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BDS2 OCB > OCB04-2004 > Flashcards

OCB04-2004 Flashcards

1
Q

Where are the bodies of the sensory aspect of the trigeminal nerve located?

A

Trigeminal/Gasserion/semilunar ganglion

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2
Q

What does the ophthalmic division of the trigeminal nerve supply?

A

Sensory to:

  • most of skin of forehead
  • conjunctiva
  • upper eyelid
  • bridge of node
  • frontal sinus
  • anterosuperior nasal cavity mucosa
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3
Q

What does the maxillary division of the trigeminal nerve supply?

A

Sensory to:
- most of skin of cheek, upper lip and all structures deep to them (upper teeth, gums, soft and hard palate, maxillary sinus, posteroinferior nasal cavity)

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4
Q

What does the mandibular division of the trigeminal nerve supply?

A

Sensory to:
- skin of temple and most of skin over lower jaw (except over angle) and structures deep to them (lower teeth, gums, tongue)

Motor to muscles of mastication, tensor tympani, tensor palatini and anterior belly of digastric

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5
Q

What innervates the upper teeth?

A

Superior dental plexuses of V2

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6
Q

What innervates the lower teeth?

A

Inferior dental plexuses of inferior alveolar/dental nerve of V3

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7
Q

What is the main difference in the way the upper and lower teeth are innervated?

A

Upper = separate plexuses supply multiple teeth

Lower = inferior dental plexus supplies each tooth individually

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8
Q

Describe trigeminal neuralgia.

A

Sudden bursts of severe pains coming from one of more branches of C.V - V2 and V3 most commonly affected

Usually unilateral (rarely bilateral)

Most cases caused by a blood vessel pressing on the root of the nerve where it exits the skull

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9
Q

How can trigeminal neuralgia be treated?

A

Carbamazepine (anticonvulsant) calms activity of nerve and therefore pain

If ineffective then surgery (vascular decompression)

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10
Q

Describe the surgery often used to treat trigeminal neuralgia.

A

Posterior fossa craniotomy at the confluence of the sigmoid and transverse sinuses

Enter Meckel’s Cave and try to conduct vascular decompression of affected branch

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11
Q

What is the supraorbital nerve a branch of?

A

V1

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12
Q

What is the supratrochlear nerve a branch of?

A

V1

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13
Q

What is the infraorbital nerve a branch of?

A

V2

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14
Q

What is the mental nerve a branch of?

A

V3 (after inferior alveolar nerve)

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15
Q

What is the auriculotemporal nerve a branch of?

A

V3

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16
Q

What are the two parts of the auriculotemporal nerve?

A

Superior = sensory

Inferior = secretory motor parasympathetic fibres

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17
Q

Describe the branching of the external carotid artery that supplies the head/face.

A

Branches into external (facial) and internal maxillary arteries

Internal maxillary artery branches into:

  • infraorbital artery
  • greater palatine artery
  • middle meningeal artery
  • inferior alveolar artery
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18
Q

Where does the facial artery end?

A

After a tortuous journey, ends as the angular artery at the commissure of the eye

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19
Q

What does the infraorbital artery supply?

A

Skin of orbital area

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20
Q

What does the greater palatine artery supply?

A

Roof of mouth

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21
Q

What arteries does the middle meningeal artery anastomose with?

A

Ophthalmic and lacrimal arteries

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22
Q

Where does the (anterior) facial vein start?

A

Side of the root of the nose, direct continuation of angular vein

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23
Q

Which of the facial vein and artery has a more tortuous route?

A

Facial artery

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24
Q

What vein drains into the (anterior) facial vein?

A

External palatine vein

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25
Q

What are the possible courses for the (anterior) facial vein?

A

Join the anterior branch of the retromandibular vein to form the common facial vein

Drain directly into the internal jugular vein

26
Q

Why is the (anterior) facial vein important clinically?

A

Direct connection with ophthalmic vein which leads to the cavernous sinus

Bacteria can reach the internal cranial structures from the pterygoid plexus via this route

27
Q

Which muscle raises the eyebrows?

A

Epicranius (frontalis and occipitalis)

28
Q

What makes up the epicranius?

A

Frontalis and occipitalis

29
Q

Where is the origin and insertion of the epicranius?

A

Cranial aponeurosis

Eyebrows

30
Q

What does the epicranius do?

A

Raises the eyebrows

31
Q

Which muscle blinks and closes the eyes?

A

Orbicularis oculi

32
Q

What does orbicularis oculi do?

