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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
Q

What is the thickness of tympanic membrane

A

0.1 mm

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26
Q

What are the components of middle ear

4

A

Eustacian tube
Ossicles
Oval window
Round window

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27
Q

What is the role of eustacian tube

A

Connect muliddle ear to nasopharynx to equalise pressure

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28
Q

What are the ossicles called

A

Malleus, incus, stapes

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29
Q

Where does oval window sit between

A

Middle ear and vestibule

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30
Q

Where is the inner ear located

A

Petrous temporal bone

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31
Q

What are the components of inner ear

3

A

Vestibule
Semicircular canals
Cochleae

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32
Q

What are the otolith organs
Where are they
What do they do

A

Utricle and saccule
Vestibule
Balance

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33
Q

What are the semicircular canals filled with

What do they do

A

Endolymph

Balance

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34
Q

What are the ducts of the cochlea called And what are they filled with

A

Scala vestibule: perilymph
Cochlea duct: endolymph
Scala tympani: perilymph

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35
Q

What is the tip of the cochlea called

A

Helicotrema

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36
Q

What is the membrane between Scala vestibuli and cochlea duct called

What is the membrane between Scala tympani and cochlea duct called

A

Reissners membrane

Basilar membrane

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37
Q

Which membrane houses organs of Corti

A

Basilar membrane

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38
Q

How are ions distributed in cochlea

A

Scala vestibuli and Scala tympani high in sodium

Cochlea duct high in potassium

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39
Q

How many hair cells in the organ of Corti and how are they arranged

A

15000 hair cells

4 parallel rows

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40
Q

What separates the stereocillia from the endolymph of the cochlea

A

Tectorial membrane

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41
Q

What is the process of mechanico neural transduction in the cochlear
6

A

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

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42
Q

What makes up the vestibular system

3

A

Semicircular canals
Utricule
Saccule

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43
Q

What are semi circular canals filled with
What structure sits at the base of each canal
What do the semi circular canals detect

A

Endolymph
Ampulla
Movement of the head in different planes and rotation

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44
Q

What does the utricle detect

What does it use to detect this

A

Linear acceleration and head tilts in the horizontal plane

Small stones, viscous fluid, hair cells

45
Q

What does the saccule detect

What does it use to detect this

A

Movement in vertical plane

Small stones, viscous fluid, hair cells

46
Q

What are the types of hearing loss

A

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
Q

Why is amalgam being faded out

8

A 
Minimum intervention 
Material durability 
Aesthetics
Patient preference 
Potential occlusal loading 
Mercury toxicity and the environment 
Time taken to complete restoration
48
Q

What are the advantages of amalgam 5

A 
Strong and durable
Similar wear rate to enamel 
Seals at margins due to corrosion
Doesn’t alter sub gingival plaque biofilm 
Reliable
49
Q

What are the disadvantages of amalgam

4

A

Colour
Mechanical retention
Must remove healthy tissues
Waste management

50
Q

When is amalgam used

2

A 
Large class 2 restorations
Deep sub gingival restorations
51
Q

When is amalgam not used

5

A 
Class 1 restorations
Primary dentition
Pregnant or breastfeeding women 
Those with impaired renal clearance
Under 15s
52
Q

How much mercury escapes amalgam fillings

A

3-17 micrograms of mercury vapour daily

53
Q

How much mercury in the urine of those with amalgam restorations

A

5 micrograms per litre

54
Q

How much mercury in the urine of dentists

A

Below 10 micrograms per litre

55
Q

What level of mercury in urine can lead to mercury poisoning

A

25-50 micrograms per litre

56
Q

What level of mercury in urine is seen during neurological symptoms of mercury poisoning

A

Above 500 micrograms per litre

57
Q

When was minimata convention signed
How many countries signed
What was agreed

A

October 2013
128
Reduce mercury effect on environment in 4 years

58
Q

Which nerve supplies skin of face

A

Trigeminal nerve

59
Q

What are the trigeminal nuclei called

4

A

Menecephalic nucleus
Chief sensory nucleus
Motor nucleus
Spinal nucleus

60
Q

Which fissure does V1 run through

A

Superior orbital fissure

61
Q

Is the ophthalmic nerve sensory, motor or mixed

A

Sensory

62
Q

After the trigeminal ganglion where does the ophthalmic nerve run

A

Lateral wall of cavernous sinus

63
Q

What are the three main branches of ophthalmic nerve

A

Nasocilliary
Frontal
Lacrimal

64
Q

What are the branches of nasocilliary branch of V1 and what do they do
5

A

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
Q

What are the branches of frontal branch of V1 and what do they do
2

A

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
Q

What does the lacrimal branch do

What is a special feature of lacrimal branch

A

Supplies lacrimal gland, conjunctiva, upper eyelid

Communicating branch with zygomaticotemporal branch of maxillary nerve

67
Q

Is the maxillary nerve motor sensory or mixed

A

Sensory

68
Q

Which foramen does the maxillary nerve go through

Into which fossa

A

Foramen rotundum

Pterygopalatine fossa

69
Q

What branch is given of V2 before foramen rotundum

A

Meningeal branch

70
Q

What are the branches of pterygopalatine ganglion

5

A 
Pharyngeal 
Lesser palatine nerve
Greater palatine nerve
Nasopalatine nerve
Nasal branch
71
Q

