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250 Cards in this Set

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FASCIAL SPACES
FASCIAL SPACES
FASCIAL SPACES
Define Fascia
A sheet of Fibrous Tissue that closes off the body beneath the skin
-encloses the musces and seperates their layers and groups
2 divisions of the fascia
Superfical
Deep
Division of the FASCIA found immediately deep to the DERMIS
Superfical Fascia
aka: Subcutaneous Tissue
Functions of the Superfical Fascia
Storage
Conduction
Protective Cushion
Thermal Insulation
The Superficial Fascia contains the ___ and the ____.
Platysma
Cutaneous Branches of the Cervical Plexus
What is the Deep Fascia
Forms a CT covering/sheath for structures(muscles, vessels, and nerves)

-Deep to the Superficial Fascia
What are the 5 Layers of the Deep Fascia
Investing
Pretracheal
Prevetebral
Alar
Carotid
"I CAPP"
Name the Fascia:
-Cylinder Shape around the neck
-Covers the Ant. and Posterior Triangles of the Neck
-Encolses the Trapezius M
-Surronds the Muscles that that border the Triangles
Investing
Name the Fascia:
-Surrounds the Thyroid Gland, Larynx, Trachea, Pharynx, and Esphogus
-Covers the infrahyoid muscles
Pretracheal
Name this Fascia:
-Surrounds the scalens, deep muscles of the back, nerves of the brachial plexus and the vetebral column
Prevetebral
How are you going to remember what is in the Investing Fascia?
"Try Investing in Apples and Peaches"
How are you going to remember the components in the Prevetebral Fascia
"PreView Salads, Vegtables, Bread and Donuts"
How are you going to remember the components of the Pretracheal Fasicia
Trachea
Esphogus
Thyroid Gland
Pharynx and Larynx
What is the Alar Fascia
Continuous w/ the Prevetebral Fascia
-Divides Prevertebral from Pretracheal
It is from the TRANSVERSE Process of the Vertebra to the Base of the Skull
Name the components of the Carotid Sheath?
Common Carotid
Int and Ext Carotid ARTERIES
Int Jugular VEIN
Vagus NERVE
Sympathetic Fibers
Spaces between the Fascial Layers is called what?
Name the 4 Fascial Spaces
Fascial Spaces
-Pretracheal
-Retropharyngeal
-Parapharyngeal
-Prevetebral(Danger Space)
3 P and an R
Buccopharyngeal turns into ___ space.
Pretracheal
What is the pretracheal space between
Trachea and the Esphogas
What is the pretracheals superior and inferor borders
Superiorly it is delimited by the infrahyoid to the thyroid cartlages and the hyoid bone

Inferiorly it goes into the Thoracic Cavity
Retropharyngeal Space
-Superior Border
-Anterior Borders
-Posterior Border
-Inferior Border
Superior Border: Skull

Anterior Border:Superior Constricter and Buccopharyngeal Fascia

Posterior Border: Alar Fascia

Inferior Border: Mediastinum
What is the Lateral and Medial Border of the Retropharyngeal Fascia?
Lateral: Fascia that extends POSTERIORLY from the Caroid Sheath

*Can be continuous w/ the Lateral Pharyngeal Space

Medial-Pharyngeal Fascia

Medial
What is often found in this space?

What does this have to do w/ Infection?
Lymph Nodes

Infections can spread to the Mediastinum
What is AKA the Lateral Pharyngeal Space
Parapharyngeal Space
What is the Superior Border of the Lateral Pharyngeal Space?
-Inferior Border
Superior Border: Skull
Inferior Border: Hyoid Bone
Whatis the Medial and Lateral Border of the Lateral Phayngeal Space?
Medial:Superior Constricter and Buccopharyngeal Fascia
Medial Pterygoid Muscle (head) and SCM (neck)
What is the Anterior and Posterior Borders of the Lateral Pharyngeal Space?
Anterior: Superior Constrictor and Buccopharyngeal

