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BDS3 BAMS Anatomy > Week 7 > Flashcards

Week 7 Flashcards

1
Q

What does the mandible consist of

A

the body and the ramus

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2
Q

What does the body of the mandible consist of

A

external and internal surface

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3
Q

Where is the mental symphysis

A

secondary cartilaginous joint that joins the two halves of the mandible together in a fetus

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4
Q

Wha tis the mental protuberance

A

forward projection of the chin and it is a feature seen only in humans

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5
Q

What is the mental tubercle

A

feature seen near the mental protuberance and those who have a cleft mandible will see it in this area

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6
Q

What is the mental foramen

A

is where the mental nerve and the blood vessels emerge from the bone

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7
Q

How is the mental foramen orientated

A

such that the nerve tends to pass backwards and outwards as it emerges from the foramen

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8
Q

What is the base of the mandible

A

is what the underside of the mandible is and what it lies on

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9
Q

What is the digastric fossa

A

an oval depression for the attachment for the anterior belly of digastric

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10
Q

What is the alveolar process

A

bone that bears the teeth

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11
Q

What happens to the alveolar process without the presence of teeth

A

§ It will atrophy if teeth are not present

If the mandible becomes very atrophic then a denture can end up sitting on the mental foramen which can be painful

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12
Q

Where is the mylohyoid line seen

A

on the medial side of the mandible

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13
Q

What is the mylohyoid line

A

It is the place of attachment for the mylohyoid muscle and the two mylohyoid muscles meet at the midline

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14
Q

Why is the mylohyoid line significant in pros

A

§ A denture should stop short of this line otherwise when speaking or eating the mylohyoid will lift the denture

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15
Q

What is the submandibular fossa

A

where the submandibular gland sits
§ It is a smooth area
§ Below the mylohyoid line

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16
Q

What is the sublingual fossa

A

sublingual fossa is where the sublingual salivary gland sits
§ Smooth area
§ Above mylohyoid line

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17
Q

What is the mental spine/genial tubercle

A

§ There are 4 mental spines and collectively they rare known as genial tubercles
§ They give attachment to the geniohyoid (below) and the genioglossus (above)

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18
Q

What is the mylohyoid groove

A

a distinct groove

§ The nerve to mylohyoid lies in this groove

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19
Q

Describe the ramus

A

○ It has a lateral and medial surface

○ It has an anterior, posterior, inferior and superior border

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20
Q

What is the mandibular foramen

A

is seen on the ramus in which the inferior alveolar nerve and vessels pass through

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21
Q

What is the mandibular canal

A

what the foramen leads to

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22
Q

What is the lingula

A

little projection that creates the shadow of the canal. It varies in shape from patient to patient. You do not want to hit the lingula when drawing back as you will deposit the LA too far

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23
Q

What is the rough surface on the angle of the mandible for (medial side)

A

has a rough surface and this rough surface is where the medial pterygoid muscle attaches

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24
Q

What is the mandibular notch

A

Where the nerves and vessels to the masseter coming from the mandibular nerve enter through

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25
Q

What is the coronoid process

A

where the temporalis attaches

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26
Q

What is the condylar process

A

what makes up the head and neck of the mandible

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27
Q

What is the pterygoid fovea

A

seen at the front of the neck of the mandible and there is a little depression and it is the place of insertion for the inferior belly of the lateral pterygoid muscle

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28
Q

What is the pterygoid hamulus

A

○ The pterygoid hamulus is part of the sphenoid bone
○ It is the medial pterygoid plate that ends in this small hook-shaped process called the pterygoid hamulus which projects behind the posterior border of the hard palate

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29
Q

What is the pterygomandibular Raphe

A

thin band consisting of interlacing tendinous fibres from the buccinator anterior and the pterygopharyngeal part of the superior constrictor posteriorly

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30
Q

Where does the raphe descend from

A

○ The raphe descends from the hamulus of the medial pterygoid plate to the posterior end of the mylohyoid line of the mandible

