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Dentistry Year 1 Term 2 > Gregory Giles > Flashcards

Gregory Giles Flashcards

1
Q

Where does the facial nerve arise

A

Between pons and medulla as motor root and sensory root which pass through internal auditory meatus into facial canal of petrous temporal bone

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2
Q

Where are upper motor neurones

Where are lower motor neurones

A

From cortex to brainstem

From brainstem to motor components

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3
Q

What is the pathway of motor route of facial nerve

7

A

Emerges between pons and medulla
Through internal auditory meatus into facial canal of petrous temporal bone
Travels laterally to medial wall of middle ear
Joins nervus intermedius to form facial nerve in petrous temporal bone
Sharp turn at geniculate ganglion
Greater petrosal nerve, nerve to stapedius and chorda tympani given off
Exits through stylomastoid foramen into infra temporal fossa where small sensory branch innervates skin over external auditory meatus, upon emerging nerve entirely motor

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4
Q

Are the upper motor neurones for upper 1/3 of the face contralateral, ipsilateral or bilateral

A

Bilateral

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5
Q

Are upper motor neurones for lower 2/3 of face contralateral, ipsilateral or bilateral

A

Controlateral

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6
Q

What innervates muscles of facial expression and where do the muscles originate and insert

A

Facial nerve
Surface of skull
Dermis of skin

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7
Q

What are the layers of the face

4

A

Skin
Subcutaneous fat
Musculoaponeuritic system
Deep fascia

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8
Q

What gives blood supply to muscles of facial expressions

A

Internal carotid artery and external carotid artery

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9
Q

What is the pathway of facial nerve in petrous temporal bone

5

A

Originate between pons and medulla
Through IAM then travel laterally to medial wall of middle ear
Sharp turn at geniculate ganglion to run horizontally across medial wall of middle ear
Nerve reaches posterior wall of petrous temporal bone
Sharp turn to exit through stylomastoid foramen into infra temporal fossa

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10
Q

Which branches of facial nerve carry fibres of nervus intermedius
4
What do they innervate

A

Lesser superficial petrosal- parasympathetic fibres to parotid gland
Greater superficial petrosal- sensory fibres to palate, parasympathetic fibres to lacrimal and mucous gland
Chorda tympani- sensory fibres to anterior 2/3, parasympathetic fibres to submandibular and sublingual gland

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11
Q

Which branches of facial nerve carry fibres of motor route
5
What do they innervate

A

Nerve to stapedius- stapedius muscle of inner ear
Nerve to digastric- digastric muscle posterior belly
Nerve to stylohyoid- stylohyoid muscle
Posterior auricular nerve- muscles around ear
Facial motor branches- muscles of facial expression

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12
Q

What is the pathway of greater superficial petrosal nerve

4

A

Arises from geniculate ganglion in facial canal
Passes through greater superficial petrosal foramen into middle cranial fossa
Joined by deep petrosal nerve from internal carotid plexus to form nerve of pterygoid canal
Nerve of pterygoid canal passes through foramen lacerum to pterygopalatine ganglion

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13
Q

What is the pathway of chorda tympani

A

Branches off in mastoid section of facial nerve
Passes across tympanic membrane
Pterygotympanic fissure into infra temporal fossa
Joins lingual nerve and passes to submandibular ganglion

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14
Q

What is the pathway of parasympathetic, sensory and sympathetic input through ganglia

A

Parasympathetic: relay and synapse in ganglion
Sensory: pass through
Sympathetic: pass through

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15
Q

What is the difference between the courses of parasympathetic and sympathetic fibres?

