Chapter 10: Face and Thorax Flashcards
What nerve gives cutaneous sensation to the face?
trigeminal (V1-3)
What are the three divisions of trigeminal nerve?
opthalmic, maxillary, mandibular
Where does the trigeminal nerve come off of?
off of the brainstem on the pons, then divides into its three branches
What is the only branch of trigeminal nerve to give motor innervation to the face?
mandibular: supplies muscles of mastication
Facial nerve is what number of cranial nerve?
CN 7
What cranial nerve is trigeminal?
CN 5
If a patient has mumps, which gland is visably swollen?
parotid
T/F: Facial nerve branches off into the face.
true
Where does the facial nerve divide?
parotid gland
What nerve is responsible for facial expression muscles?
facial nerve
Discuss the path of CN 7.
facial nerve exits cranial cavity off of the brainstem, goes through the stylomastoid foramen, then divides into branches after it pierces through the parotid gland
What kind of information does the facial nerve supply?
motor, general sensory, parasympathetic
What nerve is known as the wandering nerve?
vagus
What components are in the carotid triangle?
vagus nerve, internal jugular vein, and common carotid a.
Which has branches, the internal or external carotid a.?
external has branches
What is the largest salivary gland?
parotid
What do the lymph nodes do?
protect the face and neck by collecting lymph; can get swollen here (beneath parotid gland, submandibular, and other areas)
What artery takes a “tortuous course”?
facial artery
The parotid gland’s duct will pierce what muscle?
parotid duct pierces buccinator to get into oral cavity
T/F: The innervation to the parotid gland is autonomic.
true
What are the three sources of innervation for the parotid gland? What do each do?
1) sympathetic fibers from cervical ganglia; decrease salivation
2) parasympathetic fibers from CN 9; increase salivation, prepare for digestion
3) great auricular nerve (C2, C3); general sensation
What artery supplies the anterior half of the brain?
internal branch of the common carotid a.
What gland crosses and pierces through muscle to get into the oral cavity?
parotid gland
What are the salivary glands?
parotid, submandibular, sublingual
Which salivary gland is palpable?
submandibular
How does a dentist use nerve blocks involving the maxillary and mandibular nerves?
dentist hits V2-3 with anesthesia to numb them so he can work with the lip and oral cavity
If a patient complains of a tingling nose, which nerve would you suspect is the issue?
trigeminal V1 - opthalmic n.
If a patient feels tingling along the front of their cheeks, what nerve would you suspect is the issue?
trigeminal V2 - maxillary n.
What is herpes zoster? What does it affect?
reactivation of chicken pox in the body, causing a painful rash; can affect whole ganglia of trigeminal n., causing scarring of cornea
What is the pterion of the skull?
point where several bones come together; frontal, temporal, sphenoid, parietal
What is trigeminal neuralgia?
- very painful, stabbing pain; affects V2
- patient is sensitive to touch on face, esp. cheeks and nose
- can affect whole ganglia of trigeminal nerve
What are the boundaries of the infratemporal fossa?
lateral = ramus of mandible anterior = maxilla medial = lateral pterygoid plate roof = sphenoid
What does the buccal nerve supply?
sensory to the cheek and gums
What does the inferior aveolar supply?
all teeth related to the mandible
What muscles are found in the infratemporal fossa?
inferior temporalis, lat. and med. pterygoids
What artery is in the infratemporal fossa?
maxillary a.
What nerves are in the infratemporal fossa? (7)
1) pterygoid venous plexus
2) mandibular
3) inferior alveolar
4) lingual
5) buccal
6) chorda tympani
7) otic ganglion
What is the maxillary a. a branch of?
comes off of external carotid a., found in infratemporal fossa
What does the mental nerve innervate?
skin of the chin
What does the lingual nerve innervate?
sensory to gums, tongue, and floor of mouth
What are the muscles of mastecation?
temporalis, masseter, lat. and med. pterygoids
What nerve innervates the muscles of mastecation?
trigeminal V3 - mandibular
If a patient is experiencing pain in their teeth, what nerve is alerting them of this?
inferior alveolar n.
What nerve is affected in Bell’s palsy?
