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REVISION BDS > oral function and dental development p253 > Flashcards

oral function and dental development p253 Flashcards

1
Q

masseter

origin

A

zygomatic arch

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2
Q

masseter

insertion

A

lateral surface and angle of mandible

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3
Q

masseter

action

A

elevates mandible

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4
Q

masseter

exam

A

place one finger intre orally adn other on the cheek

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5
Q

temporalis

origin

A

floor of temporal fossa

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6
Q

temporalis

insertion

A

coronoid process and anterior border of ramus

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7
Q

temporalis

action

A

elevates and retracts the manidible

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8
Q

temporalis

exam

A

tender in bruxist

palpate origin and get pt to clench

digital palpation between superior and inferior temporal lines

just above the ear

extend forwards towards supra-orbital region

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9
Q

lateral pterygoid

origin

A

lateral surface of the lateral pterygoid plate

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10
Q

lateral pterygoid

insertion

A

inferior head - anterior border of the head of the condyle

superior head - intra articular disc of the TMJ

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11
Q

lateral ptergygoid

action

A

protrudes and laterally deviates the mandible

inferior head acts with madnibular depressors to open mouth

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12
Q

lateral ptyegoid exam

A

n/a for palpation

can exam resisted movement

resist lateral and vertical movement

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13
Q

medial pterygoid

origin

A

deep head - medial surface of lateral pteygoid plate

superifical head - maxillary tuberosity

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14
Q

medial pterygoid insertion

A

medial surface angle of the mandible

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15
Q

medial pteygoid action

A

elevates and assists in protrusion of the mandible

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16
Q

medial pterygoid exam

A

n/a no reliable way to perform

if hit by LA causes trismus

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17
Q

role of buccinator and orbicularis oris

A

prevent spillage of bolus and control its placement in the mouth

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18
Q

strap muscles a.k.a

A

infrahyoid muslces

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19
Q

infrahyoid muscles

A

TOSS

thryohyoid

omohyoid

sternohyoid

strenothyroid

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20
Q

suprahyoid muscles

A

mylohyoid

digastric

geniohyoid

stylohyoid

My Dog Gets Shy

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21
Q

intrisic tongue muscles

A

longitudinal

vertical

transverse

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22
Q

extrinsic tongue muscles

A

hyoglossus

styloglossus

palatoglossus

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23
Q

movement in upper compartment of TMJ

A

gliding

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24
Q

movement in lower compartment of TMJ

A

rotating

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25
Q

neurons

afferent

A

sensory

carry message to CNS

going towards brain or spinal cord

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26
Q

neuorns

efferent

A

motor

carry message to muscle, gland or other effector

carry message away from CNS

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27
Q

interneurons

A

connecting

one neuron to another

multiple interneurons in reflexes

connect sensory to motor

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28
Q

CN involved in gag reflex

A

V

IX

X

XI

XII

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29
Q

gag reflex

A

acts to prevent material entering the pharynx

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30
Q

gag reflex evoked by

A

mechanical stimulation of

  • fauces
  • palate
  • posterior tongue
  • pharynx
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31
Q

gag reflex has efferent response from

A

CN V, IX, X, XI, XII

visceral nerves of salivary glands

32
Q

how to manage gag reflex in RPD

A

CoCr mesh at post dam region to reduce mucosal coverage

reduce the weight of a large connector

33
Q

signs of Bells palsy

A
  • inability to wrinkle brow
  • drooping of eyelid
  • inability to close eye
  • inability to puff cheeks - no muscle tone
  • drooping of mouth, food stuck in cheek
34
Q

branches of facial nerve

A

temporal

zygomatic

buccal

mandibular

cervical

To Zanzibar By Motor Car

35
Q

facial nerve is

A

CNVII

36
Q

causes of bells palsy

A

infections (HSV/Cold sores)

otitis media (inflammation of middle ear)

diabetes

trauma

toxins

temporarilu by infiltration of LA to facial nerve branches

  • inject to far distally
  • parotid gland is penetrated
  • allows diffusion of LA through loose glandular tissue
  • affects 5 terminal branches of facial nerve
37
Q

oropharyngeal dysphagia

A

pt has feeling of things being stuck in throat

difficulty swallowing

often associated with achalsia (faily of parasymp ganglion for oesphageal wall) -> failure of peristalsis