A

Parasympathetic has long pre ganglionic course and short post ganglionic coarse

Sympathetic has short pre ganglionic and long post ganglionic coarse

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16
Q

What does submandibular ganglion house

A

Parasympathetic secretomotor fibres to SM and SL glands, sensory fibres to anterior 2/3 tongue

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17
Q

What does otic ganglion house

A

Parasympathetic secretomotor fibres to parotid gland

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18
Q

What does meckels ganglion house

A

Secretomotor fibres to lacrimal glands, mucous and serous glands of palate, nose and paranasal sinuses

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19
Q

What does cilliary ganglion house

A

Fibres to sphincter pupillae and cillary muscle

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20
Q

What is Frey’s syndrome

What is it’s symptom

A

Regrowth of nerve supply to parotid gland resulting in nerve supply to sweat glands
Gustatory sweating

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21
Q

What is Ramsay hunt syndrome

What is it’s symptoms

A

Herpes zoster infection in geniculate ganglion

Facial nerve paralysis, ear pain, taste loss, dry mouth and eyes, vesicles in ear canal, tongue and hard palate

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22
Q

What is horners syndrome

What is it’s symptoms

A

Interuption of sympathetic nerve supply to eye

Miosis, partial ptosis, loss of hemifacial sweating

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23
Q

What is the physiology of hearing?

5

A

Vibrations captured by auricle and transmitted to external auditory meatus
Vibrations stimulate tympanic membrane and impulses transmitted through ossicles to cochlear
Vibrations pass through oval window to cochlea via Scala vestibuli
Impulses travel through cochlea stimulating organs of Corti which transduce vibrations to nerve impulses
Impulses travel to cerebrum by cochlear nerve you be analysed in auditory cortex

