Nervous system Flashcards

1
Q

Cranial Nerve V

A

trigeminal nerve, the nerve we are most concerned with in dentistry. has three divisions, comes off the lateral surface of the pons. large sensory root, small motor root. the sensory and motor roots enter the trigeminal ganglion, which sits in the middle of the skull.

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2
Q

the three divisions of the trigeminal nerve

A
  1. ophthalmic V1-sensory
  2. maxillary V2-sensory
  3. mandibular V3-sensory and motor
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3
Q

ophthalmic nerve V1

A

purely sensory. it transmits pain, temperature, touch, and proprioception from conjunctiva, cornea, eye, forehead, and frontal sinuses. it travels through in superior orbital fissure of the sphenoid bone.

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4
Q

most important nerves in dentistry

A

Trigeminal
Facial
Glossopharyngeal
Hypoglossal

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5
Q

branches of ophthalmic nerve V1

A

Frontal n.
Lacrimal n.
Nasociliary n.

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6
Q

Lacrimal nerve

A

General sensory:
Lateral part upper eyelid
Conjunctiva
Lacrimal gland

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7
Q

Maxillary nerve (V2)

A
General sensory:
Maxillae and overlying skin
Maxillary sinuses
Nasal cavity
Palate
Nasopharynx
Part of dura matter
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8
Q

Maxillary nerve (V2) BRANCHES

A
Branches:
Zygomatic
Zygomaticofacial n.
Zygomaticotemporal n.
Infraorbital
Anterior superior alveolar (ASA) n.
Middle superior alveolar (MSA) n.
Posterior superior alveolar (PSA) n.
Greater & lesser palatine nerves
Nasopalatine nerve
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9
Q

To which of the following structures does the posterior superior alveolar nerve and its branches supply?

A

maxillary posterior teeth

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10
Q

Through which of the following foramina does the facial nerve pass through the skull?

A

stylomastoid foramen

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11
Q

Which of the following cranial nerves is directly involved in Bell palsy?

A

facial nerve

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12
Q

Which of the following nerve and muscle pairs is a correct match?

A

hypoglossal nerve, intrinsic tongue muscles

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13
Q

Which of the following nerve and innervation pairs is a correct match?

A

chorda tympani, sublingual salivary gland

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14
Q

Which of the following cranial nerves has fibers that provide crossover innervation to the contralateral side in the skull before continuing into the brain?

A

optic nerve

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15
Q

Which of the following cranial nerves carries taste sensation for the base of the tongue?

A

glossopharyngeal nerve

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16
Q

In which of the following regions of the head and neck is the trigeminal ganglion located?

A

anterior surface of the petrous part of the temporal bone

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17
Q

Sensory information is supplied for the soft palate by which of the following?

A

lesser palatine nerve

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18
Q

What is not present in all people?

A
middle superior alveolar nerve (MSA)
When not present,
ASA & PSA innervate area 
When present,
There is communication between MSA and both ASA & PSA
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19
Q

Zygomaticofacial n.

A

General Sensory: skin of cheek
Pierces foramina in frontal process of zygomatic bone
Enters orbit through lateral wall
Turns posteriorly to join with zygomaticotemporal n

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20
Q

Zygomaticotemporal n

A

General Sensory: skin of temporal region
Pierces foramina in temporal surface of zygomatic bone
Transverses lateral wall of orbit
Joins with zygomaticofacial n

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21
Q

Zygomatic n.

A

Merger of:
Zygomaticofacial n.
Zygomaticotemporal n.
Travels posteriorly along lateral orbit floor; enters pteryopalatine fossa through inferior orbital fissure (between maxilla and sphenoid bone); joins maxillary nerve

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22
Q

Infraorbital n.

A

From cutaneous (skin) branches:
Upper lip
Medial part of cheek
Lower eyelid
Side of nose
Enters infraorbital foramen, travels through infraorbital canal to emerge in floor of orbit.
ASA & MSA nerves join IO here.
After merger with ASA & MSA nerves, IO travels posterior through inferior orbital fissure and enters pterygopalatine fossa.
Here it receives the posterior superior alveolar (PSA) nerve.

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23
Q

Infraorbital (IO) Nerve branches

A

-Anterior superior alveolar (ASA) n.
General sensory
Maxillary incisors, canine & associated tissues
-Middle superior alveolar (MSA) n.
General sensory
Maxillary premolars, MB root of maxillary 1st molar, & associated tissues

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24
Q

Posterior Superior Alveolar n.

A

General sensory
Maxillary molars (except MB root of 1st molar) & associated tissue
Enters foramina on maxillary tuberosity
Joins IO in pterygopalatine fossa