38
Q

aetiology of dysphagia

A

stroke

brain injury

multiple sclerosis

GORD

tumors

39
Q

5 types of receptors

A

mechanoreceptors

thermoreceptos

nociceptors

proprioceptors

chemoreceptors

40
Q

mechanoreceptors

A

Have a low thresholds, allowing the senses of touch and pressure (0.5mN)

Adapt to constant stimulus- they are slow and adapting types

TMJ receptors, Muscle receptors, PDL receptors

Periodontal Mechanoreceptors

  • Sensitive 10-100mN
  • They display directionality > Can percieve direction of pressure
  • Used in food texture discrimination
  • Tooth contacts
  • functional loading

DETECTION OF HIGH SPOTS!* - can detect down to half the thickness of a human hair
*remember scenario that shows benefits of keeping teeth in rpd for mechanorecptive use

> loss of periodontal mechanoreception precludes to

= poorer jaw control
= poorer precision of bite force magnitude
= poorer perception of direction
= rate of occlusal load application

41
Q

thermoreceptors

A

Cold Thermoreceptors

  • increase firing with a decrease in temperature [Aδ and C fibres]
  • located at dermal-epidermal junction

Hot Thermoreceptors

  • increase firing with an increase in temperature [C fibres]
  • located in dermis
42
Q

nociceptors

A

Free nerve endings with high thresholds

respond to intense stimuli associated with pain

  • > Aδ fibres - Noxious mechanical and heat stimuli
  • > C fibres - Polymodal

Carry receptor proteins responsive to different noxious stimuli

43
Q

proprioceptors

A

‘Self sense’

Awareness of position and orientation of body parts

Types include

  • Joint receptors
    • Joint position (mouth open/closed)
    • joint movement (opening/closing)
    • useful in controlling movements e.g chewing
  • Muscle receptors
    • Golgi Tendon organs
    • Muscle spindles
  • Periodontal receptors
44
Q

chemoreceptors

A

e.g. taste buds, olfactory

Sense of smell stimulates salivary glands – smelling disorders often affect the sense of taste

In Nasopharyngeal infection a loss of smell (Anosmia) may be present

Patients have a difficulty discerning between taste and olfaction

45
Q

4 stages in feeding sequence

A

ingestion

transport

mechanical processing

food processing

46
Q

ingestion

A

Movement of food from external environment > mouth

Accomplished by biting (anterior teeth) and/or using ‘tools’ (cutlery, cups, etc)

Lips provide anterior oral ‘seal’

  • Orbicularis Oris
  • Buccinator
47
Q

transport in feeding sequence

A

Moving material from the front of the mouth to the level of the posterior teeth

  • Food is gathered on tongue tip
  • Tongue retracts pulling the material to the posterior teeth (pull back processs) > takes 1 second
  • Hyoid bone retracts > oropharynx narrows
48
Q

mechanical processing in feeding sequence

A

Some solid foods must be broken down and mixed w/ saliva before they can be swallowed

Moist solid foods (e.g fruits) have to have fluid removed before transport and swallowing

Food masticated by pre-molars and molar teeth

some soft foods are squashed by tongue against hard palate

49
Q

food processing in feeding sequence

A

Involves co-ordination of muscles

  • Muscles of mastication
  • Tongue Muscles
  • Lips and cheeks
  • Supra hyoid muscles
50
Q

tongue role in food processing

A
  • controls the bolus
  • gathers food and rotates to reposition the bolus on the occlusal table
  • along with cheeks it keeps the bolus on the chewing surfaces
  • moves the bolus side to side of the mouth
  • gatehrs bolus for transport

during occlusal and inital opening phases of eating the tongue contacts the hard palate

