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BDS2 BAMS > BDS2 Anatomy (Trigeminal Nerve, etc) > Flashcards

BDS2 Anatomy (Trigeminal Nerve, etc) Flashcards

1
Q

what are the 2 divisions of the trigeminal nerve?

A

sensory

motor

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2
Q

why is the sensory route of the trigeminal nerve important

A

aiming for with LA

supples the skin of face; nasal and sinus mucosa and teeth

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3
Q

what does the motor route of the trigeminal nerve supply

A

muscles of mastication and 4 other muscles

aware of so know side effects

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4
Q

trigeminal nerve is CN

A

V

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5
Q

special feature of trigeminal nerve

A

largest CN nerve

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6
Q

3 divisions of trigeminal nerve

A

Ophthalmic V1

Maxillary V2

Mandibular V3

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7
Q

what branches of the CNV are targeted in local anaesthesia

A

CNV2 and 3 (maxillary and mandibular)

CNV1 ophthalmic can show symptoms

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8
Q

what is a foramen

A

hole

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9
Q

what is a notch

A

semi-circular opening

ligament disintegrates - get notch form

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10
Q

where does CNV1 exit

A

supra orbital notch/formamen

above the human orbit

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11
Q

where does CNV2 exit

A

infraorbital foramen

below orbit

2nd branch of CNV2

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12
Q

where does CNV3 exit

A

metal foramen

below the mandibular teeth

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13
Q

what is the frontal process of hard palate called

A

palatine process of maxilla

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14
Q

what is the dorsal section of hard palate called

A

horizontal plate of palatine bone (not maxilla)

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15
Q

what are the 3 openings on the hard palate

A

from front to back

  • incisive foramen
  • greater palatine foramen
  • lesser palatine foramen
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16
Q

what are the functional purposes of the osteology of the mandible

A

condylar process, ramus, angle, body

  • Site of muscle attachments
  • Foramina for passage of neurovascular structures
  • Lower teeth in alveolar process
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17
Q

condylar process

A

part of mandible (dorsal head)

part of TMJ - feel on opening and closing

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18
Q

coronoid process

A

part of mandible (anterior head)

site of attachment of temporalis

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19
Q

mandibular foramen

A

where the inferior alveolar nerve passes on the ramus of mandible

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20
Q

lingula

A

on the internal mesial side of the ramus of mandible

- can feel not easy to see

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21
Q

where does the CNV exit through on the base of the skull

A

through the mid-level of human brainstem pons

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22
Q

what are the 2 components of the CNV

A

special visceral efferent

general somatic afferent

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23
Q

special visceral efferent functions of the CNV

A

Motor from motor nucleus in the pons

Predominantly to muscles of mastication

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24
Q

general somatic afferent functions of CNV

A

To the mesencephalic (midbrain), chief (pons) and spinal nuclei (medulla)

Sensory is vital for clinical practice

  • More complex – 3 brainstem nuclei
  • Different sensory information processed at different parts of the brain

Fibres come together and exit brainstem at pons level

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25
Q

where is the motor nucleus of CNV

A

level of pons

predominately to muscles of mastication

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26
Q

what are the 3 sensory nuclei for the CNV

A

mesencephalic (midbrain)

chief sensory

spinal nucleus

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27
Q

what is the purpose of the mesencephalic sensory nucleus of CNV

A

proprioception

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28
Q

what is the purpose of the chief sensory nucleus of CNV

A

discriminating touch

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29
Q

what is the purpose of the spinal nucleus of the CNV

A

pain and temperature for structures supples by CNV as well as general conscious sensation for the viscera supplies by CN IX and X

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30
Q

where do the 3 sensory nuclei of CNV exit

A

come together and exit midway through the pons

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31
Q

exit point for CNV1

A

supraorbital notch/foramen

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32
Q

exit point for CNV2

A

infraorbital foramen

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33
Q

exit point for CNV3

A

mental foramen

carries motor fibres for muscles of mastication

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34
Q

basic key role of CNV3

A

carries motor fibres for muscles of mastication

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35
Q

trigeminal ganglion

A

lies in a cave of dura mater (Meckel’s cave)

