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20130409Parotid/Temp
Anatomy 20130409 Parotid/Temporal Regions
| Question | Answer |
|---|---|
| Where are preganglionic parasympathetic neuron cell bodies located? | In the inferior salivatory nucleus in the medulla associated w/ CN IX. |
| Through what foramen do preganglionic fibers leave the skull and what nerve, if any, do they pass through this foramen with? | They leave the skull through the jugular foramen with CN IX and then pass through tympanic nerve. |
| Which nerve enters the middle ear through the tympanic canaliculus in petrous part of temporal bone? | The tympanic nerve. |
| What and where does the tympanic nerve merge? | Merges w/ the tympanic plexus on promontory of medial wall of middle ear. |
| How do preganglionic parasympathetic fibers leave the tympanic plexus? | Via lesser petrosal nerve which passes through hiatus for lesser petrosal nerve in petrous part of temporal bone into middle cranial fossa. |
| What is the fissure b/n the petrous part of temporal bone and greater wing of sphenoid in which the lesser petrosal nerve leaves the cranial cavity? | The foramen ovale. |
| T/F Preganglionic axons synapse on postganglionic neurons in the otic ganglion? | True. |
| T/F The otic ganglion is lateral to the mandibular nerve (V3)? | False-it is medial to the mandibular nerve. |
| How are postganglionic parasympathetic axons distributed to the parotid gland? | Via the auriculotemporal nerve. |
| T/F Most parotid tumors in adults are cancerous? | False-most are benign, but removal of a gland can damage neurovascular structures associated w/ the gland. |
| Frey's syndrome-redness and sweating anterior to the ear associated w/ eating-can occur due to damage to what? | Damage and inappropriate regeneration of postganglionic parasympathetic axons into sympathetic pathways to blood vessels and sweat glands in the area. |
| What type of joint is the TMJ and where is it? | Double synovial located b/n mandible and cranium. |
| The TMJ is a synovial joint. What does this mean it can do? | It is both a hinge and gliding joint that allows for complex movements. |
| The chondylar head of the mandible articulates with what? | The mandibular (glenoid) fossa and articular tubercle of the temporal bone. |
| The articulating surfaces involved around the TMJ are covered with what? | Fibrocartilage. |
| What are the structures concerning the TMJ? Hint, there are 4. | Articular disc, capsule, synovial membrane, intrinsic ligament. |
| What completely divides the TMJ into two joints? | The articular disc. |
| What are the attachments of the articular disc? | Around its edge, to fibrous joint capsule. Anteriorly, the tendon from the pterygoid muscle attaches. |
| What action does the pterygoid muscle have on the articular disc? | It pulls the disc forward during mouth opening. |
| This structure attaches along the periphery of the mandibular fossa and articular tubercle of the temporal bone, and below to neck of condyle of mandible? | The capsule which is thin and loose to accommodate movement of the TMJ. |
| What lines the joint capsule above and below the articular disc? | Synovial membranes. |
| What helps prevent posterior displacement of the head of the mandible? | The lateral ligament which attaches to inferior surface of zygomatic arch and courses obliquely downward to attach to lateral and posterior surface of neck of mandible. |
| The lateral ligament helps to strengthen the joint capsule anterolaterally. T/F | True |
| What two extracapsular ligaments connect the mandible to the cranium? Are these directly connected to the TMJ? | Stylomandibular and sphenomandibular ligaments; No. |
| This ligament is a thickening of the parotid fascia (component of the investing layer of deep cervical fascia) that attaches the styloid process to the angle of the mandible? | Stylomandibular ligament. |
| This ligament limits the inferior movement of the mandible and attaches superiorly to spine of sphenoid bone? | Sphenomandibular ligament. |
| Inferiorly, the sphenomandibular ligament attaches where? | To the lingula on medial aspect of ramus of mandible. |
| Maxillary vessels and inferior alveolar vessels and nerves pass b/n the mandible and what? | The sphenomandibular ligament. |
| Parotid duct leaves 1 edge of gland inferior to 2 - courses 3, 4 to masseter, and dives deeply, 5 to buccal fat pad to pierce the 6. | 1. anterior 2. zygomatic arch 3. anteriorly 4. superficial 5. anterior 6. buccinator muscle |
| Where does the duct orifice lie? | Opposite 2nd upper molar in the oral cavity. |
| Accessory glandular tissue may lie 7 to 8. | 7. superior 8. parotid duct |
| What is superficial extent of parotid gland? | Zygomatic arch superiorly; external acoustic meatus, mastoid process, and anterior part of upper SCM posteriorly; angle of mandible inferiorly. |
| The ramus of the mandible as it is flanked by the masseter and medial pterygoid muscle make-up what border of the parotid bed? | Anterior. |
| Posteriorly, the parotid gland is associated w/ 1 and 2 and 3. Medially- 4 and the three muscles that attach to this process. Superiorly- 5 and 6. | 1. mastoid process 2. SCM 3. Post. belly of digastric muscle 4. Styloid process 5. TMJ 6. External acoustic meatus |
