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BDS3 - Anatomy > week 7 > Flashcards

week 7 Flashcards

1
Q

what are the 2 main parts of the mandible

A
  • body

- ramus

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2
Q

what is a symphysis

A

secondary cartilaginous joint

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3
Q

what is the mental symphysis

A

In a foetus there is a fibrous joint / material between the 2 halves but these 2 halves then unite by a bony union by the time of birth

not a true symphysis

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4
Q

what is the mental protuberance

A

forward projection of the chin

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5
Q

what is found in the middle of the mental protuberance

A

mental tubercle

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6
Q

what passes through the mental foramen

A

the mental nerve emerges from bone here as well as mental blood vessels

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7
Q

what is the mental nerve a continuation of

A

inferior alveolar nerve

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8
Q

where can the mental foramen be found on the mandible

A

just below the premolars

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9
Q

what is the oblique line

A

where the buccinator muscle attaches to the mandible

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10
Q

what is the base of the mandible

A

the underside of the mandible

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11
Q

where can you see the digastric fossa

A

when looking at the mandible from underneath

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12
Q

what attaches to the digastric fossa

A

the digastric muscles (right and left)

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13
Q

what is the alveolar process of the mandible

A

the part of the bone that bears the teeth

the roots go down into the alveolar process

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14
Q

what happens to the alveolar bone if you lose your teeth

A

the alveolar process atrophies / disappears

If you lose the teeth, the alveolar process disappears and you are left with the body without the alveolar process

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15
Q

what is the problem with losing the alveolar process

A

it means that the mental foramen comes to be very high up on the remaining body

If the mandible is very atrophic, (ie if the person lost their teeth a long time ago) you can get patients with the mental foramen sitting on the top part of the body of the mandible so in a patient with dentures the denture might sit on the mental foramen / nerve and this can be a cause of pain

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16
Q

what is the mylohyoid line

A

found on the medial surface

This is for the attachment of the mylohyoid muscle

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17
Q

what do the mylohyoid muscles do

A

The 2 mylohyoid muscles meet in the midline and they are a bit like a hammock supporting the structures in the oral cavity such as the tongue

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18
Q

why is the mylohyoid line important

A

This line is separating the tissues of the floor of the mouth from the submandibular region

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19
Q

what is the problem with an abscess bursting above or below the mylohyoid line

A

above: infected material comes into the tissues in the floor of the mouth
below: infected material is released into submandibular region

if it is a really bad infected it can start to track back and drop down through the tissue planes and into the thorax (if this happens it doesn’t matter if it is coming from the floor of the mouth or the submandibular region as they both lead back into the tissues lateral to the pharynx and the infected material can pass down into the thorax)
This is called Vincent’s Angina

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20
Q

why is the mylohyoid line important in the making of dentures

A

if you are making dentures for the lower jaw, the denture has to stop short of the mylohyoid muscle

otherwise when you are speaking or eating, the contraction of the mylohyoid will lift the denture

and in the same way the denture has to miss the oblique line on the external surface otherwise it will be interfering with the buccinator muscle

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21
Q

what is the smooth area behind and below the mylohyoid line called

A

the area where the submandibular gland lies

called the submandibular fossa

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22
Q

what is the smooth area above the mylohyoid line

A

the area where the sublingual salivary gland lies

called the sublingual fossa

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23
Q

what are the little bumps in the midline of the internal surface of the mandible called

A

mental spines / genial tubercles

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24
Q

what attaches to the upper mental spines

A

genioglossus muscle

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25
Q

what does the genioglossus muscle do

A

the muscle that sticks your tongue out

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26
Q

what attaches to the lower mental spine

A

geniohyoid muscle

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27
Q

what does the geniohyoid muscle do

A

pulls the hyoid bone forward when you are swallowing

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28
Q

what groove is found near the mylohyoid line

A

mylohyoid groove

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29
Q

what nerve travels in the mylohyoid groove

A

nerve to mylohyoid

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30
Q

where does the nerve to mylohyoid come from

A

branch off the inferior alveolar nerve

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31
Q

where does the tendon of the temporalis muscle attach

A

attaches around the coronoid process

also comes quite far down the anterior border of the ramus

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32
Q

what is the coronoid process

A

projection of the mandible

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33
Q

what is the condylar process

A

projection of the mandible

consists of the head and neck

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34
Q

what does the inferior alveolar nerve pass into

A

mandibular foramen

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35
Q

what is the mandibular canal

A

it is found within the mandible and carries the IAN inside the bone

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36
Q

what is the problem with the lingula during and IAN block

A

if the lingula is big the needle can hit the lingula rather than advancing forward so the LA is deposited to the wrong area

