Oral Region Flashcards
What are the movements possible at the TMJ?
- Depression (gravity and digastric)
- Elevation
- Protrusion
- Retrusion
- Lateral
What is the most common postion for jaw dislocation?
anterior (the mandibular condyle displaces anterior to the articular turbercle)
Who does TMJ more commonly affect?
- younger people
- women
What are the muscles of mastication?
- Masseter
- Temporalis
- Medial pterygoid (two heads)
- Lateral pterygoid (two heads)
What nerve supplies motor innervation to the muscles of mastication?
Mandibular nerve (V3)
Temporalis actions
- elevation
- retrusion
Masseter action
-elevation
Lateral pterygoid actions
- protrusion (bilateral)
- lateral movement (unilatera
Medial pterygoid actions
bilateral:
- elevation
- protrusion
unilateral:
-lateral movement
Where does the Mandibular nerve (V3) pass through the cranium?
foramen ovale
Mandibular nerve (V3) motor
muscles of mastication
Mandibular nerve (V3) sensory
lower lip, chin, posterior/lateral cheek, up to the temporal area
What are the somatic sensory branches of Mandibular nerve V3?
- Buccal nerve
- Lingual nerve
- Auriculotemporal nerve
- Inferior alveolar nerve
Where is a inferior alveolar nerve block directed?
toward the mandibular foramen
Describe the pathway of the inferior alveolar nerve
- out of the foramen ovale
- into the mandibular foramen
- through mandible
- out the mental foramen where it becomes the mental nerve
What branch comes off the inferior alveolar nerve before heading into the mandibular foramen?
-Nerve to mylohyoid (small motor branch)
What does the nerve to mylohyoid supply?
motor:
- mylohyoid
- anterior digastric
Buccal nerve sensory
- cheek
- mandibular gingivae
Lingual nerve sensory
- mandibular gingivae
- floor of mouth
- anterior 2/3 of tongue
Auriculotemporal nerve
-ear region
Inferior alveolar nerve
- mandibular teeth
- mandibular gingivae
- chin
- lower lip
Chorda Tympani special sensory
Taste to anterior 2/3 of tongue
Chorda Tympani parasympathetic
Salivary glands:
- submandibular gland
- sublingual gland
Which nerve does Chorda tympani travel with to reach the tongue?
lingual nerve (CN V3)
Name the vessels branching from the external carotid
External carotid > Maxillary artery > middle meningeal > Inferior alveolar
Rupture of anterior branch of middle meningeal artery will cause?
epidural hematoma
Describe the flow of venous blood from the pterygoid venous plexus to the Subclavian
Pterygoid plexus > maxillary vein > Retromandibular vein > External jugular vein > Subclavian
*note:
What two structures does the pterygoid venous plexus communicate with? Significance?
- Facial vein
- Cavernous sinus
*potential for superficial-to-depp pathway for infection
Where does the pterygopalatine fossa communicate with the nasal cavity?
sphenopalatine foramen
Where does the pterygopalatine fossa communicate with the orbit?
inferior orbial fissure
How does the pterygopalatine fossa communicate with the middle cranial fossa?
foramen rotundum
Name the nerves and vessels in the pterygopalatine fossa
- Maxillary nerve (CN V2)
- Pterygopalatine ganglion
- Maxillary artery
- Sphenopalatine
- Descending Palatine
- Infraorbital
- (Posterior) Superior Alveolar
What does the pterygopalatine ganglion supply?
pterygopalatine ganglion recieves preganglionic fibers from the facial nerve (CN VII) (via greater petrosal nerve).
supplies:
- lacrimal gland
- mucosa of nasal vacity and palate
What supplies sensory to the upper lip?
Infraorbital nerve (V2)
What supplies sensory to the lower lip?
Mental nerve (V3)
What supplies sensory to the cheek?
Buccal nerve (V3)
How many total teeth do we have?
32
How many incisors?
2 per quadrant
4 total
How many canines?
1 per quadrant
2 total
How many premolars?
2 per quadrant
4 total
How many molars?
3 per quadrant
6 total
What supplies somatic sensory to the maxillary gingiva?
Maxillary nerve (CN V2)
- Superior alveoloar nerves
- Infraorbital nerves
- Nasopalatine nerve
- Greater palatine nerve
What supplies somatic sensory to the maxillary teeth?
Maxillary nerve (CN V2)
-Superior alveolar nerves
What are the boundaries of the oropharynx?
anterior: posterior 1/3 of the tongue
Superiorly: soft palate
Laterally: palatoglossal and palatopharyngeal arches
Inferiorly: epiglottis
What supplies somatic sensory to the mandibular gingiva?
Mandibular nerve CN V3
- Buccal nerve
- Lingual nerve
Mandibular teeth sensory
Mandibular nerve CN V3
-Inferior alveolar nerve
Genioglossus action
- protrude tongue (bilateral)
- Deviate tongue to side (unilateral)
Styloglossus action
retrude tongue
Hyoglossus action
depress tongue
Palatoglossus action
- Elevate posterior tongue
- Depress soft palate
What nerve innervates intrinsic and most extrinsic tongue muscles
Hypoglossal (CN XII)
Which extrinsic tongue muscle is not innervated by hypoglossal?
Palatoglossus (innervated by Vagus CN X)
What nerve supplies somatic sensory to the anterior 2/3 of the tongue?
Lingual nerve (CN V3)
Which nerve supplies somatic sensory to the posterior 1/3 of the tongue
Glossopharyngeal (CN IX)
Special sensory (taste): Posterior 1/3 of tongue
Glossopharyngeal (CN IX)
Special sensory (taste): anterior 2/3 of the tongue
Chorda tympani (Facial nerve (CN VII))
Special sensory (taste): near epiglottis
Vagus nerve (CN X)
Arterial supply to tongue
Lingual artery (branch of external carotid)
Venous drainage of tongue
Deep lingual veins > Lingual Vein > Internal jugular vein
- each side of frenulum
- superficial location exploited in sublingual drug delivery
Where does the Parotid gland open into the oral cavity?
Opposite the second maxillary molar
Parasympathetic parotid gland: Where are the cell bodies of the preganglionic nerve supplying the parotid gland?
brain
Parasympathetic innervation of parotid gland: preganglionic fibers
lesser petrosal branch of glossopharyngeal nerve (CN IX)
Parasympathetic innervation of parotid gland: post ganglionic cell bodies?
otic ganglion (in infratemporal fossa)
Parasympathetic innervation of parotid gland: post ganglionic fibers?
hitchhike with auriculotemporal nerve (branch of CN V3)
Parasympathetic preganglionic cell bodies of sublingual and submandibular glands
brain
Parasympathetic preganglionic fibers for submandibular and submaxillary
CN VII Facial nerve, then chorda tympani, then hitchhike with the lingual nerve (CN V3)
Parasympathetic postganglionic fibers for submandibular and submaxillary
follow arteries to reach the gland
Parasympathetic postganglionic cell bodies for submandibular and submaxillary
submandibular ganglion
