anatomy of parotid gland with applied

2. DR PRATIK MISTRY

3. Parotid bed (mould)

4. PAROTID GLAND

5. Introduction
 Largest
 Meaning of “parotid”
 Para=around, otic=ear
 Inverted pyramid shape
 25 gms

6. Coverings
 True capsule
 False capsule
(parotid sheath)

7. Presenting parts of the
gland
 Apex
 Base (upper surface)
 3 surfaces- superficial (lateral),
anteromedial, anterolateral
 3 borders- anterior, posterior and medial
 Parotid duct

8. Apex
 Directed below
 Overlap post belly of
digastric and appear
in carotid triangle
 Structures are:
1. Cervical br of facial n.
2. ant. division of
retro-mandibular vein
3. Formation of external
jugular vein

9. Base
 Concave
 Related meatus and
t.m. joint
 Structures are:
1. Temporal br of facial n.
2. Superficial temporal
vessels
3. Auriculo-temporal n.

10. Superficial (lateral) surface
 Covered by skin, superficial fascia,
platysma, superficial lamella of parotid
sheath
 Fascia contain parotid L.N and branches
of great auricular nerves

11. Antero-medial surface
 Grooved for ramus
and related with:
 Masseter muscle
 Mandibular ramus
and capsule of
T.M. joint
 Medial pterygoid
muscle

12. Postero-medial surface
 Related with:
 Mastoid process and
sternocleidomastoid
and post. belly of
digastric
 Styloid process and
muscles
 ICA and IJV
 Last four cranial
nerves
 Facial nerve

13. Anterior border
 Thin, rest on masseter
 Separate superficial and
antero-medial surfaces
 Structures are:
1. Zygomatic n.
2. Transverse facial vessel
3. Upper buccal n.
4. Parotid duct
5. Lower buccal n.
6. Marginal mandibular n.

14. Posterior border
 Rests on SCM
 Structures are:
1. Post. auricular br of
facial n.
2. Post. auricular
vessels

15. Medial border (pharyngeal border)
 Contact with pharynx

16. Processes of the gland
 Facial
 Accessory gland
 Pterygoid
 Glenoid
 Pre & post styloid

17. Structures passing
 Facial nerve and its branches
 Retro-mandibular vein
 External carotid artery
 Parotid LN

18. Pes anserinus Patey’s fasciovenous
plane

20. Parotid duct (stenson’s
duct)
 5 cm and 3mm
 Union of 2 vertical ducts
 Course of duct
(forward, medially, obliquely forward)

21. Blood supply Lymphatic drainage
 Branches of ECA
 Veins into the external
jugular vein
 Parotid LN
 Jugulodigastric LN

22. Nerve supply
 SYMPATHETIC
 Plexus around ECA
from superior
cervical ganglion
 Vasomotor in
function
 Produce mucous
rich secretion
 PARASYMPATHETIC
 Provide secretomotor
fibres to the gland
 Produce watery
secretion
 Very important

23. Secretomotor fibres of the
gland

24. Clinical Anatomy
 Painful swelling
 Mumps
 Parotid abscess (Hilton’s method of
drainage)
 Mixed parotid tumour
 Parotidectomy
 Frey’s syndrome
 Parotid calculus and sialography

25. Parotitis

26. Mumps

27. Hilton’s method

28. Mixed parotid tumour

29. Sialography

30. Frey’s syndrome

31. FACIAL NERVE

32. Introduction
 7th cranial nerve
 Mixed nerve with motor and sensory
root
 Arise from pons of brain stem
 Have motor, secretomotor components
 Carry taste sensations from ant 2/3 of
tongue
 Carry sensory fibres from auricle

33. Facial N.

34. Origin
 Motor nucleus
 Superior salivatory nucleus
 Inferior salivatory nucleus
 Spinal nucleus of trigeminal nerve

35. Course and relation
 Intracranial-intrapetrous
 Extracranial course

37. Extracranial part

38. Branches of distribution
 In the Facial canal
 N. To stapedius
 Chorda tympani
 Below stylomastoid
foramen
 Post. Auricular
 N. To post. Belly of
diagastric
 N. To stylohyoid
 In face
 Temporal
 Zygomatic
 Buccal
 Marginal mandibular
 Cervical

39. Clinical anatomy
 Supranuclear paralysis
 Nuclear paralysis
 Infranuclear paralysis

41. Infranuclear facial palsy (bell’s palsy)
 Wrinkles of forehead absent on
affected side
 Drooping of eyebrow
 Wide palpebral fissure.
 Unable to close the eyes, dry eye,
ectropion,
 Corneal reflex absent. Corneal
ulcer
 Nasolabial fold absent
 During smiling, angle of the
mouth motionless. Triangular
outline
 Food accumulate in the vestibule
of mouth on affected side
 Dribbling of saliva between lips on
affected side

43. Crocodile tear syndrome

44. Posterior triangle of neck

45. THANK YOU