HEAD AND NECK EXAM 3 SCRATCH

Olfactory nerve type and function

(afferent) – transmits smell from nasal mucosa to brain

optic nerve type and function

(afferent) – transmits sight from retina of eye to brain

Oculomotor type and function

(afferent) – eye muscle move eyeball

trochlear nerve type and function

efferent) – one eye muscle move eyeball and proprioception (no parasympathetic)

trigeminal nerve type and function

efferent: muscles of mastication and other cranial muscles

afferent: teeth, tongue, oral cavity, most of skin of face and headbr

branches of trigeminal nerve

ophthalmic, maxillary and mandibular

what does the ophthalmic nerve branch do

general somatic sensation from skin of anterior scalp and forehead, upper eyelid and nose, nasal cavity, cornea and lacrimal gland

what does the maxillary nerve branch do

general somatic sensation from skin of cheek, upper lip, and lower eyelid, nasal cavity mucosa, palate and upper teeth

what does the mandibular nerve branch do

general somatic sensation from skin of chin and temporal region of scalp, anterior tongue and lower teeth

where does the ophthalmic branch enter through

the superior orbital fissure

where does the maxillary branch enter through

the foramen rotundum

where does the mandibular branch enter

the foramen ovale

abducens nerve type and function

efferent) – one eye muscle moves eyeball

facial nerve type and function

efferent: muscles of facial expression (temporal, zygomatic, buccal, mandibular and cervical) and posterior suprahyoid muscles (anterior belly of digastric)

afferent: tiny patch of skin behind ear and taste sensation of lingual papilla from anterior 2/3 of tongue

what does the visceral motor function (parasympathetic) do in the facial nerve

§  Preganglionic parasympathetic of lacrimal gland (pterygopalatine ganglion) and submandibular and sublingual salivary glands (submandibular ganglion)

where does the facial nerve enter and exit from

the skull through the internal acoustic meatus and exits via the stylomastoid foramen.

vestibulocochlear nerve type and function

afferent) – conveys signals from inner ear to balance for hearing and balance

glossopharyngeal type and function

efferent:  Innervates a pharyngeal muscle, stylopharyngeus, (elevates the pharynx during swallowing)

afferent: Special visceral sensory from taste buds on posterior third of tongue. General visceral sensory from posterior third of the tongue, pharyngeal mucosa, chemoreceptors in carotid body, and baroreceptors of carotid sinus. Small area of external ear

where does the glossopharyngeal nerve pass through

jugular foramen and travel to pharynx

what are the two branches in the glossopharyngeal nerve

tympanic and inferior

what does the tympanic branch of the glossopharyngeal nerve do

supplies middle ear and leave through foramen ovale and terminate in otic ganglion

what does the inferior branch of the glossopharyngeal nerve do

supply carotid artery, oropharynx, and base of tongue, stylopharyngeus muscle

vagus nerve type and function

efferent: innervated the Muscles of soft palate, pharynx, larynx

afferent: Small amount of skin around ear and epiglottis taste sensation

what is the pathway of the vagus nerve

The pathway of the vagus nerve involves exiting the skull through the jugular foramen, descending in the neck, and traveling down into the thorax and abdomen, where it innervates various organs.

what nerves pass through the superior orbital fissure

oculomotor, trochlear, ophthalmic and abducens

what nerves pass through the jugular foramen

glossopharyngeal, vagus

what nerve passes through the foramen magnum

spinal accessory

what are the motor nerves the innervate the oral region

mandibular division of trigeminal nerve: mastication

facial nerve: facial expression

glossopharyngeal: stylopharyngeus

vagus nerve: most soft palate muscles

hypoglossal nerve: tongue muscles

spinal accessory nerve type and function

efferent) – trapezius and sternocleidomastoid, assists tenth cranial nerves

hypoglossal nerve type and function

efferent: innervates the intrinsic and extrinsic muscles of tongue

where does the hypoglossal nerve exit

Exits through hypoglossal canal in occipital bone

what is the posterior superior alveolar (PSA) nerve block used for

wMaxillary molars and associated buccal periodontium/gingiva within on max. quad

what is the middle superior alveolar (MSA) nerve block used for

what iMaxillary premolars and associated buccal periodontium/gingiva within one max. quad

