2. CN V

Question 1

V1

• ____
• ____
• ____
• Suspensory root of the ____

Answer 1

nasociliary nerve
frontal nerve
lacrimal nerve
ciliary ganglion

Question 2

V1 has three main branches in the orbit (NFL)

• ____
• ____
• ____

___ convey
sensation from the cornea

Afferent limb of the corneal reflex (VI-VII)

Answer 2

nasociliary
frontal
lacrimal

long ciliary nerves

Question 3

• FRONTAL
• ___
  • Forehead and scalp skin
  • Frontal sinus
• ___
  • Conjunctiva
  • Upper lid
  • Forehead
  • Lateral nose
• LACRIMAL
  • Skin near ___
  • Conjunctiva
• NASOCILIARY
  Enters the orbit through the ___
• ___
  Including lacrimal sac and related structures

Answer 3

supraorbital
supratrochlear
lacrimal gland
annular tendon

Question 4

The
___
branches
of the nasociliary nerve will be considered when we examine the innervation of the nasal cavity

Answer 4

ethmoidal

Question 5

V2 (ZIP)

• ___

V2 branches extensively within the ___

Answer 5

Maxillary nerves

pterygopalatine fossa

Question 6

V2

• Zygomatic
• ___
• Zygomaticoorbital
• ___

Infraorbital

• ___
• Nasal
• ___

Answer 6

zygomaticofacial
zygomaticotemporal

superior labial
inferior palpebral

Question 7

SUPERIOR ALVEOLAR NERVES

These nerves course along the walls of the ___ sinus to form the
___ plexus…
… the plexus gives rise to ___ branches to the apices of the maxillary tooth roots and ___ branches as well

Answer 7

maxillary
superior dental
dental
gingival

Question 8

Infection of the hard-to-drain MAXILLARY SINUSES may produce compression of the
__
NERVES…… And produce __ dental pain

Answer 8

superior alveolar

referred

Question 9

The Pterygopalatine Ganglion is suspended from ____ within the pterygopalatine fossa

POSTGANGLIONIC PARASYMPATHETICS arising from the ganglion are distributed by terminal branches of ____

The ganglion receives preganglionic parasympathetic inputs from the ____ from CN VII

Answer 9

V2
V2
greater petrosal nerve

Question 10

NASAL CAVITY

NOTE THE CONTRIBUTION OF ____ BRANCHES

Answer 10

V1

Question 11

The
____
nerve terminates by coursing through the incisive canal
of the hard palate

Answer 11

nasopalatine

Question 12

PALATINE NERVES

• ____
• ____

Answer 12

greater palatine

lesser palatine

Question 13

Understanding the peripheral distribution of branches of V2 and V3 is crucial to appreciating the basis of introducing dental anesthesia via both ____ and ____ injections

Answer 13

infiltration

block

Question 14

Most maxillary teeth may be anaesthetized by ____ as fluid is injected directly into an area of concern and diffuses through both soft tissue AND thin ____ to block local terminal nerve fibers

Answer 14

local infiltration

alveolar bone

Question 15

The needle pierces the mucobuccal fold at ____ and is advanced to the injection site above the roots of ____

Inadvertent penetration of either the ____ vessels or, more likely, the ____ plexus may result in a hematoma

Posterior superior alveolar nerves

Answer 15

M2
M3
posterior superior alveolar
pterygoid venous

Question 16

The anesthetic may be infiltrated above the root tips of the ____
Both ____ and the ____ root of ____ will be anesthetized

Middle superior alveolar nerves

Answer 16

first maxillary premolar
premolars
mesial
M1

Question 17

The anesthetic may be infiltrated in the canine fossa above the root tip of the ____
The ____ and the ____ will be anesthetized (but beware the central incisor!)

Anterior superior alveolar nerve

Answer 17

maxillary canine
incisors
canine

Question 18

The anesthetic is injected into the ____
on either side of the
____

Necessary for anesthetizing mucosa of the ____

Nasopalatine nerve

Answer 18

incisive foramen
incisive papilla
primary palate

Question 19

The nerve may be blocked along an imaginary line
halfway between the ____ and the ____

Necessary for anesthetizing mucosa of the ____

Greater palatine nerve

Answer 19

mid palate raphe
free gingival edge
secondary palate

Question 20

MAXILLARY NERVE BLOCK
(RARE)

A long needle is passed up through the ____ and pterygopalatine canal into the ____!!!

The infraorbital block is also quite challenging - WHY?

