ICL 11.0: Muscles of the Face & Infratemporal Flashcards
1
Q
what are the 5 groups of muscles of the face?
A
- epicranial group
- circumorbital and palpebral group
- auricular group
- nasal group
- buccolabial group
2
Q
which muscles are in the epicranial group?
A
- epicranius aka occipitofrontalis
2. temporoparietalis
3
Q
which muscles are in the circumorbital and palpebral group?
A
- orbicularis oculi
- levator palpebrae superioris
- corrugator supercilii
4
Q
which muscles are in the auricular group?
A
- auricularis anterior
- auricularis superior
- auricularis posterior
5
Q
which muscles are in the nasal group?
A
- procerus
- nasalis
- depressor septi
6
Q
which muscles are the buccolabial group?
A
- orbicularis oris
- levator labii superioris
- levator Labii superioris alaeque nasi
- risorius
- zygomaticus major
- zygomaticus minor
- mentalis
- levator anguli oris
- depressor labii inferioris
- depressor anguli oris
- buccinator
7
Q
where do facial muscles originate and attach too?
A
they arise from the facial bones and attached to the skin or encircle facial orifices
8
Q
what is the innvervation of the facial muscles?
A
all of them are innervated by the facial nerve
EXCEPT levator palpebrae superiors which is innervated by the oculomotor nerve
9
Q
what is the route of the facial nerve?
A
it leaves the skull through stylomastoid foramen, and soon pierces the parotid gland
within the parotid gland, it ramifies into terminal branches which leave the parotid gland from the different borders and run in the superficial fascia of the face to reach their target muscles
this is very close to the TMJ so it is at risk if there is a fracture/dislocation of TMJ
10
Q
what are the 7 branches of the facial nerve?
A
- greater petrosal nerve
- nerve to the stapedius
- chorda tympani
- osterior auricular
- nerve to posterior belly of digastric muscle
- nerve to stylohyoid
- five terminal branches for the muscles of facial expression
11
Q
what are the 5 terminal branches of the facial nerve?
A
- temporal
- zygomatic
- buccal
- marginal mandibular
- cervical
“To Zanzibar By Motor Car”
12
Q
what is facial palsy?
A
aka Bell’s Palsy
it is a type of facial paralysis that results in an inability to control the facial muscles on the affected side
symptoms may include include muscle twitching, weakness, or total loss of the ability to move one or rarely both sides of the face, drooping of the eyelid, a change in taste, pain around the ear, and increased sensitivity to sound
cause is unknown
13
Q
what are the symptoms of Bell’s palsy?
A
- paralysis of the orbiculares oculi which leads to an inability to close the eye –> serious issue because it leads to eye dryness and corneal ulceration
- paralysis of the orbicularis oris = angle of the mouth sags in the affected side, and there may be drooling in that side
- paralysis of the buccinator = accumulation of food between the cheek and the teeth on the affected side; flattened nasolabial fold on effected side
14
Q
what is the arterial supply of the face? what is the route that is takes?
A
- facial artery
2. superficial temporal artery
15
Q
what is the route of the facial artery?
A
its a branch of the external carotid artery
it runs part of its course in the digastric triangle and reach the face at the lower anterior angle of the masseter where its pulse can be palpated
it kind of travels through the mouth up the nose to the eye where it ends near the medial angle of the orbit by becoming the angular artery
16
Q
what are the branches of the facial artery?
A
- ascending palatine
- tonsillar
- inferior labial*
- superior labial*
- lateral nasal*
17
Q
what is the route of the superficial temporal artery?
A
it’s one of the terminal branches of the external carotid artery (the other is the maxillary artery)
it arises inside the parotid gland near the neck of mandible, runs upward and crosses the zygomatic arch and runs in the superficial fascia of the face, supply the skin of face and part of the scalp
it basically runs up the side of the face infant of the ear
you can feel its pulse at the tragus
18
Q
what are the branches of the superficial temporal artery?
A
- transverse facial (it goes and anatomoses with the facial artery)
- frontal (anterior branch)
- parietal (posterior branch)
19
Q
which veins drain the face?
