Oral Anatomy & Histology (Review: Outcome 12)

Question 1

Major arteries of the face and oral cavity

Answer 1

1) Common carotid artery
- arises from the aorta and subdivides into the internal and external carotid arteries

2) Internal carotid artery
- supplies blood to the brain and eyes

3) External carotid artery
- provides the major blood supply to the face and mouth

Question 2

External Carotid Artery branches into…

Answer 2

1) Facial artery - 6 branches supply:
- pharyngeal muscles, soft palate, tonsils, posterior tongue, submandibular gland, muscles of the face, nasal septum, nose and eyelids

2) Lingual artery: several branches supply:
- tongue, floor of mouth, lingual gingiva, a portion of soft palate and tonsils

3) Maxillary artery - divides into inferior alveolar, pterygoid and pterygopalatine

4) Mandibular artery

Question 3

What is the nervous system composed of?

Answer 3

1) Central Nervous System
- brain
- spinal cord

2) Peripheral Nervous System
a. Autonomic nervous system
- sympathetic
- parasympathetic
b. Somatic nervous system

Question 4

How many cranial nerves are there?

Answer 4

12 pairs of cranial nerves, all connected to the brain
- these nerves serve both sensory and motor function
- generally named for the area or function they serve and are also identified with the use of Roman numerals

Question 5

Olfactory (I)

Answer 5

Type:
- Sensory

Function:
- sense of smell

Question 6

Optic (II)

Answer 6

Type:
- Sensory

Function:
- Sense of sight

Question 7

Oculomotor (III)

Answer 7

Type:
- Motor

Function:
- Movement of eye muscles

Question 8

Trochlear (IV)

Answer 8

Type:
- Motor

Function:
- Movement of eye muscles

Question 9

Trigeminal (V)

Answer 9

Type:
- Motor
- Sensory

Function:
- Movement of muscles of mastication and other cranial muscles
- General sensations for face, head, skin, teeth, oral cavity, and tongue

Question 10

Abducens (VI)

Answer 10

Type:
- Motor

Function:
- Movement of eye muscles

Question 11

Facial (VII)

Answer 11

Type:
- Motor
- Sensory

Function:
- Facial expression, functions of glands and muscles
- Sense of taste on tongue

Question 12

Vestibulocochlear (VIII)

Answer 12

Type:
- Sensory

Function:
- Senses of sound and balance

Question 13

Glossopharyngeal (IX)

Answer 13

Type:
- Motor
- Sensory

Function:
- Functioning of parotid gland
- General sensation of skin around ear

Question 14

Vagus (X)

Answer 14

Type:
- Motor
- Sensory

Function:
- Moves muscles in soft palate, pharynx, and larynx
- General sensation on skin around ear and sense of taste

Question 15

Accessory (XI)

Answer 15

Type:
- Motor

Function:
- Movement of muscles of the neck, soft palate, and pharynx

Question 16

Hypoglossal (XII)

Answer 16

Type:
- Motor

Function:
- Movement of muscles of the tongue

Question 17

Trigeminal Nerve (V)

Answer 17

• The primary source of innervation for the oral cavity
• Subdivides into 3 main divisions:
  1) Ophthalmic division (V1)
  2) Maxillary division (V2)
  3) Mandibular division (V3)

Question 18

Maxillary Division (V2)

Answer 18

• Supplies maxillary teeth, periosteum, mucous membrane, maxillary sinuses, and soft palate
• Subdivides into the:
  i. Nasopalatine nerve
  ii. Greater palatine nerve
  iii. Anterior superior alveolar nerve
  iv. Middle superior alveolar nerve
  v. Posterior superior alveolar nerve

Question 19

Nasopalatine Nerve

Answer 19

• Passes through the incisive foramen
• Supplies the mucoperiosteum palatal to the maxillary anterior teeth

Question 20

Anterior/Greater Palatine Nerve

Answer 20

• Passes through the posterior palatine foramen and forward over the palate
• Supplies the mucoperiosteum, intermingling with the nasopalatine nerve

Question 21

Anterior Superior Alveolar Nerve (ASA)

Answer 21

• Supplies the maxillary central, lateral, and cuspid teeth, along with their periodontal membranes and gingivae
• Also supplies the maxillary sinus