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36
Q

role of Meckel’s cave

A

Practical

Protective cave that holds the trigeminal ganglion

  • All the fibres of CNV are still together
  • Before divide into the 3 divisions
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37
Q

what happens to the CNV nerve roots after they emerge from the mid pons

A

they pass forward to the apex on the petrous temporal bone where the trigeminal ganglion lies in a cave of dura mater (Meckel’s cave)

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38
Q

how does the CNV1 reach the superior orbital fissure

A

pass anteriorly in the lateral wall of the cavernous sinus to reach the superior orbital fissure

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39
Q

how does CNV2 pass through the foramen rotundum

A

pass anteriorly in the lateral wall of the cavernous sinus to pass through the foramen rotundum

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40
Q

what does CNV3 pass through

A

passes through the foramen ovale

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41
Q

what important structures are the foramina (superior orbital fissure, rotundum and ovale) close to

A

neurovascular structures - cavernous sinus

- close proximity to the internal carotid artery and sympathetic plexus

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42
Q

where must the lesion be if all 3 divisions of the CNV are affected

A

If all 3 CNV divisions are affected the lesion must be in the pons (i.e. stroke) or at the cranial base (i.e. trauma or tumour)

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43
Q

what can occur in the cavernous sinus which has a negative effect on the CNV

A

clot can develop in the internal carotid artery

- compression on CNV (esp V1 and V2 - maxillary and mandibular symptoms)

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44
Q

what else is seen if the CNV is affected in the cavernous sinus

A

usually evidence of effect on other nerves too

CNIII and CNIV sometimes CNVI. Eye issues

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45
Q

course of ophthalmic division

A

Will pass inside the human orbit
- Lateral to cavernous sinus, pass anteriorly to reach the superior orbital fissure

Once inside the orbit divide into different branches

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46
Q

branches of ophthalmic division

A

predominatly sensory
- never going to block sensory nerve

sensory to scalp, eyes, upper facial sinuses
- carries parasympathetic via cillary ganglion to eye for accommodation and pupal constriction (10 short ciliary nerves), via pterygopalatine ganglion for lacrimal gland

sympathetics via cavernous sinus to pupil for dilation (2 long cilary nerves)

main braches

  • frontal
  • lacrimal
  • nasocillary

2 separate nerves provide sensation and innervation to different parts of head
- frontal nerve

  • lacrimal nerve
  • nasocilary nerve (complex)
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47
Q

3 main branches of opthalmaic division

A

main braches

  • frontal
  • lacrimal
  • nasocillary
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48
Q

divisions of frontal division of CNV1

A

dividing into supraobiral and supratrochlear to skin of vertex and upper eyelid

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49
Q

divisions of lacrimal division of CNV1

A

to lacrimal gland and skin of lateral upper eyelid and forehead (crying and sensation to lateral side of eyelid)

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50
Q

division and course of nasocillary division for CNV1

A

gives off long ciliary nerve(s), anterior and posterior to ethmoidal nerves before continuing as the infratrochlear nerve to skin of medial upper eyelid and root of nose

anterior ethmoidal nerve divides into external nasal nerve to top of nose sensation

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51
Q

sensory distribution of CNV1

A

the supratrochlear, supraorbirtal and lacrimal nerves supply the vertex, forehead and upper eyelids

the anterior ethmoidal nerve continues as the external nasal nerve to the skin at the tip of the nose

the infratrochlear nerve supplies the skin at the medial angle of the eye and adjacent root of nose

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52
Q

the infratrochlear nerve supplies

A

supplies the skin at the medial angle of the eye and adjacent root of nose

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53
Q

course of the anterior ethmoidal nerve

A

continues as the external nasal nerve to the skin at the tip of the nose

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54
Q

what do the supratrochlear, supraorbirtal and lacrimal nerves supply?

