Dental Anatomy and Nerve Innervation Quiz

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Questions and Answers

Which nerve provides sensory innervation to the buccal gingivae?

  • Inferior alveolar nerve
  • Long buccal nerve (correct)
  • Mental nerve
  • Lingual nerve

Which nerve carries secretomotor fibers to the submandibular and sublingual glands?

  • Inferior alveolar nerve
  • Chorda tympani nerve (correct)
  • Long buccal nerve
  • Lingual nerve

The mental nerve is a terminal branch of which nerve?

  • Lingual nerve
  • Inferior alveolar nerve (correct)
  • Masseteric nerve
  • Long buccal nerve

Which of the following nerves does NOT directly innervate a muscle of mastication?

<p>Long buccal nerve (C)</p> Signup and view all the answers

Taste sensation from the anterior two-thirds of the tongue is carried by which nerve?

<p>Chorda tympani nerve (D)</p> Signup and view all the answers

Which cranial nerve division provides both sensory and motor innervation?

<p>Mandibular division (V3) (C)</p> Signup and view all the answers

Which foramen does the mandibular nerve (V3) pass through to enter the infratemporal fossa?

<p>Foramen ovale (A)</p> Signup and view all the answers

Which nerve travels with the superficial temporal vessels?

<p>Auriculotemporal nerve (B)</p> Signup and view all the answers

Which nerve provides sensory innervation to the mandibular teeth?

<p>Inferior alveolar nerve (A)</p> Signup and view all the answers

The lesser petrosal nerve synapses on which ganglion?

<p>Otic ganglion (A)</p> Signup and view all the answers

Which nerve provides motor innervation to the mylohyoid muscle?

<p>Nerve to mylohyoid (D)</p> Signup and view all the answers

The auriculotemporal nerve conveys postsynaptic parasympathetic fibers to which gland?

<p>Parotid gland (C)</p> Signup and view all the answers

The tympanic nerve is a branch of which cranial nerve?

<p>CN IX (D)</p> Signup and view all the answers

Which anatomical structure does NOT form a boundary of the infratemporal fossa?

<p>Mastoid process of the temporal bone (B)</p> Signup and view all the answers

The infratemporal fossa is located deep to which of these structures?

<p>Zygomatic arch and ramus of the mandible (A)</p> Signup and view all the answers

The motor root of the mandibular division of the trigeminal nerve (CN V3) innervates which group of muscles?

<p>Muscles of mastication (C)</p> Signup and view all the answers

Which of the following structures is NOT a content of the infratemporal fossa?

<p>Facial nerve branches (D)</p> Signup and view all the answers

Through what pathway does the infratemporal fossa communicate with the temporal fossa?

<p>Interval between zygomatic arch and cranial bones (D)</p> Signup and view all the answers

What is the embryological origin of the muscles of mastication?

<p>First pharyngeal arch (D)</p> Signup and view all the answers

Which nerve contributes to the infratemporal fossa, but is not part of the mandibular division of CN V?

<p>Chorda tympani nerve (A)</p> Signup and view all the answers

What structure is located directly posterior to the infratemporal fossa?

<p>Styloid process of the temporal bone, and condylar process of the mandible (B)</p> Signup and view all the answers

Which of the following correctly describes the innervation provided by the auriculotemporal nerve?

<p>It carries both GSA and GVE fibers, including fibers that innervate the parotid gland. (C)</p> Signup and view all the answers

What is the most common type of TMJ dislocation?

<p>Anterior dislocation (B)</p> Signup and view all the answers

Which artery is NOT involved in the blood supply to the TMJ?

<p>Cervical artery (A)</p> Signup and view all the answers

Which statement about TMJ dislocation is accurate?

<p>The anterior dislocation is the most frequently seen type. (B)</p> Signup and view all the answers

What role does the lesser petrosal nerve play in TMJ innervation?

<p>It delivers GVE fibers to the parotid gland. (A)</p> Signup and view all the answers

Which component is NOT part of the gnathostomatic system?

<p>Vertebrae (B)</p> Signup and view all the answers

What type of joint is the temporomandibular joint (TMJ)?

<p>Modified hinge type of synovial joint (C)</p> Signup and view all the answers

What is the primary function of the lateral ligament of the TMJ?

<p>Strengthen the joint laterally (B)</p> Signup and view all the answers

Which part of the lateral ligament limits the opening of the mandible?

<p>Outer oblique part (D)</p> Signup and view all the answers

The collateral ligaments of the TMJ primarily function to:

<p>Attach to the articular disc (B)</p> Signup and view all the answers

Which accessory ligament runs from the spine of the sphenoid to the lingula of the mandible?

<p>Sphenomandibular ligament (A)</p> Signup and view all the answers

What is the role of the articular disc in the TMJ?

