Anatomy - Week 12 PP

Question 1

Blood Supply to the Head and Neck

Answer 1

• It is important to be able to locate the larger blood
  vessels of the head and neck
• These vessels may become compromised by disease or during such dental procedures as administering local anesthetic injections

Question 2

Major Arteries of the
Face and Oral Cavity

Answer 2

-Common carotoid artery
-Internal carotoid artery
-External carotid artery

Question 3

Common carotid artery

Answer 3

-arises from the aorta and subdivides into the internal and external carotid arteries

Question 4

Internal carotid artery

Answer 4

• supplies blood to the brain and eyes

Question 5

External carotid artery

Answer 5

-provides the major blood supply to the face and mouth

Question 6

External Carotid Artery branches into..

Answer 6

Facial artery - 6 braches supply: pharyngeal muscles, soft palate, tonsils, posterior tongue, submandibular gland, muscles of the face, nasal septum, nose and eyelids
◦ Lingual artery -Several branches supply: tongue, floor of the mouth, lingual gingiva a portion of the soft palate and tonsils
◦ Maxillary artery – Divides into the inferior alveolar, ptergyoid and pterygopalatine
◦ Mandibular artery

Question 7

Muscles of facial expression blood supply

Answer 7

Branches and small arteries from maxillary, facial,
and ophthalmic arteries

Question 8

Maxillary bones blood supply

Answer 8

anterior, middle, and posterior alveolar arteries

Question 9

Maxillary teeth blood supply

Answer 9

anterior, middle, and posterior alveolar arteries

Question 10

Mandible blood supply

Answer 10

inferior alveolar arteries

Question 11

mandibular teeth blood supply

Answer 11

inferior alveolar artieries

Question 12

tongue blood supply

Answer 12

lingual artery

Question 13

muscles of mastication blood supply

Answer 13

facial arteries

Question 14

Major Veins of the
Face and the Oral Cavity

Answer 14

• Maxillary vein
• Retromandibular vein
• External jugular vein
• Subclavian vein
• Facial vein
• Common facial vein
• Deep facial vein
• Lingual veins
• Internal jugular vein

Question 15

Nerves of the Head & Neck

Answer 15

• Understanding the nerves of the head and neck is
  important for the use of local anesthesia during dental treatment
• The nerves are related to certain conditions of the face, such as facial paralysis

Question 16

Nervous System is composed of…

Answer 16

Central nervous system:
-brain
-spinal cord

Peripheral nervous sustem
*Autonomic nervous system - automatically done
-Sympathetic - fight & flight
-Parasympathetic - rest & digest responses
*Somatic nervous system - under your control

Question 17

Cranial Nerves

Answer 17

There are 12 pairs of cranial nerves, all connected to the brain

• These functions serve both sensory and motor functions
• The cranial nerves are generally named for the area or function they serve and are also identified with the use of Roman Numerals

Question 18

Olfactory Nerve

Answer 18

Sense of Smell

Question 19

Optic Nerve

Answer 19

Sense of sight

Question 20

Oculomotor

Answer 20

movement of eye muscles

Question 21

Trochlear nerve

Answer 21

movement of eye muscles

Question 22

Trigeminal Nerve

Answer 22

Movement of muscles of mastication an other cranial muscles

General sensations for face, head, skin, teeth and oral cavity & tongue

Question 23

Cranial Nerve V

Answer 23

• Is the primary source of innervation for the oral cavity
• Subdivides into 3 main divisions:
  1. Ophthalmic division (V1)
  2. Maxillary division (V2)
  3. Mandibular division (V3)

Question 24

Maxillary Division (V2)

Answer 24

-Supplies the maxillary teeth, periosteum, mucous membrane, maxillary sinuses, and soft palate

• Subdivides into the:
  ◦ Nasopalatine nerve
  ◦ Greater palatine nerve
  ◦ Anterior superior alveolar nerve ◦ Middle superior alveolar nerve ◦ Posterior superior alveolar nerve

Question 25

Nasopalatine Nerve

Answer 25

* Passes through the incisive foramen * Supplies the mucoperiosteum palatal to the maxillary anterior teeth

Question 26

Anterior/Greater Palatine Nerve

Answer 26

* Passes through the posterior palatine foramen and forward over the palate * Supplies the mucoperiosteum, intermingling with the nasopalatine nerve

Question 27

Anterior Superior Alveolar Nerve (ASA)

Answer 27

* Supplies the maxillary central, lateral, and cuspid teeth, along with their periodontal membranes and gingivae * Also supplies the maxillary sinus

Question 28

Middle Superior Alveolar Nerve (MSA)

Answer 28

* Supplies the maxillary first and second premolars, the mesiobuccal root of the maxillary first molar, and the maxillary sinus

Question 29

Posterior Superior Alveolar Nerve (PSA)

Answer 29

* Supplies the other roots of the maxillary first molar and the maxillary second and third molars * Also branches forward to serve the lateral wall of the maxillary sinus