A

the vertex, forehead and upper eyelids

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55
Q

what nerve supplies the tip of the nose

A

the external nasal branch of the anterior ethmoidal branch of the nasociliary branch of CNV1

nasocillary nerve also supplies sensation to the cornea of eye
- shingles at the tip of the nose may be a warning that the disease will also develop on the cornea

shingles can affect any of the 3 divisions of CNV

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56
Q

corneal reflex involves

A

nasocillary (sensory) and facial (motor)

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57
Q

trigger for conrneal reflex

A

Stimulate cornea with cotton wool

First part is mediated via nasocillary nerve (first limb)

Closing of eye (blink) via facial nerve CNVII

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58
Q

what do the ethmoidal nerves supply

A

Supply the ethmoidal sinuses, lateral wall of nasal cavity and nasal septum

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59
Q

course of CNV2

A

CNV2 passes anteriorly in the lateral wall of the cavernous sinus and reaches the pterygopalatine fossa via the foramen rotundum

Never actively block but be aware of

Provide substantial sensory function to maxilla and upper teeth and gingiva
- Remove the anterior and posterior fossa from cranial base and look at middle fossa

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60
Q

exit point for CNV2

A 
foramen rotundum (middle cranial fossa)
- CNV2 enters and goes to the pterygopalatine fossa
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61
Q

where does the pterygopalatine fossa lie

A

Lies just lateral to the upper aspect of the nasal cavity and nasopharynx behind the orbit and above the hard/soft palate

Hidden – can only ID on inner aspect (not if turn upside down)

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62
Q

what is the pterygomaxillary fissure

A

Opening leading to the pterygopalatine fossa and sphenopalatine foramen medial to this fossa

Below zygomatic bone and superior to hard palate

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63
Q

what is the sphenopalatine foramen

A

medial wall of the pterygopalatine fossa

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64
Q

what is the main role of the pterygopalatine fossa

A

houses a few things - including nerves of CNV

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65
Q

what does CNV2 supply

A

Sensory to middle face, hard & soft palate, sinuses, nasopharynx, nose

Carries parasympathetic via pterygopalatine ganglion to lacrimal gland, mucous gland of nose, palate and nasopharynx

Taste via hard and soft palate

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66
Q

parasympathetic role of CNV2

A

Carries parasympathetic via pterygopalatine ganglion to lacrimal gland, mucous gland of nose, palate and nasopharynx

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67
Q

sensory role of CNV2

A

Sensory to middle face, hard & soft palate, sinuses, nasopharynx, nose
- taste to hard and soft palate

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68
Q

2 main branches of CNV2

A

zygomatic
- splits into temporal and facial

infra-orbital

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69
Q

all the branches of CNV2 (6, 2 key)

A

zygomatic

infra-orbital

nasopalatine

greater and lesser palatine to palate

pharyngeal to nasopharynx

alveolar to upper teeth

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70
Q

course of nasal nerves

A

disappear through pterygoid fossa posteriorly sphenopalatine

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71
Q

course of palatine nerves

A

through palatine canal into greater and lesser branches

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72
Q

what does the infra-orbital branch of CNV2 supply

A

eye and upper lip

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73
Q

the 3 superior alveolar nerves

A

anterior superior alveolar nerve
middle superior alveolar nerve
posterior superior alveolar nerve

posterior superior comes from its on branch of CNV2

anterior and middle superior are from infra-orbital (a branch of CNV2)

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74
Q

what areas does CNV2 innervate

A

skin , nasal cavity, nasopharynx, maxillary sinus, hard and soft palate, upper teeth and gums

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75
Q

where does the infraorbital nerve exit

A

infraorbital foramen to supply the lower eyelid, cheek, nose and upper lip

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76
Q

what does the zygomatic branch of CNV2 supply

A

anterior temple (zygomaticotemporal)

zygoma (zygomaticofacial)