A
facial vein
the supraorbital and supratrochlear veins form the angular vein at the root of the nose –> the angular vein descend over the medial side of orbit to become the facial vein at the lower side of the medial margin of the orbit
then the facial veins descends and in the digastric triangle it joins the anterior division of the retromandibular vein to form the common facial vein
the common facial vein then drains into the internal jugular vein
20
Q
how does the facial vein communicate with the cavernous sinus?
A
the facial vein communicates with cavernous sinus through two routes
- superior and inferior ophthalmic veins connect the angular vein in the orbital region to the cavernous sinus
- the deep facial veins between the nose and mouth connect the facial vein to the pterygoid plexus of veins which, in turn, connects to the cavernous sinus
21
Q
what is cavernous sinus thrombophlebitis?
A
the dangerous triangle of the face = the triangle formed by the nose and mouth
face infections in the area of the dangerous triangle could cause facial vein phlebitis with secondary thrombophlebitis (blood clot) in the internal jugular vein
infected thrombi may reach to cavernous sinus, causing thrombophlebitis of cavernous sinus which may lead to:
- exophthalmos = bulging eyeball
- diplopia/ophthalmoplegia = double vision
- mydriasis and loss of near vision reflexes
- pain, paresthesia or loss of sensation in the distribution of ophthalmic or maxillary divisions of trigeminal nerve
- death
22
Q
what are the 3 pairs of salivary glands?
A
- parotid
- submandibular
- sublingual
23
Q
which salivary gland is the largest?
A
parotid
the parotid glad is surrounded by a tough capsule (parotid sheath), derived from the investing layer of the deep cervical fascia
24
Q
what is the function of the parotid gland?
A
it’s a salivary gland drains saliva through the parotid duct
it’s located under the ear and anterior to the sternocleidomastoid
25
what is sialadentis?
inflammation of the parotid gland
associated with pain, tenderness, redness, and gradual, localized swelling of the affected area
26
where is the parotid duct located?
the parotid ducts emerges from the anterior border of parotid
it runs over the masseter muscle and pierces the buccinator muscle to reach the oral cavity
the parotid ducts opens in the buccal mucosa opposite the maxillary 2nd molar tooth
occasionally, there is extension of the glandular tissue of the parotid over the parotid duct called accessory parotid gland
27
what are sialoliths?
stones in the parotid duct
28
what is sialography?
imaging the parotid after injecting radiographic contrast medium
29
what are the borders of the parotid gland?
the parotid gland extends from external auditory meatus superiorly to the angle of the mandible inferiorly, and from the ramus of the mandible anteriorly to the mastoid process posteriorly --> it's wedge shaped
it has 3 surfaces = lateral, anteromedial and posteromedial
it has 3 borders = anterior, posterior and medial borders
30
what is the parotid bed?
a group of structures related to the medial border of the parotid gland
1. styloid process
2. stylohyoid muscle
3. internal carotid
4. vagus nerve
5. glossopharyngeal nerve
5. lateral wall of the pharynx
31
which structures are at risk during surgery on the parotid gland?
1. facial nerve
2. retromandibular vein
3. external carotid artery
these 3 structures run within the parotid gland and they could be damaged during surgery
32
which muscles surround the parotid?
posteromedial:
1. posterior belly of the digastric
2. sternocleidomastoid
3. mastoid process
anteromedial surface:
1. masseter
2. medial pterygoid muscle
3. ramus of the mandible
33
how is the parotid gland parasympatheticlly innervated?
glossopharyngeal nerve --> tympanic branch --> lesser petrosal nerve --> otic ganglion --> postganglionic and parasympathetic which run in the auricolotemporal nerve --> parotid gland
most important!