<p>Absorb shock between bones (A)</p> Signup and view all the answers

Which of the following statements about the TMJ capsule is correct?

<p>It is a loosley structured capsule made of fibrous connective tissue. (C)</p> Signup and view all the answers

What is the primary movement occurring in the superior cavity of the Temporomandibular Joint (TMJ)?

<p>Translation/Gliding (A)</p> Signup and view all the answers

Which movement occurs first when the mouth is opened, contributing to the first 15° of mouth opening?

<p>Rotation/Hinge (B)</p> Signup and view all the answers

During side-to-side movements of the TMJ, what defines the role of the resting condyle?

<p>It rotates about a vertical axis (C)</p> Signup and view all the answers

What anatomical change occurs when the mouth is opened wider than 15°?

<p>Protrusion of the mandibular head begins (C)</p> Signup and view all the answers

Which nerve branches are primarily responsible for the innervation of the TMJ?

<p>Mandibular nerve (CN V3) (D)</p> Signup and view all the answers

Which of the following best describes the action of the swinging condyle during side-to-side movements?

<p>It swings inward and forward in a translational movement (D)</p> Signup and view all the answers

During mastication, what is the term used for the lateral excursion of the mandible?

<p>Bennett angle (C)</p> Signup and view all the answers

What characterizes the movements of the TMJ during grinding/pivoting?

<p>It is a combination of rotational and translational movements (C)</p> Signup and view all the answers

Flashcards

Infratemporal Fossa

Deep and inferior to the zygomatic arch, located deep to the ramus of the mandible and posterior to the maxilla. Communicates with the temporal fossa through a space between the zygomatic arch and cranial bones.

Temporal Fossa

The lateral area of the scalp and deeper soft tissues that lie above the temporal fossa of the skull, above the zygomatic arch.

Describe the boundaries of the infratemporal fossa.

This space in the skull is bounded superiorly by the greater wing of the sphenoid and the temporal bones, anteriorly by the maxilla, posteriorly by the tympanic process of the temporal bone, medially by the lateral pterygoid plate, and laterally by the ramus of the mandible.

List the contents of the infratemporal fossa.

The infratemporal fossa contains the muscles of mastication, the maxillary artery and its branches, the maxillary vein and pterygoid venous plexus, and CN V3 nerves and the chorda tympani nerve.

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What are the muscles of mastication?

The muscles of mastication are: Masseter, Temporalis, Medial Pterygoid, Lateral Pterygoid. All are innervated by the mandibular division of the trigeminal nerve.

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What are the branches of the maxillary artery?

The maxillary artery branches off into the middle meningeal artery, infraorbital artery, posterior superior alveolar artery, infraorbital artery, and sphenopalatine artery.

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What veins drain the deep face?

The deep face is drained by veins such as the maxillary vein, pterygoid plexus, superficial temporal vein, and facial vein.

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What are the branches of the mandibular nerve?

The mandibular division of CN V is responsible for sensory and motor functions of the face. Branches include the buccal nerve, mental nerve, inferior alveolar nerve, auriculotemporal nerve

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What does the mental nerve supply?

The mental nerve is a branch of the mandibular nerve (CN V3) that supplies sensation to the lower lip, chin, and front teeth.

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Where does the lingual nerve provide sensation?

The lingual nerve provides sensory innervation to the anterior two-thirds of the tongue, the floor of the mouth, and the gums of the lower teeth.

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What is the function of the chorda tympani nerve?

The chorda tympani carries taste fibers from the front part of the tongue to the brain and also carries parasympathetic fibers to salivary glands.

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What does the long buccal nerve supply?

The long buccal nerve provides sensation to the skin and mucous membrane of the cheek, including the gums of the molars (back teeth).

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What is the function of the mandibular nerve?

The mandibular nerve (CN V3) supplies the muscles of mastication, which are the muscles responsible for chewing.

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Mandibular Nerve (CN V3)

The largest division of the trigeminal nerve (CN V). It has both sensory and motor components, supplying the muscles of mastication and sensation to the lower face, teeth, and temporomandibular joint.

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Auriculotemporal Nerve

A sensory branch of the mandibular nerve (CN V3) that provides sensation to the temporomandibular joint, auricle, and temporal region. It also carries parasympathetic fibers to the parotid gland.

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Inferior Alveolar Nerve

A sensory branch of the mandibular nerve (CN V3) that runs through the mandibular canal and provides sensory innervation to the mandibular teeth.

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Nerve to Mylohyoid

A branch of the inferior alveolar nerve (CN V3) that supplies the anterior belly of the digastric muscle and carries both sensory and motor fibers.

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Otic Ganglion

A ganglion that receives postsynaptic parasympathetic fibers from the glossopharyngeal nerve (CN IX) and relays them to the parotid gland via the auriculotemporal nerve.