Posterior: Alar Fascia and Carotid Sheath
What is the Anterior and Posterior borders of the Prevetebral Fascia?
Anterior: Alar Fascia
Posteror: Prevetebral Fas cia
Head Fascial Spaces
Head Fascial Spaces
Head Fascial Spaces
Facial Vestibule of the Mandible
-Anterior and Posterior Borders
Ant: Oral Mucosa
Post:Mandible
Facial Vestibule of the Mandible
-Superior and Inferior Borders
Sup:Infratemporal Area
Inf:Mandible
Facial Vestibule of the Mandible
-Medial and Lateral Borders
Medial: Oral Mucosa
Lateral:Buccinator
Where do infections spread in the Facial Vestibule of the Mandible space
From Vestibule to Buccal Space
What is CN V
Trigeminal
What do the Trigeminal Nerve fibers innervate the face for
Touch,Pain, Temp, and Proprioception

Motor for the Muscles of Mastication
What are the 3 Main Divisons of the Trigeminal Nerve
Opthalmic (Forehead/Eyes)
Maxillary
Mandibular
CNV emerges from the brain stem as a large ___ root and small ___ root.
GSA (Mainly Sensory)
SVE (Goes to Muscles of Mastication)
Where are the cell bodies of the GSA and SVE located?
GSA: Trigeminal Ganglion
SVE:Motor Nucleus of CNV
Where does CN V emerge from in the brainstem
Out of the Ventral Lateral Aspect of the Pons
GSA and SVE are called ___.
Resident fibers
SVE fibers are ___ in orgin.
Branchial/Pharyngeal Arch Orgin
The aquired components of CN V are __ and __.
SA (Taste)
GVE (Parasympathetic/Sympathetic Glands, Sphicter// Dilator of Pupil)
Why are aquired components called aquired?
Is carried from another nerve, and aquires these fibers along its path

Not emerging from brainstem w/ Trigeminal

V innervates the Oral Cavity
VII innervates the Muscles of Fascial Expression
After the CN V leaves the brain stem it goes anteriorly to the Cranial Cavity.

What emerges from the Trigeminal Gangilion (GSA)

What travels through the Cavernous Sinus
V1- Opthalamic
V2-Maxillary
V3-Mandibular

V1 and V2 travel through the Cavernous Sinous (emerging out of cranial cavity)
What Foramen do the branches of CN V go through
V1-Superior Orbital Fissure
V2-Foramen Rotundum
V3-Foramen Ovale
Sensory Ganglion
Trigeminal Ganglion
-Pseudounipolar Neurons
-Cell bodies of GSA
Parasympathetic Ganglion Associated w/ CN V contain ___.

How many exsist?
What do they all have in common?
Postganglionic Parasympathetic Neurons

4; All receive PREGANGLIONIC Fibers forn another CN
Name the 4 Postganglionic Parasympathetic Neurons Associated w/ CN V
Ciliary (V1)

Pterygopalatine (V2)

Submandibular (V3)

Otic Ganglion(V3)
OHHH! CPS!
Which of the Postganglionic Parasympathetic Ganglions recieves Preganglionic Fibers from CN III (Oculomotor)
Ciliary Ganglion
Which TWO of the Postganglionic Parasympathetic Ganglions recieves Preganglionic Fibers from CN VII (Facial)
Pteryogopalatine Ganglion
Submandibular Ganglion
Which of the Postganglionic Parasympathetic fibers recieves Preganglionic Fibers from CN IX (Glossalpharyngeal)
Otic Ganglion
What is the smallest of the three divisions of CN V
V1- Opthalamic
Prior to entering the Orbit via the Superior Orbital Fissure,..What Branch and 3 nerves does V1 give off.
Meningeal Branch
Frontal Nerve
Lacrimal Nerve
Nasociliary Nerve
The frontal nerve is ___. It enters the ___ aspect of the orbit via the Superior Orbital Fissure.