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77
Q

where is the sphenopalatine foramen

A

Opens inside the nasal cavity

- Lateral wall of Pterygoid fossa has this opening into the nasal cavity

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78
Q

what enters the sphenopalatine foramen

A

nasopalatine nerve

  • reaches the nasal cavity septum
  • goes inferiorly downwards into incisive foramen to reach anterior hard palate
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79
Q

what are the 3 alveolar branches

A

Anterior superior alveolar
Middle superior alveolar
Posterior superior alveolar

post - separate branch on its own
ant and middle - from infraorbital

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80
Q

what teeth do the 3 superior alveolar branches supply

A

maxillary teeth

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81
Q

what do the 3 superior alveolar branches enter

A

the pterygoid fossa

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82
Q

2 branches of palatine nerve

A

greater and lesser

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83
Q

what structure do the palatine nerves pass through

A

the palatine canal

  • lateral wall of the nasal cavity
  • roof of oral cavity
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84
Q

where do the 2 palatine nerves exit

A

through their corresponding foramen in the hard palate

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85
Q

where are the upper teeth and gum sensory supply processed

A

processed in brainstem

- gathered by different branches of maxillary CNV3

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86
Q

what are the 3 sensory detections of upper teeth and gums

A

General sensation
Proprioception
Discrimination

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87
Q

what nerve supplies upper anterior teeth (3 to 3)

A

anterior superior alveolar nerve

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88
Q

what nerve supplies upper premolars (14, 15, 24, 25)?

A

middle superior alveolar nerve

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89
Q

what nerve supplies the upper molars (16, 17, 18, 26, 27, 28)

A

posterior superior alveolar nerve

90
Q

what nerve supplies the palatine and labial gums of maxillary anterior teeth

A

nasopalatine nerve

91
Q

what nerve supplies the buccal and palatine gums from the maxillary premolars distally

A

greater palatine nerve

92
Q

what is an important role for the lesser palatine nerve

A

soft palate and uvula

93
Q

interesting anatomical feature for the nasopalatine, greater and lesser palatine nerves

A

they overlap

94
Q

What are the 3 dermatomes of the head?

A

Opthalmic
Maxillary
Mandibular

95
Q

The skin on the back of the head is supplies by which Nerves

A

Upper Cervical Spinal nerves C2 and C3

96
Q

The skin on the front of the head is supplies by which main nerve

A

Trigeminal Nerve CNV

97
Q

Which anatomical landmark distinguishes the anterior and posterior part of the head

A

angle of the mandible

98
Q

What areas of the skin are supplies by the ophthalmic dermatome

A

Front of eye, upper eyelid, forehead and front of scalp

99
Q

What areas of the skin are supplied by the maxillary dermatome

A

Upper lip, over zygoma, lower eye and front of cheek

100
Q

What areas of the skin are supplies by the mandibular dermatome

A

Chin, lower lip, mucosa inside lower lip, sideburn area, posterior cheek, buccal gingivae of posterior teeth

101
Q

What is the vertex

A

the highest point of the head

102
Q

What nerve supplies the upper eyelid, frontal sinus and from the forehead to the mid scalp

A

supraorbital nerve

103
Q

What does the external nasal nerve supply

A

Lower half of the nose and nasal septum

104
Q

Where does the zygomaticofacial nerve supply

A

Skin on the prominence of the cheek

105
Q

Where does the zygomaticotemporal nerve supply

A

Skin on the side of the forehead

106
Q

When does the maxillary nerve change its name to the infraorbital nerve

A

When it passes through eh infraorbital canal

107
Q

What nerve supplies the lower eyelid, upper lip and nasal vestibule

A

Infraorbital nerve

108
Q

What 3 nerves make up the mandibular dermatome of the face

A

Buccal, mental and auricotemporal

109
Q

What does the mental nerve supply

A

Front of the chin, lower lip, and buccal gingivae of the mandibular anterior teeth

