Anatomy of Head and Neck

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Questions and Answers

What is the main difference between the lymphatic system in the right and left sides of the neck?

The left side has more lymph nodes than the right side.

The right side has more lymph nodes than the left side.

The right side has a thoracic duct, while the left side does not.

The left side has a thoracic duct, while the right side does not. (correct)

Where is the parotid gland located?

Behind the ramus of mandible (correct)

Below the carotid triangle

Above the mastoid process

Anterior to the ramus of mandible

What is the function of the duct that passes from the upper part of the parotid gland?

To carry saliva from the gland to the mouth (correct)

To innervate the buccal branch of facial nerve

To drain lymph from the parotid gland

To supply blood to the masseter muscle

What artery traverses the parotid gland deeply?

External carotid artery Signup and view all the answers

What is the main source of blood supply to the parotid gland?

External carotid artery Signup and view all the answers

Where do the lymph nodes of the parotid gland drain into?

Deep cervical lymph nodes Signup and view all the answers

Which nerve supplies the parotid gland with parasympathetic fibers?

Glossopharyngeal nerve Signup and view all the answers

What is the sympathetic supply to the parotid gland?

From the sympathetic plexus around the external carotid artery Signup and view all the answers

What is the origin of the deep head of the medial pterygoid muscle?

Medial surface of lateral pterygoid plate Signup and view all the answers

What is the nerve supply of the medial pterygoid muscle?

Mandibular division of trigeminal nerve Signup and view all the answers

What is the action of the medial pterygoid muscle?

Rises and protracts the mandible Signup and view all the answers

What forms the superior boundary of the temporal fossa?

Superior temporal line Signup and view all the answers

What is the contents of the infratemporal fossa?

Muscles of mastication and maxillary artery Signup and view all the answers

What is the boundary of the infratemporal fossa posteriorly?

Styloid process Signup and view all the answers

What is the communication of the infratemporal fossa with the orbit?

Infraorbital fissure Signup and view all the answers

What is the division of lymphatic drainage of the head and neck?

Circular and cervical Signup and view all the answers

What is the main objective of understanding the normal position of lymph nodes?

To solve clinical problems Signup and view all the answers

How is the lymphatic drainage of the head and neck divided?

Into two groups: circular and cervical Signup and view all the answers

What drains the back of the auricle, external acoustic meatus and nearby part of scalp?

Retroauricular group Signup and view all the answers

Where is the deep parotid group located?

In the sheath of parotid gland Signup and view all the answers

What drains the submandibular and lingual salivary glands, tongue, gum, tonsil, and cheek?

Submandibular group Signup and view all the answers

What is the function of the deep cervical group?

Drains the deep structure in the neck Signup and view all the answers

What is the location of the superficial cervical group?

Along the external jugular vein and anterior jugular vein Signup and view all the answers

What is the location of the retropharyngeal group?

Between the pharynx and prevertebral muscles Signup and view all the answers

Which nerve carries postganglionic parasympathetic secretomotor fibers from the otic ganglia to the parotid gland?

Auriculotemporal nerve Signup and view all the answers

What is the action of the masseter muscle on the mandible?

Rises and protracts the mandible Signup and view all the answers

Which muscle arises from the infratemporal surface of the greater wing of sphenoid?

Lateral pterygoid muscle Signup and view all the answers

Which nerve supplies the temporalis muscle?

Deep temporal nerve Signup and view all the answers

What is the function of the sympathetic fibers in the otic ganglia?

Vasoconstriction of the middle meningeal artery Signup and view all the answers

Which muscle is inserted into the coronoid process of the mandible?

Temporalis muscle Signup and view all the answers

Which nerve carries preganglionic parasympathetic fibers to the otic ganglia?

Lesser petrosal nerve Signup and view all the answers

What is the action of the lateral pterygoid muscle on the mandible?

Protracts and depresses the mandible Signup and view all the answers

Study Notes

Lymphatic Drainage of Head and Neck

Lymphatic drainage of head and neck is divided into two groups: circular and cervical groups
Circular groups include:
Occipital group: lies along occipital vessels and drains the back of scalp and upper part of neck
Retroauricular group: drains the back of the auricle, external acoustic meatus and nearby part of scalp
Superficial parotid group: lies on the fascia of parotid gland and drains the anterior part of auricle, external acoustic meatus and temporal region
Deep parotid group: lies in the sheath of parotid gland and drains the anterior part of scalp, orbit, parotid gland and part of the face
Retropharyngeal group: lies between pharynx and prevertebral muscles, and drains vertebral region and pharynx
Submandibular group: lies in the submandibular triangle and drains submandibular and lingual salivary glands, tongue, gum, tonsil and cheek
Submental group: lies in submental triangle and drains the tip of tongue, lower lip and the floor of mouth