Within the orbit, the Frontal nerve branches into what two nerves
GSA
Superior

Supratrochlear Nerves and Supraorbital Nerves
The Supratrochlear Nerves provides GSA from what 2 things
Skin and Conjuctiva of the Superior Medial Eyelid
Skin of the Anteromedial Forhead
Conjunctiva
Forhead
The Supraorbital Nerve provides GSA from what 3 things
Mucosa of the Fronal Sinus
Skin and Conjunctiva of the Superior Medial Eyelid
Skin of the Anterolateral Forhead
What does the Supraorbital innervate that they Suprtrochlear does not?
Frontal Sinus
What type of nerve is the Lacrimal Nerve
GSA and GVE
The Lacrimal Nerve enters the ___ aspect of the Orbit via the Superior Orbital Fissure.It travels ___ w/ in the orbit
Superior

Superiolaterally
The GSA fibers in the Lacrimal Nerve are from 3 things?
Lacrimal Gland
Conjuctiva
Lateral part of the Superior Eyelid
The GVE fibers in the Lacrimal Nerve are to what things?

The Lacrimal Gland recieves these GVE fibers from what CN
Lacrimal Gland

CN VII via a communicating branch of V2=Zygomaticotemporal Nerve
Nasociliary Nerve enters the orbit via the Superior Orbital Fissure.This nerve travels deep to what
Frontal Nerve
Lacrimal Nerve
Levator Palpebrae Superioris Superior Rectus

(Frontal and Lacrimal Nerves run ontop of the two muscles)
The Nasociliary Nerve has many branches:

The first branch, is called the Sensory Root which has ___ fiber. These fibers go through the ____ where they DON'T synapse and then form the ____. These nerves carry informaion regarding what 3 structures
GSA fibers
Ciliary Gangilion
SHORT Ciliary Nerves
Iris, Cornea, Ciliary Body
The 2nd branch of the Nasociliary Nerve is a PRE GANGLIONIC Parasymphathetic Root carrying ___ fibers. These fibers go through ____ to form the _____.
GVE
Ciliary Ganglion
SHORT Ciliary Nerves
The PREGANGLIONIC Parasympathetic Fibers (GVE) of the Nasociliary Nerve orginate from where and travel w/ what?
Edwinger Westphal Nucleus
CN III (Oculomotor)
Do the GVE fibers of the Nasociliary Nerve synapse in the Ciliary Ganglion
YES
They synapse w/ POST Ganglionic Parasympathetic Fibers w/ in the Ciliary Ganglion and Leave via the Short Ciliary Nerve
What do the GVE fibers of the Nasociliary Nerve provide innervation to?
Sphicter of Pupil
Take Home Points about the GVE fibers of the Nasociliary Nerve
Orginate in the EW Nucleus
Travel w/ CN III
Synapse in the Cilary Ganglion
Leave via the Short Ciliary Nerves
Innervate Sphicter of Pupil
The 3rd Branch of the Nasociliary Nerve is called the LONG Ciliary Nerves (2-3), They carry what type of fibers?
GSA and GVE
Do the Long Ciliary Nerve go through the Ciliary Ganglion?
-How do they Travel?
NO!
They travel ANTERIORLY w/in the orbit and pierce the SCLERA of the eyeball
The Long Ciliary Nerves innervae what?
GSA fibers to the Iris, Cornea, and Ciliary Body

(like short ciliary nerves)
The 4th Branch of the Nasociliary Nerve is the Posterior Ethmoid Nerve, it carries ___fibers. It exits the orbit via the ___ and does what?
GSA fibers
Posterior Ethmoid Foramen
GSA to the Sphenoidal Sinuses and the Posterior Ethmoid Sinuses
The 5th Branch of the Nasociliary Nerve is called what?
What fibers does it carry
How does this nerve travel?
Anterior Ethmoid Nerve
GSA
Exits orbit via Ant. Ethmoid Foramen
-1/2 of the fibers go to the Ant and Middle Ethmoid Sinuses
-1/2 of the fibers go into the Anterior Cranial Fossa and then trave to the NASAL CAVITY via the Cribiform Plate. Once in the Nasal Cavity they branch into Int and Ext Nasal Nerves
What does the Internal Branch of the Anterior Ethmoidal Nerve innervate
Nasal Mucosa (GSA)
Anterior Superior(medial/lateral)
What does the External Branch of the Anterior Ethmoidal Nerve Innervate?
External Surface Dorsum of the Nose(GSA)
The 6th and final branch of the Nasociliary Nerve is called what?
-Arises where?
-Travels where?
-How does it exit the orbit?
-What type of fibers does it carry and what does it innervate?
Infratemporal Nerve (GSA)
-arises @ the Anterior Ethmoidal Foramen