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Lesser Petrosal Nerve

A branch of the glossopharyngeal nerve (CN IX) that provides parasympathetic innervation to the parotid gland.

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Tympanic Nerve

A branch of the glossopharyngeal nerve (CN IX) that contributes to the tympanic plexus in the middle ear.

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Tympanic Plexus

A collection of nerves within the middle ear that includes the tympanic nerve and helps to control the muscles and glands in the ear.

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Temporomandibular Joint (TMJ)

A modified hinge-type synovial joint, responsible for movements like elevation/depression, protrusion/retrusion, and some side-to-side pivoting.

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TMJ Articulation

The area where the TMJ connects, consisting of the mandibular (glenoid) fossa and articular eminence of the temporal bone, as well as the head of the mandible.

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TMJ Capsule

A tough, fibrous sac that encloses the TMJ, attaching to the mandibular fossa, articular tubercle, and mandibular condyle.

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TMJ Ligaments

Strong ligaments that stabilize and protect the TMJ, including the lateral (temporomandibular) ligament and the collateral (discal) ligaments.

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Lateral (Temporomandibular) Ligament

The strongest TMJ ligament, strengthening the joint laterally and preventing posterior dislocation.

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Sphenomandibular Ligament

A tough, fibrous band that runs from the spine of the sphenoid bone to the lingula of the mandible, helping to limit the forward protrusion of the jaw.

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Stylomandibular Ligament

A thickening of the fibrous capsule of the parotid gland that runs from the styloid process to the angle of the mandible, also limiting forward protrusion of the jaw.

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TMJ Articular Disc

A fibrocartilaginous disc separating the bony articulations of the TMJ, attached to the joint capsule and the superior head of the lateral pterygoid muscle.

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TMJ (Temporomandibular Joint)

The temporomandibular joint (TMJ) is a complex joint responsible for jaw movements.

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TMJ Cavities

The TMJ is divided into a superior and inferior cavity, each lined by synovial membrane.

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TMJ Movements

The TMJ allows for three primary movements:

  1. Rotation/Hinge: Opening and closing the mouth.
  2. Translation/Gliding: Protrusion (moving the jaw forward) and retrusion (moving the jaw backward).
  3. Grinding/Pivoting: Side-to-side movements during chewing.
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Superior TMJ Cavity

The superior cavity of the TMJ is responsible for translational movements, like protruding and retracting the jaw.

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Inferior TMJ Cavity

The inferior cavity of the TMJ is responsible for rotational movements, like opening and closing the mouth, and pivoting movements used for side-to-side chewing.

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Mouth Opening: Rotation

The first 15° of mouth opening is achieved primarily through rotation/hinge movement within the inferior cavity.

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Mouth Opening: Translation

Beyond 15° of mouth opening, the superior cavity is recruited, involving translational movement of the mandible.

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Side-to-Side Chewing: Resting and Swinging Condyles

Side-to-side chewing movements involve the 'resting condyle' and the 'swinging condyle'. The resting condyle rotates, while the swinging condyle translates.

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What nerve innervates the TMJ?

The auriculotemporal nerve innervates the temporomandibular joint (TMJ) and carries sensory information to the external ear, tympanic membrane, temple, and TMJ.

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What are the specific types of fibers carried by the auriculotemporal nerve?

The auriculotemporal nerve carries sensory fibers (GSA) for the external ear, tympanic membrane, temple, and TMJ. It also carries parasympathetic fibers (GVE) from the lesser petrosal nerve that innervate the parotid gland.

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Where does the blood supply to the TMJ originate?

The TMJ receives blood supply from the superficial temporal artery (terminal branch of the external carotid artery), the deep auricular artery (branch of the maxillary artery), and the anterior tympanic artery (branch of the maxillary artery).

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What is TMJ dislocation?

TMJ dislocation is the displacement of the mandibular condyle from the mandibular fossa. It can be unilateral (one side) or bilateral (both sides), with the anterior dislocation being the most common. Posterior, superior, and lateral dislocations are less frequent and usually associated with trauma.

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What are the causes of TMJ dislocation?

TMJ dislocation can occur due to both atraumatic (non-traumatic) and traumatic causes. Although the majority of dislocations are anterior, other directions like posterior, superior, and lateral are rarer and often linked to trauma.