34
how is the parotid gland sympathetically innervated?
sympathetic postganglionic fibers are derived from superior cervical ganglion, reaching the gland through sympathetic plexus around external carotid artery
35
what is the sensory innervation of the parotid gland?
great auricular nerve and auriculotemporal nerve
36
what is Frey's syndrome?
a rare neurological disorder resulting from damage to or near the parotid glands responsible for making saliva, and from damage to the
*auriculotemporal nerve often from surgery
when the nerves heal they get all criss crossed between the parasympathetic, sympathetic and sensory innervation so when you smell something good instead of salivating you start sweating
symptoms include sweating and flushing on the cheek or temple, or near the ear, particularly when eating foods with more-intense flavors, such as sour, spicy, or salty foods
37
what are the boundaries of the temporal fossa?
temporal lines to the zygomatic process of the frontal bone to the zygomatic arch and then loops back around to the temporal lines
38
what are the contents of the temporal fossa?
the temporalis muscle along with its blood and nerve supply = deep temporal arteries and nerves
39
what is the infratemporal fossa?
an irregular area on the lateral surface of the skull deep below the zygomatic arch and deep to the ramus of the mandible
it goes from the ramus of the mandible to the lateral pterygoid plate to the posterior surface of the maxilla to the mastoid/styloid process of the temporal one
it goes from the infratemporal surface of the greater wing of the sphenoid down to the medial pterygoid attachment o the angle of the mandible
40
what are the contents of the infratemporal fossa?
MUSCLES
1. Medial Pterygoid
2. Lateral Pterygoid
3. Temporalis muscle tendon
BLOOD VESSELS
1. Maxillary artery and some of its branches
2. Pterygoid plexus of veins
3. Maxillary vein and its tributaries
NERVES
1. Mandibular nerve and its branches
2. Otic ganglion
3. Posterior superior alveolar nerve (branch of maxillary nerve)
41
which 4 muscles are responsible for chewing?
1. masseter
2. temporalis
3. medial pterygoid muscle
4. lateral pterygoid muscle
42
what innervates the muscles involved in mastication?
the mandibular division of the trigeminal nerve
1. masseter
2. temporalis
3. medial pterygoid muscle
4. lateral pterygoid muscle
43
where is the masseter located? what is its action?
ocated in the face over the lateral surface of the ramus of the mandible -- it basically covers the ramus
it goes from the zygomatic arch to the angle of the mandible
muscle is overlapped by the parotid gland posteriorly, and crossed by parotid duct, branches of facial nerve
it's a powerful elevator of the mandible to occlude the teeth, the muscle provides minimal protrusion
44
what is the innvervation of the masseter?
V3 = mandibular division of trigeminal nerve
45
where is the temporalis located? what is its action?
Temporalis muscle is located in the temporal fossa, occupying all the temporal fossa, and it is tendon is in the infratemporal fossa
so it goes from the interior temporal line and takes up the whole floor of the temporal fossa down to the coronoid process of the mandible
elevates and retrudes the mandible to close the mouth
46
what is the innervation of the temporalis
deep temporal branches of the mandibular nerve
47
what clinically significant thing is related to the temporalis?
the temporalis muscle is covered by tough double-layered temporal fascia commonly used as a graft tissue for tympanoplasty
48
where is the lateral pterygoid located?
upper head attaches from the infratemporal surface of the greater wing of the sphenoid
lower head attaches to the lateral surface of the lateral pterygoid plate
then they both insert at the neck of the mandible like at the condylar process
49
what is the innervation of the lateral pterygoid muscle?
mandibular nerve
50
what is the action of the lateral pterygoid muscle?
1. protrusion of the mandible
2. depresses the mandible (opening
3. with ipsilateral medial pterygoid, they rotate the mandible to the contralateral side
51
what is the location of the medial pterygoid muscle? what is it innervated by?
it originates from the medial surface of the lateral pterygoid plate & tuberosity of maxilla
it then attaches into the medial surface of the angle of the mandible
so it's like on the inside of your jaw from the inside of your mandible to the inside of the maxilla
it's innervated by the mandibular nerve
52
what is the action of the medial pterygoid muscle?