| Deeply, the parotid gland is related to 1,2,3,4,5,6. | 1. internal jugular vein 2. internal carotid 3. CN IX 4. CN X 5. CN XI 6. CN XII |
| What structures lie superficial to deep structures lying w/in parotid gland? | Facial nn., external carotid artery, and retromandibular vein |
| W/in parotid gland, the facial nn. divides into its 1 and 2 divisions which then branch into 3,4,5. | 1. Temporofacial 2. Cervicofacial 3. five 4. main 5. branches |
| Important surgically, the facial nn. divides the parotid gland into ____ and ____ _____. | superficial and deep lobes |
| What two veins unite w/in parotid to form retromandibular vein? | Superficial temporal and maxillary veins |
| What are the branches of external carotid artery that arise w/in parotid gland? | Posterior auricular artery, superficial temporal artery and its branches, and maxillary arteries |
| What nn. passes deeply through superior part of gland? | Auriculotemporal nn. ; CN V3 |
| The auriculotemporal nn. carries what kind of fibers from parotid gland and where does it carry them? | Sensory back to trigeminal ganglion (remember, auriculotemporal is a branch of V3 which is a branch of the trigeminal nn. |
| Where is the trigeminal ganglion located? | W/in Meckel's cave--> formed by two layers of dura mater which are a part of an evagination of the tentorium cerebelli near the apex of the petrous part of the temporal bone...it envelopes the trigeminal ganglion. |
| What nn. does sensation from superficial tissue travel with? | Great auricular nn. a branch of the cervical plexus (C2,3). |
| Where are the preganglionic sympathetic neuron cell bodies located? | Lateral horn of T1-T2 spinal cord segments. |
| Preganglionic sympathetic neurons of lateral horn T1-T2 spinal cord segments, send axons out ______, through _____ and ascend the _____ to synapse on _____ in the ______. | ventral roots, white rami communicantes, sympathetic trunk, postganglionic sympathetic neurons, superior cervical ganglion |
| ____ leave the superior cervical ganglion and follow the external carotid artery and its branches, as the _____ to reach the _____. | Postganglionic sympathetic fibers, external carotid plexus, parotid gland |
| Postganglionic sympathetic fibers can also leave the sympathetic plexus on the _____ artery and pass through the _____ ganglion and accompany the _____ to the parotid gland. | Middle meningeal, otic, auriculotemporal nn. |
| Postganglionic sympathetic fibers are mainly vasomotor. T/F | True |
| What does parasympathetic stimulation of the parotid salivary gland increase? | Saliva secretion |
| When the mouth is opened widely, the mandibular condyle and articular disc move backwards, underneath the articular tubercle. T/F | False-the mandibular condyle and articular disc move forward when the mouth is opened widely. The TMJ is limited posteriorly and can't easily move backwards |
| What type of movement occurs at the joint b/n the articular disc and condylar head? | Hinge movement |
| What type of movement occurs b/n the articular disc and temporal bone surfaces? | Gliding movement |
| Which of the following muscles DO NOT act on the TMJ: Muscles of mastication; suprahyhoid; infrahyoid; platysma? | Trick question...they ALL act on the TMJ |
| How does sensory innervation from the TMJ pass? | Via auriculotemporal and masseteric branches of CN V3 |
| Where would pain from a diseased TMJ be felt? | Ear, temporal region, and cheek |
| What arteries supply the TMJ? | Superficial temporal and maxillary arteries supply branches to the joint |
| Temporomandibular joint disorder (TMD) can have a muscular or an articular component. T/F | True |
| What is the most functionally severe condition of TMJ? | TMJ anterior dislocation-jaw is locked in open position |
| What keeps posterior dislocation of the TMJ uncommon? | The postglenoid tubercle of the temporal bone and the lateral ligament of the TMJ |
| Temporalis muscle arise from periosteum of temporal fossa and this dense fascia that covers the muscle? | Temporal fascia |
| Temporalis forma a tendon which runs deep to _____ and attaches to _____ of mandible and the anterior edge of ramus below coronoid process. | Zygomatic arch; coronoid process |
| This muscle is a powerful elevator of the mandible, closing the jaw. | Temporalis |
| Its posterior fibers are strong retractors of the mandible. | Temporalis |
| Deep temporal arteries are branches of what artery and where? | maxillary artery in the infratemporal fossa helping to supply temporalis muscle |
| Lying just above the zygomatic arch and helping to supply the temporalis muscle, this branch of the superficial temporal artery is? | the middle temporal artery |
| The temporalis muscle is innervated by V2 branch of the maxillary nn. T/F | False...it is innervated, as are all muscles of mastication, by the mandibular branch of the trigeminal nn. |
| What are the specific nerves to temporalis that arise in the infratemporal fossa from the mandibular nn. and they each approach temporalis from its deep aspect? | The anterior and posterior deep temporal branches. |
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