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31
Q

Where is the superior constrictor seen

A

Runs back from the pterygomandibular raphe

It is made of skeletal muscle
Its action is to constrict the upper part of the pharynx

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32
Q

What is the middle constrictor

A

○ The middle constrictor comes from the side of the hyoid bone and it overlaps the superior constrictor

○ Its action is to carry out general sphincteric and peristaltic action in swallowing

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33
Q

What is the inferior constrictor

A

○ Overlaps the middle one
○ Two parts to it - upper part acts as a propulsive force and the lower part acts as a sphincter for the oesophagus / larynx

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34
Q

What is the pharyngeal raphe

A

○ All the constrictors insert with their opposing partners into a median fibrous band known as the median pharyngeal raphe
Inferiorly it blends with the circular muscular fibres of the oesophagus and superiorly it is attached to the pharyngeal tubercle of the occipital bone

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35
Q

Where does the stylopharyngess arise and insert into

A

○ Arises from the styloid process of the temporal bone
○ It passes down into the pharynx between the superior and middle constrictor muscles
○ Some fibres merge with the constrictor muscles while others insert into the thyroid cartilage of the larynx

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36
Q

What is the function of the stylopharyngess

A

○ It elevates the pharynx and larynx

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37
Q

What is the mucosa of the oro and naso pharynx supplied by

A

○ The mucosa of the oro and nasopharynx are supplied by the glossopharyngeal nerve as well which comes around the stylopharyngeus to supply it

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38
Q

What are the constrictors supplied by

A

• The constrictors are supplied by the vagus nerve via the pharyngeal pelxus

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39
Q

Where does the tensor veil palatini come from

A

○ Comes from the base of the skull and originates from the medial pterygoid plate and the auditory tube

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40
Q

Where does the tensor veil palatini descend between

A

the medial pterygoid plate and medial pterygoid muscle to end in a tendon that winds around the pterygoid hamulus

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41
Q

What is the palatal aponeurosis

A

○ The two tendons spread out to form a flattened sheet that forms the skeleton of the soft palate - this is the tendon of the tensor veli palatini
○ When the muscles contract the tendon is pulled and it is winded around the hamulus and the palate becomes tense

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42
Q

What is tensor veil palatini supplied by

A

mandibular nerve

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43
Q

Where does levator veil palatini originate from and insert into

A

the base of the skull at the petrous part of the temporal bone and from the auditory tube
○ It inserts into the palatine aponeurosis

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44
Q

What do the levator muscles of the palate form

A

a U shaped muscular sling

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45
Q

When the palatine aponeurosis is stiffened by the tensor muscles what happens

A

contraction of the levator muscles produces an upwards and backwards movement of the soft palate so that the nasopharynx is shut off from the oropharynx by the positioning of the soft palate onto the posterior wall of the pharynx

46
Q

What is levator veli palatini supplied by

A

vagus

47
Q

Where does the palatoglossus muscle come from

A

○ Goes from the tongue to the soft palate
○ Arises from the aponeurosis
○ Extends downwards and forwards and laterally in front of the palatine tonsil to the side of the tongue
○ Innervates by glossopharyngeal / pharyngeal plexus

48
Q

What is the palatopharyngeus muscle attached to

A

○ Attached to the palatal aponeurosis
○ The muscle passes laterally and downwards behind the tonsils and it then it travels in close contact to the stylopharyngeus
○ It inserts with the stylopharyngeus muscle to the posterior border of the thyroid cartilage and some fibres blend with the constrictor muscles

49
Q

What is the uvular muscle

A

○ Inserts into mucosa of the uvula
○ Moves the uvula upwards and laterally
○ Uvula is there to improve seal of the soft palate when swallowing fluids

50
Q

What is the maxillary tuberosity

A

○ Is a rounded eminence located posterior to the third maxillary molar
○ Occasionally in extraction it can come off and open the maxillary sinus