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37
Q

why is there a rough surface at the inner aspect of the ramus at the angle of the mandible

A

where the attachment of the medial pterygoid muscle is

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38
Q

what is the mandibular notch

A

The mandibular notch is the notch between the coronoid process and the condylar process

The nerve and vessels to the masseter that are coming from the mandibular nerve comes out and heads laterally and pass through this notch

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39
Q

what is the pterygoid fovea

A

found at the front of the neck of the mandible (a little depression)

This pterygoid fovea is part of the attachment for the lateral pterygoid muscle

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40
Q

what is the pterygoid hamulus

A

the little projection at the back of the mouth at the lower end of the medial pterygoid plate

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41
Q

where is the start of the origin of the pterygomandibular raphe

A

pterygoid hamulus

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42
Q

what is the pterygomandibular raphe

A

this is a fibrous band between the pterygoid hamulus and the mandible

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43
Q

what are the 3 muscles that the pharynx is partly surrounded by

A

3 constrictor muscles
○ Superior
○ Middle
○ Inferior

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44
Q

what are the constrictor muscles made from

A

skeletal

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45
Q

what sort of control is the constrictor muscles under

A

strong reflex control

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46
Q

what do the constrictor muscles do

A

When you swallow the constrictors sort of grasp the bolus and help to move it down through the pharynx

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47
Q

what does the superior constrictor muscle attach to

A

a little bony projection from the base of the skull found a little bit in front of the foramen magnum called the pharyngeal tubercle

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48
Q

what is found at the back of the pharynx where these muscles pass

A

pharyngeal raphe

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49
Q

what muscle is attached to the side of the hyoid bone

A

middle constrictor muscle

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50
Q

what is found between the thyroid and cricoid cartilage

A

fibrous band

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51
Q

what muscle does the thyroid and cricoid cartilage and fibrous band give rise to

A

inferior constrictor muscle

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52
Q

what muscle is attached to the styloid process

A

stylopharngeus muscle

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53
Q

where does the stylopharyngeus muscle go

A

comes down from styloid process
blends with wall of pharynx
passes between superior and middle constrictor muscle

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54
Q

where does the pharynx tend to be open

A

towards the front

The constrictor muscles are coming from their different origins and going around the sides of the pharynx and meeting each other at the back

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55
Q

what nerve supplies the mucosa of the oral phayrnx and nasal pharynx

A

glossopharyngeal nerve

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56
Q

what nerve supplies the stylopharyngeus muscle and constrictor muscles

A
  • vagus nerve supplies constrictor muscles

- glossopharyngeal nerve supplies stylopharyngeus

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57
Q

what is the first part of swallowing

A

voluntary

chewing and moving the bolus

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58
Q

how does the styloglossus help with swallowing

A

helps move the bolus back

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59
Q

when the 2 tendons that wind around the pterygoid hamulus join together what is this called

A

palatal aponeurosis

the 2 tendons spread out and form a flattened sheet that forms the skeleton of the soft palate

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60
Q

what muscle runs from the pterygoid hamulus to the base of the skull

A

tensor veli palatini muscle

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61
Q

what is the tensor veli palatini quite close to at the base of the skull

A

close to where the auditory tube is

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62
Q

what happens when the tensor veli palatini muscle contracts

A

the tendons are pulled so the soft palate becomes tense

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63
Q

what nerve supplies the tensor veli palatini muscle

A

mandibular nerve (CN5)

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64
Q

what pharyngeal arch is the tensor veli palatine muscle fromed from

A

first pharyngeal arch of the emrbyo

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65
Q

what does the auditory tube allow for

A

allows air into the middle ear

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66
Q

what muscle is found coming down from the base of the skull behind the auditory tube to attach to the upper aspect of the palatal aponeurosis