what is the anterior superior alveolar (ASA) nerve block used for

maxillary anterior teeth and associated labial periodontium/gingiva to the midline within one max. quad

what is the infraorbital nerve block used for

Maxillary anterior teeth and premolars and associated facial periodontium/gingiva within one max. quad (covers both regions of MSA and ASA)

what is the greater palatine nerve block used for

Periodontium and gingiva of max posterior teeth within one max posterior sextant

what is the nasopalatine nerve block used for

o   Periodontium and gingiva of maxillary anterior teeth, bilateral from maxillary canine to canine within the maxillary anterior sextant

what is the anterior middle superior alveolar nerve (ASMA) block used for

o   Single site palatal injection that anesthetizes a large area innervated by the ASA and MSA nerves as well as the NP and GP nerves within the maxillary arch

What is the inferior alveolar (IA) nerve block used for

o   Mandibular teeth and associated lingual periodontium and gingiva to midline; associated facial periodontium and gingiva of mandibular anterior teeth and premolars to midline

what is the buccal nerve block used for

o   Mandibular teeth and associated lingual periodontium and gingiva to midline; associated facial periodontium and gingiva of mandibular anterior teeth and premolars to midline

what is the gow gates nerve block used for

o   Entire mandibular nerve within on quadrant. Used with lack of clinical effectiveness of IA

what is the vazirani akinosi mandibular nerve block used for

o   Large area of mandibular nerve within on quadrant similar to IA

o   Recommend with patient with severe trismus or when there is difficulty administering the IA. Also when pt is fearful to open

what is the mental nerve block used for

o   Anesthetizes the mental nerve and associated facial periodontium and gingiva of mandibular anterior teeth and premolars to midline, lower lip and chin

what is the incisive nerve block used for

o   Anesthetizes the mental and incisive nerves, mandibular anterior teeth and premolars, associated facial periodontium and gingiva to midline within one quadrant, and lower lip and chin

o   Does not provide anesthesia to associated lingual periodontium and gingiva; lingual supraperiosteal injection might be indicated inferior to the apices of these teeth

what are the branches of the otic ganglion

medial ptyergoid, lateral ptyergoid, masseteric nerve, posterior deep temporal nerve, anterior deep temporal nerve, tensor veli palatine nerve, tensor tympani nerve

facial paralysis

-            Loss of muscular action of the muscles of facial expression

-            Can occur secondary to a brain injury by way of stroke

-            Can also occur by directly injuring the nerve that supplies the efferent nerve to the muscles of facial expression

bell palsy

Involves unilateral facial paralysis with NO known cause, except that there is a loss of excitability of the involved facial nerve

clinical consideration with facial nerve pathology

Avoiding anesthesia of the facial nerve at its location in the parotid salivary gland is important when administering and IA because it may result in transient facial paralysis if given incorrectly

what are the nerves associated with taste

facial efferent: anterior 2/3 of tongue

glossopharyngeal afferent: special visceral sensory from taste buds on posterior 1/3 of tongue

vagus: epiglottis and lower pharynx

how is the parotid gland innervated

Lesser petrosal of ninth cranial nerve (glossopharyngeal), otic ganglion, auriculotemporal nerve of mandibular division of trigeminal nerve

how much saliva is produced form the parotid gland

only contributes approximately 25% of the total salivary volume.

