Advanced Submandibular Gland Quiz

Q1. Why are calculi particularly common in the submandibular duct?

• Its saliva is produced only at night
• Its duct has no epithelial lining
• Its duct opens into the middle ear
• Its long ascending course and relatively viscous, mineral-rich saliva favor stasis

Q2. Why does submandibular duct obstruction often cause pain and swelling during meals?

• The tongue pulls the gland into the mandibular canal
• Stimulated secretion raises pressure behind the obstruction
• Swallowing closes the facial artery
• Mastication compresses the internal carotid artery

Q3. Why is the lingual nerve particularly vulnerable during surgery or stone removal from the submandibular duct?

• The nerve forms the duct wall
• The nerve passes only through the parotid gland
• The nerve loops beneath the duct from lateral to medial
• The nerve runs inside the duct lumen

Q4. What deficit may result from injury to the hypoglossal nerve during deep submandibular dissection?

• Paralysis of the soft palate only
• Loss of hearing in one ear
• Loss of facial expression on the opposite side
• Ipsilateral tongue weakness with deviation toward the injured side on protrusion

Q5. Why can injury to the marginal mandibular branch during gland excision alter the smile?

• It provides taste to the posterior tongue
• It supplies all intrinsic tongue muscles
• It is the secretomotor nerve to the gland
• It supplies muscles controlling lower lip movement

Q6. Why can a lesion of chorda tympani proximal to its junction with the lingual nerve reduce submandibular secretion?

• It is the gland's principal sympathetic pathway
• It carries postganglionic fibers from the otic ganglion
• It carries preganglionic secretomotor fibers destined for the submandibular ganglion
• It supplies the gland through the glossopharyngeal nerve

Q7. Why can a lesion of the submandibular ganglion affect both submandibular and sublingual salivation?

• Both glands use the otic ganglion
• The ganglion is located inside the parotid gland
• Both glands use the submandibular ganglion as a parasympathetic relay
• Both glands are supplied only by the vagus nerve

Q8. Why is the facial artery important during surgical removal of the submandibular gland?

• It is enclosed within the lingual nerve
• It runs within the submandibular duct
• It is closely related to the gland and may groove or traverse its posterior part
• It lies entirely inside the mandibular canal

Q9. How does the mylohyoid relationship explain the gland's superficial and deep components?

• Mylohyoid divides the gland into right and left halves
• The gland wraps around the posterior free border of mylohyoid
• The gland passes through the center of mylohyoid in all individuals
• The gland lies entirely superior to mylohyoid

Q10. Which statement best integrates the anatomy of the submandibular gland?

• It lies entirely above mylohyoid and drains opposite the maxillary second molar
• It is a purely mucous gland supplied secretomotor fibers by the hypoglossal nerve
• It lies in the parotid bed and receives glossopharyngeal fibers through the otic ganglion
• It wraps around mylohyoid, drains at the sublingual caruncle, and receives facial parasympathetic fibers through the submandibular ganglion