51
Q

What is the TMJ

A

○ Consists of the mandibular fossa, articular tubercle and head of the mandible

52
Q

Why do the articular surfaces of the TMJ not come into contact with each other

A

they are separated by an articular disc which splits the joint into two synovial joint cavities lined by a synovial membrane

53
Q

What are the articular surfaces covered with

A

○ The articular surfaces of the bones are covered by fibrocartilage not hyaline cartilage

54
Q

What head of the lateral pterygoid is largest

A

lower head

55
Q

What does the lower head arise from

A

§ It arises from the lateral surface of lateral pterygoid plate of the sphenoid bone

56
Q

Where does the smaller head originate from

A

takes origin from the infratemporal surface of the greater wing of the sphenoid in the roof of the fossa

57
Q

What do the fibres of the upper head insert primarily into

A

the capsule and articular disc of the TMJ

58
Q

What do the fibres of the lower head insert primarily into

A

The fibres from the lower head insert into the pterygoid fovea on the mandibular condyle

59
Q

What is the action of the lateral pterygoid

A

○ Because the tendinous fibres join the capsule, when the lateral pterygoid contracts, it pulls on the neck of the TMJ bringing the head out of the fossa and into the eminence in front

60
Q

Where does the buccal nerve come out from

A

○ Coming out through the lateral pterygoid is the buccal nerve, a branch of the mandibular nerve that is sensory to the cheek and gives little twigs to the gums (buccal side)

61
Q

What is the maxillary artery

A

○ One of the terminal branches of the external carotid

○ Has 3 parts to it - the mandibular, pterygoid and pterygopalatine parts

62
Q

Where does the maxillary artery come out of

A

Comes out at the same area as the buccal nerve

	○ Sometimes it runs deep and sometimes it runs superficial to the lateral pterygoid - in the above picture it runs superficial
63
Q

What does the maxillary artery supply

A

○ Supplies tissues in the infratemporal fossa and gives supply to the lower jaw and to structures in the upper jaw

64
Q

Where is the pterygoid plexus

A

it is situated around and within the lateral pterygoid muscle and temporalis

	○ Surrounds maxillary artery
65
Q

How does the pterygoid venus plexus communicate with the cavernous sinus

A

via emissary veins passing through foramen ovale, foramen lacerum and where present, the emissary sphenoidal foramen

66
Q

Why is the pterygoid venus plexus significant to dentists

A

○ Need to aspirate during IBD administration to ensure you havent gone into one of these veins

67
Q

What is the superficial temporal artery

A

○ 1 of the terminal branches of the external carotid artery within the parotid gland

68
Q

What does the superficial temporal artery supply

A

○ Supplies the frontal and parietal parts of the scalp, temporalis muscle, the external lower part of the ear and the orbicularis oculi muscle

69
Q

What is the inferior alveolar artery

A

○ Branch of the maxillary
○ Enters mandibular foramen, prior to this it gives off a branch to mylohyoid
○ Splits into mental and incisor branches near the first premolar
○ Mental branch leaves mental foramen

70
Q

What are the heads of the medial pterygoid called

A

○ Also has 2 heads (superficial and deep NOT superior and inferior)
○ It is the deepest of the four muscles of mastication

71
Q

What is the origin of the deep head

A

§ Deep head is the bulk of the muscle and arises from the medial surface of the lateral pterygoid plate

72
Q

What is the origin of the smaller superficial head

A

originates from maxillary tuberosity and the neighbouring part of the palatine bone, the pyramidal process

73
Q

Where does the medial pterygoid insert

A

§ The fibres pass downwards and backwards to insert into the roughened surface of the angle of the mandible on its medial aspect

74
Q

What is the action of the medial pterygoid

A

§ If the two medial pterygoids contract together the muscle fibres come downwards from the origin to the angle of the mandible so they are going to elevate the mandible and protract it
§ The fibres also come towards us (laterally) as well as downwards and backwards so that if two sides work alternately, the MP will pull the angle of the mandible to the opposite side

