UNIT 6: Mandibular sys and Trigeminal Nerve (CN V) Flashcards

1
Q

The ramus of the mandible is _____ in shape; projects _____ from the _____ aspect of the body

A

quadrangular
upward
posterior

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2
Q

the angle of the mandible is where the ____ and ____ meet

A

body and ramus

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3
Q

the body of the mandible: ____ surface is modified into alveolar process/margin

A

upper

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4
Q

the mandibular notch of the mandible is a ____ separating _____ and ______

A

depression
coronoid
condyle

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5
Q

the condyle of the mandible is the ___ of the mandible and articulates w the _____

A

head
cranium

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6
Q

the mandibular foramen of the mandible is in the _____ of the medial surface of the ramus, through which the _____ nerve enters

A

centre
trigeminal

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7
Q

the coronoid process of the mandible is where the ____ muscle attaches

A

temporalis

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8
Q

dental alveoli are

A

small sacs in which the teeth sit and are on the upper surface of the alveolar margin

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9
Q

the alveolar margin …

A

bears lower teeth

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10
Q

mental symphysis develops because

A

right and left halves fuse during dev and ossifies during 1st year of life

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11
Q

mental foramen is where

A

trigeminal nerve exits

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12
Q

mental protuberance is a

A

midline elevation

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13
Q

mental spines are the site of

A

muscles attachment

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14
Q

teeth are ____ components of the _____ mechanism

A

vital
speech

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15
Q

teeth provide ______ _____ for speech sounds

A

articulatory surface

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16
Q

the integrity of dentition is important for speech bc

A

minor deficits may arise as a result of dental abnormalities

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17
Q

teeth provide the mechanism for

A

mastication

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18
Q

______ of teeth is key to effective mastication

A

orientation

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19
Q

jaws and teeth are important contributors to an indv’s characteristic _____ _____

A

facial structure

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20
Q

edentulous elderly experience the

A

resorption of alveolar bone

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21
Q

3 parts of the tooth

A

root
crown
neck

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22
Q

the root is hidden beneath

A

the gingival line

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23
Q

crown is the

A

visible 1/3 above gingival line

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24
Q

neck is the juncture bw

A

crown and root

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25
Q

enamel covers the

A

crown and overlays dentin

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26
Q

pulp contains

A

the nerve supplying the tooth

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27
Q

cementum is a

A

thin layer of bone holding tooth in alveolus along w the periodontal ligament

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28
Q

periodontal ligament holds the

A

teeth together

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29
Q

5 types of teeth

A

central incisors
lateral incisors
cuspids
bicuspids
molars

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30
Q

central incisors are ____ shaped and contain ___ root

A

chisel shaped
one root

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31
Q

mandibular central incisors are _____ than maxillary central incisors

A

smaller

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32
Q

lower central incisors are

A

overlapped by uppers

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33
Q

lateral incisors are ___ than centrals and have ____ roots than centrals

A

smaller
shorter

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34
Q

cuspids are ____ to lateral incisors

A

lateral

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35
Q

cuspids are

A

large, have a single point, good solid root

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36
Q

upper cuspids are ____ than lower cuspids

A

larger

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37
Q

bicuspids aka premolars are the

A

first and second bicuspids

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38
Q

bicuspids are only found in the

A

adult arch

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39
Q

bicuspids have

A

2 cusps
may have one or two roots

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40
Q

the largest of all the teeth are the

A

molars

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41
Q

there are ____ molars in the permanent arch

A

12

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42
Q

molars have

A

large, rectangular crowns

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43
Q

the first molar is the _____, the third molar (wisdom tooth) is the ____

A

largest
smallest

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44
Q

upper molars are ____ than lowers

A

smaller

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45
Q

upper and lower dental arch contain the ______ number of teeth

A

same

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46
Q

each dental arch can be divided in …

A

half by a midline

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47
Q

each tooth has ___ surfaces that can be described, which are….

A

5

occlusal
medial (mesial)
distal
buccal/labial
lingual

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48
Q

occlusal surface is where

A

the teeth touch on their upper surface - touch the teeth above them

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49
Q

lingual surface is

A

the surface closest to your tongue

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50
Q

buccal surface is the

A

surface closest to lip/cheek

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51
Q

mesial surface is

A

the surface closest to midline

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52
Q

distal surface is the

A

surface farthest from midline

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53
Q

there are ___ deciduous teeth, ___ on each arch

A

20
10

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54
Q

for deciduous teeth on each 1/2 arch there is ….

