Gross 2 Vasculature, TMJ, Eye, Ear and Mouth Flashcards
What arteries supply the face?
(Superficial and Deep)
The Facial and Transverse Facial Arteries
(They supply the vast majority of the face, superficially)
The deep structures are supplied by the Maxillary Artery and branches off the External Carotid.
What are the 3 parts to the Maxillary Artery?
1st part) Mandibular
2nd part) Pterygoid
3rd part) Pterygopalatine
In the Mandibular part (p. 1) of the Maxillary Artery, what are the branches?
- Deep Auricular A.
- Inferior Alveolar A. which comes off the Mental A.
- Middle meningeal A.
In the Pterygoid part (p. 2) of the Maxillary Artery, what are the branches?
- Masseter A.
- Deep Temporal A.
- Pterygoid A.
- Buccal A.
In the Pterygopalatine part (Pt. 3) of the Maxillary Artery, what are the branches?
- Superior Alveolar A. (Ant., Middle, Post.)
- Sphenopalatine A.
- Infraorbital A.
- Descending Palatine A., which then spits to Lesser and Greater Palatine A.
What are the Arteries of the Scalp?
External Carotid
- Occipital A.
- Posterior Auricular A.
- Superficial Temporal A.
Internal Carotid
- Supra-Trochlear A.
- Supra-Orbital A.
What structures form the Temporomandibular Joint?
- The Temporal bone: mandibular fossa
- The Mandible: Condyle of mandible
Has an Intra-articular disc that separates the joint into 2 cavities.
What nerve(s) innervate the TMJ?
The Mandibular Nerve (V3) via the Deep Temporal N., Masseteric N., and Auriculotemporal N.
What does the Intra-Articular Disc of the TMJ attach to?
Anteriorly: Lateral Pterygoid
Posteriorly: Posterior Capsule (Superior and Inferior Lamina)
What are the Intrinsic TMJ ligaments?
What does it reinforce and prevent?
- Lateral Ligament of TMJ
–A thickening of lateral capsule
–This reinforces joint laterally and prevents posterior dislocation
What are the Extrinsic TMJ ligaments?
- Stylomandibular Ligament
- Sphenomandibular Ligament
The Posterior Capsule of the TMJ contains two lamina, superior and inferior lamina (Ligaments). Which of the lamina contains elastic fibers?
- The superior lamina contains (fibro) elastic fibers. This allows for protrusion of the disc anteriorly during jaw opening, it then recoils when the jaw closes
The inferior lamina is non-elastic to limit anterior translation of disc
When the Jaw is opening, what are the stages and degrees?
- 1st Stage: The Condyles roll anteriorly;
0-25° - 2nd Stage: Condyles and disc move anteriorly; 25-50°
When the Jaw is closing, what are the stages and degrees?
- 1st Stage: Condyles and disc moves posteriorly; 50-25°
- 2nd Stage: Condyles move posteriorly; 25-0°
In Jaw Movement, what happens with Protrusion?
The condyles and disc translate over articular tubercles of temporal bones; 6-9mm
In Jaw Movement, what happens with Retrusion?
The condyles and disc move posteriorly to post-glenoid tubercle; 3mm
In the Jaw Muscle activity, which muscles are involved in Depression or opening the mouth?
- **The Lateral Pterygoid pulls the intra-articular disc and condyles forward
- **The Anterior Digastric, Mylohyoid and Genohyoid pull the mandible down
- Also the infrahyoid muscles
** are the main ones
In the Jaw Muscle activity, which muscles are involved in closing/occlusion of the mouth?
- The Masseter, Temporalis, and Medial Pterygoid pull the mandible up
Which muscles will be involved with Lateral Excursion (chewing) to the left?
Excursion is the side to side motion
- Left Masseter
- Left Temporalis
- Right Medial Pterygoid
- Right Lateral Pterygoid
(The Pterygoid’s are the pre-dominant movers)
Which muscles are responsible for TMJ Protrusion (Protrude the chin)?
- Lateral Pterygoid (Dominant)
- Masseter
- Medial Pterygoid
Which muscles are responsible for TMJ Retrusion of chin?
Temporalis (Posterior Oblique and near-horizontal fibers)
What is the result when the Mandible is dislocated?
This results in Displacement of the TMJ
If the TMJ joint is dislocated medially, what structures would be affected?
- Chorda Tympani Nerve
- Middle Meningeal Artery
If the TMJ joint is dislocated Laterally, what structures would be affected?
- The Temporal Branch of Facial Nerve (CN VII)
If the TMJ joint is dislocated Anteriorly, what structure would be affected?