A

levator veli palatini muscle

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67
Q

what is the function of the levator veli palatini muscle

A

pulls the palate up

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68
Q

what nerve supplies the levator veli palatini

A

vagus nerve

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69
Q

what muscle runs from the tongue up to the palatal aponeurosis

A

palatoglossus muscle

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70
Q

what nerve supplies the palatoglossus muscle

A

vagus nerve

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71
Q

what muscle attaches to the palatal aponeurosis and blends with the wall of the pharynx

A

the palatopharyngeus muscle

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72
Q

what nerve supplies the palatopharyngeus muscle

A

vagus nerve

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73
Q

what is the uvulua

A

found at the back end of the soft palate

the little piece that hangs down

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74
Q

what is the function of the uvulua

A

improves the seal of the soft palate when swallowing fluids

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75
Q

what muscle runs in the soft palate immediately on the upper surface of the palatal aponeurosis on either side of the midline

A

uvular musles

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76
Q

what is the space between the palatoglossal folds called

A

isthmus of the fauces

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77
Q

where is the maxillary tuberosity found

A

an elevation of the posterior part maxilla is the maxillary tuberosity

This is just behind the upper third molar

78
Q

what is the articular disc

A

Disc of fibrous material inside the TMJ and it fuses with the back part of the capsule

79
Q

how many compartments does the TMJ have

A

The joint has 2 compartments - an upper and a lower part

80
Q

what nerve comes out of the lateral pterygoid muscle

A

buccal nerve

81
Q

what is the buccal nerve

A

A long nerve which is a branch of the mandibular nerve that is sensory to the cheek / mucosa at the back of the cheek

This nerve also gives branches to the gums / buccal gingivae

82
Q

what artery comes out of the lateral pterygoid muscle close to the buccal nerve

A

maxillary artery

sometimes it runs deep to the lateral pterygoid muscle

83
Q

what is the maxillary artery a branch of

A

external carotid artery

84
Q

what other artery comes off the external carotid artery

A

superficial temporal artery

85
Q

what artery comes off the maxillary artery

A

inferior alveolar artery

86
Q

what gland does the external carotid artery run through

A

parotid salivary gland

87
Q

roughly where does the external carotid artery brach

A

Just as this artery reaches the area of the TMJ, just around the upper part of the parotid gland this artery splits into 2 terminal branches

88
Q

what does the maxillary artery supply

A

Runs forward to supply the tissues in the infratemporal fossa and gives off branches to the upper and lower jaws

89
Q

where does the inferior alveolar artery run

A

The inferior alveolar artery runs into the mandible along with the inferior alveolar nerve

There would be a vein inside the jaw as well accompanying the artery and nerve

90
Q

what is found amongst the fat underneath the ramus of the mandible

A

pterygoid venous plexus

lots of veins

91
Q

what do you call the area that is deep to the ramus

A

infratemporal fossa

92
Q

how many heads does the lateral pterygoid muscle

A

2 heads

  • superior
  • inferior
93
Q

where does the superior head of the lateral pterygoid muscle come from

A

base of the skull

94
Q

what direction does the fibres of the superior head of the lateral pterygoid muscle run

A

Its fibres run backwards and downwards

95
Q

where does the superior head of the lateral pterygoid muscle attach to

A

As they run back the fleshy fibres gives way to tendon and the tendon attaches to the capsule of the TMJ

96
Q

where does the inferior head of the lateral pterygoid muscle come from

A

lateral side of the lateral pterygoid plate

97
Q

what nerve and artery are superficial to the inferior head of the lateral pterygoid muscle

A

The buccal nerve and the maxillary artery is superficial to this muscle

98
Q

what direction does the fibres of the inferior head of the lateral pterygoid muscle run

A

Fibres are running backwards and slightly upwards as they go

99
Q

where does the inferior head of the lateral pterygoid muscle attach to

A

becomes tendonous just before they reach the capsule of the TMJ

100
Q

as well as the capsule, where else do the 2 heads of the lateral pterygoid muscles attach to

A

pterygoid fovea on the mandible

101
Q

what happens when the lateral pterygoid muscle contracts

A

When the lateral pterygoid contracts it pulls on the neck of the mandible and pulls on the capsule of the TMJ and the disc inside
so the whole of the head of the mandible slides out of its fossa to the eminence in front