25
Greater & lesser palatine n.
``` -Greater palatine nerve General sensory Posterior hard palate Posterior palatal gingiva -Lesser palatine nerve General sensory Soft palate Palatine tonsils ```
26
Greater palatine (GP) n.
From hard palate, enters greater palatine foramen; ascends through pterygopalatine canal; emergences within pterygopalatine fossa and merges with maxillary nerve.
27
Lesser palatine Nerve
From soft palate, enters lesser palatine foramen; ascends through pterygopalatine canal; emerges within pterygopalatine fossa and merges with maxillary nerve.
28
Nasopalatine nerve
General Sensory Anterior hard palate Palatal gingiva of maxillary anterior teeth Nasal septal tissue Communicates with GP in area lingual to maxillary canines. From anterior hard palate, enters incisive foramen to enter incisive canal; travels along the nasal septum.
29
Maxillary Nerve
Enters cranium through foramen rotundum, | And enters trigeminal ganglion within middle cranial fossa.
30
Mandibular nerve (V3)
``` FROM: (General Sensory) Buccal region Side of head & scalp Entire lower jaw Anterior 2/3 tongue Chin & lower lip Meninges of anterior & middle cranial fossa TO: (Branchial Motor) Muscles of mastication Temporalis Masseter Lateral pterygoid Medial pterygoid Tensor typmani Tensor palatini Mylohyoid Anterior belly digastric ```
31
Mandibular Nerve (V3) branches
-Buccal n. -Muscular branches -Auriculotemporal n. -Lingual n. -Inferior alveolar (IA) n. Mylohyoid n. Mental nerve Incisive nerve
32
``` Anterior Trunk (V3) Buccal Nerve ```
General sensory from: Buccal mucosa Buccal gingiva (1st- 2nd mandibular molar)
33
``` Anterior Trunk (V3) masseteric nerve ```
Motor to: | Masseter muscle
34
``` Anterior Trunk (V3) lateral pterygoid n. ```
Motor to: | Lateral pterygoid muscle
35
``` Anterior Trunk (V3) Deep Temporal Nerve ```
Motor to: | Temporalis muscle
36
``` Posterior Trunk (V3) auriculotemporal n. ```
General sensory from: External ear Scalp
37
``` Posterior Trunk (V3) Lingual N. ```
General sensory from: Anterior 2/3 of tongue Floor of mouth Lingual gingiva of mandibular teeth
38
``` Posterior Trunk (V3) Inferior alveolar N. ```
``` General sensory from: Mandibular teeth and associated tissues Branches: Mental nerve Incisive nerve Mylohyoid nerve ```
39
Mental Nerve
External branches: Sensory from lip, labial mucosa of mandibular anterior & premolar teeth External branches enter mental foramen on lateral surface of mandible and enters mandibular canal.
40
Incisive nerve
From the anterior mandibular teeth, the incisive nerve joins the mental nerve in the mandibular canal.
41
Inferior Alveolar (IA) nerve
Incisive and mental nerves join inferior alveolar nerve; IA emerges from mandibular canal via the mandibular foramen on the medial side of the mandible.
42
Mylohyoid nerve
Just as the inferior alveolar nerve exits the mandibular canal, a small branch is noted, the mylohyoid nerve. The mylohyoid nerve is motor to the mylohyoid muscle and the anterior belly of the digastric muscle.
43
Mandibular Nerve
Enters cranium through foramen ovale | And enters trigeminal ganglion within middle cranial fossa
44
Functions of cranial nerves
1. Motor (efferent) -Somatic -Branchial -Visceral 2. Sensory (afferent) -Visceral -General -Special Smell Vision Taste Balance/hearing
45
Facial nerve (CN VII)
Emerges from brain stem and enters internal acoustic meatus, Motor and general sensory branches exit skull through stylomastoid foramen Functions: -Branchial motor (nerve of 2nd branchial arch) Muscles of facial expression -General sensory Area around external ear, external surface of tympanic membrane -Visceral motor All glands of head (except parotid & of skin) -Special sensory Taste, anterior 2/3 of tongue
46
Branchial Motor
1. Temporalis n. - Frontalis m. 2. Zygomatic n. - Orbicularis oculi m. 3. Buccal n. - Buccinator & orbicularis oris m. 4. Mandibular n. - Orbicularis oris m. 5. Cervical nerve - Platysma
47
Branchial Motor branches
``` temporal zygomatic buccal mandibular cervical ```
48
Pneumonic to remember branchial motor branches
``` To (temporal) Zanzibar (zygomatic) By (buccal) Motor (mandibular) Car (cervical) ```
49
General Sensory
-Posterior auricular n | Skin of external ear
50
Visceral Motor
1. Greater petrosal nerve Parasympathetic to lacrimal gland, mucosa of nose & oral cavity 2. Chorda tympani nerve Parasympathetic to submandibular & sublingual salivary glands and minor salivary glands of floor of mouth
51
Greater Petrosal Nerve
The greater petrosal nerve travels through the temporal and sphenoid bones to reach the pterygopalatine fossa. Synapses in the pterygopalatine ganglion Post ganglionic fibers run with V2 to reach the lacrimal gland and mucous membranes on the nasal and oral cavities to stimulate secretion
52
Chorda Tympani
The chorda tympani nerve exits the skull through the petrotympanic fissure The chorda tympani synapses in the submandibular ganglion, which hangs from the lingual nerve Post ganglionic fibers travel to submandibular and sublingual salivary glands to stimulate secretion.
53
Special sensory: taste
The chorda tympani is parasympathetic to submandibular and sublingual salivary glands and sensory for taste from the anterior 2/3 tongue Sensory fibers from taste buds in the tongue run with the lingual nerve (branch of V3) and then separate from it and join the chorda tympani
54
Trigeminal Nerve
``` -Zygomatic nerve General sensory to skin -Buccal branch General sensory to buccal mucosa & gingiva (posterior molars) -Mandibular nerve (V3) ```
55
Facial Nerve
``` -Zygomatic nerve Motor to or obicularis oculi -Buccal nerve Motor to buccinator & orbicularis oris muscles -Mandibular nerve Motor to obicularis oris ```
56
Glossopharyngeal Nerve (CN IX)
``` Functions: 1. Branchial motor (3rd arch) To stylopharyngeus m. 2. Visceral motor To parotid salivary gland 3. Visceral sensory From carotid body 4. General sensory From posterior 1/3 of tongue and internal surface of the tympanic membrane 5. Special sensory Taste from posterior 1/3 of tongue ```
57
Clinical considerations
``` 1. Trigeminal neuralgia (tic doloureus) Severe pain of unknown cause 2. Bell’s palsy Damage to facial nerve at or beyond stylomastoid foramen Affects all actions of facial muscles ```
58
What are the six modalities of cranial nerves?
1. somatic motor 2. branchial motor 3. visceral motor 4. visceral sensory 5. general sensory 6. special sensory