1. elevation of the mandible
2. protrudes the mandible
3. with ipsilateral lateral pterygoid, they rotate the mandible to the contralateral side
53
which muscles allow you to grind your jaw side to side?
the lateral and medial pterygoid muscles
so when the left medial and lateral pterygoid muscles contract they move the jaw to the right
54
which muscles help elevate the mandible? aka close the mouth
1. temporalis
2. masseter
3. medial pterygoid
55
which muscles help depress the mandible? aka open the mouth
lateral pterygoid
2. supra hyoid and infra hyoid muscle groups
gravity
56
which muscles help with protrusion of the mandible?
1. lateral pterygoid
2. medial pterygoid
3. masseter
57
which muscles with recursion of the mandible?
temporalis
58
what are the articulating processes of the TMJ?
from the skull it's the mandibular fossa and articular tubercle (part of the temporal bone)
from the mandible the head of the mandible aka the condylar process articulates with the skull
the articular surfaces are covered by fibrocartilage, but predominantly fibrous
59
what are the extrinsic and intrinsic ligaments of the TMJ?
the lateral temporomandibular ligament attaches from the zygomatic arch to the condylar process
the extrinsic ligaments are the stylomandibular ligament and the sphenomandibular ligament
60
what is the function of the articular disc of the TMJ?
the TMJ has an articular disc that's attached to the joint capsule and divides the joint cavity into an upper and lower compartment
the upper compartment has a loos capsule which permits forward and backward gliding movements of the mandibular head and the articular disc as a unit
the lower compartment has a slightly tenser capsule which allows a hinge-like downward and upward rotation of the mandibular head within the articular disc
61
what happens when you open your mouth?
forward and downward gliding of the mandibular head and articular disc over the articular tubercle in the upper compartment of the joint
there's also hinge-like downward rotation of the mandibular head in the lower compartment, i.e., within the articular disc around a horizontal axis
62
what happens when you close your mouth?
upward and backward gliding movement of the mandibular head and articular disc in the upper compartment
there's also hinge-like upward rotation of the mandibular head in the lower compartment, i.e., within the articular disc around a horizontal axis
63
what happens when you grind your mouth to the right?
forward and downward gliding of the left mandibular head and the articular disc while the right mandibular head stays in the occlusal position and spins rightward around its vertical axis
64
what happens when you grind your mouth to the right?
forward and downward gliding of the right mandibular head and the articular disc while the left mandibular head stays in the occlusal position and spins leftward around its vertical axis
65
what happens when the TMJ is dislocated?
it always happens anteriorly due to lack of bony congruence of the articular process during opening of the mouth
usually due to excessive yawning, opening of the mouth, violent contractions of the lateral pterygoid or receiving a blow to the mandible with the mouth open
NO posterior dislocation due to congruence of the articular surfaces and the presence of the postglenoid tubercle
66
what happens if you get punched in the jaw with your mouth closed?
in a direct blow to the mandible from front, with the mouth closed, the neck of the mandible will break before dislocation
if you get punched with your mouth open, the TMJ will dislocate anteriorly
67
if you're surgically repairing the TMJ, which nerves do you need to watch out for?
1. acial nerve
| 2. auriculotemporal nerve
68
what is the route of the maxillary artery?
the maxillary artery is the larger of the two terminal branches of external carotid artery
it arises opposite the neck of the mandible, runs most of its course through the infratemporal fossa
then it dives into the pterygomaxillary fissure to reach pterygopalatine fossa where it divides into two terminal branch; infraorbital and sphenopalatine arteries
69
what are the branches of the maxillary artery?
1. deep auricular
2. anterior tympanic
3. inferior alveolar
4. deep temporal
5. buccal
6. posterior superior alveolar
7. middle meningeal (the most important**)
8. accessory meningeal
9. muscular branches
70
what is the route of the middle meningeal artery?
it's a branch of the maxillary artery that ascends upward deep to the lateral pterygoid muscle
it accesses the cranial cavity through the foramen spinosum and then splits into a larger anterior frontal branch and a posterior parietal branch
71
what is the origin of the mandibular nerve?
it's one of the three branches of the trigeminal nerve
V3
72
what is the route of the mandibular nerve?
