Cranial Nerves Flashcards
What are the branches of the trigeminal nerve, maxillary branch (CNV2) aka the maxillary nerve::
the branches of CNV2 are the pterygopalatine branch * (has further branching), the posterior superior alveolar (PSA), infraorbital n., and zygomatic n.
of what nerve does the pterygopalatine nerve come from, and what are the branches of the pterygopalatine nerve?
the pterygopalatine n. is a branch of the trigeminal nerve, CNV2, the maxillary branch.
the branches of the pterygopalatine nerve include
- the descending palatine that gives the greater palatine, (innerv post 2/3 of gingiva and hard palate)
- nasopalatine branches (innerv the ant 1/3 hard palate and nasal septum, and the
- the middle and posterior palatine, (innerv tonsils and soft palate
from where does the posterior superior alveolar nerve originate and what does it supply?
the PSA originates as the 2nd branch off of the maxillary nerve (CNV2) – the PSA enters the maxilla from behind the 3rd molars via the alveolar canals == innerv the molars, and of the molar area- the pulp, ligaments, alveolar bone, and facial gingiva
-EXCEPT MB root of MAX 1st molar is NOT innerv by the PSA (is innerv by the MSA, middle superior alveolar nerve from the infraorbital branch of CNV2)
T/F are there proprioceptive receptors in the periodontal ligament? Where else are they found?
True, there are proprioceptive receptors in the periodontal ligaments as well as in ,muscles and other ligaments.
what nerve innervates primary molars?
the MSA - middle superior alveolar nerve. Logical, in adult, MSA innervates the premolars which replace the primary molars. If MSA is not present, then PSA and ASA loop together to cover the territory
Can the Mandible be infiltrated?
mostly No. The MAND cannot be infiltrated bc it is too dense for anesthetic infiltration (injection into bone), a block is appropriate for the MAND region (injection through foramina
–however, in the area of MAND incisors, the bone is really thin and can potentially be infiltrated there
Can the MAXillary be infiltrated?
Yes. The MAX arch can be infiltrated bc it is porous.
If wanting to anesthetize the anterior 1/3 of the hard palate.. how would this be done?
To anesthetize the anterior 1/3 of the palate, an injection would be given through the incisive papilla to numb the nasopalatine nerve ( a branch of the pterygopalatine nerve, which is a branch of the maxillary division of trigeminal, CNV2
what are the branches of the maxillary division of the trigeminal nerve?
the branches of CNV2 are the pterygopalatine nerver, the posterior superior alveolar nerve (PSA),the infraorbital nerve and the zygomatic nerve
what does the greater palatine innervate? (and where does it come from)
the greater palatine nerve is a branch off of the pterygopalatine nerve (which is a branch of CNV2)
the greater palatine nerve innervates the posterior 2/3 of the hard palate and the gingiva of the area (including pulp, ligaments, alveolar bone, and facial gingiva)
what does the lesser palatine innervate? (and from where does it come?)
the lesser palatine nerve comes from the pterygopalatine nerve (a branch of CNV2). the lesser palatine nerve innervates the tonsils and the soft palate
what does the nasopalatine nerve innervate and from where does it come?
the nasopalatine nerve comes from the pterygopalatine nerve (which is a branch from the maxillary nerve, CNV2) the nasopalatine nerve innervates the anterior 1/3 of the hard palate, and the septum
how is the anterior hard palate anesthetized?
the anterior hard palate is innerv by the nasopalatine nerve and is anesthetized via block through the incisive canal located posterior to the MAX central incisors
what is another name for the lesser palatine nerve?
the lesser palatine nerve is also called the middle and posterior palatine
how is the lesser palatine nerve anesthetized, and what are does it impact?
the lesser palatine nerve is anesthetized via block to the lesser palatine foramen and anesthetizes the soft palate and tonsils of the oral cavity.
what is the pathway of the PSA from the maxillary nerve?
the PSA (posterior superior alveolar ) nerve separates from the CNV2 just before CNV2 enters the infraorbital canal (wherein the MSA and ASA branch off..). the PSA then travelsto the maxilla and enters behind and above the MAX 3rd molars via tiny tuberosities that are the alveolar canals.
