Facial Anatomy & Parotid Gland Quiz

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Questions and Answers

Which of the following structures does not pass through the substance of the parotid gland?

External carotid artery

Facial nerve

Retromandibular vein

Internal jugular vein (correct)

What type of axons form the three divisions of the trigeminal nerve?

Motor only

Both sensory and motor (correct)

Autonomic only

Sensory only

Which of the following foramina does not house a branch of the trigeminal nerve?

Foramen rotundum

Foramen ovale

Superior orbital fissure

Foramen spinosum (correct)

What is the significance of the SMAS (Superficial Musculoaponeurotic System) in facial anatomy?

It is a key component of facial expression, allowing for muscle movement (D) Signup and view all the answers

Which of the following branches of the facial nerve proper supplies the muscles of facial expression?

All of the above (D) Signup and view all the answers

Which of the following is NOT a structure that passes through the parotid gland?

Hypoglossal n. (D) Signup and view all the answers

What is the primary symptom that distinguishes mumps from influenza?

Swelling of the salivary glands (B) Signup and view all the answers

What is the action of the Platysma muscle?

Depresses the lower lip and pulls the corners of the mouth downward (D) Signup and view all the answers

Which of the following muscles is NOT a muscle of facial expression?

Masseter m. (D) Signup and view all the answers

What is the name of the superficial layer of the parotid capsule?

SMAS (D) Signup and view all the answers

What is the typical treatment for parotid neoplasms?

Parotidectomy (C) Signup and view all the answers

What percentage of parotid neoplasms are benign?

70-80% (D) Signup and view all the answers

What is the name of the duct that carries saliva from the parotid gland to the oral cavity?

Stenson's duct (C) Signup and view all the answers

Which of the following is NOT a function of the buccal fat pad?

Supports the parotid gland (A) Signup and view all the answers

Which of the following accurately describes the relationship between the facial nerve and the Superficial Musculo-Aponeurotic System (SMAS)?

The facial nerve branches become superficial as they travel medially and lie within the SMAS. (B) Signup and view all the answers

What is the primary function of the Superficial Musculo-Aponeurotic System (SMAS)?

To provide a supportive framework for the facial muscles. (D) Signup and view all the answers

What is the significance of the Superficial Musculo-Aponeurotic System (SMAS) for the branching pattern of the facial nerve?

The SMAS is a conduit for the facial nerve branches, facilitating their passage through the face. (A) Signup and view all the answers

How does the buccal fat pad differ from other facial fat in terms of its behavior with age?

It remains relatively consistent in size and shape with age. (D) Signup and view all the answers

What is the functional component of the trigeminal nerve that provides motor innervation to the muscles of mastication?

Special Visceral Efferent (SVE) (B) Signup and view all the answers

Which of the following statements accurately describes the trigeminal ganglion?

It contains the cell bodies of sensory neurons and synapses are absent within the ganglion. (B) Signup and view all the answers

Compared to the trigeminal ganglion, what distinguishes the paravertebral ganglia of the sympathetic trunk and parasympathetic ganglia of the cranial nerves?

Paravertebral ganglia contain motor neuron cell bodies, while the trigeminal ganglion contains sensory neuron cell bodies. (A) Signup and view all the answers

Which of the following is NOT a division of the trigeminal nerve?

Facial (VII) (B) Signup and view all the answers

Where does the trigeminal ganglion reside?

Meckel's cave in the middle cranial fossa (C) Signup and view all the answers

What opening does the Ophthalmic nerve (V1) use to enter the orbit?

Superior orbital fissure (D) Signup and view all the answers

The Danger Triangle is a region of the face associated with a significant risk of infection spreading to what structure?

Cavernous sinus (B) Signup and view all the answers

In contrast to sensory ganglia, like the trigeminal ganglion, what key feature characterizes motor ganglia like the paravertebral ganglia?

Synapses between neurons (B) Signup and view all the answers

What is the primary effect of sympathetic innervation on salivary production?

Decreased salivary production (A) Signup and view all the answers

Where do the preganglionic sympathetic neurons that innervate the salivary glands synapse?

Superior cervical ganglion (B) Signup and view all the answers

Which of the following statements accurately describes the pathway of postganglionic sympathetic axons to the salivary glands?

They travel with branches of the external carotid artery (ECA) to reach the glands (D) Signup and view all the answers

What is the role of the inferior salivatory nucleus in regulating salivary production?

It houses the cell bodies of preganglionic parasympathetic neurons that innervate the salivary glands (C) Signup and view all the answers

Which of the following components is NOT involved in the sympathetic innervation of the salivary glands?

Facial nerve (A) Signup and view all the answers

Which of the following structures is NOT innervated by the mental nerve?

Buccinator muscle (C) Signup and view all the answers

What is the specific location of the geniculate ganglion in relation to the facial canal?

At the bend where the facial canal turns anteriorly (C) Signup and view all the answers

Which of the following nerves emerges from the infratemporal fossa posterior to the middle meningeal artery?

Auriculotemporal nerve (C) Signup and view all the answers

Which of the following structures is NOT a branch of the mandibular nerve (V3)?