It leaves the skull through foramen ovale to reach the infratemporal fossa
it then divides into anterior and posterior trunks from which multiple branches emerge
when it comes out of the foramen ovale it branches behind the lateral pterygoid muscle
73
what's special about the mandibular nerve?
mandibular nerve is the only division of the trigeminal nerve which is mixed nerve, carrying motor fibers for the muscles of mastication, tensor veli palatini, mylohyoid, and anterior belly of digastric, and sensory fibers supplying part of the skin of the face and oral cavity
74
what are the branches of the mandibular nerve?
from the posterior trunk:
1. auriculotemporal nerve
2, inferior alveolar nerve
3. lingual nerve
from the anterior trunk:
1. deep temporal nerves
2. nerve to masseter
3. nerve to lateral pterygoid
4. nerve to medial pterygoid
5. buccal nerve --> sensory; do NOT confuse with buccal branch of the facial nerve which is motor
75
what is the route of the aurticulotemporal nerve?
arises from the mandibular nerve by two roots which encircle the middle meningeal artery
it passes deep to the lateral pterygoid muscle and the neck of the condylar process of mandible
it's at risk in fracture of the neck of the mandible or during surgical repair of dislocated temporomandibular joint
76
what does the auritculotemporal nerve innervate?
sensory fibers to:
1. skin of the temple
2. auricle of the ear
3. external auditory canal
4. parotid gland
5. TMJ
it also carries postganglionic parasympathetic fibers from the otic ganglion to the parotid gland
77
in what location would you perform a mandibular nerve block?
through the mandibular notch
it's literally a straight shot at the mandibular nerve
78
what is the route of the inferior alveolar nerve?
it's a branch of the mandibular nerve that enters the mandible through the mandibular foramen and runs in the mandibular canal
it emerges from the mental foramen as the mental nerve
79
what does the inferior alveolar nerve innervate?
it supplies all the mandibular teeth and area of the skin over the chin and lower lip
also, before it enters the mandibular foramen the inferior alveolar nerve gives its nerve to mylohyoid branch which supplies mylohyoid and anterior belly of digastric
80
in what location would you do an interior alveolar nerve block?
from inside of the oral cavity, midway between the anterior and posterior border of the ramus of the mandible and 1 cm above the occlusal surface of the third mandibular molar tooth
81
what is the route of the lingual nerve?
it's a branch of the mandibular nerve and it emerges in the infratemporal fossa below the lower border of the lateral pterygoid and runs over the medial pterygoid on its way to the tongue
it reaches the oral cavity between the mylohyoid and hyoglossus muscle
it ends by supplying general sensation to the anterior 2/3 of the tongue
it basically runs down your mandible
the lingual nerve is joined by the chorda tympanic branches of facial nerve
82
what is the function of the chorda tympanic nerve?
the lingual nerve is joined by the chorda tympanic branches of facial nerve
the chorda tympanic nerve carries preganglionic parasympathetic fibers to the submandibular ganglion from which postganglionic secretomotor fibers innervates submandibular and sublingual salivary glands
83
during what procedure could the lingual nerve be damaged?
the lingual nerve enters the oral cavity very close to the mandibular 3rd molar and is at risk during its extraction aka your wisdom teeth!
84
what is the route of the buccal nerve?
it's a branch of the mandibular nerve that emerges between the two heads of lateral pterygoid
it runs over the lower head of the lateral pterygoid, medial pterygoid and buccinator and supplies the skin of the cheek and buccal mucosa
85
where would you perform a buccal nerve block?
inside the oral cavity, injection is made in the retromolar fossa which is posterior and superior to the mandibular 3rd molar
86
what is the sensor distribution of the mandibular nerve?
the mandibular nerve is V3 so it's the lower part of the face
the auriculotemporal nerve innervates the ear to the middle temple
the buccal nerve innervates the lateral cheek
the mental nerve innervates the chin and lower lip
87
what is the pterygomaxillary fissure?
it's a v-shaped space between the posterior surface of maxilla and the lateral pterygoid process
it connects the infratemporal fossa with the pterygopalatine fossa
88
what passes through the pterygomaxillary fissure?
the 3rd part of the maxillary artery
it dives through the fissure to reach to the pterygopalatine fossa
89
what are the contents of the pterygopalatine fossa?