  • contact point moves progressively backwards squeezing bolus through fauces
  • SQUEEZE BACK MECHANISM
51
Q

squeeze back mechanism

tongue

A

during occlusal and inital opening phases of eating the tongue contacts the hard palate

  • contact point moves progressively backwards squeezing bolus through fauces
52
Q

key difference between ingestion of solids and liquids

A

Solids

  • accumulate on pharyngeal tongue until swallowing (with the mouth being continues with the oropharynx)

Liquids

  • posterior oral seal acheived during ingestion i.e because liquids are swallowed from the mouth
53
Q

chewing

A

Jaw joint = Nutcracker hinge
Anterior teeth = Near nutcracker handles
Posterior teeth = Near hinge

if Nut far away from hinge it will require extra force to crack if it cracks at all

If the nut is close to the hinge it cracks easily

  • Hence why first molars have the maximum bite force (due to position and PDL attachment)
54
Q

natural prevention of reflux

A

Elevation of soft palate

Tongue (sides) contacts pillars of fauces

Tongue (dorsum) contacts posterior pharyngeal wall

Upper oesophageal sphincter

  • Reflux from oesophagus into pharynx

Lower oesophageal sphincter

  • Reflux from stomach into oesophagus

*If not prevented tooth erosion can result

55
Q

airway protection

A

Upward and forward movement of larynx

Closure of laryngeal inlet

  • aryepiglottic muscles – epiglottis

Adduction of vocal folds

Stop breathing (apnoea)

56
Q

dysphasia

A

specific language disorfer

involving damage to particular parts of brain (Broca’s area; Wernicke’s area)

57
Q

dysphagia

A

swallowing problems

58
Q

dysarthria

A

difficultuy speaking caused by muscles used in speech

59
Q

language and speech defects due to

A

neuromuscular defects
Lesions in descending neural pathways
➡ Cranial nerves
➡vocal muscles
➡neuromuscular junctions

60
Q

oral causes of language and speech issues

A

Anterior Open Bite

  • Tongue thrusting
  • Digit sucking
  • skeletal origin
    • Loss of teeth
    • Cleft Lip
    • Cleft Palate
      • Nasal quality
      • Oral and Nasal cavities not separated

Tongue Conditions

  • Tongue tie
  • Partial atrophy
  • Tongue stud

Xerostomia

  • Impeded speech due to inadequate saliva
  • not solved by simply swallowing then speaking

Torus palatinus and Torus Mandibularis

  • Bony protrusion either on palate or floor of mouth

Denture related

  • Restricted tongue space!!
  • Denture base too thick?
  • artificial Teeth not set properly (tilting lingually?)
  • Wrong occlusal planes > produces fricative!
61
Q

consontants sounds produced by

A

partial or complete stoppage of airflow

62
Q

fricatives sounds made

A

escape through air constriction

missing maxillary incisors can impair fricative soudns, edge should touch vermillion border of lower lip

63
Q

plosives sounds made

A

sudden release after complete stoppage of airflow (‘stop’ consonants)

64
Q

nasals sound made

A

air flows through nose

65
Q

vowels sound made

A

continous airflow

shape of mouth varies

tongue position main factor

66
Q

tooth origin

A

Ectoderm - Enamel Organ

Ectomesenchyme (Part of the Neural Crest) forms between the ectoderm and neural tube -

  • Dental Papilla (Dentine and Pulp)

Mesenchyme - Dental Follicle

  • Cementum
  • PDL

WHOLE STRUCTURE OF - EO, DP and DF = TOOTH GERM

67
Q

ectoderm ->

A

enamel

68
Q

ectomesenchyme ->

A

dental papilla (denine and pulp)

69
Q

mesenchyme ->

A

dental follicle (cementum and PDL)

