Anatomy Tables - Parotid Gland & Face

Osteology

Bone Structure Description
frontal superior orbital margin (N2, TG7-03, TG7-57) contains supraorbital notch or foramen
superciliary arches (TG7-03) above orbtial margins
supraorbital notch (foramen occasionally) (N2, TG7-03, TG7-57) in superior orbital margin, for supraorbital neurovascular bundle
maxilla frontal process (N4, TG7-03) forms part of medial orbital wall & margin
zygomatic process (N4, TG7-03) articulates with zygomatic bone
infraorbital foramen (N2, TG7-03, TG7-57) anterior opening of infraorbital canal, for infraorbital neurovascular bundle
alveolar process (N2, TG7-03) forms sockets for upper teeth
zygomatic temporal process (N4, TG7-04A) articulates with zygomatic process of temporal bone to form the zygomatic arch (Greek, zygoma = a yoke, this bone yokes or joins several bones together)
frontal process (N4, TG7-04A) forms most of lateral orbital margin and anteroinferior part of lateral orbital wall; articulates with frontal bone anteriorly and greater wing of sphenoid bone posteriorly
maxillary process (N4, TG7-04A) forms lateral part of inferior orbital margin and anterolateral part of orbital floor; articulates with maxilla
mandible body (N15,N2, TG7-32B) U-shaped, halves fused at symphysis menti
symphysis menti (TG7-32C) midline symphysis between the two halves of mandible; fuses during first year (Greek, symphysis = a growing together)
mental protuberance (N15,N2, TG7-32B) forms bone of chin anteriorly
mental foramen (N15,N2, TG7-32B) on anterior surface of body, inferior to premolar teeth; transmits mental neurovascular bundle
ramus (N15,N2, TG7-32B) rises nearly vertically from posterior end of body (Latin, ramus = a branch)
angle (N15,TG7-32B, TG7-32C) posteroinferior bend formed by union of body & ramus
temporal petrous part (TG7-06, TG7-07) contains tympanic cavity & bony labyrinth
zygomatic process (N4, TG7-04A) articulates with temporal process of zygomatic bone to form the zygomatic arch
mastoid process (N4, TG7-04A) projects inferiorly from junction of petrous & squamous parts; contains mastoid air cells that open into tympanic cavity through mastoid antrum
styloid process (N4, TG7-04A, TG7-06) projects inferiorly from petrous part; attachment for stylohyoid, styloglossus & stylopharyngeus muscles & stylomandibular & stylohyoid ligaments (Greek, styloid = resembles a pillar or post)
stylomastoid foramen (N8, TG7-06) located between the styloid and mastoid processes; exit of the facial nerve from the base of the skull
external acoustic meatus (N4, TG7-04A) opening which allows sound to reach tympanic membrane (Latin, meatus = a passage)

Muscles

MuscleOriginInsertionActionInnervationNotesImage
depressor anguli oris (N26, N54, TG7-29, TG7-30A) oblique line of mandibleangle of mouthpulls the corner of the mouth downwardmarginal mandibular & buccal branches of facial nerve (VII)a "frown" muscle
levator labii superioris (N26, N54, TG7-29, TG7-30A) inferior margin of orbitskin of upper lipelevates upper lipbuccal branch of facial nerve (VII)(Latin, levator = to lift)
zygomaticus major (N26, N54, TG7-29, TG7-30A) zygomatic bone, upper lateral surfaceskin of angle of mouthelevates and draws the corner of mouth laterallyzygomatic and buccal branches of facial nerve (VII)a "smile" muscle
orbicularis oris (N26, N54, TG7-29, TG7-30A) skin and fascia of lips and area surrounding lipsskin and fascia of lipspurses the lipsbuccal branch of facial nerve (VII)(Latin, orbicularis = a small disk)
buccinator (N26, N54, TG7-29) pterygomandibular raphe, mandible, and maxilla lateral to molar teethangle of mouth & lateral portion of upper and lower lipspulls corner of mouth laterally; pulls cheek against teethbuccal branches of facial nerve (VII)although buccinator is important in mastication, it is innervated by the facial nerve, and NOT by the buccal nerve from V3 (a sensory nerve) (Latin, buccinator = trumpeter)
platysma (N26, TG7-29, TG7-30A) fascia overlying the pectoralis major and deltoid musclesinferior border of mandible and skin of lower facedraws corners of mouth down; aids in depression of the mandiblefacial nerve (VII), cervical branch(Greek, platysma = a flat plate)

Nerves

NerveSourceBranchesMotorSensoryNotes
facial (N25, TG7-31A, TG7-87C)