1. part of the maxillary nerve
2. pterygopalatine ganglion and the beginning parts of its branches
3. the 3rd part of the maxillary artery and the beginning parts of its branches
90
what does the pterygopalatine fossa communicate with?
Oral cavity through the palatine canal
Orbits through the inferior orbital fissure
Middle crania fossa through foramen rotundum
Nasal cavity through sphenopalatine foramen
Pharynx through pharyngeal canal
Infratemporal fossa through pterygomaxillary fissure
Base of the skull through pterygoid canal
91
where does the maxillary nerve originate from?
it's V2
the maxillary nerve is the second branch of trigeminal nerve
it is a PURE sensory nerve
92
what is the route of the maxillary nerve?
it leaves the middle cranial fossa where it is located in the lateral wall of cavernous sinus through the foramen rotundum to reach the pterygopalatine fossa
it runs within the pterygopalatine fossa and leaves it through the inferior orbital fissure to reach the infraorbital canal where it becomes infraorbital nerve
the infraorbital nerve exits the infraorbital canal through infraorbital foramen where it supplies areas of the face, nose, and lower eye lids and upper lip
93
what are the branches of the maxillary nerve?
1. zygomatic nerve (ends in the face as zygomaticotemporal and zygomatic facial)
2. posterior superior alveolar nerve
3. two sensory roots to the pterygopalatine ganglion
94
what is the pterygopalatine ganglion?
the pterygopalatine ganglion is a parasympathetic ganglion topographically related to maxillary nerve but functional related to facial nerve through its greater petrosal nerve
95
what are the roots that contribute to the pterygopalatine ganglion?
2-3 sensory roots from the maxillary nerve
the motor root of the greater petrosal nerve
the sympathetic root of the deep petrosal nerve from the plexus around the internal carotid artery
96
which nerves contribute to the pterygoid canal?
deep petrosal nerve and the motor root of the greater petrosal nerve
97
what are the branches of the ophthalmic nerve?
top
1. supraorbital
2. supratrochlear
3. infratrochlear
4. external nasal
bottom
98
which nerves supply the sensory innervation of the face?
sensory innervation of the face is derived from the three divisions of the trigeminal nerve; ophthalmic, maxillary and mandibular
***the exception is the skin over the angle of the mandible is supplied by great auricular nerve (C2,3)
99
what is trigeminal neuralgia?
a painful condition affecting areas of the face supplied by trigeminal nerve
very rare though and the cause is unknown
effects 50-70 year olds and more women
the patient suffers from sudden episode of agonizing or excruciating pain which is described as stabbing, burning, piercing-Shock-like or lightening
100
a patient suffering from agonizing pain under the nose as a result of trigeminal neuralgia. Which of the following nerves is most likely affected?
A. Ophthalmic
B. Maxillary
C. Mandibular
D. Auriculotemporal
E. Facial
B. Maxillary
101
to extract the mandibular 3rd molar tooth, which nerve of the following should be anesthetized?
A. Buccal nerve
B. Posterior superior alveolar nerve
C. Auriculotemporal
D. Inferior alveolar
E. None of the above
D. Inferior alveolar
102
a patient who squeezes a pimple on his upper lip is at risk of cavernous sinus thrombophlebitis due to retrograde spread of infection into the cavernous sinus though which of the following venous routes?
A. Superficial temporal vein
B. Pterygoid plexus of veins
C. Retromandibular vein
D. Common facial vein
E. Internal jugular vein
B. Pterygoid plexus of veins
103
during chewing of food, which muscle of the following will move the mandible to the left side?