What branch leaves maxillary nerve before inferior orbital fissure

A

Posterior superior alveolar nerve

72
Q

After foramen rotundum what does maxillary nerve pass through

A

Inferior orbital fissure

73
Q

What does V2 branch into after inferior orbital fissure

A

Zygomatic nerve

Infra orbital nerve

74
Q

What are the branches of zygomatic nerve of V2

A

Zygomaticofacial

Zygomaticotemporal

75
Q

What are the branches of infra orbital nerve of V2

A

Middle and anterior superior alveolar nerves
Palpebral branch
Nasal branch
Superior labial branch

76
Q

Where is pterygopalatine ganglion located

A

Pterygo palatine fossa

77
Q

What innervates the pterygopalatine ganglion

A

Greater petrosal branch of facial nerve

78
Q

What does the pterygopalatine ganglion supply parasympathetic innervation to
4

A

Lacrimal gland
Mucosal glands of oral cavity
Mucosal glands of nose
Mucosal glands of pharynx

79
Q

What does the meningeal branch of V2 do

A

Supplies dura mater in middle cranial fossa with sensory fibres

80
Q

What does zygomaticotemporal nerve supply

What does zygomaticofacial nerve supply

A

Skin around temples, lacrimal nerve

Skin of cheek

81
Q

What does posterior superior alveolar nerve supply

A

Molars, gingivae, by cal bone and maxillary sinus

82
Q

What does the anterior superior alveolar nerve supply

A

Incisors, canines, premolars, mesiobuccal route of 6, maxillary sinus, middle superior alveolar nerve

83
Q

What does the palpebral branch supply

A

Skin of lower eyelid and conjunctiva

84
Q

What does nasal branch supply

A

Skin of nose

85
Q

What does superior labial branch supply

A

Skin of upper lip

86
Q

What shape is the bony orbit

A

Pyramid shaped

87
Q

Where in the orbit is the lacrimal fossa

A

Medial wall anteriorly

88
Q

Where is the lamina papyracea

What is this

A

Paper thin plate of bone overlying ethmoid sinus on medial wall of orbit

89
Q

What foramen are located on medial wall of orbit

3

A

Optic canal
Posterior ethmoidal foramen
Anterior ethmoidal foramen

90
Q

Which bones form lateral wall of orbit

2

A

Zygomatic bone anteriorly and greater wing of sphenoid posteriorly

91
Q

Where is the lateral tubercle located

A

Zygomatic bone in lateral wall of orbit

92
Q

What nerve passes through zygomatico temporal foramen

A

Zygomaticotemporal nerve

93
Q

What nerve passes through zygomaticofacial foramen

A

Zygomaticofacial nerve

94
Q

Which bone forms roof of orbit

A

Frontal bone

95
Q

What structures does the infra temporal fossa house

5

A 
Temporalis
Maxillary artery
Maxillary vein
Buccal fat pads
Temporalis fat pads
96
Q

What structures does the pterygopalatine fossa house

3

A

Pterygopalatine ganglion
Maxillary nerve
Infra orbital branch of maxillary artery

97
Q

Where does superior orbital fissure lye

A

At orbital apex between greater and lesser wings of sphenoid

98
Q

What is the annulus of zinn

A

A tight fibrous ring dividing superior orbita fissure into intra coronal and extra coronal spaces
Also acts as origin for rectus muscles

99
Q

What is the acronym for nerves passing through superior orbital fissure

A 
Luscious 
French
Tarts
Sitting 
Naked 
In
Anticipation
100
Q

Which nerves pass through superior orbital fissure outside annulus of zinn

A

Lacrimal nerve v1
Frontal nerve v1
Trochlear nerve CN 4

101
Q

Which nerves pass through superior orbital fissure within annulus of zinn

A

Superior division oculomotor CN3
Nasocilliary nerve V1
Inferior division occulomotor CN3
Abducens CN 6

102
Q

Where do the extra ocular muscles insert

A

Pierce fascial sheath to insert into sclera

103
Q

What suspends the eye in place

A

Check ligaments

Suspensory ligament of Lockwood

104
Q

What are the ocular muscles and what do they do

6

A

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
Q

Which nerve has fibres passing to cilliary ganglion to hitchhike with opthalmic nerve

A

Parasympathetic fibres of oculomotor nerve

106
Q

What are fibres from cilliary ganglion responsible for

A

Miosis- constriction of pupil

Accommodation- change in focus

107
Q

Where is the lacrimal gland and what type of gland is it

A

Lacrimal fossa

Exocrine gland

108
Q

Where do tears produced by lacrimal gland flow

A

Lacrimal sac

Naso lacrimal duct to inferior meatus of nose

Dentistry Year 1 Term 2 (5 decks)

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