oral functions 2 Flashcards

1
Q

what are the 3 branches of the trigeminal nerve

A
  • ophthalmic branch
  • maxillary branch
  • mandibular branch
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2
Q

what are the sensory branches of the trigeminal nerve

A
  • ophthalmic branch

- maxillary branch

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3
Q

what are the mixed branches of the trigeminal nerve

A

mandibular branch

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4
Q

what cranial nerve is the trigeminal nerve

A

cranial nerve 5 / V

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5
Q

name the cranial nerves

A
I. Olfactory 
II. Optic 
III. Oculomotor 
IV. Trochlear
V. Trigeminal 
VI. Abducens 
VII. Facial 
VIII. Vestibulochlear 
IX. Glossopharyngeal 
X. Vagus 
XI. Accessory 
XII. Hypoglossal
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6
Q

what does the mandibular branch of the trigeminal nerve innervate

A

> inferior alveolar (dental) never

= the largest terminal branch of

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7
Q

where does the inferior alveolar (dental) nerve travel

A

travels in the mandibular canal as far as the mental foramen

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8
Q

where is LA injected for the lower posterior teeth

A

inferior alveolar (dental) nerve

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9
Q

what is the mental nerve

A

the sensory branch of the inferior alveolar nerve

the inferior nerve gives off the mental nerve anteriorly which exits the mandible via the mental foramen

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10
Q

what does the mental nerve supply

A

the chin and lower lip

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11
Q

what is injection to numb the lower posterior teeth called

A

the inferior alveolar nerve block
or
ID block

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12
Q

name the branches of the mandibular nerve

A
  • inferior alveolar nerve
  • lingual nerve
  • buccal nerve
  • nerve to mylohyoid
  • mental nerve
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13
Q

when performing the ID block what part of the face is numbed

A

the side of the face where the injection was given up to the midline (central lower incisor)

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14
Q

when giving LA - where do you want the injection to hit and where dont you want the injection to hit

A

you want the needle to hit bone - want to deposit the LA next to the nerve

you dont want the needle to hit the actual nerve or soft tissues

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15
Q

what does directly hitting the nerve with the needle cause

A

temporary damage of the ID nerve
(patient will feel as though you have directly hit their lip)
this will take longer for the numbness to wear off
make sure to warn patient not to bite their lip as they wont be able to feel pain if they do bite it

nerve has been traumatised but there was no complete intersection of the nerve so there is not permanent damage

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16
Q

define anaesthesia

A

loss of sensation

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17
Q

define paraesthesia

A

an abnormal sensation (typicall tingling or prickling / pins and needles)
caused cheifly by pressure on or damage to the peripheral nerves

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18
Q

define dysaethesia

A

an abnormal unpleasant sensation felt when touched

caused by damage to peripheral nerves

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19
Q

where should the needle be in the correct position within to ensure they hit the bone

A

correct position within the pterygomandibular triangle

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20
Q

what happens when the needle accidentally hits the muscle instead of the bone

A

might cause trismus
also called lock jaw
this is reduced opening of the jaws (limited jaw range of motion)
can be temporary or permanent

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21
Q

what is the purpose of the gag reflex

A

prevent material entering the pharynx

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22
Q

what evokes the gag reflex

A

mechanical stimulation of fauces, palate, posterior tongue and pharynx

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23
Q

when does the gag reflex cause a clinical problem

A

when it is oversensitive

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24
Q

what nerves are involved in the gag reflex

A

efferent (motor) response from

  • V = trigeminal
  • IX = glosspharyngeal
  • X = vagus
  • XI = accessory
  • XII = hypoglossal

the motor (secretory) visceral nerves of the salivary glands are also stimulated

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25
Q

name 3 types of neurons based on function

A

> afferent / sensory neurons
efferent / motor neurons
interneuron / connecting neuron

26
Q

what are afferent / sensory neurons

A

these carry a message into the CNS

They are going towards the brain or spinal cord

27
Q

what are efferent / motor neurons

A

these carry a message to a muscle, gland or other effector

they are carrying messages away from the CNS

28
Q

what are interneurons

A

these neurons connect one neuron with another

in many reflexes interneurons connect the sensory and motor neurons

29
Q

what should be done when making a RPD for a patient with a problematic gag reflex

A

the posterior part of this RPD is constructed with a retaining mesh to facilitate the attachment of the acrylic extension
this design is indicated when the post dam cannot be tolerated by the patient (gagging reflex) allowing it to be adjusted more easily
in addition this approach will reduce the weight of a large metal connector

30
Q

what is bell’s palsy

A

a motor disorder

cranial nerve VII (facial nerve) affected

31
Q

what are the features of bell’s palsy

A
  • inability to wrinkle brow
  • drooping eyelid
  • inability to close eye
  • inability to puff cheeks
  • no muscle tone
  • drooping mouth
  • food stuck in cheek
32
Q

what are the branches of the facial nerve

A
  • temporal
  • zygomatic
  • buccal
  • mandibular
  • cervical
33
Q

what are the functions of the orbicularis oris and the buccinator

A

help to control food and prevent spillage

34
Q

do all patients with facial paralysis have bell’s palsy?