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Study Notes

Deep Face & Gnathostomatic System

  • The gnathostomatic system includes the head and neck structures and functions.
  • This system has the following components:
    • Infratemporal fossa
    • Muscles of mastication
    • Vasculature of the infratemporal fossa
    • Mandibular nerve branches
    • Components of the TMJ

Infratemporal Fossa

  • The boundaries of the infratemporal fossa include:
    • Superior: infratemporal surface of the greater wing of the sphenoid bone and infratemporal surface of the temporal bones.
    • Anterior: posterior surface of the maxilla.
    • Posterior: styloid process of the temporal bone and condylar process of the mandible.
    • Medial: lateral pterygoid plate of the sphenoid bone and pyramidal process of the palatine bone.
    • Lateral: ramus of the mandible.
  • The contents of the infratemporal fossa include:
    • Muscles of mastication
    • Maxillary artery and branches
    • Maxillary v. & Pterygoid venous plexus
    • CN V3 nerves & Chorda tympani n. of CN VII

Muscles of Mastication

  • Temporalis
    • Origin: entire temporal fossa, inferior temporal line, deep surface of temporal fascia
    • Insertion: coronoid process & anterior border of the ramus of the mandible.
    • Action: elevates mandible (closing jaws) & horizontal fibers retract mandible
  • Masseter
    • Origin: inferior border and medial surface of the zygomatic arch.
    • Insertion: lateral surface of the ramus and angle of the mandible.
    • Action: Elevates mandible, closing jaws, protrudes mandible (superficial head).
  • Medial Pterygoid
    • Origin:
      • Superficial head: Maxillary tuberosity; pyramidal process of palatine bone.
      • Deep head: Medial surface of lateral pterygoid plate.
    • Insertion: Medial surface of the ramus of the mandible.
    • Action: Bilateral contraction - elevates mandible, closing jaws, protrudes mandible. Unilateral contraction - causes mandible to deviate to contralateral side.
  • Lateral Pterygoid
    • Origin:
    • Upper head: Greater wing of the sphenoid bone.
    • Lower head: Lateral surface of lateral pterygoid plate
    • Insertion:
      • Upper head: Joint capsule & articular disc of TMJ
      • Lower head: Pterygoid fovea on the neck of condylar process of mandible
    • Action: Bilateral contraction - protrudes & depresses mandible. Unilateral contraction - causes mandible to deviate to contralateral side.

TMJ

  • Modified hinge type of synovial joint.
  • Permits hinge (elevation/depression), as well as gliding (protrusion/retrusion) and a small degree of pivoting (side-to-side) movements.
  • The TMJ is comprised of the following
  • Mandibular fossa & Articular eminence
  • Head of the mandible
  • Articular disk
  • Synovial Membrane
  • Joint capsule
  • Lateral (temporomandibular) ligaments:
    • Thickened portion of the joint capsule
    • Strongest TMJ ligament; strengthens joint laterally and prevents posterior dislocation.
  • Collateral ligaments:
    • Medial collateral ligament: connects medial aspect of articular disk to medial pole of condyle.
    • Lateral collateral ligament: connects lateral aspect of articular disk to lateral pole of condyle.
  • Accessory Ligaments:
  • Sphenomandibular ligament: Runs from spine of sphenoid to lingula of mandible; helps limit anterior protrusion of mandible.
  • Stylomandibular ligament: Thickening of fibrous capsule of parotid gland; runs from styloid process to angle of the mandible; helps limit anterior protrusion of mandible.

###Additional Accessory Muscles

  • Buccinator: Keeps bolus between check & teeth.
  • Orbicularis oris: Aids in keeping bolus in oral cavity.
  • Tongue muscles: Food manipulation.
  • Suprahyoid: Assists in opening/depressing mandible.

TMJ Vascularity

  • Superficial temporal a.
  • Deep auricular a.
  • Anterior tympanic a.

TMJ Innervation

  • Auriculotemporal nerve
  • Masseteric nerve
  • Posterior deep temporal nerve

TMJ Dislocation

  • Unilateral or bilateral (more common) displacement of the head of the mandible from the mandibular fossa.
  • Can result from atraumatic& traumatic causes.
  • Dislocations can be Anterior, Posterior, Superior, or Lateral
  • anterior dislocation is the most common type.
  • Posterior, superior, & lateral dislocations are rare and mostly associated with trauma.
  • Anterior dislocation: head of mandible passes anterior to articular eminence. Mandible remains depressed; person unable to close mouth. It is usually due to atraumatic causes (excessive mouth opening).
  • Posterior dislocation: uncommon due to resistance from the postglenoid tubercle & strong lateral ligament.

Temporomandibular Disorders (TMD)

  • Over 30 conditions that cause pain and dysfunction of the TMJ and muscles that control jaw movement collectively referred to as TMD.
  • Divided into 2 Subtypes:
    • Arthrogenous: pain and dysfunction due to the joint itself; pain is commonly located around the TMJ and the ear.
    • Myogenous: pain and dysfunction within masticatory muscles; pain is generally described as deep, diffuse, achy, and often refers to TMJ, ear, temples, or teeth.

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