Cervical Groups

Cervical groups are formed of superficial and deep groups
Superficial group: lies along external jugular vein and anterior jugular vein, and drains superficial structures of neck
Deep group: lies along the internal jugular vein and drains the deep structure in neck (pharynx, larynx, esophagus, trachea and thyroid gland)

Parotid Gland

The parotid gland is the largest salivary gland
It lies behind the ramus of mandible and extends to the mastoid process posteriorly
Medially, it reaches up to the styloid process of the skull
The gland is irregular in shape and part of it passes over the masseter muscle, which is called the accessory parotid gland
The parotid gland has a duct that passes anteriorly and crosses the masseter muscle, then pierces the cheek to open in the vestibule of the mouth opposite the upper second molar tooth

Blood Supply of Parotid Gland

External carotid artery (superficial temporal and maxillary artery)
Transverse facial artery (branch of superficial temporal artery)
Deep auricular artery (branch of maxillary artery)

Lymphatic Drainage of Parotid Gland

To the deep parotid lymph nodes, which pass to the deep cervical lymph nodes

Nerve Supply of Parotid Gland

Parasympathetic from glossopharyngeal nerve through otic ganglia, carried to the gland via auriculotemporal nerve
Sympathetic from sympathetic plexus around external carotid artery

Otic Ganglia

The otic ganglia is a small parasympathetic ganglia that lies below the foramen ovale
Components:
Preganglionic parasympathetic fibers from glossopharyngeal nerve through lesser petrosal nerve to the ganglia
Postganglionic parasympathetic secretomotor fibers carried from the ganglia by auriculotemporal nerve to the parotid gland
Motor fibers to tensor palate and tensor tympani muscles from nerve to medial pterygoid muscle (branch of mandibular division of trigeminal nerve)
Sympathetic fibers from plexus around middle meningeal artery
Sensory fibers from glossopharyngeal nerve and distributed through the branches of the ganglia

Muscles of Mastication

There are four muscles of mastication:
Masseter muscle
Temporalis muscle
Medial pterygoid muscle
Lateral pterygoid muscle

Masseter Muscle

The masseter muscle arises from the lower border and deep surface of zygomatic arch
It runs downward to be inserted into the lateral aspect of ramus of mandible
Nerve supply: mandibular division of trigeminal nerve
Action: rises and protracts the mandible

Temporalis Muscle

The temporalis muscle is a fan-shaped muscle that arises from the medial wall of temporal fossa and from the temporal fascia
It is inserted into the coronoid process of mandible and anterior border of ramus of mandible
Nerve supply: deep temporal nerve which is a branch of mandibular division of trigeminal nerve
Action: rises and retracts the mandible

Lateral Pterygoid Muscle

The lateral pterygoid muscle arises by two heads, the smaller upper head arises from the infratemporal surface of greater wing of sphenoid, and the lower large head arises from the lateral surface of lateral pterygoid plate
It is inserted into the front of neck of mandible and articular disc through temporomandibular joint
Nerve supply: mandibular division of trigeminal nerve
Action: protracts the mandible and depresses the chin

Medial Pterygoid Muscle

The medial pterygoid muscle has two heads, superficial small head arises from maxillary tuberosity, and deep head which forms nearly the whole muscle arises deep to the lateral pterygoid from medial surface of lateral pterygoid plate
The two heads unite to form one tendon which passes downward, backward, and laterally to be inserted into the medial surface of the angle and ramus of mandible
Nerve supply: mandibular division of trigeminal nerve
Action: rises and protracts the mandible

Temporal and Infratemporal Fossa

Temporal fossa: situated in the side of the head and bounded by superior temporal line, frontal process of zygomatic bone, and zygomatic arch
Contents of temporal fossa:
Temporalis muscle and covering fascia
Deep temporal nerves and vessels
Auriculotemporal nerve
Superficial temporal artery

Infratemporal Fossa

Infratemporal fossa: irregular space presents below and deep to zygomatic arch, medial to the ramus of mandible
Boundaries:
Superiorly: infratemporal surface of greater wing of sphenoid
Inferiorly: alveolar margin of maxilla
Medially: lateral pterygoid plate
Laterally: ramus of mandible
Anteriorly: posterior surface of maxilla
Posteriorly: styloid process
Contents of infratemporal fossa:
Muscles of mastication (medial pterygoid and lateral pterygoid muscle)
Branches of mandibular division of trigeminal nerve
Chorda tympani nerve
Otic ganglia
Maxillary artery and its branches
Pterygoid venous plexus

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Description

This quiz covers the normal anatomy of the parotid gland, position of lymph nodes, and lymphatic drainage of the head and neck. It's essential for solving clinical problems and practicing surgery.