T/F The PSA is sufficient to anesthetize the MAX molars
False. The PSA does not reach the Mesiobuccal root of the first MAX molar (which is innerv by the MSA). Therefore, both the MSA (via..) and the PSA (via the alveolar canals that are close to the fornix (deepest part of the MAX vestibule) superior to the MAX molars on the buccal side of of the arch
What are the terminal branches that leave the infraorbital nerve?
The terminal branches of the infraorbital nerve are the MSA and the ASA
what does the Middle Superior Alveolar nerve innervate?
The MSA innervates the MB root of the 1st MAX molar as well as theMAX premolars, and their gingiva (facial gingiva, bone, ligament)
What does the ASA innervate?
the ASA is a terminal brnach of the infraorbital nerve (which is a branch of hte CNV2 that enters the infraorital canal..) the ASA innervates the MAX canines and the MAX incisors as well as the facial gingiva of that area, and the part of the MAX sinus
T/F the zygomatic branch (branch of … what?) innervates the mouth
False. The zygomatic branch is off of the CNV2,maxillary division of trigeminal,and does not extend to the mouth. It innervates the skin of the termporal and orbit region
where is the trigeminal ganglion located?
on the apex of the petrous portion of the temporal none inside the cranium
How is the MSA nerve anesthetized?
An injection into the infraorbital foramen anesthetizes the MSA nerve. the infraorbital foramen is located lateral to the septum and can be reached from the buccal aspect of the MAX arch, at the superior most portion ofthe vesitbule ling bt the 2nd MAX premolar and the 1st MAX molar (waaay up there). Pinching the cheek while reflecting the upper lip helps distract, this injection is painful
Can the maxillary 1st molar be infiltrated at the apex of its root?
Yes, the MAX 1st molar can be infiltrated at the apex of its root
Where is the greater palatine foramen located and what does it anesthetize (nerve and impact)
The greater palatine foramen is located on the lingual aspect ofthe MAX arch, just medial to the 3rd MAX molar anterior and medial to the Maxillary tuberosity = the ledge at the posterior end of the MAX arch). The greater palatine foramen is penetrated by the greater palatine nerve which is responsible for innervation of hte posterior 2/3 of the hard palate and the gingiva of the area including pulp, ligament, alveolar bone, and facial gingiva
What nerve enters the pterygopalatine space as it exits the cranium?
CNV2 enters the pterygopalatine space as it exits the cranium via foramen rotundum
What nerve enters the infrateporal space as it exits the skull?
CNV3 enters the infraorbital space as it exits the cranium via foramen ovale.
Is the MAX division of trigeminal (CNV2) a mixed nerve? (motor and sensory)?
No, CNV2 is only an Afferent nerve = sensory. CNV1, the opthalmic, is also only sensory. CNV3 the mandibular division, however, is mixed with both sensory and motor nerves
Is the CNV3 a sensory only nerve?
No, CNV3, th mandibular division of trigeminal, is a MIXED nerve and has oth afferent (sensory_ and efferent (motor) function.
What is the territory ofthe CNV3
CNV3 impacts ALLLL MAND teeth (sensory) and the muscles of mastication (motor)
What are the branches of the Mandibular division of trigeminal?
Like CNV2, the maxillary division, CNV3 also has 4 branches.
CNV3 branches are the auriculotemopral branch, the buccal branch (aka buccinator nerve), the lingual nerve, and the inferior alveolar nerve
what does the auriculotemporal nerve innervate and from where does it come from?
the auriculotemporal nerve is a branch off of the CNV3 and innervates (gives sensation to) the outer ear and the skin of the face that is anteriortothe ear.
The auriculotemporal nerve also provides propriocetion to the TMJ
What nerve travels between the 2 heads of the lateral pterygoid (and is therefore traveling through the infratemporal space) ?