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24
Q

What are the components of external ear

3

A

Auricle
External auditory canal
Tympanic membrane

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25
What is the thickness of tympanic membrane
0.1 mm
26
What are the components of middle ear | 4
Eustacian tube Ossicles Oval window Round window
27
What is the role of eustacian tube
Connect muliddle ear to nasopharynx to equalise pressure
28
What are the ossicles called
Malleus, incus, stapes
29
Where does oval window sit between
Middle ear and vestibule
30
Where is the inner ear located
Petrous temporal bone
31
What are the components of inner ear | 3
Vestibule Semicircular canals Cochleae
32
What are the otolith organs Where are they What do they do
Utricle and saccule Vestibule Balance
33
What are the semicircular canals filled with | What do they do
Endolymph | Balance
34
What are the ducts of the cochlea called And what are they filled with
Scala vestibule: perilymph Cochlea duct: endolymph Scala tympani: perilymph
35
What is the tip of the cochlea called
Helicotrema
36
What is the membrane between Scala vestibuli and cochlea duct called What is the membrane between Scala tympani and cochlea duct called
Reissners membrane Basilar membrane
37
Which membrane houses organs of Corti
Basilar membrane
38
How are ions distributed in cochlea
Scala vestibuli and Scala tympani high in sodium | Cochlea duct high in potassium
39
How many hair cells in the organ of Corti and how are they arranged
15000 hair cells | 4 parallel rows
40
What separates the stereocillia from the endolymph of the cochlea
Tectorial membrane
41
What is the process of mechanico neural transduction in the cochlear 6
Pressure waves begin at oval window and travel through Scala vestibuli Parts of reissners membrane are displaced to create vibratory wave in potassium rich endolymph Steriocillia of hair cells are displaced by vibratory wave which opens mechanically gated ion channels of hair cells Potassium ions flow into hair cells leading to change in membrane potential, triggering the opening of vaultage gated calcium ion channels Calcium enters which triggers neurotransmitter release AP created in vestibulocochlear nerve afferents
42
What makes up the vestibular system | 3
Semicircular canals Utricule Saccule
43
What are semi circular canals filled with What structure sits at the base of each canal What do the semi circular canals detect
Endolymph Ampulla Movement of the head in different planes and rotation
44
What does the utricle detect | What does it use to detect this
Linear acceleration and head tilts in the horizontal plane | Small stones, viscous fluid, hair cells
45
What does the saccule detect | What does it use to detect this
Movement in vertical plane | Small stones, viscous fluid, hair cells
46
What are the types of hearing loss
Conductive- sounds unable to pass freely to inner ear Sensorineural- damage to hair cells in cochlea or damage to vestibulocochlear nerve Prespycussis- age related hearing loss due to histological changes
47
Why is amalgam being faded out | 8
``` Minimum intervention Material durability Aesthetics Patient preference Potential occlusal loading Mercury toxicity and the environment Time taken to complete restoration ```
48
What are the advantages of amalgam 5
``` Strong and durable Similar wear rate to enamel Seals at margins due to corrosion Doesn’t alter sub gingival plaque biofilm Reliable ```
49
What are the disadvantages of amalgam | 4
Colour Mechanical retention Must remove healthy tissues Waste management
50
When is amalgam used | 2
``` Large class 2 restorations Deep sub gingival restorations ```
51
When is amalgam not used | 5
``` Class 1 restorations Primary dentition Pregnant or breastfeeding women Those with impaired renal clearance Under 15s ```
52
How much mercury escapes amalgam fillings
3-17 micrograms of mercury vapour daily
53
How much mercury in the urine of those with amalgam restorations
5 micrograms per litre
54
How much mercury in the urine of dentists
Below 10 micrograms per litre
55
What level of mercury in urine can lead to mercury poisoning
25-50 micrograms per litre
56
What level of mercury in urine is seen during neurological symptoms of mercury poisoning
Above 500 micrograms per litre
57
When was minimata convention signed How many countries signed What was agreed
October 2013 128 Reduce mercury effect on environment in 4 years
58
Which nerve supplies skin of face
Trigeminal nerve
59
What are the trigeminal nuclei called | 4
Menecephalic nucleus Chief sensory nucleus Motor nucleus Spinal nucleus
60
Which fissure does V1 run through
Superior orbital fissure
61
Is the ophthalmic nerve sensory, motor or mixed
Sensory
62
After the trigeminal ganglion where does the ophthalmic nerve run
Lateral wall of cavernous sinus
63
What are the three main branches of ophthalmic nerve
Nasocilliary Frontal Lacrimal
64
What are the branches of nasocilliary branch of V1 and what do they do 5
Nerve to ciliary ganglion- sensory info from eyeballs via short cilliary nerves Long cilliary nerve- sensory info from cilliary body, iris and cornea, innervate dilator papillae Posterior ethmoidal- sensory fibres to posterior ethmoidal and sphenoidal sinuses Anterior ethmoidal- sensory fibres to anterior ethmoidal cells, nasal mucosa, skin of nasal dorsum Infratrochlear- sensory fibres to lacrimal sac, conjunctiva, eyelids, upper lateral aspect of nose