Question 22

Middle Superior Alveolar Nerve (MSA)

Answer 22

• Supplies the maxillary first and second premolars, the mesiobuccal root of the maxillary first molar and the maxillary sinus

Question 23

Posterior Superior Alveolar Nerve (PSA)

Answer 23

• Supplies the other roots of the maxillary first molar and maxillary second and third molars
• Also branches forward to serve the lateral wall of the maxillary sinus

Question 24

Mandibular Division (V3)

Answer 24

1) Buccal nerve
- supplies branches to the buccal mucous membrane and mucoperiosteum of the mandibular molar teeth

2) Lingual nerve
- supplies the anterior two thirds of the tongue and gives off branches to supply the lingual mucous membrane and mucoperiosteum

3) Inferior Alveolar nerve
- Further subdivides into the mylohyoid nerve, mental nerve, incisive nerve, and small dental nerves that supply the molar and premolar teeth, alveolar process, and periosteum

Question 25

Inferior Alveolar Nerve (IAN)

Answer 25

1) Mylohyoid nerve
- supplies the mylohyoid muscles and the anterior belly of the digastric muscle

2) Small dental nerves
- supply molar and premolar teeth, alveolar process, and periosteum

3) Mental nerve
- moves outward and anteriorly through the mental foramen and supplies the chin and mucous membrane of the lower lip

4) Incisive nerve
- continues anteriorly within the bone and gives off small branches to supply the incisor teeth

Question 26

Facial Nerve

Answer 26

Cranial nerve VII
Mixed Nerve
- Sensory portion concerned with taste; motor portion controls facial expression and secretion of tears and saliva
- Damage causes sagging facial muscles and a distorted sense of taste

Question 27

Injection Techniques

Answer 27

The location and innervation of the tooth or teeth to be anesthetized will determine where topical anesthetic is placed, and the type of injection given
- Maxillary anesthesia
- Palatal anesthesia
- Mandibular anesthesia

Question 28

Maxillary Anesthesia

Answer 28

• Local anesthesia injection techniques differ from mandibular approaches because of the porous nature of alveolar cancellous bone in the maxilla
• This bone structure allows the anesthetic solution to diffuse through the bone and reach the apices of the teeth in a different manner than the mandible

Question 29

Injection Techniques - Maxilla

Answer 29

• Local infiltration is completed by injecting into a small, isolated area
• Field block refers to the injection of anesthetic near a larger terminal nerve branch
• Nerve block occurs when local anesthetic is deposited close to a main nerve trunk

Question 30

Palatal Anesthesia

Answer 30

Local anesthesia in the palatal area may be necessary for procedures that involve the soft tissues of the palate

i. Greater palatine nerve
- passes through the posterior palatine foramen
- innervates the mucosa of the hard palate (except lingual to the maxillary incisors)

ii. Nasopalatine nerve
- passes through the incisive foramen
- innervates the gingiva palatal to the maxillary anterior teeth

Question 31

Mandibular Anesthesia

Answer 31

• Because of the dense, compact nature of the mandibular bone, anesthetic solution does not diffuse easily through it
• Block anesthesia is frequently required for most mandibular teeth
• Solution is injected near a major nerve, and the entire area served by that nerve branch is numbed

i. Inferior Alveolar nerve block (Mandibular nerve block)
ii. Buccal nerve block
iii. Incisive nerve block

Question 32

Mandibular Innervation

Answer 32

1) Buccal nerve
- supplies branches to the buccal mucous membrane of the mandibular molars

2) Lingual nerve
- supplies the anterior 2/3rd’s of the tongue and the lingual mucous membrane

3) Inferior Alveolar (subdivides)
a. Small dental nerves: supply molar and premolar teeth
b. Mental nerve: exits through the mental foramen and supplies the chin and mucous membrane of the lower lip
c. Incisive nerve: continues anteriorly within the bone and branches supply incisor teeth

Question 33

Periodontal Ligament Injection

Answer 33

• Injection of the anesthetic solution under pressure directly into the periodontal ligament and surrounding tissues
• Periodontal ligament injection is generally an adjunct (addition) to conventional techniques

Question 34

Other Injection techniques

Answer 34

1) Intro-osseus
2) Gow-Gates Mandibular block
3) Vazirani-Akinosi Mandibular block