Extraoral Exam Competency Questions - Packet

Why do we do an ElO?

Abnormality -Baseline-Cancer screening-Deviation from normal

When does the ElO begin?

In the waiting room to assess for any irregularities, such as a limp

What is the first thing palpated during the Extra Oral exam?

The frontalis

What is the name of the muscle that brings the eyebrows inward or makes you frown

The corrugator

What are the muscles of mastication (MOM)?

Masseter, medial pterygoid, lateral pterygoid, and temporalis

Which muscle of mastication is associated with the TMJ? What structure/part of the TMJ does this MOM attach to?

Lateral pterygoid, attaches to the anterior of the disc

Which cranial nerve, and specific branch, innervates the TMJ?

CN V, V3 Mandibular

Describe the Disc of the TMJ

Divides the TMJ into 2 compartments (synovial cavities), upper and lower

Attaches anteriorly to the lateral pterygoid muscle, the posterior has upper attachment to the postglenoid process, and the lower attaches to the neck of the mandibular condyle

Describe the Capsule of the TMJ:

Fibrous tissue that encloses the TMJ completely

Membranes lining the joint capsule secrete synovial fluid to lubricate and nourish the joint

• Which cranial nerve innervates the MOM? (specify the specific division)

CN V, Trigeminal Nerve, V3 Mandibular Division

What are the actions of the Lateral Pterygoid muscle

Only MOM that assists in depressing mandible

Bilateral contraction: protrusion of jaw and slight depression of jaw

Unilateral contraction: Lateral deviation

Which artery primarily services the MOM?

Maxillary Artery

From which branchial arch are the MOM derived?

first

Which cranial nerve innervates the Muscles of Facial Expression?

CN VII(7), Facial Nerve

From which Branchial Arch are the Muscles of Facial Expression derived?

Second

What kind of palpation should be used?

Bimanual and bidigital

What might be found when palpating the lymph nodes? What might this mean

Lymphadenopathy (enlarged lymph nodes)

nodes may also be inflamed or tender

Infection of the head and/or the neck

What bone is not attached to any other bone?

Hyoid bone

What structures are in the neck?

The larynx, trachea, and thyroid

What is the difference between the trachea and the larynx?

trachea: used for breathing

- contains rings of cartilage

larynx: used for passing food

What are we feeling when we ask the patient to swallow?

To feel for a smooth up and down motion of the larynx

What is the landmark in the back of the tongue that is 2/3 down the notch that gives rise to the thyroid?

foramen cecum

What is the name of the base of the tongue that forms during fusion?

sulcus terminalus

What shape is the thyroid gland?

Butterfly-shaped

What is the function of the thyroid gland?

Regulates metabolism

The thyroid develops from what during embryonic development?

foramen cecum

What hormone does the thyroid release?

Т3 (Tri-iodothyronine), T4 (thyroxine) and Calcitonin

What mineral is associated with the thyroid?

lodine

Where do we get this mineral from?

Salt in our diet

What are 2 disorders associated with the thyroid?

Hypothyroidism: too little of the hormone is being produced Hyperthyroidism: too much of the hormone is being produce

What is the main disease associated with Hyperthyroidism?

Graves' disease

What is the main disease associated with Hypothyroidism?

Hashimoto's disease

What would someone with Hyperthyroidism look like?

Weight loss, energetic, anxious, tachycardia

What would someone with Hypothyroidism look like?

Weight gain, moon face (Cushing's syndrome), low energy, tiredness, bradycardia, if they have Hashimoto's there is swelling of joints

What is a medicine for Hypothyroidism?

Synthroid

What is the muscle responsible for grimacing?

Platysma

What muscle encircles the mouth?

Obicularis oris

What muscle encircles the eye?

Obicularis oculi

What muscle is responsible for smiling?

Zygomaticus major

What is the muscle responsible for lifting the upper lip?

Levator labii superioris

What is the smooth part of the forehead called, located above and between the eyebrows?

The glabella

How many bones are in the skull (cranial and facial)?

22

How many Facial Bones do we have, and what are their names?

14 Single: Vomer Mandible Paired: Zygomatic Lacrimal Inferior Nasal Conchae Maxillae Nasal Palatine**

How many Cranial Bones do we have and what are their names?

Single: Occipital, Frontal, Sphenoid, Ethmoid Paired: Parietal Temporal

list the cranial nerves

I. Olfactory

II. Optic

III. Oculomotor

IV. Trochlear

V. Trigeminal

VI. Abducens

VII. Facial

VIII. Vestibulocochlear

IX. Glossopharyngeal

X. Vagus

XI. Accessory

XII. Hypoglossal

What are the hard tissue articulations of the TMJ?

Temporal bone

- Articular eminence and articular fossa

Mandible

- Articular surface of the mandibular condyle

Describe the TMJ Joint capsule

Fibrous joint capsule that completely encloses TMJ • Superiorly wraps around the margin of the temporal bones and inferiorly wraps around the mandibular condyle, including the neck of the condyle

Describe the Disc of the Joint:

Fibrous, divides TMJ into two compartments (synovial cavities), upper and lower. Contains synovial fluid that lubricates and nourishes the joint

What does crepitus of the TMJ sound like?

Crackling

What is it called when there is hypermobility of the mandibular condyle, and it moves too far anteriorly and gets stuck anterior to the articular eminence?

subluxation

• List the foramen the three divisions of CN V exit the cranium, from superior to inferior

SORO Superior Orbital Fissure: Ophthalmic Foramen Rotundum: Maxillary Foramen Ovale: Mandibular