A

1 central incisors
1 lateral incisor
1 cuspid
2 molars

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55
Q

there are ____ permanent teeth, with ___ on each arch

A

32
16

56
Q

each 1/2 arch of permanent teeth contains…

A

1 central incisor
1 lateral incisor
1 cuspid
2 premolars/bicuspids
3 molars

57
Q

relationship of arches to each other is important for

A

mastication

58
Q

3 types of dental occulsions

A

class I neutral occlusion
class II malocclusion
class III malocclusion

59
Q

class I neutral occlusion is where the

A

1st mandibular molar is 1/2 tooth advanced of 1st maxillary molar

60
Q

class II malocclusion is where the

A

1st mandibular molars are retracted from 1st maxillary molars - aka overbite

sometimes accompanied by micrognathia which is a small mandible

61
Q

class III malocclusion is where the

A

1st mandibular molars are advanced greater than 1 tooth beyond 1st maxillary molars (underbite)

62
Q

torsiversion is

A

rotation of tooth along axis

63
Q

labioversion/buccoversion is

A

tooth tilts towards lips/cheek

64
Q

linguaversion is

A

tooth tilts toward tongue

65
Q

distoversion is

A

tooth tilts away from midline

66
Q

mesioversion is

A

tooth tilts toward midline - toward mesial surface

67
Q

infraversion is

A

tooth has not sufficient erupted to meet its partner on the other arch - aka too low

68
Q

supraversion is

A

the tooth has erupted too far

69
Q

the jaw moves in 3 dimensions

A

superior/inferior
anterior/posterior
laterally

70
Q

muscles of the jaw need to make 5 movements

A

depress the jaw
elevate the jaw
retract the ja
protrude the jaw
swing the jaw laterally

71
Q

muscles that depress the jaw do what

A

open the mouth

72
Q

muscles that elevate the jaw do what

A

close the mouth

73
Q

anterior belly of digastric: O, I, A, Inn

A

O = Internal surface of mandible
I= Intermediate tendon at hyoid
A= Depresses mandible (or elevates hyoid)
Inn = mandibular branch of CN V

74
Q

geniohyoid: O, I, A, Inn

A

O= Inferior mental spine on mandible
I = Anterior surface of the body of they hyoid
A = Depresses mandible (pulls hyoid anteriorly)
Inn = 1st cervical spine nerve of CN XII

75
Q

mylohyoid: O, I, A, Inn

A

O = Mylohyoid line on mandible
I = Hyoid and midline raphe
A = Depresses mandible (pulls hyoid anteriorly and sueperiorly)
Inn = mandibular branch of CN V

76
Q

anterior b of digastric, geniohyoid, mylohyoid all do what

A

depress the mandible

77
Q

temporalis is a

A

large fan shaped muscles with anterior and posterior fibres

78
Q

temporalis: O, I, A, Inn

A

O = greater wing of sphenoid, frontal, parietal, temporal bones
I = medial surface of coronoid process of mandible via a tendon deep to zygomatic arch
A = anterior fibres elevate mandible, posterior fibres retract the jaw
Inn = mandibular branch of CN V

79
Q

the only jaw retractor muscle is the

A

temporalis

80
Q

masseter is a

A

thick, flat, powerful
most superficial muscle of mastication

81
Q

masseter: O, I, A, Inn

A

O = zygomatic arch (inferior and deep surfaces)
I= external surface of angle and ramus of mandible, coronoid process of mandible
A= elevates mandible (major role in chewing)
Inn = mandibular branch of CN V

82
Q

massester has a major role in

A

chewing

83
Q

the lateral pterygoid is ___ to the masseter, and ____ to medial pterygoid m

A

deep
superior

84
Q

lateral pterygoid: O, I, A, Inn

A

O= greater wing of sphenoid, lateral pterygoid plate of sphenoid
I= condyle of mandible, capsule of the TMJ
A= inferior compartment depresses the jaw, bilateral contraction protrudes the jaw, unilateral contraction moves jaw laterally (to opp side)
Inn= mandibular branch of CN V

85
Q

medial pterygoid: O, I, A, Inn

A

O = medial surface of lateral pterygoid plate, pterygoid fossa, tubercle of the palatine bone
I = medial surface of angle of mandible and ramus
A = bilateral contraction elevates jaw, protrudes jaw w lateral pterygoid, unilateral contraction moves jaw laterally (toward opp side)
Inn = mandibular branch of CN V

86
Q

medial pterygoid is ____ to lateral pterygoid, runs along _____ surface of mandible

A

deep
internal

87
Q

describe the masticatory cycle aka how the jaw moves in a looping pattern…. what does it result in?