110
Q

The mental nerve is a branch of which nerve and passes through which foramen

A

Inferior alveolar nerve

Mental foramen

111
Q

What area of the skin does the buccal nerve supply

A

cheek

112
Q

The auricotemporal nerve supplies where and runs with which artery and vein

A

Side of the head

Runs with the superficial temporal artery and vein

113
Q

What are the 5 branches of the facial nerve which pass through the parotid gland

A

Temporal

Zygomatic

Buccal

Mandibular

Cervical

114
Q

The maxillary branch of the trigeminal nerve CNV passes through what

A

foramen rotundum

115
Q

What nerve supplies the mucosa of the upper lip

A

infraorbital nerve

116
Q

What nerve supplies the skin of the cheek

A

buccal nerve

117
Q

What nerve supplies the mucosa of the posterior part of the cheek

A

buccal nerve

118
Q

What nerve supplies the posterior part of the gingiva on the buccal side

A

buccal nerve

119
Q

What nerve supplies the mucosa of the floor of the mouth

A

lingual nerve

120
Q

What nerve supplies the mucosa of the lower lip

A

mental nerve

121
Q

What nerve supplies the mucosa of the anterior tongue

A

lingual nerve

122
Q

What nerve supplies the mucosa of the upper soft palate

A

lesser palatine nerve

123
Q

What nerve supplies the posterior 2/3 of the hard palate

A

greater palatine nerve

124
Q

What nerve supplies the anterior 1/3 of the hard palate

A

nasopalatine nerve

125
Q

What division of the trigeminal nerve is the largest

A

mandibular

126
Q

what branch of the trigeminal nerve do dentists target

A

third branch

- ID blocks (lower teeth LA)

127
Q

why is targeting the Trigeminal nerve comple

A

several branches

128
Q

what are the components of the mandibualr division of trigeminal

A

sensory distribution
- focussed on oral cavity

motor components
- to muscles of mastication

unlike other 2 branches just pure sensory

129
Q

course of mandibular division course

A

passes through the foramen ovale and into the infratemporal fossa where it gives several branches

  • Comes out at pons level (see all CNV nerve roots)
  • Hides in Meckel’ cave
  • Trigeminal ganglion formed
    (Dura met excised can see trigeminal ganglion)
130
Q

where does 3rd division exit

A

through the foramen ovale

  • More lateral and inferior
  • Not in close proximity to cavernous sinus
  • Branch out from trigeminal ganglion
131
Q

what 2 openings cannot see when turn skull upside down/on base of external skull

A
  • superior orbital fissure

- foramen rotundum

132
Q

what is the only opening you can see on base of skull

A

foramen ovale

133
Q

what fossa is foramen ovale

A

middle cranial fossa

Third division exits into less protected structure than CNV1 and CNV2

  • CNV1 – superior orbital fissure
  • CNV2 – ptertygoid fossa

CNV3 into infratemporal fossa
- No bone
- 2 boundaries
Nerve and branches can be vulnerable to injuries

134
Q

how is the CNV3 more vulnerable than the CNV1 and 2?

A

infratemporal fossa

  • no bone
  • 2 boundaries

nerve and branches can be vulnerable to injuries

135
Q

what is the difference between infratemporal fossa

A

very different to Pterygopalatine fossa

- not bone bound/rigid box

136
Q

what forms the boundaries of the infratemporal fossa

A

not bone/rigid box

  • small bone congregations
  • muscles
137
Q

how to trace the infratemporal fossa

A

Take skull lateral

Transverse temporalis muscle on temporalis fossa

Below zygomatic arch

Find empty space (infratemporal fossa)

  • Masseter and mandible anterior
  • Posterior bone
138
Q

lateral boundary of infratemporal fossa boundary

A

ramus of manible

139
Q

medial boundary of infratemporal fossa

A

lateral pterygoid plate of sphenoid bone

140
Q

anterior boundary of infratemporal fossa

A

posterior aspect of maxilla

141
Q

posterior boundary of infratemporal fossa

A

tympanic plate

mastoid (most posterior) and styloid process

142
Q

superior boundary of infratemporal fossa

A

infratemporal crest of sphenoid bone

143
Q

inferior boundary of infratemporal fossa

A

angle of mandible

144
Q

why is the boundaries of infratemporal fossa not being connected/continuous significant

