude the chin

Temporalis, masseter

Muscles that move the jaw laterally

Temporalis (ipsilateral), masseter, pterygoids (contralateral)

The left pterygoids move the jaw to the left. T/F

F Movement of the jaw to one side is caused by the contralateral pterygoid muscles.

Origin of masseter

Maxillary process of zygomatic bone and zygomatic arch

Insertion of masseter

Angle and lateral surface of ramus of mandible

Origin of temporalis

Temporal fossa and deep surface of temporal fascia

Insertion of temporalis

Tip and medial surface of coronoid process and anterior border of ramus of mandible

Origin of lateral pterygoids

Upper head: infratemporal surface and crest of sphenoid bone, Lower head: lateral surface of lateral pterygoid plates

Insertion of lateral pterygoid

Upper head: joint capsule and articular disc of TMJ | Lower head: Pterygoid fovea on anteromedial aspect of neck of condylod process of mandible

Origin of medial pterygoid

Upper head: medial surface of lateral pterygoid plates, and pyramidal process Lower head: Tuberosity of maxilla

Insertion of medial pterygoid

Medial surface of ramus of mandible, inferior to mandibular foramen (mirror image of ipsilateral masseter)

Maxillary artery is the larger terminal branch of which artery?

External carotid artery

The maxillary artery is divided into three parts in relation to which structure?

Lateral pterygoid muscle

Position of the first part of the maxillary artery relative to the lateral pterygoid muscle

Proximal (posterior) to the lateral pterygoid muscle

Position of the second part of the maxillary artery relative to the lateral pterygoid muscle

Adjacent (superficial or deep) to the lateral pterygoid muscle

Position of the third part of the maxillary artery relative to the lateral pterygoid muscle

Distal (anteromedial) to lateral pterygoid muscle

Branches of the first part of the maxillary artery

Deep auricular artery, anterior tympanic artery, middle menigeal artery, accessory meningeal artery, inferior alveolar artery

Deep auricular artery supplies which structures?

External auditory meatus, external part of tympanic membrane, TMJ

The deep auricular artery is a branch of which part of the maxillary artery?

First (mandibular)

The anterior tympanic artery is a branch of which part of the maxillary artery?

First (mandibular)

The middle meningeal artery is from which part of the axillary artery?

First (mandibular)

The middle meningeal artery enters the cranial cavity through which cavity?

Foramen spinosum

The accessory meningeal artery is from which part of the maxillary artery?

First (mandibular)

The accessory meningeal artery enters the cranial cavity through which structure?

Foramen ovale

Structure supplied by the anterior tympanic artery

Internal aspect of tympanic membrane

Structure supplied by the middle meningeal artery

Neurocranium, trigeminal ganglion, CN VII, geniculate ganglion, tympanic cavity, tensor tympany muscles

Structures supplied by the accessory meningeal artery

Extracranial muscles of the ITF and sphenoid bone, V3, Otic ganglion

Structures supplied by the inferior alveolar artery

Mandible, mandibular teeth, mylohyoid, chin

The inferior alveolar artery enter which opening

Mandibular foramen to the mandibular canal

Arterial supply of masseter

Masseteric artery

Branches of the second part of the maxillary artery

Masseteric artery, Deep temporal arteries, Pterygoid artery, Buccal artery

Structures supplied by the masseteric artery

Masseter

Structures supplied by the deep temporal arteries

Temporalis muscle

Structures supplied by the pterygoid arteries

Pterygoid muscles

Structures supplied by the buccal artery

Buccal fat pads, buccinator, buccal oral mucosa

The masseteric artery is from which part of the maxillary artery?

Second (pterygoid)

The deep temporal arteries are from which part of the maxillary artery?

Second (pterygoid)

The pterygoid artery is from which part of the maxillary artery?

Second (pterygoid)

The buccal artery is from which part of the maxillary artery?

Second (pterygoid)

The branches of the third part of the maxillary artery

Posterior superior alveolar artery, pharyngeal artery, artery to the pterygoid canal, sphenopalatine artery, infraorbital artery, descending (greater) palatine artery

The posterior superior alveolar artery is from which part of the maxillary artery

Third (pterygoid-palatine)

The pharyngeal artery is from which part of the maxillary artery?

Third (pterygoid-palatine)

The artery to the pterygoid canal is from which part of the maxillary artery?

Third (pterygoid-palatine)

Sphenopalatine artery is from which part of the maxillary artery?

Third (pterygoid-palatine)

Infraorbital artery is from which part of the maxillary artery?

Third (pterygoid-palatine)

The descending palatine artery is from which part of the maxillary artery?

Third (pterygoid-palatine)

The venous equivalent of most of the maxillary artery

Pterygoid venous plexus

The pterygoid plexus anastamoses anteriorly with which vein?

Facial vein

The pterygoid plexus anastamoses with the facial vein through which vein?

Deep facial vein

The pterygoid plexus anastamoses superiorly with which vein?

Cavernous sinus

The pterygoid plexus anastamoses with the cavernous sinus via which vein?

Emissary veins

V3 innervates these four muscles of mastication

Medial and lateral pterygoids, masseter, temporalis

The buccinator receives motor innervation from V3. T/F

F It receives motor innervation from CN VII.

Branches of the mandibular nerve (V3)

Auriculotemporal, buccal, inferior alveolar and lingual

The auriculotemporal nerve encircles which artery?

Middle meningeal artery

Inferior alveolar nerve enters which foramen?

Mandibular foramen

The inferior dental plexus is formed by which nerve?

Inferior alveolar nerve

The mental nerve is a branch of which nerve?

Inferior dental plexus of the inferior alveolar branch (V3)

The lingual nerve lies posterior to the inferior alveolar nerve. T/F

F It lies anterior to the inferior alveolar nerve

Chorda tympani is a branch of which nerve?

CN VII

Chorda tympani joins the lingual nerve in the infratemporal fossa. T/F

The chorda tympani carries secretomotor fibers for the submandibular and sublingual salivary glands. T/F

Location of otic ganglion

In temporal fossa, inferior to foramen ovale, medial to V3 and posterior to medial pterygoid muscle.

The stylomandibular ligament is a thickening of this fascia

Investing layer of the deep cervical fascia

Which gland is affected by mumps?

Parotid gland