75
Q

Where does the inferior alveolar nerve

A

○ Comes from the undercover of the lateral pterygoid
○ Sinks into the mandibular foramen to go into the jaw in the bone to supply the teeth
○ Before it enters it gives off nerve to mylohyoid which supplies the mylohyoid and the anterior belly of the digastric
LA is coming at where the pencil is pointing at

76
Q

Where is the lingual nerve

A

○ Makes its way near the area of the mandible
○ Similar size to the inferior alveolar nerve
○ Infront of the inferior alveolar nerve

77
Q

What comes off the main trunk of the mandibular nerve

A

○ Nerve to the medial pterygoid comes off of this main trunk
○ Further along the nerve splits into 2 - an anterior and posterior division

78
Q

What comes off the anterior division of the mandibular nerve

A

nerve to masseter
deep temporal nerves
nerve to lateral pterygoid

79
Q

Where does the anterior division run

A

high up in the infra temporal fossa and gives off several branches

80
Q

When does the anterior division change its name

A

§ It is after it goes through the two heads of the lateral pterygoid (after supplying it) that its name changes to the buccal nerve which is the continuation of the anterior division

81
Q

What comes off the posterior division

A

lingual nerve
inferior alveolar
auriculotemporal

82
Q

What is the lingual nerve

A

§ Goes downwards and forwards to supply sensation to the mucosa of the anterior 2/3 of the tongue and to the floor of the mouth and the lingual gingiva in the lower jaw
§ It is purely sensory
§ It is at risk of being pressed by forceps due to the close proximity to the roots of the third molar

83
Q

What is the inferior alveolar nerve?

A

§ Runs 2-3mm behind the lingual nerve is the inferior alveolar nerve and it enters the jaw

84
Q

What does the inferior alveolar nerve give off before entering the mandibular foramen

A

§ where it enters the jaw, it gives a branch to the mylohyoid called the Nerve to mylohyoid and it supplies the mylohyoid and anterior belly of digastric
§ The nerve to mylohyoid is the only motor fibre of the posterior division

85
Q

What does the inferior alveolar nerve give off anteriorly

A

§ At the area of the root of the premolars it gives off the mental nerve which turns laterally and comes out through the mental foramen to supply the skin of the lip and chin
§ The incisive branch is the continuation of the IAN

86
Q

What is the function of the auriculotemporal never

A

§ The auriculotemporal nerve is the sensory nerve to supply sensation to the TMJ and supplies the skin anterior to the ear

87
Q

What is the course of chorda tympani

A

§ The facial nerve is in the posterior cranial fossa and goes into the acoustic internal meatus, into temporal bone close to the middle ear and then turns down to come out at the stylomastoid foramen at the base of the skull and it branches in the parotid
§ A few mm from the stylomastoid foramen the chorda tympani nerve branches from the facial nerve as it passes downwards behind the tympanic cavity
§ It then runs upward and forward in a canal and enters the tympanic cavity and it crosses the tympanic membrane
§ After emerging from it, It then joins the lingual nerve

88
Q

What does the chorda tympani supply

A

§ It provides taste to the anterior 2/3 of the tongue
§ It also carries preganglionic parasympathetic fibres that make the salivary gland secrete
The sublingual and submandibular gland get their parasympathetic supply from the facial nerve. These fibres follow the same route as the fibres concerned with taste through the chorda tympani branch joining the lingual nerve which helps carry these preganglionic parasympathetic fibre

89
Q

What is the palatine bone

A

• The palatine bone is a small bone, shaped like a square and the two narrow plates of bone meet at right angles.

90
Q

What does the palatine bone make up

A

○ Part of the palatine bone makes up the posterior part of the palate and the other extends up into the side of the wall of the nasal cavity but that cannot be seen clearly
○ The piece of palatine bone that contributes to the bony palate is called the horizontal plate of the palatine bone

91
Q

What is the rough thick bone of the maxilla called

A

we call it the palatine process of the maxilla where it is a bony shelf.