 

pons & medulla: nucleus solitarius of medulla via nervus intermedius (SVA sensory root) from geniculate ganglion; superior salivatory nucleus (GVE preganglionic parasympathetic) of pons via nervus intermedius, facial motor nucleus of pons via motor rootgreater petrosal (preganglionic parasympathetic to pterygopalatine ganglion, postganglionic parasympathetic travels with brs. of maxillary div. of V), chorda tympani (SVA taste from anterior 2/3rds of tongue; preganglionic parasympathetic to submandibular ganglion, postganglionic parasympathetic to submandibular & sublingual glands), n. to stapedius, posterior auricular, intraparotid plexus with temporal, zygomatic, buccal, marginal mandibular & cervical brs.stapedius, stylohyoid, posterior belly of digastric, muscles of facial expression; secretomotor to lacrimal, submandibular, sublingual, and mucous glands of nasal & oral cavitiestaste (SVA) from anterior 2/3rds of tongue; part of skin of external auditory meatusalso known as: CN VII, 7th cranial nerve; passes into internal acoustic meatus, goes through facial canal, exits at stylomastoid foramen
supraorbital (N24, N36, N45,N122, TG7-29, TG7-82) frontalmedial & lateral brs. skin of forehead, frontal sinus
supratrochlear (N24, N36, N45,N122, TG7-29, TG7-82) frontalskin of forehead medially & upper eyelid medially & associated conjunctiva (Latin, trochlea = a pulley)
infratrochlear (N24, N36, N45,N122, TG7-82) nasociliary br. of V1skin & conjunctiva of eyelids medially, skin of nose laterally (Latin, trochlea = a pulley)
infraorbital (N24,N36, N45,N122, TG7-29, TG7-83) maxillary division of trigeminal (V2)middle & anterior superior alveolarmaxillary sinus, upper premolar, canine & incisor teeth & gingiva, skin of lateral nose & face below orbitpasses through infraorbital groove, canal & foramen
mental (N24,N46,N122, TG7-29, TG7-84) inferior alveolarskin of chin & lower lippasses through mental foramen
auriculotemporal (N24,N46,N122, TG7-29, TG7-30, TG7-84) mandibular division of trigeminal n. (V3)parotid brs., articular brs., anterior auricular brs.secretomotor to parotid gland: postganglionic parasympathetic from communicating br. of otic ganglion; preganglionic parasympathetic from lesser petrosal br. of glossopharyngeal n. (IX)skin of anterior ear & anterosuperior to ear; part of external auditory meatus; temporomandibular jointtwo roots of auriculotemporal encircle the middle meningeal a.
buccal nerve (N24, N122, TG7-29) mandibular division of trigeminal n. (V3)skin of cheek, oral mucosanot a motor nerve
buccal branches of facial n. (N25, TG7-31A, TG7-87C) facial n. (VII); has temporofacial & cervicofacial divisionszygomaticus major & minor, buccinator, orbicularis oris, levator anguli oris, levator labii superioris & alaeque nasi, risorius, procerus, nasalisnot a sensory nerve

Arteries

ArterySourceBranchesSupplyNotes
facial (N69,N23, TG7-71) external carotidascending palatine a., tonsilar br., submental a., sup. & inf. labial as., lat. nasal br., angular a. lower part of palatine tonsil, submandibular gland, facial muscles & fasciaits angular branch anastomoses with the ophthalmic a.
labial, inferior (N69, TG7-71) faciallower lip - skin, muscles & mucosa
labial, superior (N69, TG7-71) facialseptal br.lower nasal septum; upper lip - skin, muscles & mucosa
nasal, lateral (N69,N23, TG7-71) faciallateral noseanastomoses with dorsal nasal
angular (N69,N23, TG7-71) facialorbicularis oculi and lacrimal sacterminal branch of the facial a.
facial, transverse (N69, N23, TG7-71) superficial temporal a.parotid gland; masseter m.; skin of the faceanastomoses with branches of the buccal, infraorbital and facial arteries
supraorbital (N69,N23, TG7-71) ophthalmicmuscles, skin & fascia of forehead
infraorbital (N69,N23, TG7-71) maxillaryanterior & middle superior alveolarmaxillary sinus, incisors, canine, premolars, skin of cheek below orbit, mucosa over maxilla and adjacent cheeka terminal branch of the maxillary a.
supratrochlear (N69, N23, TG7-71) ophthalmicmuscles, skin & fascia of forehead medially
carotid, external (N69,N23, TG7-19, TG7-71) common carotidsuperior thyroid, ascending pharyngeal, lingual, facial, occipital, post. auricular, maxillary & superficial temporal (terminal brs.)upper neck, face & scalpprimary blood supply to face & superficial head
superior thyroid (N69, TG7-19, TG7-71) external carotid infrahyoid br., sternocleidomastoid br., sup. laryngeal, cricothyroid br., ant., post. & lat. glandular brs. thyroid gland, upper larynx, infrahyoid muscles, sternocleidomastoid
ascending pharyngeal (N69, TG7-71) external carotid pharyngeal brs., inf. tympanic, post. meningeal pharynx arises from the medial side of the external carotid a. close to the birfurcation
lingual (N69, TG7-71) external carotid suprahyoid br., dorsal lingual brs., deep lingual, sublingual tongue, suprahyoid muscles, palatine tonsil (Latin, lingula = tongue)
occipital (N69, N23, TG7-71) external carotid sternocleidomastoid brs., auricular br., mastoid br., descending br., occipital brs. lateral & post. neck, post. scalp anastomoses with deep cervical; joins greater occipital nerve posteriorly