Nasopalatine nerve (D) Signup and view all the answers

Which of the following muscles is NOT innervated by the facial nerve (VII)?

Masseter (D) Signup and view all the answers

Which of the following foramina is used by the infraorbital nerve to exit the maxilla?

Infraorbital foramen (A) Signup and view all the answers

Which of the following nerves is responsible for innervating the skin of the medial cheek and upper lip?

Infraorbital nerve (D) Signup and view all the answers

What type of nerve fibers are responsible for the motor innervation of the muscles of facial expression?

Motor fibers (D) Signup and view all the answers

Study Notes

Superficial Face

The superficial face is comprised of facial features, muscles of facial expression, perfusion and drainage patterns, the parotid gland, and its innervation.
Skin landmarks include glabella, philtrum, nasolabial fold, mentolabial fold/sulcus, labial commissure, oral fissure, and nasal ala.
Buccal fat pads are prominent in newborns and help support suckling. They protect neurovasculature. Unlike other facial fat, it stays consistent in size and shape with age.
The superficial musculoaponeurotic system (SMAS) is a continuous network of collagen, elastic fibers, muscle fibers, and adipose tissue. Facial nerve branches become more superficial and lie within the SMAS.

Learning Objectives

List the muscles of facial expression and describe their actions.
- Understand the significance of the facial expression muscles and their function in controlling the orbit, nose, and mouth openings.
- Explain the function of the SMAS.
Detail the three divisions of the trigeminal nerve and describe the type of axons they contain, which foramina they are traveling through, and their relationships with other structures.
Define the trigeminal and geniculate ganglion.
Describe the pathway of the facial nerve, its exit from the skull, and the branches leading to the face.
Describe the external carotid artery branches and tributaries of the internal jugular vein system for the face.
Identify the parotid gland and its duct. Explain which structures travel through it and its autonomic innervation.

Muscles of Facial Expression

Lie within superficial fascia and originate from bone (or deep fascia) or other facial muscles. They are anchored to skin via the SMAS.
Exhibit emotion and control the openings of the facial skeleton (they act as sphincters around the eyes, mouth, and nares).
All are innervated by facial nerve branches.
Organized into 4 groups: epicranial, circumorbital/palpebral, nasal, buccolabial
Individual muscles in each group will be further studied and detailed for their specific actions.

Parotid Gland

The largest salivary gland.
Located anterior to the external ear, superficial to the masseter muscle and the ramus of the mandible. Extends between the zygomatic arch and angle of mandible.
Structures that pass through the gland include the facial nerve proper and its branches, auriculotemporal nerve, external carotid artery, superficial temporal vessels, transverse facial vessels, and maxillary vessels. Also, the retromandibular vein.
The parotid gland accounts from 2-6% of head and neck neoplasms. 80-90% of these are benign, but 70-80% of parotid neoplasms are benign masses that present as painless swelling. Treatment typically involves a parotidectomy (either total or partial).
Parotid capsule (parotid fascia): a tough, connective tissue layer that encloses the parotid gland consisting of deep (cervical fascia) and superficial (SMAS) layers of fascia.

Mumps

A viral infection that affects major salivary glands.
Initial symptoms are similar to the flu; a key symptom is swelling of the salivary glands
An inflamed parotid gland causes pre-auricular pain that is exacerbated during mealtime.
Prevention is possible via the MMR vaccine (about 86% effective).

Parotid Duct

Also known as Stenson's duct
Travels medially, over a muscle, and then pierces the muscle.
Opens into the oral cavity at the parotid papilla.

Facial Vasculature

Blood supply to the face and scalp predominantly comes from branches of the external carotid artery (8 branches):
- Superior thyroid a., Ascending pharyngeal a., Lingual a., Facial a., Occipital a., Posterior auricular a., Maxillary a., and Superficial temporal a.
Branches of the internal carotid artery (ICA) (supratrochlear & supraorbital) also play a minor role.
The branches of the ECA and ICA anastomose extensively, which needs to be considered by clinicians.
Venous drainage: Facial v. runs posterior to facial artery, continuing superiorly as angular v., which communicates with the ophthalmic veins and cavernous sinus; communicates with the deep facial vein, and pterygoid plexus → cavernous sinus = an unfortunate anastomosis). Retromandibular vein is formed by superficial temporal v and maxillary v, and travels within theparotid gland. It then travels to the internal or external jugular v.
Danger triangle: area of the face from the upper lip to the bridge of the nose where infection could spread to the cavernous sinus.

Innervation

Trigeminal nerve provides sensory innervation to the face. It gives rise to 3 divisions: ophthalmic (V1), maxillary (V2), and mandibular (V3).
Trigeminal does NOT contain parasympathetic fibers
The Facial nerve provides motor innervation to the muscles of facial expression and arises from the pons, with its geniculate ganglion.
The glossopharyngeal nerve provides motor and sensory innervation, including preganglionic parasympathetic fibers that synapse in the otic ganglion.

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Description

Test your knowledge on facial anatomy, particularly focusing on the parotid gland and its related structures. This quiz covers critical concepts such as the trigeminal nerve, facial expressions, and conditions affecting the parotid gland. Perfect for students in anatomy or medical fields.