70
Q

5 stages in tooth development

A

initiation

morphogenesis

cytodifferentiation

matrix secretion

root formation

71
Q

initiaion in tooth development

A

Maxillary process formed

Stomodaeum formed

mandibular process formed

  • Primary Epithelial band forms at 6w IUL on the stomodeum
  • This then progresses into the Dental Lamina at 7w IUL it splits into the
    • Vestibular lamina from which the buccal sulcus develops
    • Dental lamina from which the enamel organ develops
72
Q

morphogenesis in tooth development

A

Bud’ stage

  • Dental Lamina thickens (A) - Enamel Organ
  • ectomesenchymal condensation (B) - Dental Papilla

‘Cap’ stage

  • Enamel organ forms a cap over the papilla
    • External Enamel Epithelium
    • Internal Enamel Epithelium
    • Meet at cervical loop
73
Q

cytodifferentiation in tooth development

A

‘Early ‘Bell stage’

  • More cell layers differentiate to form a complex enamel organ
    • IEE
    • EEE
    • Stratum intermedium
    • Stellate reticulum

Tooth shape is more defined

74
Q

matrix secretion in tooth development

A

Late ‘Bell stage’

  • Crown stage well defined
  • Apposition of enamel and dentine begins

Dental Papilla cells adjacent to the IEE differentiate into odontoblasts

Odontoblasts lay down dentine matrix which is later mineralised

Once dentine formation has begun IEE differentiates into ameloblasts to form enamel

‘Induction’

  • Dentinogenesis
    • Odontoblast differentiation from IEE
    • Deposition of the Dentine matrix (mainly collagen)
    • This unmineralised dentine is predentine
    • Mineralised dentine is by HAP
  • Amelogenesis
    • Ameloblast differentiation
      • Dentine induces IEE cells to differentiate into ameloblasts
      • They elongate becoming columnar
      • The nucleus then migrates to the basal end of the cell
    • Secretory phase
      • Ameloblasts become secretory cells
      • They synthesis and secrete enamel matrix proteins (amelogenins)
      • Matrix is then partially mineralised (30% mineral)
  • Maturation phase
    • Most of the matrix proteins are removed
    • Leaving room to increase the mineral content of enamel
    • Mature enamel is 95% enamel
  • Protection phase
    • Ameloblasts regress to form a protective layer (the reduced enamel epithelium)
    • Involved in eruption
    • Formation of epithelial attachment
75
Q

dentinogenesis

A
  • Odontoblast differentiation from IEE
  • Deposition of the Dentine matrix (mainly collagen)
  • This unmineralised dentine is predentine
  • Mineralised dentine is by HAP
76
Q

amelogenesis

A

Ameloblast differentiation

  • Dentine induces IEE cells to differentiate into ameloblasts
  • They elongate becoming columnar
  • The nucleus then migrates to the basal end of the cell

Secretory phase

  • Ameloblasts become secretory cells
  • They synthesis and secrete enamel matrix proteins (amelogenins)
  • Matrix is then partially mineralised (30% mineral)

Maturation phase

  • Most of the matrix proteins are removed
  • Leaving room to increase the mineral content of enamel
  • Mature enamel is 95% enamel

Protection phase

  • Ameloblasts regress to form a protective layer (the reduced enamel epithelium)
  • Involved in eruption
  • Formation of epithelial attachment
77
Q

root formation in tooth development

A

Crown formation must be fully completed before root formation

Then enamel organ maps out the shape of the crown

The EEE and IEE meet at the cervical loop

Migration of the cervical loop maps the crown shape

The root shape is defined by apical growth of the cervical loop which is now called hertwig’s epithelial root sheath

  • It is a 2 cell type layered structure not 4 like the enamel organ

Process

  1. Hertwig’s Epithelial root sheath (HERS) induces formation of root dentine
  2. Then once the initial layer of root dentine is made HERS breaks up (as there is no enamel in the root)
  3. Remnants of HERS persist as the Epithelial cell rests of Malassez
  4. Mesenchymal cells from the follicle contact the dentine and differentiate into cementoblasts which form cementum
  5. Fibres from the developing PDL are embedded in the cementum ‘Sharpey’s Fibre’s’

REVISION BDS (43 decks)

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