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Semester 2

Trace the path of the parotid duct 1.) Comes out from anterior edge of parotid gland inferior to zygomatic arch. 2.) Courses anterior &superficial to masseter 3.) Dives deep to buccinator fat pad & into buccinator muscle 4.) Opens opposite to 2nd molar into oral cavity
What is the parotid fascia an extension of? What does it split into? Deep cervical fascia. A superficial & deep layer.
Where does the partoid fascia attach? Superficial layer attaches to zygomatic arch with extensions going into the gland. Both layers fuse with the muscle fascia around it.
How far does the parotid gland extend superficially? Up to zygomatic arch superiorly. From external acoustic meatus to mastoid process & anterior upper SCM posteriorly. Down to the angle of the mandible inferiorly.
What are the borders of the parotid bed? Anterior: ramus of mandible Posterior: mastoid process w/SCM & posterior digastric Medial: styloid process & the 3 muscles attached there Superior: temporomandicular joint & ext acoustic meatus Deep: internal jugular vein & internal carotid & CN9-12
What structures lie within the parotid gland from superficial to deep? CN7 (facial), retromandibular vein & ext carotid artery with a few of their branches/tributaries.
What does the facial nerve divide into within the parotid gland? temporofacial & cervicofacial divisions that divide into the 5 main branches.
What tributaries of the retromandibular vein are contained in the parotid gland? Superficial Temporal & Maxillary
What branches of the exteral carotid artery come off in the parotid gland? Posterior auricular, superficial temporal w/transverse facial coming off it & maxillary.
We know facial nerve is within the parotid gland, but what other nerve goes thru it & where in the gland? Auriculotemporal nerve (off V3 of trigeminal). It goes thru superior part of parotid gland.
How is the parotid gland divided into a superficial and deep lobe? The facial nerve divides the gland into superficial & deep lobes.
How does the parotid gland get its blood? Where does it go when it's done with it? From the branches off the external carotid. The blood then drains into the large veins, like the superficial temporal & maxillary into the retromandibular.
How does the parotid gland get its sensory innervation? What about the superficial tissue associated with it? Trigeminal V3 branch: auriculotemporal Fibers go from gland back to trigem ganglion. Superficial tissues get sensation from Great Auricular (C2,3).
What is the path of sympathetic supply to the parotid gland? pregang sympathy cell bodies in lateral horn of T1-T2 > ventral roots > white rami > sympathy chain > postgang neurons in superior cervical ganglion > external carotid plexus > parotid gland....OR
It can go from sympath plexus onto MMA and go thru otic ganglion with auriculotemporal nerve to get to parotid.
What is the path of parasympathetic supply to the parotid gland? pregang parasympath cell bodies in inferior salivatory nucleus in medulla > CN9 > out jugular foramen > tympanic nerve > tympanic plexus in middle ear > leaves as lesser petrosal > synapse in otic ganglion > auriculotemporal nerve to parotid gland
What does the condylar head of the mandible articulate with? The mandibular/glenoid fossa & articular tubercle of temporal bone. Or the cranium if you wanna go big pic general.
What type of joint is the TMJ? What are the articulating surfaces covered with? A DOUBLE synovial joint. Doubles as both a hinge AND gliding joint. The articulating surfaces are covered in fibrocartilage.
What are the TMJ joint structures? articular disc, capsule, synovial membrane & lateral ligament
What does the articular disc of TMJ do? What does it attach to? Divides TMJ into 2 joint cavities. Attaches to fibrous joint capsule around its edges & the TENDON of lateral pterygoid muscle anteriorly.
What is important about the capsule of the TMJ? Where does it attach? It's thin & loose so joint can move around. It attaches along mandibular foss & articular tubercle & down to neck of condyle.
Where are the synovial membranes of the TMS? One lines joint capsule above articular disc & another lines the one below.
What does the lateral ligament of the TMJ do? Strengthens joint capsule anterolaterally which helps prevent posterior displacement of head of mandible.
Where does the lateral ligament attach? Attaches to inferior surface of zygomatic arch & goes down obliquely to attach to lateral & posterior NECK of mandible.
What are the extracapsular ligaments of the TMJ? What makes them extracapsular? stylomandibular ligament & sphenomandibular ligament. they are outside the TMJ & connect mandible to cranium.
What is the stylomandibular ligament & what does it attach? Is thickening of parotid fascia. Attaches styloid process to angle of mandible.
What does the sphenomandibular ligament do? Where does it attach? Limits inferior movement of mandible. Attaches superiorly to spine of sphenoid & down to lingual on medial aspect of mandibular ramus.
What passes between the sphenomandibular ligament and the mandible? The maxillary vessels & inferior alveolar vessels & nerves.
What movements are permitted at the TMJ? Depression, elevation, protrusion, retraction & lateral movement.
Why does the jaw move forward when you open it really widely? Where does hinge movement occur? Where does gliding movement occur? Mandibular condyle & articular disc move forward b/c posteriorly, space is limited. Hinge is btwn condylar head & articular disc. Gliding is btwn articular disc & temporal bone.
What muscles act on the TMJ? Muscles of mastication, suprahyoid, infrahyoid & platysma.
What innervates the TMJ? So how does pain spread from TMJ? Auriculotemporal & masseteric branches of V3. It goes to ears, temporal region & cheeks.
What is the blood supply to the TMJ? Branches off maxillary and superficial temporal arteries.
What is the anterior boundary of the temporal fossa? Posterior surface of frontal process of zygomatic & zygomatic process of frontal bone.
What is the superior and posterior boundary of the temporal fossa? Superior & inferior temporal lines.
What is the lateral boundary of the temporal fossa? Temporal fascia.
What is the inferior boundary of the temporal fossa? Supramastoid crest of temporal bone. Infratemporal crest of greater wing of sphenoid. Zygomatic arch.
What is the floor of the temporal fossa? What will you find the fossa? The greater wing of the sphenoid, frontal, temporal, and parietal bones. The pterion will be sitting in there.
Where does the temporalis muscle attach? It attaches to periosteum of the temporal fossa and the temporal fascia, then runs down deep to zygomatic arch to attach to coronoid process & anterior ridge of mandibular ramus.
Where is the temporalis muscle located? In the temporal fossa.
What does the temporalis muscle do? Powerfully elevates jaw. And posterior fibers are powerful retractors.
What is e blood supply to the temporalis muscle? Deep temporal arteries, branches off maxillary artery (in infratemporal fossa) & middle temporal artery off superficial temporal juuuust above zygo arch.
What is the temporalis muscle innervated by? V3 in general. Anterior and posterior deep temporal arteries to be specific.
What is parotidectomy? What is a possible risk? Surgical removal of the parotid gland, usually b/c of a tumor. Can wind up damaging postgan parasympath fibers that regenerate in the wrong place, into sympath pathways, causing Frey's syndrome.
What is TMD? Temporomandibular joint disorder. Can be mainly either muscular or articular. Usually lateral pterygoid has increased tension on it. Or can be a dislocation of articular disc, it can be so bad that jaw can get stuck in open position (anterior dislocation)
Why is posterior dislocation of TMJ so uncommon? Postglenoid tubercle of temporal bone is in the way & lateral ligament of TMJ just doesn't go that way.
Created by: h.pang00
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