Facial nerve
What can result from Bell’s palsy?
- best case: difficulty closing eye and smiling on one side (hit far from stylomastoid foramen)
- worse: loss of taste to tongue, lacking salivary and lacrimal gland function, and hearing loud sounds (if stress is severe enough, this can involve the entire facial nerve, causing all these things to happen)
Why is there amplified noise in some people with Bell’s palsy?
- the stapedius is a muscle that dampens noise in the ear, and it’s innervated by facial nerve
- when this nerve is damaged, so is the muscle
- this indicates severe Bell’s palsy
How do we think trigeminal neuralgia occurs?
possibly because of an artery in the brain
What nerves innervate the lip and oral cavity?
maxillary and mandibular nerves
What does herpes zoster infection affect?
potentially the entire ganglia of trigeminal n.
What two clinical issues can affect the ganglia of trigeminal nerve?
herpes zoster, trigeminal neuralgia
Nerve blocks on what two nerves are commonly used by dentists to work on the oral cavity?
V2-3
What artery is in the infratemporal region?
maxillary a.
With left lateral excursion of the mandible, which muscles are working?
left temporalis and masseter, right pterygoids
What two muscles elevate and retract the mandible?
masseter and temporalis
Which muscle is the primary mover in protruding the jaw forward?
lateral pterygoid
Which mastication muscles do contralateral lateral motion?
pterygoids
What does the medial pterygoid do?
elevates and protracts mandible, contralateral lateral excursion
What forces open the mouth? (3)
gravity, hyoid muscles, and lateral pterygoid
T/F: All mastication muscles do protraction.
true; lateral pterygoid is the primary mover, but all the rest do a little
Which muscle can you only palpate inside the mouth?
lateral pterygoid
What are the supporting ligaments of TMJ?
1) stylomandibular ligament
2) sphenomandibular ligament
What does the sphenomandibular ligament prevent?
excessive forward translation; it’s the check ligament for the joint; “swinging hinge” ligament
What bony articular surfaces are involved in TMJ?
mandibular fossa and articular tubercle of the temporal bone (superiorly), and the head of the mandible (inferiorly)
What muscle group is also referred to as the strap muscles?
infrahyoid muscles
What ligament is a thickening of the parotid gland?
stylomandibular joint; doesn’t contribute much to the strength of the joint
What is the check ligament for TMJ?
sphenomandibular ligament
When is TMJ prone to dislocation?
during asymmetrical movements, because poor contact can cause stress to the disk
What nerve innervates the pterygoids?
CN 5
Where would referred pain be for TMJ?
face and jaw, because it’s innervated by trigeminal nerve
What is the clicking of your jaw caused by?
the disk slipping forward when you open your mouth, and then clicking back into place when you close it
Why could forward head posture be a cause of TMJ pain?
it changes the position of the mandible, potentially putting it into a vulnerable position and causing pain
T/F: Excessive motion, or anterior dislocation, can cause stress to the TMJ disk.
true
The labial frenula connects what to what?
gums to lips
What nerves create the dental plexus that innervate the upper and lower teeth?
maxillary and mandibular
What nerves innervate the gums?
maxillary, mandibular, buccal, lingual
What is the space between the gums and teeth called?
the vestibule
The tongue is connected to the floor of the mouth by what structure?
lingula frenula
What two parts is the oral cavity divided into?
hard palate (anterior 2/3) and soft palate (posterior 1/3)
What are the openings in the palatine bone called? What are they for, and what palate are they in?
incisive foramen; openings in the palatine bone that allow nerves to pass through (hard palate)
What is the soft palate made up of? (general)
muscle
What 3 parts create the soft palate?
1) palatine aponeurosis
2) uvula
3) five muscles
What 2 parts make up the hard palate?
1) palatine process of maxillae
2) horizontal plates of palatine bone
• incisive foramen also in hard palate
What are taste buds called?
lingual papillae
What gives sensory innervation to the palate?
trigeminal nerve, both maxillary and mandibular?
What gives blood supply to the palate?
branches of maxillary
What nerve gives innervation to both intrinsic and extrinsic muscles? (all except palatoglossus)
hypoglossal (CN 12)