Can potentially pierce the ____, and get ophthalmalgia (the recti will be temporarily paralyzed)

Answer 20

greater palatine foramen
pterygopalatine fossa
orbit

Question 21

V3

Recall that V3 is the only division containing ____ fibers

Answer 21

SVE (branchial major)

Question 22

SVE fibers in V3 innervate:

\_\_\_\_ Muscles of Mastication
\_\_\_\_
Tensor Veli Palatini
\_\_\_\_
Anterior Digastric

Answer 22

4
tensor tympani
mylohyoid

Question 23

MUSCULAR BRANCHES
(Lateral view)

• Deep temporal nerves
• ____
• Lateral pterygoid nerve
• nerve to ____
• • ____
• • ____

Answer 23

masseteric nerve
mylohyoid
mylohyoid
anterior digastric

Question 24

MUSCULAR BRANCHES
(Medial View)

• Nerve to ____
• Nerve to tensor veli palatine
• ____
• Otic ganglion

Answer 24

tensor tympani

medial pterygoid nerve

Question 25

CN V Lower motor neuron lesions (SVE) – Paralysis of ____ – ____ of masticatory muscles – ____ deviation of jaw upon protrusion Also contralateral deviation of ____ and ____

Answer 25

masticatory muscles atrophy ipsilateral soft palate uvula

Question 26

V3 has four main sensory branches - ____ - ____ - ____ - ____

Answer 26

long Buccal Auriculotemporal Inferior alveolar Lingual

Question 27

The AURICULOTEMPORAL is formed by two roots that surround the ____ below the ____

Answer 27

middle meningeal artery | foramen spinosum

Question 28

The AURICULOTEMPORAL is vulnerable to fractures of the neck of the ____ The primary nerve responsible for innervation of the ____

Answer 28

condyle | TMJ

Question 29

LONG BUCCAL Mediates sensation from both the skin superficial to, and the mucosa deep to, the ____ muscle of the cheek

Answer 29

buccinator

Question 30

LINGUAL NERVE ``` Provides general sensation to: MUCOSA of the ____ FLOOR of the ____ ____ GINGIVAE ```

Answer 30

presulcal tongue mouth mandibular

Question 31

LINGUAL NERVE - ____ (CN VII) Chorda tympani from CN VII joins the lingual nerve in the ____

Answer 31

chorda tympani | infratemporal fossa

Question 32

Lingual nerve + chorda tympani Both are destined to mediate sensation from the mucosa of the ____ of the tongue

Answer 32

anterior 2/3

Question 33

CHORDA TYMPANI also contains ____ fibers which synapse in the ____

Answer 33

GVE | submandibular ganglion

Question 34

Postganglionic parasympathetics arising from the ____ travel with terminal branches of the lingual nerve to innervate the ____ and ____ salivary glands - ____ - Inferior alveolar nerve - ____

Answer 34

submandibular ganglion submandibular sublingual ``` dental branches (plexiform) mental ```

Question 35

Given the thickness of mandibular bone, ____ in which the anesthetic solution is deposited adjacent to a large peripheral nerve proximal to the operative site, are usually used to numb the ____ dentition and adjacent soft tissue

Answer 35

nerve block injections | mandibular

Question 36

MANDIBULAR BLOCK Should anesthetize the ____ and ____ nerves with a single needle penetration Anesthetic is deposited just above the mandibular foramen where the ____ enters the mandible... and on the ____ as the needle is retracted

Answer 36

inferior alveolar lingual inferior alveolar lingual

Question 37

Posterior penetration of the needle may lead to injection of anesthetic into the ____ producing transient, ____ facial paralysis

Answer 37

parotid gland capsule | unilateral

Question 38

Long buccal nerve Often performed to complement the ____ block, the ____ BRANCHES of the LONG BUCCAL NERVE supply the buccal gingiva adjacent to the ____

Answer 38

mandibular gingival mandibular molars

Question 39

Mental nerve For blocking a portion of the inferior alveolar and mental nerves to anesthetize the ____ and ____ THE NEEDLE PENETRATES THE ____ FOLD ADJACENT TO THE PREMOLARS AND IS DIRECTED TOWARD THE ____

Answer 39

premolars incisors mucobuccal mental foramen

Question 40

Trigeminal Neuralgia (Tic doloureux) - Symptoms: ____, paroxysmal pain; ____; unilateral; disabling - The pain is frequently triggered by moving the ____, smiling or yawning, or by cutaneous or mucosal stimulation - Almost always ____; often seniors - Usually within ____ or ____ divisions - Etiology: ____ or compression of the sensory root ____ (by the superior cerebellar artery); postherpetic neuralgia, tongue ____; ideopathic; but NOT OF ____ ORIGIN (usually)! - Treatment: ____, anticonvulsants, surgical decompression, ____, ____ ablation

Answer 40

``` lancinating intermittent mandible adults second third demyelination endocranially piercing dental analgesics rhizotomy gamma knife ```

Question 41

Additional CN V lesions - ____ infection - Ischemic lesions (branch of cavernous ICA) - ____ (petrous apicitis) - Dental and facial trauma - Neoplasm - - ____ (benign) - - Cerebellopontine angle tumors - - ____ spread from face, cavities, or sinuses - ____ disease - mycobacterium ____

Answer 41

``` herpes zoster gradenigo syndrome trigeminal schwannomas perineurial hansen's leprae ```