Lateral Pterygoid Muscle
If the TMJ joint is dislocated Posteriorly, what structures would be affected?
- Auriculotemporal Nerve
- Facial Nerve
- Parotid Gland
- Superficial Temporal A. and V.
- External Auditory Meatus
A patient suffers a medial dislocation of the TMJ, what are some potential issues that may arise?
Damage to the Chorda Tympani Nerve:
- Impacts taste to the anterior 2/3 of tongue
- Submandibular and sublingual glands secretion (salivary glands)
Damage to the Middle Meningeal Artery:
(This artery is found in the first part/Mandibular part of the Maxillary Artery)
- Impacts blood flow to the meninges particularly the dura mater
What are the borders of the Oral Cavity?
Superiorly: Hard and Soft palate
Inferiorly: Tongue
Laterally: Teeth
Anteriorly: Teeth
Posteriorly: Pharynx
What contents are in the Oral Cavity?
- Hard and Soft Palate
- Teeth
- Tongue
For the teeth, what supplies and innervates the Upper Row?
Arterial Supply:
- Superior Alveolar Artery (Posterior, Anterior, and Middle), the 3rd part of the Maxillary Artery
Innervation:
- Superior Alveolar Nerve (Posterior, Anterior, and Middle), of V2 from the Trigeminal Nerve (CN V)
For the teeth, what supplies and innervates the Lower Row?
Arterial Supply:
- Inferior Alveolar Artery, the 1st part of the Maxillary Artery
Innervation:
- Inferior Alveolar Artery of V3 from the Trigeminal Nerve
Describe the role of the Palate. What does it consist of?
The Palate separates the oral cavity from the nasal cavity
Consist of Hard and Soft Palate:
- The Hard Palate is formed by the palatine plate from the maxillary and palatine bone
- The Soft Palate acts as a valve closing the nasal cavity from the oral cavity
- Composed of an aponeurosis anteriorly and muscles posteriorly
What are the 5 Muscles of the Palate, their actions and innervations?
- Tensor Veli Palatini: Tenses soft palate when yawing and swallowing (Mandibular N.)
- Levator Veli Palatini: Elevates soft palate when yawing and swallowing (Vagus N.)
- Palatoglossus: Lowers the palate onto tongue (Vagus N.)
- Palatopharyngeus: Elevates and pulls the pharynx anteriorly during swallowing and speaking (Vagus N.)
- Musculus Uvulae: Shortens and pulls the uvulae superiorly to close the nasopharynx (Vagus N.)
What nerve provides sensation of the soft palate?
Lesser Palatine
What nerve(s) provide sensation of the hard palate?
Greater Palatine and Nasopalatine
Describe the Tongue.
(The function, parts, ect.) (5)
- Functions in speech, taste and eating
- Divided into an anterior 2/3, a posterior 1/3 and a roof of the tongue posteriorly
- Fills most of the oral cavity when the mouth is closed
- Has specialized mucosa with lingual papillae (contain taste buds)
- Has 2 types of muscles (Extrinsic and Intrinsic)
–To manipulate food and for speech
What are the Extrinsic Muscles of the Tongue and what are their actions?
- Genioglossus (Protrudes)
- Hyoglossus (Depresses)
- Palatoglossus (Elevates post. Tongue)
- Styloglossus (Retracts)
These muscles control the tongues position
What are the Intrinsic Muscles of the Tongue?
- Transverse Bundle
- Superior Longitudinal Bundle
- Inferior Longitudinal Bundle
These muscles control tongues shape
What are the 5 nerves that innervate the tongue, what do they do?
- Lingual N. : Sensation to anterior 2/3 of tongue
- Chorda Tympani (CN VII) : Taste to anterior 2/3 of tongue
- Glossopharyngeal N. : Does both sensory and taste for posterior 1/3 of tongue
- Vagus N. : Does both sensory and taste for the roof of the tongue
- Hypoglossal N. : Does motor for the tongue
Where does the Lingual Artery arise from and what are its branches, what do they supply?
The Lingual Artery arises from the External Carotid Artery. This Artery passes deep to the Hyoglossus muscle and provides branches:
- Dorsal Lingual artery: Supplies root of tongue
- Deep Lingual Branches: Supply the body of the tongue
- Sublingual Arteries: Supply the sublingual glands, geniohyoid, mylohyoid, and oral mucosa
These are the structures of the floor of the mouth
What are the 3 parts of the Pharynx and their function?