A

means can target CNV3 from different angles

145
Q

what does dislocation of the TMJ joint lead to potentially

A
  • branches of CNV3 can be affected as affect space (infraorbital fossa)

anterior dislocation most common

146
Q

2 components of the mandibular division of CNV3`

A

sensory and motor

147
Q

what is the sensory function of CNV3`

A

Predominately in temple, jaw and part of chin (lower face), anterior 2/3 of tongue

148
Q

what nerve supplies the skin over the angle of the mandible

A

Skin over angle of mandible is not supplies by CNV, but by the cervical plexus with the great auricular nerve (C2, 3)

149
Q

what is the motor components of CNV3

A

muscles of mastication, tensors tympani and palati

150
Q

what are the 6 branches of CNV3

A

auriculotemporal

buccal

mental

lingual

muscular (not encounter often)

inferior alveolar

151
Q

how does the CNV3 divide

A

into 3 main branches and then more smaller ones

152
Q

how to get direct surgical access of infratemporal fossa

A

to cut mandible

153
Q

what are the 3 main branches of CNV3

A

branches from main trunk

then anterior

then posterior

154
Q

what are the 4 branches of the main branch of CNV3

A

meningeal

branch to tensor tympani

branch to tensor veli palatini

nerve to medial pterygoid

155
Q

what is the role of the meningeal branch of CNV3 main trunk

A

goes to supply sensory of dura mater

156
Q

what is the role of the branch to tensor Tympani of CNV3 main trunk

A

in the middle ear they are 3 small bones help with conducting vibrations

2 muscles attach to little bones control vibration of ear bones speed – innervated by CNV3 main branch

157
Q

what are 3 consequences of severe fracture to side of mandible

A

Lack of ability to clench teeth

Sensitive to loud noises
- defect in branch to tensor tympani of CNV3 main trunk

Sensory loss in temple, jaw and chin

158
Q

what is the role of the branch to tensor veli palatini on CNV3 main trunk

A

small muscle on soft palate

- elevates soft palate

159
Q

what is the role of the nerve to medial pterygoid of CNV3 main trunk

A

muscle of mastication motor innervation

160
Q

are the branches of CNV3 main trunk sensory or motor or combination

A

all motor bar meningeal branch (sensory supply of dura mater)

161
Q

are the branches of anterior trunk of CNV3 sensory or motor or combination

A

all motor bar buccal nerve (sensory)

- to skeletal muscles

162
Q

4 branches of CNV3 anterior trunk

A

deep temporal nerves
- to temporalis MOM

Nerve to lateral pterygoid
- to lateral pterygoid MOM

buccal nerve
- sensory

masseteric nerve
- to masseter MOM

163
Q

what are the 3 nerves of the CNV3 posterior trunk

A

Auriculotemporal

Inferior alveolar
- Disappears inside the mandible

Lingual

164
Q

what is the position of the lingual nerve in relation to the inferior alveolar nerve

A

anterior to

165
Q

are the nerves of the posterior trunk of CNV3 sensory, motor or combination

A

auricolotemporal and lingual are sensory

inferior alveolar
- mixed motor and sensory

166
Q

when does the inferior alveolar nerve become putely sensory

A

when it enters the manidibular foramen of the jaw

mylohyoid branch of to support muscles of the oral cavity floor of mouth

167
Q

what is CNV3 facial distribution like

A

General sensation to the floor of the mouth along with the lower teeth and gums

General sensation to the anterior 2/3rd of the tongue (general somatic afferent)