A. Right masseter
B. Left temporalis
C. Right medial pterygoid
D. Left lateral pterygoid
E. Left Medial pterygoid
C. Right medial pterygoid
104
a 45-year old female patient with left-sided facial palsy affecting all the muscles of facial expressions and she is additionally complaining of decreased tolerance to loud sounds. Lacrimation was normal in the left eye. you locate the lesion of the facial nerve at:
A. parotid gland
B. distal end of the facial canal in the mastoid part of temporal bone
C. proximal end of the facial canal
E. the stylomastoid foramen
F. the internal auditory canal
C. proximal end of the facial canal
105
a patient with rhabdomyosarcoma ( a malignant tumor of the muscle) in the medial pterygoid may cause pressure symptoms in which of the following nerves?
A. Auriculotemporal nerve
B. Lingual nerve
C. Posterior superior
alveolar nerve
D. Maxillary nerve
E. Deep temporal nerve
B. Lingual nerve
106
a patient with facial palsy is more likely to complain of:
A. Loss of sensation in the left side in the buccal mucosa and skin of the cheek on the left side
B. Loss of general sensation from the anterior 2/3 of the tongue on the left side
C. Loss of taste sensation in the posterior 1/3 of the tongue on the left side
D. Decreased salivation from the left parotid gland
E. None of the above
E. None of the above
107
a 22-year old male came to the Emergency Department after an altercation in which he received a blow to the chin that fractured the neck of the mandible as evidenced by x-ray. Which of the following nerve is at risk and should be evaluated?
A. Inferior alveolar nerve
B. Auriculotemporal nerve
C. Lingual nerve
D. Buccal nerve
E. Deep temporal nerve
B. Auriculotemporal nerve
108
9. A patient with rhabdomyosarcoma ( a malignant tumor of the muscle) in the lateral pterygoid my cause pressure symptoms in which of the following nerves?
A. Auriculotemporal nerve
B. Lingual nerve
C. Inferior alveolar nerve
D. Deep temporal nerve
E. All of the above
A. Auriculotemporal nerve
B. Lingual nerve
C. Inferior alveolar nerve
D. Deep temporal nerve
E. All of the above
109
a fracture in the middle of the ramus of the mandible will result in sensory loss in which of the following areas of the face?
A. Upper lip
B. Cheek
C. Over the surface of the parotid
D. Skin of the chin and lower lip
E. Auricle of the ear
D. Skin of the chin and lower lip
110
trigeminal neuralgia affecting the mandibular division of the trigeminal nerve suffers from pain in the following area of the face except:
A. Lower lip
B. The skin of the cheek
C. The skin of the chin
D. The skin over angle of the mandible
E. Skin of the temple region
D. The skin over angle of the mandible
111
postganglionic parasympathetic fibers from the otic ganglion to the parotid gland are carried to the parotid gland through which of the following nerves?
A. Deep auricular nerve
B. Inferior alveolar nerve
C. Lingual nerve
D. Auriculotemporal nerve
E. Chorda tympani nerve
D. Auriculotemporal nerve
112
Preganglionic parasympathetic fibers to the pterygopalatine ganglion are derived from which of the following cranial nerve?
A. Oculomotor nerve
B. Abducens nerve
C. Facial nerve
D. Glossopharyngeal nerve
E. Maxillary division of trigeminal nerve
C. Facial nerve
113
Pterygopalatine ganglion supplies post-ganglionic secretomotor fibers to which of the following glands?
A. Parotid gland
B. Sublingual gland
C. Lacrimal gland
D. Submandibular gland
E. None of the above
C. Lacrimal gland
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Pressure on the lingual nerve by Schwannoma (largely benign tumor of Schwann cells) at its origin from the mandibular nerve may result in:
A. Loss of general sensation of the anterior 2/3 of the tongue
B. Loss of taste sensation from the anterior 2/3 of the tongue
C. Combined loss of taste and general sensation of the anterior 2/3 of the tongue
D. Loss of saliva secretion from the submandibular and sublingual salivary gland
E. Loss of saliva secretion from parotid gland
A. Loss of general sensation of the anterior 2/3 of the tongue