Veins

VeinTributariesDrains IntoRegion Drained Notes
angular (N23,N70, TG7-73) union of supraorbital & supratrochlearcontinues as facial vein at inferior margin of the orbitforehead, nose, upper eyelid valveless; connects with superior & inferior ophthalmic vv.
retromandibular (N70, TG7-11, TG7-73) formed by the union of the superficial temporal & maxillary vv.anterior & posterior divisions of retromandibular; anterior division unites with facial to form common facial, posterior division unites with posterior auricular to form external jugularside of head & scalp; deep face contained within the parotid gland
posterior auricular (N70, TG7-11, TG7-73) unites with post. div. of retromandibular to form external jugularbehind ear connects with occipital v. behind ear (Latin, auris = ear)
common facial (N70, TG7-11, TG7-73) union of ant. div. of retromandibular & facialinternal jugular face & anterior scalp
anterior jugular (N27,N70, TG7-11, TG7-73) submental, communicatingexternal jugularanterior neck superficially (Latin, jugulum = throat)
external jugular (N27,N70, TG7-11, TG7-73) formed by the union of the retromandibular & posterior auricular vv.; tributaries: posterior external jugular, transverse cervical, suprascapular, anterior jugularsubclavian v.head & neck, shoulder (Latin, jugulum = throat)
internal jugular (N27,N70, TG7-11, TG7-73) formed by the union of the sigmoid & inferior petrosal sinuses; tributaries: pharyngeal vv.; lingual, common facial, sternocleidomastoid, superior & middle thyroid vv.brachiocephalic v.brain & skull, face, viscera of necklargest vein of the nead and neck (Latin, jugulum = throat)

Lymphatics

StructureLocationAfferents fromEfferents toRegions drainedNotes
cervical nodes, deep (TG7-74)in and around carotid sheathlymphatic vessels from head & neckjugular trunkhead & necksuperior and inferior subdivisions are delineated by the crossing of the omohyoid m.
cervical nodes, superficial (TG7-74)in superficial fascia and along superficial vessels of the head & necklymphatic vessels from superficial structures in head & neckvaries by group; ultimate destination is the jugular trunkhead & neckseveral groups are designated by location: occipital, retroauricular, anterior auricular, superficial parotid, facial, submental, submandibular, external jugular, anterior jugular

Viscera/Fascia

OrganLocation/DescriptionNotes
parotid gland (N25, N61, N54, TG7-30A, TG7-30B, TG7-31A) largest salivary gland; located lateral & posterior to mandibuilar ramus; innervated by postganglionic parasympathetic fibers from the oticic ganglion via the auriculotemporal n. (Greek, parotid = the gland beside the ear)
parotid duct (N25, N61, N54, TG7-30A, TG7-30B, TG7-31A) drains parotid gland across masseter through cheek to oral cavity near upper 2nd molar tooth (Greek, parotid = the gland beside the ear)

Clinical Terms

Term Definition
Bell's palsy a condition that involves the facial nerve (VII cranial nerve) and results in the paralysis of one side of the face. Bell's (facial nerve palsy) can be differentiated from a central (stroke) deficit by the inability to raise the eyebrow on the affected side.
trigeminal neuralgia/tic douloureux a disorder of trigeminal nerve (cranial nerve V) dysfunction. Synonym: tic douloureux. Characterized by excruciating paroxysms of pain in the lips, gums, cheek or chin, and, very rarely, in the distribution of the eye (ophthalmic division of the trigeminal nerve).
Frey's syndrome a condition in which the parasympathetic nerves (branches in the auriculotemporal) which normally supply the parotid gland innervate the sweat glands in the area, leading to sweating over the parotid when eating
parotid calculus a stone in the parotid duct (Latin, calculus = a pebble)
sialogram an X-ray study of the salivary ducts. A contrast material is injected into the salivary duct (within the mouth) to highlight the course and caliber of the ducts. This test is used to detect a stricture or blockage (for example stones, tumor) of the salivary ducts.
sialolithiasis formation of a stone in a duct of a salivary gland
mumps an infectious acute viral disease affecting the parotid glands. The gonads, meninges and pancreas can also be affected. The causative agent is a paramyxovirus. Humans are the only natural host for this disease. Common symptoms include weakness, fever, sore throat, malaise and puffiness to the cheeks (due to parotid gland swelling). Patients are contagious 1 day prior to the onset of swelling until the swelling is gone. Recovery is generally in 2 weeks.

The material presented in these tables is contained in the book:
MedCharts Anatomy by Thomas R. Gest & Jaye Schlesinger
Published by ILOC, Inc., New York
Copyright © 1995, unauthorized use prohibited.
The excellent editorial assistance of
Dr. Pat Tank, UAMS
is gratefully acknowledged.