Question 30

Mandibular Division of the Trigeminal Nerve - 3 main subdivisions

Answer 30

- The buccal nerve - The lingual nerve -The inferior alveolar nerve

Question 31

The buccal nerve

Answer 31

- supplies branches to the buccal mucous membrane and mucoperiosteum of the mandibular molar teeth

Question 32

The lingual nerve

Answer 32

- supplies the anterior two thirds of the tongue and gives off branches to supply the lingual mucous membrane and mucoperiosteum

Question 33

the inferior alveolar nerve

Answer 33

-further subdivides into the mylohyiod nerve, mental nerve, incisive nerve, and small dental nerves that supply the molar and premolar teeth, alveolar processes and periosteum

Question 34

Inferior Alveolar Nerve (IAN)

Answer 34

1. Mylohyoid nerve ◦ supplies the mylohyoid muscles and the anterior belly of the digastric muscle. 2. Small dental nerves ◦ supply the molar and premolar teeth, alveolar process, and periosteum. 3. Mental nerve ◦ moves outward and anteriorly through the mental foramen and supplies the chin and mucous membrane of the lower lip. 4. Incisive nerve ◦ continues anteriorly within the bone and gives off small branches to supply the incisor teeth

Question 35

Cranial Nerve VII - Facial Nerve

Answer 35

Mixed Nerve -Sensory portion concerned with taste; motor portion controls facial expression and secretion of tears and saliva - Damage causes sagging facial muscles and a distored sense of taste

Question 36

Injection Techniques

Answer 36

The location and innervation of the tooth or teeth to be anesthetized will determine where topical anesthetic is placed, and the type of injection given ◦ Maxillary anesthesia ◦ Palatal anesthesia ◦ Mandibular anesthesia

Question 37

Maxillary Anesthesia

Answer 37

* Local anesthesia injection techniques differ from mandibular approaches because of the porous nature of alveolar cancellous bone in the maxilla. * Allows the anesthetic solution to diffuse through the bone and reach the apices of the teeth in a different manner than the mandible

Question 38

Injection Techniques - Maxilla

Answer 38

* Local infiltration is completed by injecting into a small, isolated area * Field block refers to the injection of anesthetic near a larger terminal nerve branch * Nerve block occurs when local anesthetic is deposited close to a main nerve trunk

Question 39

Posterior Superior Alveolar Nerve Block anestheizes..

Answer 39

◦ Maxillary 2nd and 3rd Molars and the distobuccal and lingual root of the 1st molar and surrounding buccal gingiva

Question 40

Middle Superior Alveolar Nerve block anesthesizes....

Answer 40

◦ Maxillary 1st and 2nd premolars and the mesiobuccal root of the 1st molar and surrounding buccal gingiva

Question 41

Anterior Superior Alveolar Nerve Block anesthesizes...

Answer 41

Maxillary central, lateral and cuspid teeth and the surrounding buccal gingiva

Question 42

Palatal Anesthesia

Answer 42

* Local anesthesia in the palatal area may be necessary for procedures that involve the soft tissues of the palate

Question 43

Greater Palatine Nerve

Answer 43

 Passes through the posterior palatine foramen  Innervates the mucosa of the hard palate (except lingual to the maxillary incisors)

Question 44

Nasopalatine Nerve

Answer 44

 Passes through the incisive foramen  Innervates the gingiva palatal to the maxillary anterior teeth

Question 45

Mandibular Anesthesia

Answer 45

* Because of the dense, compact nature of the mandibular bone, anesthetic solution does not diffuse easily through it * Block anesthesia is frequently required for most mandibular teeth * Solution is injected near a major nerve, and the entire area served by that nerve branch is numbed ◦ Inferior alveolar nerve block (mandibular nerve block) ◦ Buccal nerve block ◦ Incisive nerve block

Question 46

Mandibular Innervation - Buccal Nerve

Answer 46

* Buccal Nerve ◦ Supplies branches to the buccal mucous membrane of the mandibular molars

Question 47

Mandibular Innervation - Lingual Nerve

Answer 47

* Lingual Nerve ◦ Supplies the anterior 2/3rds of the tongue and the lingual mucous membrane

Question 48

Mandibular Innervation - Inferior Alveolar

Answer 48

* Inferior Alveolar (subdivides) ◦ Small dental nerves supply the molar and premolar teeth ◦ Mental nerve - exits through the mental foramen and supplies the chin and mucous membrane of the lower lip ◦ Incisive/mental nerve – continues anteriorly within the bone and branches supply the incisor teeth

Question 49

Periodontal Ligament Injection

Answer 49

* Injection of the anesthetic solution under pressure directly into the periodontal ligament and surrounding tissues * Periodontal ligament injection is generally an adjunct (addition) to conventional techniques

Question 50

Other Injection Techniques

Answer 50

* Intra-osseus * Gow-Gates Mandibular Block - higher up on nerve branch, main branch of trigemal (not performed often) * Vazirani-Akinosi Mandibular Block