The buccal nerve of CNV3 travels bt the 2 heads of the lateral pterygoid though the infratemporal space
What nerve innervates the buccal gingiva of MAND molars, and 2nd premolars, as well as the skin and mucosa ofthe cheek and commissure (corner of mouth)?
The buccal nerve (aka the buccinator) of the CNV3 innervates the buccal gingiva, MAND molars and 2nd premolars, and skin and mucosa of the cheek and commisure **NOTE MAND molar an premolar pulps are innerv by a different nerve- the inferior alveolar nerve))
What nerve gives off the mylohyoid branch?
The inferior alveolar nerve gives off the mylohyoid branch that supplies the mylohyoid and anterior belly ofthe digastric
what nerve enters the mandibular foramen and here is it located?
the inferior alveolar nerve enters the MAND foramen that islocated onthe lingual posterior aspect of the MAND arch (found in the lingula - a mucosal protuberance)
What does the inferior alveolar nerve innervate?
the inferior alveolar nerve innervates the MAND molar and MAND premolar pulps, ligaments, and surrounding alveolar bone
does the buccal nerve of CNV3 travel on the buccal or lingual side of the MAND arch?
the buccal nerve oc CNV3 travels long the buccal side of the MAND ramus
along what structure can the nerve to mylohyoid be found?
the nerve to mylohyoid can be found running along hte mylohyoid groove (a linear protuberance on the lingual side of the mandible.. starts inferior tothe 2nd MAND molars
the mental branch and the incisive branch are the terminal nerve branches of what nerve?
the mental nad incisive rnaches are terminal brnaches of the inferior alveolar nerve.
Through what foramen does the mental nerve travel?
The mental nerve through the mental foramen found on the medial aspect of the chin
What does the mental nerve innervate and h0w would the area be anesthetized?
The mental nerve innervates the lower lip, chin,. and anterior facial gingiva – the mental nerve of CNV3 can be anesthetized via the mental forament
what innervates the MAND canines and incisors?
The incisive nerve, the terminal end of theinferior alveolar nerve, is what innervates the MAND canines and the MAND incisors ((recall, in MAX arch, the ASA does the MAX canines and MAS incidors)
Of what nerve is the lingual nerve a branch?
The lingual nerve is a branch of the CNV#, mandibular division of trigeminal
Between what 2 structures does the lingual nerve travel through?
The lingual nerve travels between the ramus of the mandible (medial to it) and the medial pterygoid muscle (lateraltotheuscle)
What does the lingual nerve innervate?
The lingual nerve innervates the anterior 2/3 of the tongue with General Sensation, as well as the mucosa of the floor ofthe mouth, a lingual gingiva of hte entire mouth
if the lingual gingiva of the incisors needs to be anesthetized, which nerve should be injected?
The lingual nerve of CNV3 should be anesthetized for any procedure requiring numbing of lingual gingiva - thelingual brnach of CNV3 provides general sesation to ALLL of the lingual gingiva of the buccal branch.
At what location isthe buccal nerveof CNV3 anesthetized?
the buccal nerve of CNV3 is anesthetized along the buccal shelf of the MAND (on buccal aspect) – specifically, find the retormolar pad / retromolar triangle and go a little bit superior = the spot.
(technique: put thumb sideways (D side of thumb flush w buccal shelf) along bucca shelf.. at middle of thumbnail (the middle of M-D dimension) is the spot to inject)
T/F it is not possible to infiltrate the MAND bone at all
False. While the MAND bone is more dense than the MAX bone, it can be infiltrated along the anterior teeth bc the bone is thinner in that location.
what branch of the trigeminal has motor function?