what type of saliva is secreted from the parotid gland

serous w

what is the innervation of the sublingual salivary gland

Chorda tympani nerve of facial nerve, submandibular ganglion, lingual nerve of mandibular division of trigeminal nerve

how much saliva is secreted form the sublingual gland

smallest, most diffuse, and only unencapsulated major salivary gland. The gland only contributes approximately 10% of the total salivary volume

what type of saliva is secreted from the sublingual salivary gland

mainly mucous secretion

what is the innervation of the submandibular salivary gland

Chorda tympani nerve of facial nerve, submandibular ganglion, lingual nerve of mandibular division of trigeminal nerve

how much saliva is produced from the submandibular salivary gland

: Even with being number two in size, it is the main contributor to total salivary volume at approximately 60% to 65%.

what type of saliva is secreted from the submandibular gland

serous and mucous

where is the von ebner minor salivary gland

base of the large circumvallate lingual papillae on the posterior part of the tongue’s dorsal surface

what type of saliva is secreted from the von ebner salivary gland

serous

what does the thyroid produce

largest endocrine gland. produces and secretes thyroxine (thahy-rok-sin) directly into the vascular system. Thyroxine is a hormone that stimulates the metabolic rate of the body.

what does the parathyroid produce

endocrine - they produce and secrete parathyroid hormone directly into the vascular system to regulate calcium and phosphorus levels. In addition, the parathyroid glands may alter the function of the thyroid gland if they are involved in a disease process.

what does the thymus do

-            endocrine

-            also part of the immune system that fights disease processes; the T-cell lymphocytes, white blood cells of the immune system, mature in the gland in response to stimulation by thymus hormones

what is the different between endocrine and exocrine

Endocrine glands release hormones directly into the bloodstream, while exocrine glands secrete substances through ducts to external surfaces or cavities.

endocrine has ducts

what are the branches of the infraorbital foramen (what does it innervate)

o   Inferior palpebral – supplies the lower eyelid.

o   External nasal – supplies the side of the nose.

o   Superior labial – supplies the upper lip

o   Zygomaticofacial branches – cheek

what are the branches of the facial nerve

greater petrosal nerve, chorda tympani nerve, posterior auricular, stylohyoid nerve, posterior digastric nerve and branches to the muscles of facial expression

where is the greater petrosal nerve and what type of nerve fibers does it carry

o   is a branch off the facial nerve before it exits the skull

o   The greater petrosal nerve carries efferent nerve fibers, which are preganglionic parasympathetic fibers to the pterygopalatine ganglion in the pterygopalatine fossa

what is the chorda tympani nerve

o   is a parasympathetic efferent nerve for the submandibular and sublingual salivary glands and also serves as an afferent nerve for taste sensation for the anterior two-thirds or the body of the tongue

what are the posterior auricular, stylohyoid nerve, and posterior digastric nerve

o   are branches of the facial nerve after it exits the stylomastoid foramen . All are efferent nerves. The posterior auricular nerve supplies the occipital belly of the epicranial muscle. The other two nerves supply the stylohyoid muscle and the posterior belly of the digastric muscle, respectively.

what are the muscles of facial expression

o   temporal, zygomatic, buccal, (marginal) mandibular, and cervical branches.

what is a goiter

lesion of the thyroid gland. A goiter may be firm and tender when palpated during an extraoral examination and may contain hard masses and may or may not be associated with endocrine disease.

what is hypothryoidism

o   Associated with hyposecretion of thyroxine

o   Most common is Hashimoto thyroiditis- autoimmune disorder that attacks gland

what are the oral manifestations of hypothyroidism

In children: both enlarged tongue and lips, with delayed tooth eruption and possible enamel hypoplasia.

In adults: enlarged tongue; chronic, severe periodontal disease; slow, hoarse speech, possibly gingival hyperplasia.

what is hyperthyroidism

o   Associated with Graves disease- autoimmune hypertrophy of gland with hypersecretion of thyroxine

o   Causes exophthalmos (protruding eyes), tachycardia (increased pulse rate), severe weight loss, sweating, tremors, heat intolerance, frequent bowel movements

what are the oral manifestations of hyperthyroidism

§  In children: premature primary exfoliation, early eruption of permanent teeth

§  In adults: aggressive periodontal disease, dental caries, osteoporosis of jaws, burning tongue, increased salivation

what is neoplastic growth

o   The diseased thyroid gland may lose its mobility and not move up when swallowing

what is the purpose of minor salivary glands

-            The minor salivary glands are smaller than the larger major salivary glands but are more numerous

-             not individually encapsulated but surrounded by connective tissue within the submucosa.