  • Via the lingual nerve
  • —The lingual nerve carries the chorda tympani nerve (Branch of CNVII)
168
Q

where does CNV3 carry general sensation to

A

floor of mouth
lower teeth and gum
anterior 2/3 of tongue

169
Q

what is the key vital role of CNV3

A

large important motor components

  • easy target
  • vulnerable to injurt
170
Q

where does the auricotemporal branch of posterior trunk innervate

A

sensory innervation to the temple and anterior ear

- do not need to LA

171
Q

where does the buccal branch of the posterior trunk innervate

A

sensory innervation to the cheek

172
Q

where does the mental branch of the posterior trunk innervate

A

sensory innervation to the chin

173
Q

what is trigeminal neuralgia

A

excessive, extreme pain that is felt in one of the distributions of CNV

different medications to help with pain

let it settle before commencing treatment

174
Q

what branch of CNV is most commonly affected by trigeminal neuralgia

A

CNV3 most common

Occasionally CNV2

175
Q

what is the general sensory supply of oral cavity

A

Buccal nerve to cheek and lateral gum

Inferior alveolar nerve and its branch – incisive nerve – to lower teeth

Inferior alveolar nerve to skin of chin and lower lip (skin and mucous membranes) as the mental nerve

176
Q

what is the general sensory supply of the cheek and lateral gum

A

buccal nerve (CNV anterior, 3)

177
Q

what is the general sensory supply of the lower teeth

A

inferior alveolar nerve and its branch the incisive nerve (CNV3 posterior, 2)

178
Q

what is the general sensory supply to chin and skin and mucous of lower lip

A

inferior alveolar nerve as the mental nerve

CNV3, posterior 2

179
Q

where does the buccal nerve orginate

A

comes from the anterior trunk to the cheek and lacrimal glands

180
Q

course of inferior alveolar nerve

A

After enters the mandibular foramen, Nerve goes from inferior alveolar nerve to incisive nerve (innervates lower anterior teeth)
- On the medial aspect of mandible

Branch from mental foramen to supply general sensation to chin and mucous membranes is the mental nerve

The inferior alveolar nerve also supplies the mylohyoid and anterior belly of digastric before entering the mandibular foramen to supply general sensation to the lower teeth

181
Q

what is the role of the incisive nerve

A

sensory innervation of lower teeth on medial aspect of mandible
(inferior alveolar, CNV3, posterior 2)

182
Q

what is the role of the mental nerve

A

sensory innervation supply to chin, skin and mucous membranes
(inferior alveolar, CNV3, posterior 2)

183
Q

what is the sensory supply of lower teeth and gums

A

incisive nerve branch of inferior alveolar nerve (target)

184
Q

what is the sensory supply of the gingivae of the lingual side

A

lingual nerve (CNV3, posterior 3)

185
Q

what is the sensory supply of the gingival on the lateral/buccal side

A

buccal nerve (CNV3, anterior 2)

186
Q

what is the general sensory supply of the gingivae on the anterior section of gingivae

A

mental nerve

187
Q

upper teeth general sensory supply

A

from CNV2

infraorbital
- anterior superior alveolar nerve
- middle superior alveolar nerve
Posterior superior alveolar (own branch)

188
Q

lower teeth general sensory supply

A

from CNV3

inferior alveolar nerve and divisons

189
Q

what is the anterior 1/3 of tongue area referred to

A

oral part

190
Q

what supplies the general sensory supply of anterior part of the tongue

A

via mandibular division of trigeminal nerve CNV3

- branch on lingual (posterior trunk)

191
Q

what is the significance of the tongue have general sensory and special sensory supply

A

numb tongue but can still have taste

192
Q

what supplies the special sensory supply of the anterior 2/3 of tongue

A

taste via facial nerve CNVII

- the chorda tympani

193
Q

what is the branch of the facial nerve that supplies taste sensation to anterior 2/3 of tongue

A

the chorda tympani

- CNVII

194
Q

what is encompassed in general sensation of the mouth

A

pressure, temperature, pain etc

195
Q

what is special sensation of the tongue

A

taste

196
Q

what is the anatomical relation of the lingual nerve and inferior alveolar nerve

A

close to each other

block both

  • pt will present with numbness on tongue tip
  • need to warn not to bite
197
Q

what are the 4 muscles of mastication

A

temporalis

masseter

lateral pterygoid

medial pterygoid

198
Q

role of temporalis

A

elevator (close)