A

lower incisor swings away from the working side during jaw opening

then crosses midline and moves toward working side during jaw closing

looping pattern results in grinding motion across the surfaces of the premolar and molar teeth

88
Q

what is the central pattern generator?

A

a network of neurons that sets the basic chewing rhythm

89
Q

for the CPG, alternating activity in antagonistic muscles is generated by activity of …

A

isolated groups of neurons

90
Q

the CPG is modulated by inputs from

A

peripheral sensory organs (proprioception, somatosensation, taste from muscles of mastication/oral cavity)

91
Q

CPG may be triggered by

A

peripheral afferent inputs or inputs from higher brain centres (cortex) - ex. knowing that a food you had before required more chewing

92
Q

CPG is located in _________ it is ________ and interconnected

A

reticular formation of the pons
bilateral - aka one on left and one on right and they communicate

93
Q

temporomandibular joint - TMJ is _____ joint with ____ ligament support

A

synovial joint
weak

94
Q

the TMJ is maintained mainly by

A

muscles of mastication acting on the joint and the mandible

95
Q

integrity of the TMJ is important for

A

speech

96
Q

major movements in the TMJ occur during

A

chewing and yawning

97
Q

TMJ disorders occur in ____ % of the population and is associated with _____

A

5%
bruxism aka teeth grinding

98
Q

TMJ is comprised of 3 things, held together by ….

A

condyle
mandibular fossa
articular tubercle/eminence

held together by a lax joint capsule

99
Q

the lax joint capsule of the TMJ has a lateral thickening called the _______ ______, also receive support from 2 other ligaments

A

temporomandibular ligament

stylomandibular ligament
sphenomandibular ligament

100
Q

TMJ has an _________ which divides the synovial cavity into superior and inferior compartments

A

articular disc

101
Q

the superior and inferior compartments of TMJ allow for 2 types of jaw movement

A

lower compartment = permits the condyle to make hinge-like jaw opening/closing aka speech

upper compartment = permits the condyle to glide anteriorly and sit under the articular tubercle when the mouth is opened widely

102
Q

in the TMJ, the _____ is braced against the articular tubercle preventing the mandible from crushing thru the thin mandibular fossa during _____

A

condyle
biting of hard food

103
Q

in speech the mandible provides …. what if the tongue is weak?

A

a moving platform for the tongue

if the tongue is weak, the mandible may compensate w exaggerated movement in attempts to retain adequate constriction of the vocal tract

104
Q

in mastication the mandible brings…

A

the jaw into occlusion thru repeated rotary lateral motion

105
Q

in deglutition the mandible provides…

A

a stable platform for the tongue

106
Q

two types of fibers in CN V

A

special visceral efferent
general somatic afferent

107
Q

SVE of CN V ….

A

supply muscles of mastication, tensor tympani, tensor palatini, mylohyoid, anterior belly of digastric

innervates muscles arising from 1st branchial arch

108
Q

GSA of CN V….

A

mainly sensory

sensations of the face, scalp, eye, mucous membranes of the nasal and oral cavities, tongue, teeth, part of the external aspect of tympanic membrane, meninges of anterior and middle cranial fossa

109
Q

intracranial course of SVE of CN V

A

LMN - cells bodies in trigeminal motor nucleus in the pons

Axons leave pons, exit skull at foramen ovale in sphenoid bone

110
Q

extracranial course of SVE of CN V

A

Pass thru foramen ovale w sensory fibres of V3 forming the mandibular nerve

Nerve branches supply muscles of mastication

111
Q

the trigeminal motor nucleus receives input from 3 things

A

CN V sensory signals relating to conditions in the oral cavity and stretch receptors in muscles of mastication

CN VIII sensory input for control of tension of tympanic membrane

bilateral inputs from the cortex to mediate movements of jaw in speech and voluntary mastication

112
Q

extracranial course of GSA of CN V - 3 major divisions

A

carry sensory info from various regions of the face and head

ophthalmic - V1
Maxillary - V2
Mandibular - V3

113
Q

what is innervated by V1 of GSA CN V?

