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Local Anesthesia > Nerves of the Face > Flashcards

Nerves of the Face Flashcards

1
Q

V2 gives off branches to which areas?

A

1) cranium
2) pterygopalatine fossa
3) infraorbital canal
4) face

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2
Q

The 4 main branches of V2 in the pterygopalatine fossa are:

A

1) zygomatic branches
2) nasopalatine branches
3) palatine branches
4) posterior superior alveolar branches

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3
Q

The 3 main branches of V2 in the infraorbital canal are:

A

1) infraorbital nerve
2) middle superior alveolar nerve
3) anterior superior alveolar nerve

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4
Q

The terminal branches of V2 on the face are:

A

1) inferior palpebral nerve
2) external nasal nerve
3) superior labial nerve

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5
Q

The zygomatic branch of V2 exits the pterygopalatine fossa through ________ and splits into ________ to innervate:

A

1) inferior orbital fissure
2) zygomaticofacial n. which innervates the skin side of the forehead and zygomaticotemporal n. which innervates the skin side of the upper cheek

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6
Q

Pathway and innervation of nasopalatine nerve:

A

Exits the pterygopalatine fossa through the SPHENOPALATINE FORAMEN and passes through the nasal cavity anterior-inferiorly to innervate the nasal septum and lateral nasal cavity, then enter the incisive canal in the floor of the nasal cavity. The left and right nerves join and exit the skull through the incisive foramen to innervate the GINGIVAL, MUCOSAL, and OSSEOUS tissue from the maxillary central incisors to the canine.

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7
Q

The greater and lesser palatine nerves exit the pterygopalatine fossa through the:

A

pterygopalatine canal

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8
Q

The greater palatine nerve innervates:

A

palatal gingival, mucosal, and osseous tissues from premolars to posterior of hard palate

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9
Q

The lesser palatine nerve innervates:

A

palatal mucosa of the soft palate and uvula

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10
Q

Pathway of the posterior superior alveolar (PSA) branches

A

exits the pterygopalatine fossa through the pterygomaxillary fissure, splits into external branches that travel along the posterior surface of the maxilla and internal branches that enter the posterior-inferior maxilla through the PSA foramina

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11
Q

The PSA nerve innervates:

A

dental pulp, facial gingiva, PDL, and alveolar bone of the of the maxillary first (except mesiobuccal root), second, and third molars

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12
Q

The inferior palpebral nerve innervates:

A

lower eyelid

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13
Q

The external nasal nerve innervates:

A

lateral skin of the nose

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14
Q

The superior labial nerve innervates:

A

mucosa and skin of the upper lip

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15
Q

The MSA innervates:

A

dental pulps, facial gingiva, PDL, and alveolar bone of premolars and mesiobuccal root of maxillary first molar

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16
Q

The ASA innervates:

A

dental pulps, facial gingiva, PDL, and alveolar bone of maxillary incisors and canines

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17
Q

The infraorbital nerve innervates:

A

cheek area

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18
Q

The motor root of V3 innervates:

A

1) muscles of mastication
2) mylohyoid
3) ant. belly of digastric
4. tensor tympani
5. tensor veli palatini

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19
Q

The sensory root of V3 provides cutaneous innervation to:

A

1) skin anterior to ear
2) lower cheek
3) lower lip
4) lower part of face
5) buccal mucosa
6) anterior 2/3 of tongue
7) mastoid air cells
8) mandibular teeth and periodontal tissues
9) bone of mandible
10) TMJ
11) parotid gland

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20
Q

What are the branches of the undivided V3?

A

1) nervus spinosus (meningeal branch of mandibular nerve)

2) nerve to medial pterygoid

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21
Q

What is the pathway and innervation of the nervus spinosus (meningeal branch of mandibular nerve)?

A

originates from medial V3 out the infratemporal fossa in superior direction through foramen spinosum, joins the middle meningeal artery to supply the dura mater and mastoid air cells

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22
Q

What is the pathway and innervation of the nerve to the medial pterygoid?