199
Q

role of masseter

A

elevator (close

200
Q

anatomical location of medial and lateral pterygoid

A

posterior to mandible in infra-temporal fossa

201
Q

role of lateral pterygoid

A

horizontal

depressor (open)
- only MOM that will, others are assisting muscles

202
Q

role of medial pterygoid

A

vertical

elevator (close)

203
Q

what is the key role of motor root of CNV3

A

supplies all muscles of mastication

204
Q

the motor root of CNV3 supplies

A

all muscles of mastication

tensor tympani muscle in middle ear

tensor palati (the latter via the branch to medial pterygoid)

mylohyoid and anterior belly of digastric (via inferior alveolar branch)

205
Q

jaw jerk reflex and CNV

A

Tap chin

Proprioception stimulate
- Position of chin changes

Goes to mesencephalic nucleus

Goes to CNV and closes the jaw

Mediated by afferent (sensory) and Efferent (motor)
- Same nerve CNV - Unlike corneal - CNV1 and CNVII

206
Q

where can you test sensory innervation of CNV1 (opthalmic)

A

temples

207
Q

where can you test sensory innervation of CNV2 (maxillary)

A

cheeks

208
Q

can you test sensory innervation of CNV3 (mandibular)

A

chin

209
Q

what is the sensory supply for the skin over the angle of the mandible

A

not supplied by CNV, but by the cervical plexus with the great auricular nerve (C2 and C3)

210
Q

what is shingles

A

Reactivation of varicella zoster virus in the trigeminal ganglion

Cutaneous involvement in the distribution of CN V1

Erythematous, vesicular, crusting rash & burning sensation
- PC painful blistery rash on nose

Hutchinson’s sign: cutaneous involvement of the tip of the nose (external nasal branch of nasociliary nerve)

  • Progress posterior to rest of CNV1
  • To involve eye

A positive Hutchinson’s sign increases the likelihood of ocular complications (nasociliary nerve)

211
Q

what is Hutchinson’s sign in shingles

A

cutaneous involvement of the tip of the nose (external nasal branch of nasociliary nerve)

  • Progress posterior to rest of CNV1
  • To involve eye
212
Q

what does a positive Hutchinson’s sign in shingles indicate

A

increased likelihood of ocular complicatoins
- Conjunctivitis, keratitis (cornea) & uveitis (anterior chamber of globe)
—-Same nerve that supplies sensation to tip of nose and eye
——Can lose eyesight if left untreated
Catch early can treat - improve quality

213
Q

eye complications due to shingles

A
  • Conjunctivitis, keratitis (cornea) & uveitis (anterior chamber of globe)
    —-Same nerve that supplies sensation to tip of nose and eye
    ——Can lose eyesight if left untreated
    Catch early can treat - improve quality
214
Q

2 methods of avoiding iatrogenic damage when administering dental anaesthesia

A

aspirate

not hit vein or artery

215
Q

potential vein that can be iatrogenically damaged in dental anaesthesia

A

pterygoid plexus

216
Q

potential arteries that can be iatrogenically damaged in dental anaesthesia

A

many - external carotid

217
Q

potential muscles that can be iatrogenically damaged in dental anaesthesia

A

if go deep then the medial pterygoid

  • trismus: ability to open mouth gone as muscles anaesthetised
  • — more common than CNVII palsy
218
Q

trismus

A

ability to open mouth gone as muscles anaesthetised

—- more common than CNVII palsy

219
Q

potential gland that can be iatrogenically damaged in dental anaesthesia

A

parotid gland

220
Q

consequence of damaging of parotid gland on LA injection

A

LA going into gland may hit CNVII

Ipsilateral (same side) half face paralysis
- All facial nerve fibres is affected

Will resolve after a day or 2

  • Not permanent
  • Reassure pt

BDS2 BAMS (54 decks)

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