Q&A 10: Parotid gland, Scalp, Face,

Lacrimal apparatus

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Q & A – 10 : Head and Neck

Topics:
 Parotid gland
 Scalp
 Face
 Lacrimal apparatus

*Why parotid swellings are painful ?*

Due to the unyielding nature of parotidomasseteric fascia (Formed by investing

layer of deep cervical fascia)

*Which structures enter the parotid gland through its posteromedial

surface ?*

Facial nerve in upper part

External carotid artery in lower part

*Structures present within parotid gland ?*

Superficial to deep:
Facial nerve
Retromandibular vein
External carotid artery

*What is Patey's Faciovenous plane ?*

Plane between superficial and deep lobe of parotid gland where nerves and
veins lie.
Plane helps the surgeons to remove parotid tumor without damaging the facial
nerve.

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*Length of Parotid duct / Stenson's duct ? how many bends in its course
? where does it open in the mouth ?*

 Length - 5 cm

 3 bends

 Opens in vestibule of the mouth

opposite the upper second
molar tooth

*Parasympathetic fibres of parotid gland arise from which nucleus, which

part of brainstem ?*

Inferior salivatory nucleus in *Pons, just above the pontomedullary junction.

(Gray’s 41st ed.)

*Note: Inferior salivatory nucleus is in Medulla oblongata as per Vishram Singh

Gross Anatomy 3rd ed.

*What is Hiltons method to drain parotid abscess ?*

Horizontal incision given in parotid capsule to avoid injury to the branches of

facial nerve

*5 layers of Scalp?*

S – Skin

C - Connective tissue

A - Aponeurosis (Galea aponeurotica)/Aponeurosis of Occipitofrontalis muscle

L - Loose areolar tissue

P - Pericranium

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*Applied Anatomy of each layer of scalp ?*

*Skin* - Sebaceous cyst

*Connective tissue* - blood vessels, nerves are present - bleeding is stopped

by pressure on the vessel

*Aponeurosis* - Black eye

*Loose areolar tissue*- Intracranial spread of infection, safety valve

hematoma

*Pericranium* - Cephal hematoma

*Which layer is called as dangerous layer of Scalp ?*

Loose areolar tissue layer - Pus collected in this layer can travel from emissary
veins to the intracranial dural venous sinuses.

*Difference between Cephal hematoma and Caput succedaneum ?*

Cephal hematoma Caput succedaneum

Subperiosteal bleed Subcutaneous edema

Haematoma is bound by suture lines Crosses suture lines

Commonly seen in parietal region Commonly seen in occipital region

It is Pathological, requires It is Physiological, resolves on its

intervention. own

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*Muscles of face develop from which pharyngeal arch ? Nerve of the
arch?*

 2nd pharyngeal arch

 Facial nerve

*What is Panniculus Carnosus ?*

Morphologically represents subcutaneous muscles of lower animals.

Facial muscles are included in it.

*Other examples of Panniculus Carnosus in the body?*

 Dartos muscle
 Palmaris brevis
 Corrugator cutis ani

*Sensory Nerve supplying tip of Nose ? Angle of Mandible ?*

 Tip of nose - Ophthalmic nerve

 Angle of Mandible - Great auricular nerve

*Constrictor muscle of*

 Eye - Orbicularis oculi

 Nose - Compressor naris

 Mouth - Orbicularis oris.

Each opening has 1 constrictor and variable number of dilators

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*Branches of facial artery in face ?*

 Inferior labial
 Superior labial
 Lateral nasal
 Muscular branches

Note: facial artery was previously called as external maxillary artery.

Has 2 parts - Cervical and Facial.

Branches from cervical part of facial artery are

 Ascending palatine artery
 Tonsillar artery
 Submental artery
 Branches to submandibular salivary gland

Terminal part of facial artery is called as angular artery

*Components of Lacrimal apparatus ?*

 Lacrimal gland
 Lacrimal ducts
 Conjunctival sac
 Lacrimal puncta
 Lacrimal canaliculus
 Lacrimal sac
 Nasolacrimal duct

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*Nasolacrimal duct opens in which part of lateral wall of nose? Guarded
by which valve?*

Inferior meatus,
Guarded by Hasner's valve

*Parasympathetic fibres of lacrimal gland arise from which nucleus ?

Which part of brainstem ?*

Lacrimatory nucleus (part of superior salivatory nucleus)

From Pons

*What are Glands of Krause & Wolfring ?*

Accessory lacrimal glands located beneath palpebral conjunctiva.

35 to 40 in upper eyelid
6-8 in lower eyelid

-x---x---x-

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