-            line the oral mucosa of the oral cavity and oropharynx. The minor salivary glands contribute less than 10% of total salivary volume

what are the different types of minor salivary glands

buccal, labial, and lingual mucosa; the soft palate; the posterior part of the lateral zones of the hard palate; and the floor of the mouth

what is the parotid gland innervated by (efferent or afferent)

innervated by the efferent (parasympathetic) fibers of the otic ganglion of the ninth cranial or glossopharyngeal nerve by way of the lesser petrosal nerve with these efferent fibers synapsing in the otic ganglion

what are the branches of the ophthalmic nerve

frontal, lacrimal and nasocilliary

what does the frontal branch of the ophthalmic nerve do

§  Merger of supraorbital nerve from forehead and anterior scalp + supratrochlear nerve from bridge of nose and medial parts of the upper eyelid and forehead

what nerves come from the nasocilliary branch of the ophthalmic nerve

§  Infratrochlear nerve- from skin of medial part of eyelids and side of nose

§  Ciliary nerve- to and from the eyeball

§  Anterior and posterior ethmoidal nerve- from nasal cavity and paranasal sinuses

what are the branches of the maxillary nerve

zygomatic nerve, infraorbital nerve, PSA, greater and lesser palatine nerve, nasopalatine nerve

what does the zygomatic nerve of the maxillary nerve give heed to

o   Zygomaticofacial nerve

o   Zygomaticotemporal

what nerves come from the infraorbital nerve of the maxillary nerve

ASA and MSA

what are the branches of the mandibular nerve

anterior trunk, posterior trunk

what nerves are in the anterior trunk of the mandibular nerve branch

buccal and muscular nerve

what nerves are in the posterior trunk of the mandibular nerve

auriculotemporal, lingual, IA (mental, mylohyoid, incisive)

what does the temporal branch of the facial nerve inneravte

§  temporal branches supply the muscles anterior to the ear, frontal belly of the epicranial muscle, superior part of the orbicularis oculi muscle, and corrugator supercilii muscle.

what does the zygomatic branch of the facial nerve innervate

§  The zygomatic branches typically supply the inferior part of the orbicularis oculi muscle and zygomatic major and minor muscles.

what does the buccal branch of the facial nerve innervate

The buccal branches (not to be confused with the sensory [long] buccal nerve from V3) supply the muscles of the upper lip and nose and buccinator, risorius, and orbicularis oris muscles. The zygomatic and buccal branches are usually closely associated, exchanging many fibers

what does the mandibular branch of the facial nerve innervate

The mandibular (marginal) branch supplies the muscles of the lower lip and mentalis muscle. The mandibular branch should not be confused with the mandibular nerve or V3

what does the cervical branch of the facial nerve innervate

§  The cervical branch runs inferior to the mandible to supply the platysma muscle.

what is the autonomic nervous system

Subdivision of efferent division on peripheral nervous system

This system operates without any conscious control as a considerate caretaker of the body

what are the subdivision of the ANS

Sympathetic and parasympathetic

what does the sympathetic nervous system of the ANS do

is involved in “fight-or-flight” responses such as occur with the shutdown of salivary gland secretion

what does the parasympathetic of the ANS do

involved in “rest-or-digest” responses such as occur with the stimulation of salivary gland secretions.

what is included in the CNS

Brain and spinal cord

what is in the PNS

all nervous tissue outside the CNS

neuron

functional cellular component of the nervous system and is composed of three parts, one neural cell body with two types of neural cytoplasmic processes and an axon or dendrite.