A

Blinks and closes the eyes

33
Q

Where is the origin and insertion of the orbicularis oculi?

A

Portions of frontal and maxilla bones to skin around eyes

34
Q

What does the orbicularis oris do?

A

Closes and protrudes lips

35
Q

What muscle closes and protrudes the lips?

A

Orbicularis oris

36
Q

Where is the origin and insertion of orbicularis oris?

A

Skin around mouth

37
Q

What does the buccinator do?

A

Flattens cheek against teeth

38
Q

What muscle flattens the cheek against teeth?

A

Buccinator

39
Q

Where is the origin and insertion of the buccinator?

A

Mandible/maxilla to skin around mouth

40
Q

What does the zygomaticus do?

A

Raises corner of mouth

41
Q

What muscle raises the corner of the mouth?

A

Zygomaticus

42
Q

Where is the origin and insertion of the zygomaticus?

A

Zygomatic bone to corner of lips

43
Q

What does the platysma do?

A

Draws mouth downwards

44
Q

What muscle draws the mouth downwards?

A

Platysma

45
Q

Where is the origin and insertion of the platysma?

A

Fascia of chest to lower border of mandible

46
Q

What are the four types of branches found in the facial nerve?

A

Branchial motor/special visceral efferent

Visceral motor/general visceral efferent

Special sensory/special afferent

General sensory/general somatic afferent

47
Q

Which part of the facial nerve has the main 5 branches?

A

Branchial motor/special visceral efferent

48
Q

What does the branchial motor/special visceral efferent branch of the facial nerve innervate?

A

Muscles of facial expression

Posterior belly of digastric

Stylohyoid

Stapedius

49
Q

What does the visceral motor/general visceral efferent branch of the facial nerve innervate?

A

Parasympathetic to lacrimal, sublingual and submandibular glands and mucous membranes of nasopharynx, hard and soft palates

50
Q

What does the special sensory/special afferent branch of the facial nerve innervate?

A

Taste for anterior 2/3 of tongue, hard and soft palate

51
Q

What does the general sensory/general somatic afferent branch of the facial nerve innervate?

A

General sensation from skin of concha of the auricle and from a small area behind the ear

52
Q

Which branches of the branchial motor/special visceral efferent facial nerve control the upper muscles of facial expression? Is it bi or unilateral control?

A

Temporal and zygomatic

Bilateral control

53
Q

Which branches of the branchial motor/special visceral efferent facial nerve control the lower muscles of facial expression? Is it contra or unilateral control?

A

Buccal and mandibular

Contralateral control

54
Q

Describe Bell’s palsy.

A

Lower motor neuron lesion of facial nerve due to swelling, inflammation, infection…

Develops quickly in 1-3 days

Slowly improves or completely goes away in 1-3 months

Most recover but some are left with weakness on affected side

Most common in adults in their 40s

Symptoms:

  • droopy eyelid, dry eye or excessive tears
  • unilateral facial paralysis, twitching or weakness
  • drooping of corner of mouth, dry mouth, impaired taste
55
Q

Why is any swelling of the parotid gland painful?

A

Gland is tightly enclosed in fascia

56
Q

What muscles does the Stensen duct lie on and pierce?

A

Lies on masseter

Pierces buccinator

57
Q

Which structures branch within/close to the parotid gland?

A

Facial nerve

External carotid artery –> maxillary and superficial temporal

58
Q

What are the layers of the scalp from superficial to deep?

A

Skin

Connective tissue (dense)

Aponeurosis of epicranius/occipitofrontalis

Loose connective tissue

Periosteum

(SCALP is an acronym for the layers)

59
Q

What is the cutaneous innervation for the scalp?

A

Supraorbital nerve of V1 = front (forehead)

Auriculotemporal nerve of V3 = sides

Lesser occipital nerve of C2 = sides

Greater occipital nerve of C2 = back

60
Q

Describe the arterial supply of the scalp.

A

Superficial temporal artery of ECA

Supraorbital artery

Occipital and posterior auricular artery of ECA

Free anastomoses from side to side and they run through the dense connective tissue

61
Q

How do “panda’s eyes” arise?

A

Loose connective tissue of scalp allows fluid to pass freely from the posterior aspect to the eyelids anteriorly

Trauma at the back of the head leads to blood in the eyelids

62
Q

Where does the facial nerve leave the skull?

A

Stylomastoid foramen

IAM = exiting the intracranial region

BDS2 OCB (22 decks)

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