deep face Flashcards
what are the cartilaginous parts of the nose
- 2 lateral cartilages
- 2 major and minor alar cartilages
- 1 septal cartilage (nasal septum)
the nasal cavity (except for vestibule of nose) are lined with nasal mucosa which divide into 2 parts which are
lower 2/3 = respiratory
-middle and inferior turbinate
upper 1/3 = olfactory
-superior turbinate with CN 1 nerve endings
what are the 2 main branches that supply blood to the nasal cavity
- maxillary A. (sphenopalatine,, greater palatine)
- facial A. (inferior labial a. and lateral nasal)
- othalmic a. (from ICA) = ethmoidal a.
what is the innervation of the TMJ joint
- branches of V3 (mandibular N.)
- capsule head = auriculotemporal N. , posterior deep temporal N. , massesteric N.
bones of the external nose
- nasal bone
- frontal bone (nasal part and nasal spine)
- frontal part of the maxilla
- boney part of nasal septum (-medial line down the nose where where vomer and ethmoid bones are )
what structures can be damages in a TMJ joint fracture
- paroitd gland,
- superficial temporal
- facial nerve
what muscle attaches to the articular disc of the articular capsule of the TMJ joint
-superior head of the lateral pterygoid M..
what are the 4 passage ways of the nasal cavity and where do they open
- spheno-ethmoidal recess (opening to sphenoid sinus)
- superior nasal meatus (opening to posterior ethmoidal sinuses)
- middle nasal meatus
-anterior semilunar hiatus opens into frontal sinus
-ethmoidal bulba - opening to anterior and middle ethmoid sinus
-posterior semilunar hiatus- opening to the maxillary sinus
(semilunar hiatus is below the ethmoidal bulba) - inferior nasal meatus (opening to nasolacrimal duct)
boundaries of the internal nose (nasal cavity)
Roof
-frontal, nasal, ethmoid, sphenoid
Floor
-palatine, maxila
lateral wall
-inferiror nasal concha and ethmoid (superrior and middle nasal concha)
medial (septum)
-vomer, ethmoid, palatine, maxilla, septal cartilage
what happens to the TMJ joint when the mouth is opened <15 degrees, greater than 15 degrees ?
<15 = pivot of the joint with minimal sliding of the articular disc by the lateral pterygoid M.
> 15 = anterior dislocation of the joint (mandibular bone comes out of mandibular fossa on temporal bone). articular disc being pulled forward by the lateral pterygoid M. holding the joint together
when does the nasal cavity drain venous blood
sphenopalatine, facial, and opthalmaic veins
what are the two main types of epistaxis
- nose bleed
1. anterior - bleeding out of nostrils - most common
- source : kieseelbach plexus (anterior ethmoidal A. , superoir labial A. , sphenopalatine A. greater palatine A.)
- posterior -bleeding down the throat
- less common, harder to control
- source: woodruffs plexus (posterior ethmoidal A. and sphenopalatine A. )
- associated with bleed from both nostrils, flowing into pharynx, and increased risk of aspiration and airway compromise bc of difficulty controlling the bleed
primary cause: spontaneous, idiopathic
secondary cause: trauma
what is the nerve and blood supply to the paranasal sinuses
- frontal
- blood: anterior ethmoidal, supraorbital
- nerve- supraorbital (V1) - ethmoid
- blood: ethmoidal A.
- nerve- nasociliary N (V1) - sphenoid
- blood: posterior ethmoidal A.
- nerve- posterior ethmoid N. (V1) - maxillary
- blood: superior alveolar a., greater palatine a.
- nerve: superior alveolar n. (V2)
what are the boundaries of the pterygopalatine fossa
anterior: maxilla
posterior: sphenoid
medial- palatine
lateral: infra temporal fossa
roof: sphenoid
floor: palatine
where is an inferior alveolar dental nerve block inserted
*inside check part of the mouth
-between the pterygomandibular raphe and the coronoid notch inside the mouth.
(raphe is between buccinator and pharyngeal constrictor muscles)
where do you inject a nerve block for the superior posterior, middle, and anterior alveolar N.
posterior (back upper molars )
-inject above the back 3 upper molars, above the gums
middle (premolar and middle teeth)
-inject anteriorly to the 3rd upper molar into the gums
anterior (front teeth and below nose area)
-inject up the lip in the front the hit the infraorbital N. (after it has branched of the middle superior alveolar N.)
what bones meet to make the nasal septum
perpinducular plate of ethmoid and the vomer
nasal crests of maxillary and palatine
what boney parts of the temporal bone are important in making the articular capsule of the TMJ joint
postglenoid tubercle, auricular tubercle
(have an anterior and posterior band on the inside to keep the mandible in place on the mandibular fossa of the temporal bone)
what opening is located in the superior portion of the pterygopalatine fossa? and what foramen is located superiorly and posteriorly? and what canal is located posteriorly ?
inferior orbital fissure
- foramen rotundum
- pterygoid canal
what are the parts of the nasal septum
- vomer
- cartilagionous part of septal cartilage
- perpindicular part of ethmoid
what ligaments are associated with the TMJ joint
(these prevent anterior protrusion and inferior excursion of TMJ)
stylomandibular L.
shpenomandibular L.
-articular capsule (holds the articular disc)
what innervates the tensor veli palatini and the tensor tympani ?
V3 (mandibular part) of CN 5
contents of the pterygopalatine fossa
- Maxillary N (v2) -
- pterygopalatine nerves (synapse and make greater and lesser palatine)
- zygomatic n.,
- superior alveolar n.
2. maxillary a. (3rd part) --- sphenopalatine A. infraorbital A. superior alveolar a. greater/lesser palatine
- pterygopalatine ganglion
- Vidian N.
