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Flashcards in week 7 Deck (190)
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1

what are the 2 main parts of the mandible

- body
- ramus

2

what is a symphysis

secondary cartilaginous joint

3

what is the mental symphysis

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

4

what is the mental protuberance

forward projection of the chin

5

what is found in the middle of the mental protuberance

mental tubercle

6

what passes through the mental foramen

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

7

what is the mental nerve a continuation of

inferior alveolar nerve

8

where can the mental foramen be found on the mandible

just below the premolars

9

what is the oblique line

where the buccinator muscle attaches to the mandible

10

what is the base of the mandible

the underside of the mandible

11

where can you see the digastric fossa

when looking at the mandible from underneath

12

what attaches to the digastric fossa

the digastric muscles (right and left)

13

what is the alveolar process of the mandible

the part of the bone that bears the teeth
the roots go down into the alveolar process

14

what happens to the alveolar bone if you lose your teeth

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

15

what is the problem with losing the alveolar process

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

16

what is the mylohyoid line

found on the medial surface

This is for the attachment of the mylohyoid muscle

17

what do the mylohyoid muscles do

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

18

why is the mylohyoid line important

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

19

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

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

20

why is the mylohyoid line important in the making of dentures

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

21

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

the area where the submandibular gland lies

called the submandibular fossa

22

what is the smooth area above the mylohyoid line

the area where the sublingual salivary gland lies

called the sublingual fossa

23

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

mental spines / genial tubercles

24

what attaches to the upper mental spines

genioglossus muscle

25

what does the genioglossus muscle do

the muscle that sticks your tongue out

26

what attaches to the lower mental spine

geniohyoid muscle

27

what does the geniohyoid muscle do

pulls the hyoid bone forward when you are swallowing

28

what groove is found near the mylohyoid line

mylohyoid groove

29

what nerve travels in the mylohyoid groove

nerve to mylohyoid

30

where does the nerve to mylohyoid come from

branch off the inferior alveolar nerve

31

where does the tendon of the temporalis muscle attach

attaches around the coronoid process
also comes quite far down the anterior border of the ramus

32

what is the coronoid process

projection of the mandible

33

what is the condylar process

projection of the mandible
consists of the head and neck

34

what does the inferior alveolar nerve pass into

mandibular foramen

35

what is the mandibular canal

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

36

what is the problem with the lingula during and IAN block

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

37

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

where the attachment of the medial pterygoid muscle is

38

what is the mandibular notch

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

39

what is the pterygoid fovea

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

40

what is the pterygoid hamulus

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

41

where is the start of the origin of the pterygomandibular raphe

pterygoid hamulus

42

what is the pterygomandibular raphe

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

43

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

3 constrictor muscles
○ Superior
○ Middle
○ Inferior

44

what are the constrictor muscles made from

skeletal

45

what sort of control is the constrictor muscles under

strong reflex control

46

what do the constrictor muscles do

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

47

what does the superior constrictor muscle attach to

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

48

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

pharyngeal raphe

49

what muscle is attached to the side of the hyoid bone

middle constrictor muscle

50

what is found between the thyroid and cricoid cartilage

fibrous band

51

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

inferior constrictor muscle

52

what muscle is attached to the styloid process

stylopharngeus muscle

53

where does the stylopharyngeus muscle go

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

54

where does the pharynx tend to be open

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

55

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

glossopharyngeal nerve

56

what nerve supplies the stylopharyngeus muscle and constrictor muscles

- vagus nerve supplies constrictor muscles
- glossopharyngeal nerve supplies stylopharyngeus

57

what is the first part of swallowing

voluntary

chewing and moving the bolus

58

how does the styloglossus help with swallowing

helps move the bolus back

59

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

palatal aponeurosis

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

60

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

tensor veli palatini muscle

61

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

close to where the auditory tube is

62

what happens when the tensor veli palatini muscle contracts

the tendons are pulled so the soft palate becomes tense

63

what nerve supplies the tensor veli palatini muscle

mandibular nerve (CN5)