Nasopharynx: Respiratory function
Oropharynx: Digestive function
Laryngopharynx: Both Respiratory and Digestive Function
- Communicates with the larynx
- For the digestive system it serves as the pathway to the esophagus. The muscular walls aid the process of swallowing
What nerve(s) innervates the Pharynx muscles?
All pharyngeal muscles, Except the Stylopharyngeus (CN IX) are innervated by Vagus Nerve (CN X)
In the Pharynx, what muscles in the external layer constrict during swallowing?
- Superior, Middle and Inferior Pharyngeal Constrictor
These muscles are the muscles that constrict during swallowing
What are the Extra-Ocular Muscles?
- Levator Palpebrae Superiori
Recti (4)
- Superior
- Inferior
- Lateral
- Medial
Oblique (2)
- Superior
- Inferior
If you are looking “Up and Out” on the left side, which muscles are acting on the left eye and the right eye?
- For the left Inferior oblique
- For the Right eye the Superior Rectus
If you are looking straight to the right side, which muscle are acting on the left eye and the right eye?
For the right eye the Lateral Rectus
For the left eye the Medial Rectus
If you are looking “Down and Out” on the right side, which muscles are acting on the left eye and the right eye?
For the Right eye the Superior Oblique
For the left eye the Inferior Rectus
In the eye, what is Sclera?
An opaque white fibrous layer covering the eye
- Attachment sight for extrinsic muscles of the eyeball
In the eye, what is the Cornea?
A convex and transparent layer, the most anterior part of the eye
- Refracts light entering the eye
- Protects the eye from external environment
In the eye, what is the Iris?
- The attachment site for intrinsic muscles of the eye
- Controls the diameter to modify amount of light entering the eye
In the eye, what is the Pupil?
A black opening in the center of the iris
- Transmits light into the eye
In the eye, what is the Lens?
A layer that is posterior to the pupil
- This changes shape to focus objects
What is the Dilator Pupillae? What type of innervation does it have?
- An intrinsic muscle that has radially arranged fibers that dilates the pupil (Increases the diameter of pupil)
Has sympathetic innervation
What is the sphincter Pupillae? What type of innervation does it have?
- An intrinsic muscle that has circularly arranged fibers that constricts the pupil
Has Parasympathetic innervation (CN III)
What is Horner’s Syndrome? What is it characterized by?
A lesion of a Cervical sympathetic trunk in the neck
- Characterized by:
–Constriction of the pupil (Miosis)
–Drooping of the superior eyelid (Ptosis)
–Redness and increase temperature of the skin (vasodilation)
–Absence of sweating (Anhydrosis)
In the Inner layer of the Eye, what are the Retina, Rods, and Cones
Retina: A layer is the eye that light reaches and the image is detected by rods and cones
Rods: Detects black and white shades of light; most plentiful along the sides of the retina
Cones: Detects color; most plentiful in the posterior central portion called fovea
What is the function of the External Ear?
Funnel sound waves
What are the arteries that supply the External Ear?
- Posterior Auricular (of External Carotid)
- Superficial Temporal (of External Carotid)
What are the nerves that innervate the External Ear?
- Great Auricular (Cervical Plexus)
- Auriculotemporal (of V3)
- Auricular branches of Vagus N.
- Branches of Facial
What are the Boarders of the Middle Ear?
Tympanic membrane to Auditory Tube
What contents are in the Middle Ear?
- Tympanic Membrane (Ear Drum)
- Auditory Ossicles
- Tensory Tympani Muscles
- Stapedius Muscle
Chorda Tympani N. Travels across the Tympanic Membrane
What is the Tympanic Membrane?
Aka the Ear drum
- Sound waves hits the membrane which vibrates and transmits waves to bones of middle ear
What are the 3 auditory ossicles?
Malleus, Incus, and Stapes
- These are the smallest bones in the body and they transmit the waves onto the cochlea
What is the function of the Tensor Tympani Muscle? What innervates it?
Functions to tense the Tympani Membrane
Innervated by the Medial Pterygoid off the Mandibular (V3) of Trigeminal
What is the function of the Stapedius Muscles? What innervates it?
Stabilizes the stapes (one of the auditory bone) to prevent excessive movement of stapes.
Innervated by a branch off the Facial Nerve
What contents are in the Inner Ear? What are their functions?
Referred to as the Labyrinth
- Cochlea: Sensory Organ for hearing
- Vestibule: Responses to changes in positions of the head (ex. a head tilt) and linear acceleration
- Semicircular Canal: Responds to rotational position of head (dynamic positions)
All innervated by Vestibulocochlear Nerve (VIII)