The Mandibular branch, CNV3 has motor function and innervates the muscles of mastication
What muscles are innervated by the motor portion of the CNV3
The muscles of mastication are motor innervated (efferent) by CNV3. The mm. of mastication include the termporalis, the masseter (+ TMJ), and the medial and lateral pterygoids
what innervates the facial gingiva of the MAND 1st premolar?
the mental branch of the inferior alveolar nerve (of the CNV3) innervates the facial gingiva of the MAND 1st premolar (innervates the span of 2nd premolar through central incisors)
what nerve innervates the lingual gingiva of the
a. first MAND molar?
b. lateral MAND incisor?
both the 1st MAND molar as well as the L incisor have lingual gingiva innervated by the Lingual nerve. The lingual nerve innervates the lingual gingiva of the Entire MAND arch
Is the Facial nerve sensory, motor, or mixed?
The facial nerve is a MIXed nerve wit both sensory and motor function.
- sensory: special sense, taste, ot the anterior 2/3 of tongue via its branch, the chorda tympani
- motor: muscles of facial expression AND theposterior belly of digastric, stylohyoid, and platysma
- also gives off secretory fibers to the submandibular and sublingual glands that is considered special motor
what path does the facial nerve, CN7 take through and out of the cranium?
The facial nerve enters the petrous portion of the temporal bone via the internal acoustic meatus, and then exists the skull bia the stylomastoid foramen.
what nerve exits the skull via the petrotympanic fissure?
The chorda tympani exits the skull via the petrotympanic fissure. recall that the chroda tympani travels over the tympanic membrane near the stapes.. use this thought to connect the chorda tympano to the petrotympanic fissure
with what nerve does the chorda tympani join up with as approaches the mandible?
the chorda tympani joins up with the lingual nerve as it approacches the tongue
what does the chorda tympani do and what nerve is it a branch of?
the chroda tympani is a branch of the facial nerve, CN7, and it the sensory component of the mixed CN7nerve. the chroda tympani collects TASTE sensation (special sense) from the ANTerior 2.3 of the tongue
T/F The parotid nerve is not innervated by the facial nerve, CN7
True. The parotid gland is NOT innerv by CN7. The sublingual and submandibular glands, however, are innervated by the facial nerve ( in terms of the secretory function= special motor function)
through what foramen does the glossopharyngeal nerve exit the skull?
the glossopharyngeal nerve exits the skull via the jugular foramen
is the glossopharyngeal nerve sensory, motor, or mixed?
The glossopharyngeal nerve, CN9, is a MIXED nerve
-sensory: the sensory portion of CN9 is that it innervates the tonsils, the pharynx, and *general sensation AND special TASTE sensation** to the POST 1/3 of the tongue.
- motor: innerv. the mm of the pharynx the STYLOPHARYNGEUS m (the only motor component of CN9)
- also innerv w special motor, the parotid gland (secretory = special motor)
through what opening does the hypoglossal nerve exit the cranium?
The hypoglossal nerve exits the cranium via the hypoglossal canal. hypoglossal nerve = CN12
what kind of nerve is the hypoglossal n - sensory, motor or mixed
the hypoglossal nerve, CN12, is a motor nerve and innervates the motor function of hte ENTIRE tongue
describe the innervation scheme of the tongue
the ENTIRE motor of the tongue is supplied by CN12,hypoglossal nerve.
the anterior 2/3 of general sensation is supplied by CNV3,the lingual nerve. the anterior 2/3 of tongue of Special TASTE sensation is via the chorda tympani.
for the posterior 2/3 of the tongue, general and special sensation is supplied by CN9 the glossopharyngeal nerve.
what is the most important artery to dentists?
the MAXILLARY artery
what is the blood supply to the mouth (from where does it come?)
the blood supply of the mouth comes from the
> LEFT ventricle, to the
>common carotid, to the
>external carotid artery, which gives the
>MAXillary artery
T/F the area lateral to the MAND ramus has many arteries from the heart and nerves from the brain join
False. It is in the area MEDIAL to the ramus that many heart arteries and cranial nerves join.
The Maxillary artery has 3 main parts that supply what 3 groupings of strucutres?