65
What are the branches of frontal branch of V1 and what do they do 2
Supra orbital nerve- supplies scalp up to lambdoidal suture, pericranium and upper eyelid Supra trochlear nerve- skin of lower forehead conjunctiva and upper eyelid
66
What does the lacrimal branch do | What is a special feature of lacrimal branch
Supplies lacrimal gland, conjunctiva, upper eyelid | Communicating branch with zygomaticotemporal branch of maxillary nerve
67
Is the maxillary nerve motor sensory or mixed
Sensory
68
Which foramen does the maxillary nerve go through | Into which fossa
Foramen rotundum | Pterygopalatine fossa
69
What branch is given of V2 before foramen rotundum
Meningeal branch
70
What are the branches of pterygopalatine ganglion | 5
``` Pharyngeal Lesser palatine nerve Greater palatine nerve Nasopalatine nerve Nasal branch ```
71
What branch leaves maxillary nerve before inferior orbital fissure
Posterior superior alveolar nerve
72
After foramen rotundum what does maxillary nerve pass through
Inferior orbital fissure
73
What does V2 branch into after inferior orbital fissure
Zygomatic nerve | Infra orbital nerve
74
What are the branches of zygomatic nerve of V2
Zygomaticofacial | Zygomaticotemporal
75
What are the branches of infra orbital nerve of V2
Middle and anterior superior alveolar nerves Palpebral branch Nasal branch Superior labial branch
76
Where is pterygopalatine ganglion located
Pterygo palatine fossa
77
What innervates the pterygopalatine ganglion
Greater petrosal branch of facial nerve
78
What does the pterygopalatine ganglion supply parasympathetic innervation to 4
Lacrimal gland Mucosal glands of oral cavity Mucosal glands of nose Mucosal glands of pharynx
79
What does the meningeal branch of V2 do
Supplies dura mater in middle cranial fossa with sensory fibres
80
What does zygomaticotemporal nerve supply What does zygomaticofacial nerve supply
Skin around temples, lacrimal nerve Skin of cheek
81
What does posterior superior alveolar nerve supply
Molars, gingivae, by cal bone and maxillary sinus
82
What does the anterior superior alveolar nerve supply
Incisors, canines, premolars, mesiobuccal route of 6, maxillary sinus, middle superior alveolar nerve
83
What does the palpebral branch supply
Skin of lower eyelid and conjunctiva
84
What does nasal branch supply
Skin of nose
85
What does superior labial branch supply
Skin of upper lip
86
What shape is the bony orbit
Pyramid shaped
87
Where in the orbit is the lacrimal fossa
Medial wall anteriorly
88
Where is the lamina papyracea | What is this
Paper thin plate of bone overlying ethmoid sinus on medial wall of orbit
89
What foramen are located on medial wall of orbit | 3
Optic canal Posterior ethmoidal foramen Anterior ethmoidal foramen
90
Which bones form lateral wall of orbit | 2
Zygomatic bone anteriorly and greater wing of sphenoid posteriorly
91
Where is the lateral tubercle located
Zygomatic bone in lateral wall of orbit
92
What nerve passes through zygomatico temporal foramen
Zygomaticotemporal nerve
93
What nerve passes through zygomaticofacial foramen
Zygomaticofacial nerve
94
Which bone forms roof of orbit
Frontal bone
95
What structures does the infra temporal fossa house | 5
``` Temporalis Maxillary artery Maxillary vein Buccal fat pads Temporalis fat pads ```
96
What structures does the pterygopalatine fossa house | 3
Pterygopalatine ganglion Maxillary nerve Infra orbital branch of maxillary artery
97
Where does superior orbital fissure lye
At orbital apex between greater and lesser wings of sphenoid
98
What is the annulus of zinn
A tight fibrous ring dividing superior orbita fissure into intra coronal and extra coronal spaces Also acts as origin for rectus muscles
99
What is the acronym for nerves passing through superior orbital fissure
``` Luscious French Tarts Sitting Naked In Anticipation ```
100
Which nerves pass through superior orbital fissure outside annulus of zinn
Lacrimal nerve v1 Frontal nerve v1 Trochlear nerve CN 4
101
Which nerves pass through superior orbital fissure within annulus of zinn
Superior division oculomotor CN3 Nasocilliary nerve V1 Inferior division occulomotor CN3 Abducens CN 6
102
Where do the extra ocular muscles insert
Pierce fascial sheath to insert into sclera
103
What suspends the eye in place
Check ligaments | Suspensory ligament of Lockwood
104
What are the ocular muscles and what do they do | 6
Lateral rectus- rotates eye laterally Medial rectus- rotates eye medialy Superior rectus- rotates eye superiorly Inferior rectus- rotates eye inferiorly Superior oblique- rotates downward and outward with medial rotation Inferior oblique- rotates upwards and outwards with lateral rotation
105
Which nerve has fibres passing to cilliary ganglion to hitchhike with opthalmic nerve
Parasympathetic fibres of oculomotor nerve
106
What are fibres from cilliary ganglion responsible for
Miosis- constriction of pupil | Accommodation- change in focus
107
Where is the lacrimal gland and what type of gland is it
Lacrimal fossa | Exocrine gland
108
Where do tears produced by lacrimal gland flow
Lacrimal sac | Naso lacrimal duct to inferior meatus of nose

Dentistry Year 1 Term 2 (5 decks)

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