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49 Cards in this Set
- Front
- Back
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What space lies anterior to the parotid space?
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Masticator space
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What creates the parotid space?
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Splitting of the superficial layer of deep cervical fascia
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What space lies anterior and medial to the parotid space?
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PPS - parapharyngeal space
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What spaces lies posterior and medial to the parotid space?
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Carotid space
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What lies posterior to the Parotid space?
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Temporal bone
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What lies laterally to the Parotid space?
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Subcutaneous fat
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What are the 4 major CONTENTS of the Parotid space?
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-Parotid gland
-Facial nerve -Blood vessels -Intraparotid lymph nodes |
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What divides the Parotid gland into superficial vs deep lobes?
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The Retromandibular vein
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What structure lies adjacent to the Retromandibular vein?
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The facial nerve - that's a landmark for identifying it since its not really visible on cross-section
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What is a common sign that a Parotid mass involves BOTH superficial and deep lobes?
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Widened distance between the Mandible and Styloid Process
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At what aspect of the Parotid space does the parotid duct, stenson's duct, exit?
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Anterior
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What does the Parotid duct pass through to get to the oral cavity?
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-Masticator space (over masseter)
-Pierces Buccinator |
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Where does the Parotid duct enter the oral cavity?
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At the level of the 2nd maxillary molar
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What suggests a more LIMITED differential diagnosis when lesions are present in the parotid space?
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Multiple lesions
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When does the facial nerve begin to develop?
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1st month gestation
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What does the facial nerve develop from?
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The acousticofacial primordium - gives rise to both CN 7 and 8
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Which structure of the FN develops first?
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Geniculate ganglion
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What 2 trunks of the FN arise from the geniculate ganglion?
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Caudal - Main trunk of FN
Rostral - Chorda tympani |
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Where does the motor division of the FN establish its position?
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In the MIDDLE EAR between the
-Membranous labryinth (otic placode) -Stapes (2nd branchial arch derivative) |
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With what nerve does Chorda tympani become associated?
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Trigeminal - Lingual nerve
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What nerve carries preganglionc parasympathetic fibers of CN 7 to the pterygopalatine ganglion?
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Greater superficial petrosal nerve
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What is the name of the canal within the temporal bone thru which the facial nerve passes?
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Fallopian canal
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When are the 5 subdivisions of the extratemporal FN developed? What are they?
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By week 6 - Temporal, Zygomatic, Buccal, Mandibular, Cervical
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What happens to the facial nerve during the 3rd month of development?
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The parotid bud enlarges and EATS it!
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What does the facial nerve trunk consist of?
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10,000 nerve fibers, 7000 of which are myelinated motor fibers
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What are the 3 layers of the Facial nerve sheath?
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-Endoneurium
-Perineurium -Epineurium |
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What does the Endoneurium enclose?
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Individual nerve FIBERS
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What does the Perineurium enclose?
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Nerve FASCICLES
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What is the function of the perineurium?
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-Provides TENSILE STRENGTH
-Primary barrier to INFECTION spread |
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What important structures lie within the EPINEURIUM?
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Vasa nervorum - the blood supply
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What is the most widely used model of clinical-pathologic classification of facial nerve injury?
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Sunderland Classification
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What element principally determines whether damaged axons have potential for appropriate regeneration across a site of injury?
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Status of CONNECTIVE TISSUE elements
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What are the categories of nerve injury in Sunderland's Classification?
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1st-6th degree injuries
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What is a First-degree injury aka?
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Neuropraxia
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What is a First-degree injury?
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Blocked AXOPLASM FLOW within the nerve axon
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What type of function remains in a nerve that has undergone first-degree injury?
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No AP propagation ACROSS the lesion, but if applied DISTAL to it, the axon can propagate the potential to evoke a response
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What is a 2nd-degree injury?
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Progression of first-degree injury to involve both AXON and MYELIN disruption DISTAL to the lesion site
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What is the functional result of a 2nd-degree nerve injury?
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No longer able to propagate a potential down the axon, regardless of the origin of impulse
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What does a 3rd-degree injury refer to?
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COMPLETE disruption of the axon - both myelin and endoneurium
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What is a 4th-degree injury?
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Complete disruption of the PERINEURIUM
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What is a 5th-degree injury?
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Disruption of the EPINEURIUM
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What is seen in 6th-degree nerve injuries?
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NORMAL function of SOME fascicles
VARYING degrees of injury - 1st thru 5th degree - in different fascicles |
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What are 6th-degree injuries caused by?
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Blunt and penetrating injuries
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What degree of injuries are more likely to recover peripheral innervation? Why?
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1st and 2nd degree - because the CT elements remain intact - endoneurial tubules
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What are 2 reasons that recovery of normal peripheral innervation is less likely with endoneurial injury?
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-More likely to cause aberrant reinnervation
-More likely to be irreversible |
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And in what degrees of neuron injury is the endoneurium involved?
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3rd degree and beyond
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What is the prime example of aberrent neuron regrowth in the facial nerve?
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Crocodile tears - tearing up when eating
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What causes Crocodile tears?
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Facial nerve regeneration sending fibers with the greater superficial petrosal n to the lacrimal gland instead of with chorda tympani to the salivary glands
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Look at facial nerve testing
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ok
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