64

what pharyngeal arch is the tensor veli palatine muscle fromed from

first pharyngeal arch of the emrbyo

65

what does the auditory tube allow for

allows air into the middle ear

66

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

levator veli palatini muscle

67

what is the function of the levator veli palatini muscle

pulls the palate up

68

what nerve supplies the levator veli palatini

vagus nerve

69

what muscle runs from the tongue up to the palatal aponeurosis

palatoglossus muscle

70

what nerve supplies the palatoglossus muscle

vagus nerve

71

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

the palatopharyngeus muscle

72

what nerve supplies the palatopharyngeus muscle

vagus nerve

73

what is the uvulua

found at the back end of the soft palate
the little piece that hangs down

74

what is the function of the uvulua

improves the seal of the soft palate when swallowing fluids

75

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

uvular musles

76

what is the space between the palatoglossal folds called

isthmus of the fauces

77

where is the maxillary tuberosity found

an elevation of the posterior part maxilla is the maxillary tuberosity

This is just behind the upper third molar

78

what is the articular disc

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

79

how many compartments does the TMJ have

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

80

what nerve comes out of the lateral pterygoid muscle

buccal nerve

81

what is the buccal nerve

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

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

maxillary artery

sometimes it runs deep to the lateral pterygoid muscle

83

what is the maxillary artery a branch of

external carotid artery

84

what other artery comes off the external carotid artery

superficial temporal artery

85

what artery comes off the maxillary artery

inferior alveolar artery

86

what gland does the external carotid artery run through

parotid salivary gland

87

roughly where does the external carotid artery brach

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

what does the maxillary artery supply

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

89

where does the inferior alveolar artery run

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

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

pterygoid venous plexus

lots of veins

91

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

infratemporal fossa

92

how many heads does the lateral pterygoid muscle

2 heads
- superior
- inferior

93

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

base of the skull

94

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

Its fibres run backwards and downwards

95

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

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

96

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

lateral side of the lateral pterygoid plate

97

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

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

98

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

Fibres are running backwards and slightly upwards as they go

99

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

becomes tendonous just before they reach the capsule of the TMJ

100

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

pterygoid fovea on the mandible

101

what happens when the lateral pterygoid muscle contracts

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

what are the 2 heads of the medial pterygoid muscle

- superficial head
- deep head

103

where does the inferior alveolar nerve run

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

where does the inferior alveolar nerve enter

mandibular foramen

goes into the mandibular canal

105

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

nerve to mylohyoid

106

what does the nerve to mylohyoid supply

mylohyoid muscle

anterior belly of the digastric muscle

107

what nerve is found in front of the inferior alveolar nerve

lingual nerve

108

where does the lingual nerve come form and go

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

where does the medial pterygoid muscle attach to the mandible

at the angle of the mandible

110

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

maxillary tuberosity

111

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

medial side of the lateral pterygoid plate

112

what direction do the fibres of the medial pterygoid muscle run

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

113

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

○ 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

what happens if only the left medial pterygoid muscle contracts

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

what movements of the mandible can hte medial ptergoid muscle cause

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

116

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

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

is the pterygomandibular space an anatomy term

no

more clinic

118

what is the pterygomandibular space

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

119

what is the significance of the pterygomandibular space

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

120

what is behind the area of the pterygomandibular space

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

121

where does the main trunk of the mandibular nerve come frm

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

122

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

nerve to the medial pterygoid muscle

123

what 2 divisions does the mandibular nerve split into

○ Anterior division
○ Posterior division

124

where does the anterior division run initially

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

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

nerve to the masseter muscle

126

where does the nerve to the massester muscle run

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

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

the deep temporal nerves

128

where do the the deep temporal nerves run

