Flashcards in Parotid, Temporal and Infratemporal Region Deck (142):
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
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
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
The parotid gland is encapsulated by which fascia?
Superficial /investing layer of the deep cervical fascia
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
Parasympathetic stimulation of the parotid gland?
a. Auriculotemporal nerve
b. Lesser petrossal nerve
c. Greater petrossal nerve
d. Otic ganglion
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
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
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
Attachment for buccinators and superior constrictor?
a. Sphenomandibular ligament
b. Pterygomandibular raphe
c. Stylomandibular ligament
d. Pharyngeal raphe
This ligament prevents condylar dislocation posteriorly
A. temporomandibular ligament
B. sphenomandibular ligament
C. stylomandibular ligament
Fracture of the mandible usually involves
A. three fractures
B. four fractures
C. just one fracture
D. two fractures
Enlarged if you have a small cell carcinoma at chin
A. deep cervical lymph nodes
B. superficial cervical lymph nodes
C. submental lymph nodes
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
TRUE of parotid deep lobe tumor
A. usually malignant
B. usually benign
C. does not affect the facial nerve
D. none of the above
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
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
Medial boundary of parotid gland
C. lateral pterygoid
D. medial pterygoid
Roof/Superior border of infratemporal fossa
A. zygomatic bone
B. frontal bone
C. inferior surface of the greater wing of sphenoid
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
Which is the incorrect pairing?
A. lateral pterygoid : horizontal orientation
B. medial pterygoid : horizontal orientation
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
Which is not an infratemporal vessel?
A. deep auricular artery
B. sphenopalatine artery
C. buccal artery
D. internal carotid artery
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
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?
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
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
The area occupied by the parotid gland
The apex of the parotid gland is posterior the angle of the mandible. T/F
The duct of the parotid gland pierces which muscle?
The duct of the parotid gland lies on which muscle before it pierces the buccinator?
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
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
Type of secretion of the parotid gland
Duct of the parotid gland
Which muscle primarily occupies the temporal fossa
Lateral border of the temporal fossa
Posterior and superior border of the temporal fossa
Inferior border of the temporal fossa
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
It is intrinsic, a thickened part of the joint capsule.
The stylomandibular ligament and the sphenomandibular ligament are intrinsic ligaments of the TMJ.
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
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
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
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
The main depressor of the mandible
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
Muscles that move the jaw laterally
Temporalis (ipsilateral), masseter, pterygoids (contralateral)
The left pterygoids move the jaw to the left. T/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?
The anterior tympanic artery is a branch of which part of the maxillary artery?
The middle meningeal artery is from which part of the axillary artery?
The middle meningeal artery enters the cranial cavity through which cavity?
The accessory meningeal artery is from which part of the maxillary artery?
The accessory meningeal artery enters the cranial cavity through which structure?
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
Branches of the second part of the maxillary artery
Masseteric artery, Deep temporal arteries, Pterygoid artery, Buccal artery
Structures supplied by the masseteric artery
Structures supplied by the deep temporal arteries
Structures supplied by the pterygoid arteries
Structures supplied by the buccal artery
Buccal fat pads, buccinator, buccal oral mucosa
The masseteric artery is from which part of the maxillary artery?
The deep temporal arteries are from which part of the maxillary artery?
The pterygoid artery is from which part of the maxillary artery?
The buccal artery is from which part of the maxillary artery?
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
The pharyngeal artery is from which part of the maxillary artery?
The artery to the pterygoid canal is from which part of the maxillary artery?
Sphenopalatine artery is from which part of the maxillary artery?
Infraorbital artery is from which part of the maxillary artery?
The descending palatine artery is from which part of the maxillary artery?
The venous equivalent of most of the maxillary artery
Pterygoid venous plexus
The pterygoid plexus anastamoses anteriorly with which vein?
The pterygoid plexus anastamoses with the facial vein through which vein?
Deep facial vein
The pterygoid plexus anastamoses superiorly with which vein?
The pterygoid plexus anastamoses with the cavernous sinus via which vein?
V3 innervates these four muscles of mastication
Medial and lateral pterygoids, masseter, temporalis
The buccinator receives motor innervation from V3. T/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?
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
It lies anterior to the inferior alveolar nerve
Chorda tympani is a branch of which nerve?
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