So you open your mouth and the head of the mandible slides forward / protrudes the mandible due to the contraction of the lateral pterygoid

protracts the mandible

102
Q

what are the 2 heads of the medial pterygoid muscle

A
  • superficial head

- deep head

103
Q

where does the inferior alveolar nerve run

A

runs deep to the lateral pterygoid muscle
runs downwards and forwards and into the mandible

Found fairly close to the maxillary artery as it is going to run in the same path as the inferior alveolar artery

104
Q

where does the inferior alveolar nerve enter

A

mandibular foramen

goes into the mandibular canal

105
Q

just before the inferior alveolar nerve enters the mandibular foramen it gives off a branch, what is it called

A

nerve to mylohyoid

106
Q

what does the nerve to mylohyoid supply

A

mylohyoid muscle

anterior belly of the digastric muscle

107
Q

what nerve is found in front of the inferior alveolar nerve

A

lingual nerve

108
Q

where does the lingual nerve come form and go

A

Comes out from undercover of the lateral pterygoid muscle

it makes it’s way down to the area of the mandible near the 3rd lower molar nerve

109
Q

where does the medial pterygoid muscle attach to the mandible

A

at the angle of the mandible

110
Q

where does the tendon of the superficial head of the medial pterygoid muscle attach

A

maxillary tuberosity

111
Q

where do the fibres of the deep head of the medial perygoid muscle attach

A

medial side of the lateral pterygoid plate

112
Q

what direction do the fibres of the medial pterygoid muscle run

A

Fibres are running downwards and backwards and also coming out towards us

113
Q

If the 2 medial pterygoid muscles contract together (right and left) what would they do?

A

○ Muscle fibres are coming downwards to the angle of the mandible

○ So if these muscles contract they are going to elevate the mandible

○ 2 muscles contracting together would also pull the mandible forwards

○ So the medial pterygoid muscle can elevate and protract the mandible

114
Q

what happens if only the left medial pterygoid muscle contracts

A

If the left side contracts it will pull on the deep side of the angle of the mandible, it will pull the mandible towards the opposite side

Will pull it medially so the mandible swings to the opposite side that is contracting

115
Q

what movements of the mandible can hte medial ptergoid muscle cause

A

An elevator, protractor and moves mandible to other side when it contracts

116
Q

does the medial pterygoid muscle have to turn a corner in order to be attached to the medial side of the lateral pterygoid plate

A

no

The lateral pterygoid plate is not sitting straight but actually sits at an angle

this allows the medial pterygoid muscle to attach to the medial side of the lateral pterygoid plate and slide out that way rather than having to turn a corner

117
Q

is the pterygomandibular space an anatomy term

A

no

more clinic

118
Q

what is the pterygomandibular space

A

This is the area between the ramus of the mandible and the medial pterygoid muscle and below the lateral pterygoid space

119
Q

what is the significance of the pterygomandibular space

A

This is the space where the LA is going to be given

120
Q

what is behind the area of the pterygomandibular space

A

Parotid gland is just behind this area - don’t want LA to go there

121
Q

where does the main trunk of the mandibular nerve come frm

A

foramen ovale in the sphenoid bone in the base of the skull

122
Q

what is the first branch to come off the main trunk of the mandibular nerve

A

nerve to the medial pterygoid muscle

123
Q

what 2 divisions does the mandibular nerve split into

A

○ Anterior division

○ Posterior division

124
Q

where does the anterior division run initially

A

At the start the anterior division runs very high up in the infratemporal fossa near the base of the skull

This happens deep to the lateral pterygoid muscle

125
Q

what is the first branch of the anterior division of mandibular nerve

A

nerve to the masseter muscle

126
Q

where does the nerve to the massester muscle run

A

Runs laterally and into the mandibular notch between the head and the neck on one side and the coronoid process and enters the deep aspect of the masseter

127
Q

what is the second branch of the anterior division of mandibular nerve

A

the deep temporal nerves

128
Q

where do the the deep temporal nerves run

A

they run into the deep aspects of the temporalis muscle

Approach from the medial side

129
Q

what is the branch after the deep temporal nerves

A

nerves to lateral pterygoid muscle

130
Q

after the nerve to the lateral pterygoid muscle, where does the anterior division go