92
Q

what is the incisive foramen for

A

incisive fossa which is the site where the incisive papilla would be and inside it there would be 4 little holes and 2 of these carry branches of the nasopalatine nerve which supplies sensation to the anterior 1/4 of the hard palate and also supplies the nasal septum as it runs through it. The ant parts of the greater palatine artery make its way to the incisive foramen and it goes to supply the most anterior parts of the nasal cavity and front parts of the nasal septum

93
Q

What is the curved edge of the palatine bone called

A

palatine crest (green) and it is the attachment for the palatine aponeurosis

94
Q

What is the elevation next to the greater palatine nerve called

A

pyramidal process of the palatine bone

95
Q

Where does the greater palatine foramen run

A

• The greater palatine artery runs in the groove outlined in pink and it is a branch of the maxillary artery. It goes through the incisive foramen to give blood to the nasal septum and cavity

96
Q

What happens if the maxillary tuberosity is pulled off

A

• The maxillary tuberosity outlined in orange can be pulled off in extraction opening the maxillary sinus

97
Q

Where does the hauler notch lie

A

• The hamular notch lies between the pterygoid hamulus and maxillary tuberosity and it is this area that is covered by mucosa that gives the hamular notch and it is an important landmark in the making of upper dentures

98
Q

What does the massaterattach to

A
  • It attaches at the lower border of the zygomatic arch on its deep surface but it extends forward onto the zygomatic bone
    • Its other attachment is the lateral surface of the ramus of the mandible and attaches to most of it
99
Q

What direction do the fibres of master run

A

attaches to most of it
• Its fibres run downwards but slightly backwards as well (superficial fibres)
• In dissection, you would see the deeper fibres the fibres are more vertical in their orientation (i.e downwards)

100
Q

What happens if the two masseters contract

A

• If the two masseter contract together the action produced is the elevation of the mandible but the superficial fibres run backwards so there will be another vector for the force which will mean that it will also pull it slightly forward as well so also aids in protraction (forward movement) of the mandible

101
Q

Why is masseter so strong

A
  • Masseter has a lot of tendon in it, the power of the muscle is related to the absolute number of muscle fibres within it not so much the size of the fibres
    • A muscle fibre under the microscope is wide whereas a tendinous fibres which is continuous is narrower so it is possible by having fleshy fibres running into tendinous fibres which are narrower, that allows the masseter to have a bigger absolute number of individual contracting units. The fleshy fibres can fit around the narrower tendinous fibres.
102
Q

What is the masseter supplied by

A

mandibular nerve (trigeminal) - nerve to Masseter and it along with blood vessels come through mandibular notch and comes through deep surface of the masseter

103
Q

Where is temporalis

A

• Muscle is fan shaped and can see the superior and inferior lines for the fascia
• Behind the zygomatic arch and in front of the temporalis muscle
The posterior part is very thin but the anterior fibres is much thicker, lots of muscle behind the zygomatic arch

104
Q

What direction do anterior fibres run

A

vertically and attach to edge of coronoid process to anterior border of ramus to part where lower tooth is

105
Q

What happens if two temporalis contract together

A

it will produce elevation of the mandible because of the big bulk of the muscle and gives a powerful elevation

106
Q

What happens if the posterior fibres contract independently

A

retract the mandible

107
Q

What is the function of the buccinator

A

• Used in mastication
It pushes food between molar teeth so doesn’t collect in vestibule of the mouth and orbicularis oris is important in pushing the food between incisor teeth

108
Q

Where do upper fibres of the buccinator come from

A

the maxilla above the vestibule of the mouth

109
Q

Where do lower fibres of the masseter come from

A

from the oblique line

110
Q

What is the arrangement of the middle friers

A

• The middle fibres there is a criss crossing arrangement, the upper middle fibres run and pass into the lower lip and blend with orbicularis oris and the lower of the middle fibres pass to the upper lip and blend with orbicularis oris

CALLED MODIOLUS

111
Q

What pierces the buccinator

A

• Parotid duct has to pierce buccinator to get into oral cavity

BDS3 BAMS Anatomy (12 decks)

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