The maxillary artery has 3 main parts
1) the MAxillary part that goes to the maxillae
2) the MANDibular part that goes to the mandinle
3) and a pterygoid part that goes to the muscles
what does the MAND part of the maxillary artery supply?
The mandibular part othe maxillary artery has the following brnaches that supplies :
- the inferior alveolar = MAND molar and premolars
- mental = the lower lip and chin
- incisive = the anterior teeth
(recall, branches of the maxillary artery have the same name as the nerves that innervate the supplied structures)(so, if know what nerve innervates the structure, will know the name of the MAX branch that supplies it w blood)
what muscles does the maxillary artery supply?
the MAxillary artery supplies the muscles of mastication (the temporalis, the masseter, andthe medialand lateral pterygoids) and the buccinator m.
what does the MAXillary part of the maxillary artery supply?
the maxillar artery supplies the following structures – the entire maxillary arch and its consituents”
- PSA = the molars
- infraorbital - ASA/MSA = premolars and anterior -teeth
- descending palatine (recall = greater palatine)= nasal cavity and hard palate
- the lingual gingiva ((note NOT the floor of the mouth–this is the lingual side of gingiva surrounding the teeth))
** recall, that the branches of the maxillary artery have the same names as the nerves that supply the same structures! (so, if know what nerve innervates the structure, will know the name of the MAX branch that supplies it w blood)
what nerve and what vessel (name each) supplies the lateral MAX incisors
the lateral MAX incisors are supplied by the anterior superior alveolar nerve and therefore by an artery (branchof maxillary artery) of the same name = ASA artery
what are the branches of the external carotid?
the external carotid has 3 pertaining branches:
the lingual branch, the facial branch, and the maxillary branch
what does the lingual branch of the external carotid artery supply?
the lingual branch of the external carotid a.supplies the tongue, the floor of the mouth, the sublingual gland and surrounding gingiva
what does the facial branch of the external carotid artery supply?
the facial branch of the external carotid artery supplies the soft palate,the tonsils, the pharynx, the chin, the floor of the mouth (along w the lingual branch of ECA), lips and nose
what branch of the ECA supplies the soft palate?
the soft palate is supplied by the facial branch of the ECA
what branch of the ECA supplies the lingual gingiva?
the maxillary branch of the ECA supplies the lingual gingiva
what branch of the ECA supplies the floor of the mouth?
both the lingual and facial branches of the ECA supply blood to the floor of the mouth
what is the order of progression of h\the 3 partsofthe maxillary artery?
the first part of the maxillary artery is the mandibular part that supplies the entire mandible , the middle portion is the pterygoid part (that supplies the musclesof mastication + buccinator) , and th thirs part isthe maxcillary part that supplies all of the maxillae
what vein(s) are responsible for collecting the drained blood of the face
just one major vein -the common facial vein, is responsible for collecting the drained blood of the face
what is responsible for draining the upper part of the face?
the pterygoid plexus (a plexus of veins) drains the upper part of the face as well as the maxillae
what is reponsible for draining blood away from the maxilla?
the pterygoid plexus is responsible for draining the blood away from the maxilla as well as away from the upper part of the face
what is reponsible for draining hte mandible and lower teeth?
the inferior alveolar vein drains the mandible and lower teeth and takes it to the pterygoid plexus
to where does the pteryfoid plexus drain?
the pterygoid plexus drains into the
>maxillary vein which drains to the
>retromandiblular vein
with what vessel can the facial vein be found?
the facial vein runs alongside the facial artery (that runs across the face – from lateral neck to medial orbit)
from what area does the facial vein collect blood?
the facial vein collects blood from the
> superior and inferior labial veins
>muscles of mastication
>nose and eyes
what collects the blood from the tongue
the lingual vein collects blood from the tongue
what is the pathway of the orofacial veins drainage?
the orofacial veins drain to the >common facial vein (which is the vessel resulting fromthe joining of the facial vein and retromandibular vein), then to the >internal jugular vein >superior vena cava >heart