A

start to distribute itself to the skin of the cheek and the mucosa inside the cheek and the branches to the gums on the buccal sides of the teeth

becomes the buccal nerve

131
Q

where does the buccal nerve come out between

A

2 heads of the lateral pterygoid muscle

132
Q

what muscles does the anterior division supply

A

masseter
temporalis
lateral pterygoid muscle

133
Q

does the anterior divison supply sensation

A

the last part (buccal nerve) is sensory to the cheek, skin of mucosa and gums

134
Q

When does the anterior division stop becoming the anterior division and become the buccal nerve?

A

Not very clear in the books

Changes when it comes through the heads of the lateral pterygoid to come out to be the sensory nerve

Could argue when the last motor nerve comes off it is then the buccal nerve

Doesn’t actually matter

The buccal nerve is the continuation of the anterior division of the mandibular nerve once the motor nerves have come off

135
Q

what is the most anterior branch of the posterior division

A

lingual nerve

136
Q

what does the lingual nerve supply

A

Lingual nerve is a purely sensory nerve
Provides sensation to
§ the mucosa of the anterior two thirds of the tongue of its own side,
§ the floor of the mouth of its own side and
§ The lingual gingiva on its own side

137
Q

where does the lingual nerve pass

A

Passes close to the bone on the inner aspect of the area where the 3rd molar tooth is sitting, close to the internal aspect of the mandible

Extractions of lower 3rd molar can put this nerve at risk

138
Q

what nerve is next to the lingual nerve

A

inferior alveolar nerve

139
Q

where does the inferior alveolar nerve travel

A

Enters mandibular foramen
Runs forward in the bone within the mandibular canal
Continues below the area where the roots of the molar teeth are

140
Q

what nerve does the inferior alveolar nerve give off

A

mental nerve

141
Q

where does the mental nerve come out

A

round about the area of the premolars the mental nerve comes out through the mental foramen

142
Q

what does the mental nerve supply

A

Supplies the skin on the chin and the skin of the lip and the mucosa

143
Q

what is the nerve that is a continuation of the inferior alveolar nerve called

A

incisive nerve

144
Q

what does the incisive branch supply

A

Carrying on in the bone round to the area of the canines and incisors is the continuation of the inferior alveolar nerve which is often called the incisive branch of the nerve

145
Q

before the inferior alveolar nerve enters the mandible what does it give off

A

gives off the little branch called nerve to the mylohyoid

146
Q

what does the nerve to the mylohyoid supply

A

anterior belly of the digastric muscle

mylohyoid muscle

147
Q

what nerve supplies the posterior belly of the digastric muscle

A

facial nerve

148
Q

what is the only motor branch in the posterior division

A

nerve to mylohyoid

149
Q

what artery runs up beside the mandibular branch

A

middle meningeal artery

150
Q

what artery does the middle meningeal artery come from

A

maxillary artery

151
Q

how does the middle meningeal artery pass into the cranial cavity

A

passes through the foramen spinosum

152
Q

coming from the mandibular division, what branch forms a little loop of nervous tissue around the middle meningeal artery

A

auriculotemporal nerve

153
Q

what does the auriculotemporal nerve supply

A

Supplies sensation to the TMJ and carries on up to supply sensation to the skin anterior to the ear

154
Q

what does the posterior division of the mandibular nerve give off

A

Lingual nerve
IAN
Auriculotemporal nerve
(nerve to mylohyoid)

155
Q

what nerve joins the lingual nerve

A

a branch of the facial nerve called the chorda tympanii

156
Q

how is sensory information about taste conveyed

A

Sensory fibres leaving taste buds and travel from the tongue in the lingual nerve

These fibres then come off and run in the chorda tympanii nerve, join the facial nerve and then go to the brain stem via the facial nerve

157
Q

where does the chorda tympanii run

A

Branches off from the facial nerve close to the middle ear

Called the chorda tympani because it runs across the inside of the upper part of the ear drum (tympanic membrane)

158
Q

what does the chorda tympanii carry

A

Carries fibres concerned with taste from the anterior 2/3s of the tongue
(special sensation)