A
no
bell's palsy is coined for any type of facial paralysis that does not have any other associate causes such as 
- tumours
- trauma
- salivary gland inflammation
35
Q

what are causes of bell’s palsy

A
- infections
> HSV
> cold sores
- otitis media
> inflammation of the middle ear
- diabetes
-trauma
- toxins
- temporarily by infiltration of LA to the facial nerve branches during dental treatment
36
Q

how can LA affect the facial nerve

A

when the injection is given too far distally and the parotid gland is penetrated allowing the diffusion of the LA through loose glandular tissue which ten affects all 5 terminal branches of the facial nerve

37
Q

how should facial nerve paralysis caused by LA be managed

A
  • inform patient
  • reassure them about the transitory nature of the palsy
  • protect the eye with a loose pad so that the cornea is protected until the protective blink reflex returns
    (stops eye dehydrating)
  • recovery often occurs in a short period of time
38
Q

what is the advantage of decoronating the crown of the tooth but leaving the roots

A

keep the PDL which gives proprioception so you know how much force is on the area

39
Q

what do peridontal mechanorecpetors allow for

A

finer discrimination of food texture, tooth contacts and levels of functional loading
a better appreciation of food and a more precise control of mandibular movements is given than is provided by full dentures

40
Q

what does the loss of periodontal mechanoreception influence

A
  • control of jaw function
  • precision of magnitude
  • direction
  • rate of occlusal load application
41
Q

what are the thresholds of mechanoreceptors

A

low thresholds
(0.5mN)
senses of touch, pressure

42
Q

what is a mechanoreceptor

A

a sensory receptor that responds to mechanical pressure or distortion

43
Q

what oral functions do periodontal mechanorecpetors contribute to

A
  • mastication (food consistency)
  • salivation
  • interdental discrimination
44
Q

what is involved in interdental discrimination

A
  • ability to gauge extent of mouth opening
  • coordination of masticatory movements
  • monitoring size of food particles
  • detection of high spots (very sensitive to any change on the occlusal surface)
  • foil thresholds 8-60 micrometres
45
Q

what receptors contribute to interdental size discrimination

A
  • TMJ receptors
  • muscle receptors
  • PDL receptors
46
Q

what is shimstock

A

a metal foil for occlusal testing

thickness = 8 microns

47
Q

what is proprioception

A

self sense

awareness of position and orientation of body parts

48
Q

what is proprioception served by

A
joint receptors 
muscle receptors
> muscle spindles
> golgi tendon organs
periodontal receptors
49
Q

what do joint receptors signal

A

> joint position
- mouth open, closed

> joint movement
- opening, closing

50
Q

what is dysphagia

A

swallowing difficulties

51
Q

what causes dysphagia

A

many disorders can cause or lead to food getting stuck in your oesophagus such as

  • stroke
  • brain injury
  • multiple sclerosis
  • gastroesophageal reflux disorder
  • tumours
52
Q

what can be the first sign of a stroke

A

dysphagia

53
Q

how do you detect a stroke

A

compare sensorial and motor responses from both sides of face and oropharynx
stroke usually unilateral
one side of face is fine the other is not

54
Q

what are nociceptors

A

respond to intense (noxious) stimuli, that are usually associated with pain

55
Q

what are the most important nociceptors for dentists

A

the ones inside the dental pulp

56
Q

where are nociceptors found in the mouth

A
  • dental pulp
  • muscles
  • joints
  • mucosa
  • PDL
57
Q

what is sensitivity like around the face and the mouth

A

oro-facial tissues are very sensitive
receptors have low thresholds for activation
but not all regions are equally sensitive

58
Q

how can you tell that the sweet in your mouth is a polo without looking at it

A
  • You will have the taste buds and olfaction
  • You will also have the experience of tasting polo which facilitate the correlation
  • You acquire the format of the mint by compressing it against the hard palate with the tongue
  • Mechanoreceptors will be able to identify the format since the 2 point discrimination of both tissues allows than identification
59
Q

what stimulates salivary glands

A

sense of smell

60
Q

can can affect sense of taste

A

smelling disorders
infections of nasopharynx
loss of olfactory sense (anosmia)