A

originates from medial V3 and descends to provide motor innervation to medial pterygoid; also gives off motor branches to tensor veli palatini and tensor tympani

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23
Q

Primary functions of smaller anterior division of V3

A

1) motor innervation to muscles of mastication

2) sensory innervation to mucosa of cheek and mucosa buccal to mandibular molars

24
Q

What is the course of the anterior division of V3?

A

1) runs anteriorly, medial to lateral pterygoid muscle
2) passes between heads of lateral pterygoid to reach lateral surface
3) follows temporalis inferiorly
4) emerges under anterior border of masseter and continues in an terolateral direction
5) crosses in front of the anterior border of ramus and lateral the buccinator muscle at the level of the mandibular 3rd molars to supply the skin of the cheek

25
Q

What branches does V3 give off as it runs medial to the lateral pterygoid muscle?

A

1) posterior and anterior deep temporal nerves
2) masseteric nerve
3) nerve to the lateral pterygoid muscle

26
Q

What is the pathway of the posterior and anterior deep temporal nerves, and what do they innervate?

A

from V3 running medial to lateral pterygoid, passes lateral to the lateral pterygoid, curves around the infratemporal crest, and descends to temporal fossa to innervate temporalis muscle

27
Q

What is the pathway of the masseteric nerve, and what does it innervate?

A

from V3 running medial to lateral pterygoid, passes lateral to the lateral pterygoid and through the mandibular notch to innervate masseter

28
Q

What is the pathway of the nerve to the lateral pterygoid?

A

feeds directly from V3 as it runs medial to the lateral pterygoid

29
Q

The buccal nerve supplies sensory innervation to:

A

1) skin and mucous membrane covering buccinator

2) gingiva of the mandibular molars

30
Q

What is the course of the posterior division of V3?

A

1) descends inferiorly along the lateral pterygoid muscle

2) branches into the auriculotemporal nerve, lingual nerve, and IA nerve

31
Q

What does the auriculotemporal nerve innervate?

A

skin of the temporal area

32
Q

What does the lingual nerve innervate?

A

1) mucosa of the gingival and lingual mandibular teeth
2) anterior 2/3 of tongue
3) floor of mouth

33
Q

What does the IA nerve innervate?

A

dental pulp, facial gingiva, PDL, and alveolar bone of mandibular teeth except for facial gingiva of mandibular molars (supplied by buccal nerve)

34
Q

What is the course of the lingual nerve?

A

1) after branching from posterior division of V3, runs inferiorly and passes medially to lateral pterygoid
2) runs inferiorly, anterior and parallel to the IA nerve, between the ramus of the mandible and medial pterygoid
3) continues deep to the pterygomandibular raphe and below the superior constrictor muscle
4) reaches base of tongue lingual to mandibular 3rd molar and passes superficially, just below lingual mucosa of mandibular 3rd molar
5) runs anteriorly across muscles of tongue
6) runs downward and medial of submandibular ducts to deep surface of sublingual gland

35
Q

What does the lingual nerve innervate?

A

1) mucosa and gingiva on lingual of mandibular teeth
2) anterior 2/3 of tongue
3) floor of mouth

36
Q

What is the course of the IA nerve?

A

1) descends medial to lateral pterygoid muscle and lateral and posterior to the lingual nerve
2) continues between the sphenomandibular ligament and medial ramus
3) gives off mylohyoid branch
4) enters mandibular canal at mandibular foramen
5) divides into terminal branches at level of mental foramen (mental nerve exits at mental foramen and incisive nerve continues in canal to symphysis of mandible)

37
Q

What does the nerve to the mylohyoid innervate?

A

1) motor innervation to mylohyoid and anterior belly of digastric
2) may also provide sensory innervation to mandibular incisors, mesial root of mandibular first molar, and anterior and inferior surface of chin

38
Q

What do the 3 branches of the mental nerve provide sensory innervation to?