159
Q

what sort of sensation is supplied by the lingual nerve

A

general sensation

160
Q

what sort of supply does the submandibular gland and sublingual gland receive

A

these have a parasympathetic supply

161
Q

what nerve carries the pre-ganglionic fibres for the parasympathetic supply for salivary glands

A

facial nerve

162
Q

what makes the submandibular and sublingual salivary glands secrete

A

Chorda tympani also carry the pre-ganglionic parasympathetic fibres that make the sublingual and submandibular salivary gland secrete

163
Q

What lies between the head of the mandibular and the mandibular fossa

A

There is an articular disc

Fibrous dense tissue

164
Q

what passes through the incisive foramen

A

Nasopalatine nerve

Branch of maxillary nerve

165
Q

what does the nasopalatine nerve supply

A

Supplies hard palate

166
Q

what passes through the greater palatine foramen

A

greater palatine nerve

branch of maxillary nerve

167
Q

what does the greater palatine nerve supply

A

Posterior 2/3s of hard palate on its side

168
Q

what is found just behind the greater palatine foramen

A

1/2/3 little holes
The lesser palatine nerve comes through these
They have their own little bony canals

169
Q

whatt does the lesser palatine nerve supply

A

They supply the soft palate (sensory)

170
Q

why do you want to avoid LA in the area of the soft palate

A

can affect swallowing mechanism

171
Q

if you see a distinct groove in the bone of the hard palate what would be running in this groove

A

Greater palatine artery

172
Q

where does the masseter muscle attach

A

lower borders of zygomatic arch and deep surface

lateral surface of the ramus of the mandible / most of the outer surface of the ramus of the mandible

173
Q

what direction do the fibres of the masseter run

A

Fibres run downwards and slightly backwards (superficial)

Deeper down there are more vertical fibres

174
Q

what action is produced when the 2 masster muscles contract together

A

§ It elevates - pulls the mandible up

§ But because the superficial fibres run slight backwards there is another movement as well - it will pull the mandible slightly forward as well so helps with protrusion of the mandible as well

Elevator and protractor

175
Q

what is the nerve supply of the masseter muscle

A

nerve to masseter
branch of mandibular dividion

comes through the mandibular notch to reach masseter muscle

176
Q

where does the masseter attach

A

lower border of zygoma

177
Q

what attaches to the inferior temporal line

A

Temporalis muscle attaches to this line

Runs from temporal fossa

178
Q

what is the temporalis muscle covered by

A

dense fascia

179
Q

where does the fascia over the temporalis muscle attach

A

this runs as far as the superior temporal line and to the upper edge of the zygomatic arch

180
Q

where does the tendon of the temporalis muscle attach

A

Tendon attaches along edge of coronoid process, along anterior border of ramus almost to the lower 3rd molar tooth

181
Q

what direction do the fibres of the temporalis run

A

Anterior - vertically to coronoid process, anterior border, almost 3rd molar

Posterior - deep to zygomatic arch then attach to coronoid process

182
Q

what does the temporalis muscle do

A

• Elevation of mandible

• Retraction / retrude mandible
Only muscle that pulls the mandible back

183
Q

what nerve supplies the temporalis muscle

A

mandibular division - deep temporal nerves

184
Q

what is the buccinator muscle

A

Muscle of facial expression used when eating

185
Q

what is a raphe

A

Fibrous tissue between 2 muscles

186
Q

where do the upper fibres of the buccinator come from

A

come from side of maxilla

Above the vestibule of the mouth

187
Q

where do the lower fibres of the buccinator come from

A

coming from the mandible
To do with the oblique line
This is where these fibres arise from

188
Q

what way are the fibres of the buccinator arranged

A

• There is a criss crossing arrangement
Upper middle fibres run up and then pass into lower lip and blend with orbicularis oris
Lower middle fibres run down and then pass into upper lip and blend

189
Q

what is the modiolus

A

At angle of mandible the cheek is thicker and this is called the modiolus

190
Q

how does the parotid duct enter the oral cavity

A

has to pierce the buccinator to get into the oral cavity

Arrangement of muscle fibres around it
Comes into mouth beside crown of second upper molar

BDS3 - Anatomy (10 decks)

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