A

sensations from forehead, scalp bridge of nose, and medial upper eyelid

Sensations from upper eyelid, conjunctiva, and lacrimal gland

Sensations from medial lower eyelid, side of nose, nasal septum, and lateral wall of nasal cavity

114
Q

what is innervated by V2 of CN V GSA

A

Sensations from side of forehead, cheek
Sensations from upper lip, medial cheek, side of nose

Sensations from upper teeth - mostly pain

Sensations from hard and soft palates, nasopharynx

115
Q

What is innervated by V3 of GSA CN V?

A

Mandibular, V3 →
Sensations from mucous membranes of cheek, and upper gingiva

Sensations from anterior ⅔ of tongue (lingual nerve)

Sensations from side of head, scalp, external auditory meatus and tympanic membrane,TMJ

116
Q

intracranial course of V1 of GSA CN V

A

Enters cranium thru the superior orbital fissure and has its cell bodies in the trigeminal ganglion sitting in the trigeminal impression of the petrous bone

117
Q

intracranial course of V2 of GSA CN V

A

Enters cranium thru foramen rotundum and has cell bodies in the trigeminal ganglion

118
Q

intracranial course of V3 of GSA CN V

A

Enters cranium thru foramen ovale and then has cell bodies in the trigeminal ganglion

119
Q

after V1, V2, V3’s primary neurons enter the cranium, where are the cell bodies of the secondary neurons?

A

Cell bodies of secondary neurons are located in trigeminal nuclei

120
Q

the trigeminal sensory nuclei contains 3 subnuclei

A

mesencephalic n
principal sensory n
nucleus of spinal tract

121
Q

mesencephalic n is for…. and is located in….

A

nerves that carry stretch info (proprioception) from muscles of mastication, in midbrain

122
Q

principal sensory n is for…. and is located in….

A

nerves that carry touch sensation, in the pons

123
Q

nucleus of spinal tract is for… and is located in

A

nerves carrying pain and temp sensation, in medulla

124
Q

what are the two ways the extra cranial course of the peripheral nerve can be damaged?

A

injury to the head
herpes zoster virus aka shingles

125
Q

injury to the head can damage the extra cranial course of the peripheral nerve because…

A

bc the trigeminal nerve is pretty superficial, not rly covered by any muscles

ex. trauma to the chin can lead to sensory loss from lower lip ad chin; injection of anesthetic into the inferior alveolar nerve by the dentist

126
Q

herpes zoster virus aka shingles can…

A

lie dormant in the trigeminal gnaglion

when active it travels along the peripheral nerve, leads to irritation at the outbreak, pain following resolution

127
Q

what are the two ways the trigeminal nerve can be damaged w/i the middle cranial fossa

A

peripheral nerve can be damaged by compression as nerve passes thru MCF, or by a schwannoma of the nerve

acoustic neuroma (schwannoma of CN VIII) can compress trigeminal nerve (cerebellopontine angle syndrome, where is here the nerve travels thru)

128
Q

for the CN V, damage in the medulla causes

A

primarily loss of pain and temp sensation on ipsilateral side of face

129
Q

for CN V, damage to the pons causes

A

loss of discriminative touch ipsilaterally; may also be a LMN lesion (affecting ipsilateral muscles of mastication)

130
Q

for CN V, damage above the brainstem leads to

A

all modalities contralateral to affected hemisphere are affected - no notable UMN damage bc m of mastication are bilaterally innervated, and drive mostly by sensory input w/i the pons

131
Q

3 ways the sensory component CN V can be tested

A

discriminative touch (touch skin w sharp end of pointed object)

simple touch (w cotton swab -not at midline of face, corneal reflex)

pain/temp (warm or cool objects against skin)

132
Q

how to test jaw closure for CN V

A

at rest, palpate massester and temporalis on both sides, ask to clench jaws together tightly

w jaw closed examiner tries to depress it

133
Q

how to test jaw opening for CN V

A

client opens mouth, jaw will deviate toward weak side (side of LMN damage)

w jaw open examiner tries t close it

134
Q

how to test lateral jaw motion for CN V

A

client moves jaw to one side, examiner tries to push it back to midline

have client move jaw back and forth

135
Q

how to test jaw jerk (neurological exam) for CN V

A

tap middle of chin w reflex hammer while jaw is slightly open - no movement or slight closing constitutes normal reflex

136
Q

the mandibular system contributes to

A

speech, mastication, swallowing, and one’s facial appearance