they run into the deep aspects of the temporalis muscle

Approach from the medial side

129

what is the branch after the deep temporal nerves

nerves to lateral pterygoid muscle

130

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

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

where does the buccal nerve come out between

2 heads of the lateral pterygoid muscle

132

what muscles does the anterior division supply

masseter
temporalis
lateral pterygoid muscle

133

does the anterior divison supply sensation

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

134

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

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

what is the most anterior branch of the posterior division

lingual nerve

136

what does the lingual nerve supply

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

where does the lingual nerve pass

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

what nerve is next to the lingual nerve

inferior alveolar nerve

139

where does the inferior alveolar nerve travel

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

what nerve does the inferior alveolar nerve give off

mental nerve

141

where does the mental nerve come out

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

142

what does the mental nerve supply

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

143

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

incisive nerve

144

what does the incisive branch supply

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

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

gives off the little branch called nerve to the mylohyoid

146

what does the nerve to the mylohyoid supply

anterior belly of the digastric muscle
mylohyoid muscle

147

what nerve supplies the posterior belly of the digastric muscle

facial nerve

148

what is the only motor branch in the posterior division

nerve to mylohyoid

149

what artery runs up beside the mandibular branch

middle meningeal artery

150

what artery does the middle meningeal artery come from

maxillary artery

151

how does the middle meningeal artery pass into the cranial cavity

passes through the foramen spinosum

152

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

auriculotemporal nerve

153

what does the auriculotemporal nerve supply

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

154

what does the posterior division of the mandibular nerve give off

Lingual nerve
IAN
Auriculotemporal nerve
(nerve to mylohyoid)

155

what nerve joins the lingual nerve

a branch of the facial nerve called the chorda tympanii

156

how is sensory information about taste conveyed

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

where does the chorda tympanii run

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

what does the chorda tympanii carry

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

159

what sort of sensation is supplied by the lingual nerve

general sensation

160

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

these have a parasympathetic supply

161

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

facial nerve

162

what makes the submandibular and sublingual salivary glands secrete

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

163

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

There is an articular disc
Fibrous dense tissue

164

what passes through the incisive foramen

Nasopalatine nerve
Branch of maxillary nerve

165

what does the nasopalatine nerve supply

Supplies hard palate

166

what passes through the greater palatine foramen

greater palatine nerve
branch of maxillary nerve

167

what does the greater palatine nerve supply

Posterior 2/3s of hard palate on its side

168

what is found just behind the greater palatine foramen

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

169

whatt does the lesser palatine nerve supply

They supply the soft palate (sensory)

170

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

can affect swallowing mechanism

171

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

Greater palatine artery

172

where does the masseter muscle attach

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

what direction do the fibres of the masseter run

Fibres run downwards and slightly backwards (superficial)
Deeper down there are more vertical fibres

174

what action is produced when the 2 masster muscles contract together

§ 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

what is the nerve supply of the masseter muscle

nerve to masseter
branch of mandibular dividion

comes through the mandibular notch to reach masseter muscle

176

where does the masseter attach

lower border of zygoma

177

what attaches to the inferior temporal line

Temporalis muscle attaches to this line
Runs from temporal fossa

178

what is the temporalis muscle covered by

dense fascia

179

where does the fascia over the temporalis muscle attach

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

180

where does the tendon of the temporalis muscle attach

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

181

what direction do the fibres of the temporalis run

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

Posterior - deep to zygomatic arch then attach to coronoid process

182

what does the temporalis muscle do

• Elevation of mandible

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

183

what nerve supplies the temporalis muscle

mandibular division - deep temporal nerves

184

what is the buccinator muscle

Muscle of facial expression used when eating

185

what is a raphe

Fibrous tissue between 2 muscles

186

where do the upper fibres of the buccinator come from

come from side of maxilla
Above the vestibule of the mouth

187

where do the lower fibres of the buccinator come from

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

188

what way are the fibres of the buccinator arranged

• 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

what is the modiolus

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

190

how does the parotid duct enter the oral cavity

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