A

1) skin of chin

2) skin and mucosa of lower lip

39
Q

What does the incisive nerve provide sensory innervation to?

A

dental pulp, facial gingiva, PDL, and alveolar bone of mandibular first premolar and anterior teeth

40
Q

What are the 3 main branches of V1 (ophthalmic)?

A

1) frontal nerve
2) lacrimal nerve
3) nasociliary nerve

41
Q

What does the frontal nerve branch into and innervate?

A

1) supratrochlear nerve innervates the conjunctiva, medial upper eyelid, and skin of lower mesial forehead
2) supraorbital nerve innervates the upper eyelid and scalp

42
Q

What does the lacrimal nerve innervate?

A

lateral part of upper eyelid

43
Q

What does the nasociliary nerve innervate?

A

mucous membrane of anterior nasal septum, lateral nasal cavity, iris and cornea, skin of lacrimal sac, and parasinuses (ethmoidal and sphenoidal)

44
Q

What does the facial nerve innervate?

A

1) motor: muscles of facial expression, posterior belly of digastric, stylohyoid, stapedius, occipitofrontalis muscle
2) parasympathetic: lacrimal, submandibular, and lingual glands
3) taste: anterior 2/3 of tongue and palate

45
Q

What branches from CN VII in the facial canal?

A

1) greater petrosal nerve (parasympathetic)
2) nerve to stapedius muscle (motor)
3) chorda tympani (parasympathetic, taste)

46
Q

What is the course of the greater petrosal nerve and what does it innervate?

A

1) from CN VII, it passes under the internal carotid artery to join the deep petrosal nerve, together forming the nerve of the pterygoid canal, which joins the pterygopalatine ganglion in the pterygopalatine fossa
2) parasympathetic innervation to all glands above the oral fissure (mucous glands of nasal cavity, salivary glands in top half of oral cavity, lacrimal glands of the orbit)

47
Q

What does the nerve to stapedius muscle provide?

A

motor innervation to stapedius muscle

48
Q

What is the course of the chorda tympani and what does it innervate?

A

1) branches from CN VII in mastoid wall of middle ear, passes through middle ear, enters infratemporal fossa, descends to lateral pterygoid muscle, and joins lingual nerve from V3
2) parasympathetic to all glands below oral fissure (submandibular and sublingual glands) and taste to anterior 2/3 of tongue

49
Q

What are the two main branches of CN VII in the deep surface of the parotid gland?

A

1) temporofacial branch

2) cervicofacial branch

50
Q

What are the 5 terminal motor branches of the temporofacial and cervicofacial branches of CN VII that make up the parotid plexus?

A

1) temporofacial branch
2) zygomatic branches
3) buccal branches
4) marginal mandibular branches
5) cervical branches

51
Q

What does the temporofacial branch of CN VII emerge and what does it provide?

A

1) superior border of parotid gland
2) motor to muscles of temple, forehead, and supraorbital area (frontal belly of epicranial, superior orbicularis oculi, corrugator supercilii muscle)

52
Q

Where do the zygomatic branches of CN VII emerge and what do they provide?

A

1) anterosuperior border of parotid
2) motor to muscles of infraorbital area, lateral nasal area, and upper lip (inferior orbicularis oculi and zygomatic major and minor muscles)

53
Q

Where do the buccal branches of CN VII emerge and what do they provide?

A

1) anterior parotid

2) motor to muscles of cheek, upper lip, corner of mouth (including buccinator, risorius, orbicularis oris)

54
Q

Where do the marginal mandibular branches of CN VII emerge and what do they provide?

A

1) anteroinferior parotid

2) motor to muscles of lower lip and chin (including lower orbicularis and mentalis)

55
Q

Where do the cervical branches of CN VII emerge and what do they provide?

A

1) inferior parotid

2) motor innervation to platysma

Local Anesthesia (3 decks)

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