Travels along the MEDIAL wall of the ORBIT

Pierces the Orbital Septum to provide GSA information from the root of the nose(superior near the eye) and Superior Medial Eyelid
Where do Sympathetic fibers in the head arise from?

How do they travel
Superior Cervical Ganglion
-POST GANGLIONIC FIBERS!
NO Sympathetic Ganglia are in the head

Travel as a Plexus of Nerves around the INTERNAL CAROTID ARTERY

Widely distrubted to Sm Muscles and Glands via CN's
Summary: What are the GVE fibers of the Opthalmic (V1) of Trigeminal
Lacrimal via CN VII (communicating branch of V2 Zygomaticotemporal)>> V1

Nasociliary
-EW via CN III>>> Short Ciliary
-Long Ciliary

Sympathetic Fibers

Everything else is GSA!
The maxillary nerve arises from the ___ ganglion and travels anteriorly to pass along the ____ wall of the Cavernous Sinus
Trigeminal
Lateral Wall
When the Maxillary Division passes through the Cavernous Sinus is it Superior or Inferior to Opthalmic (V1) Nerve?
Inferior
W/in the Cranial Cavity the Maxillary Nerve givea off a ___ that carries GSA information to the ____ of the Middle Cranial Fossa
Meningeal Branch
Meninges
V2 exits the cranium via this foramen?
Foramen Rotundum
Once V2 exits the Cranial Cavity via the Forament Rotundum it enters this fossa.
Pterygopalatine Fossa
After entering the Pterygopalatine Fossa V2 branches into what 5 things?
Zygomatic Nerve

Posterior Superior Alveolar Nerve

Infraorbital Nerve

2 Communicating Branches w/ the Pterygopalatine Ganglion
The zygomatic nerve carries what type of fibers?
GSA and GVE
When does the Maxillary Nerve branch into the Zygomatic Nerve?

-What happens next?
-How does it travel?
-What does it divide into?
When it gets to the Ptyergopalatine Fossa

Enters the orbit via the INFERIOR Orbital Fissure

Travels on the Lateral Orbital Wall

Divides into the Zygomaticotemporal and the Zygomaticofacial
The Zygomaticofacial carries ___ fibers and travels along the _____. It will traverse the ____ foramen in the ____ and emerges on the FACE through the _____ muscle.
GSA fiber

Travels along the INFERIOLateral Wall of the Orbital

Zygomaticofacial forman in the Zygomatic Bone

Obicularis Oculi Muscle
What Structures is the Zygomaticofacial Nerve carrying information from?
Skin over the Zygomatic Arch
The Zygomaticotemporal Nerve is carrying what type of fibers?
GSA and GVE
In regards to V1 what does the Zygomaticotemporal Nerve do?
Sends GVE fibers to the Lacrimal Nerve
-These are POST Ganglionic Parasympathetic fibers that will supply the Secretomotor Innervation to the Lacrimal Gland
Where do the cell bodies for the Post Ganglionic Parasympathetic Fibers reside in?

Where do the Preganglionic Fibers reside in ?
-How do they travel
Post are in the Pterygopalatine Ganglia

Pre are in the Superior Salvitory Nucleus and travel w/ CN VII to the Pterygopalatine Formen
The Zygomaticotemporal Nerve Transverses the ____ foramen in the ____ to enter the ____ to give GSA information to the skin of the _____.
Zygomaticotemporal Foramen
Zygomatic Bone

Temporal Fossa
Temporal Area
The 2nd Branch of the Maxillary Nerve is the Posterior Superior Alveolar Nerve. Like the Zygomatic Nerve it emerges @ the ___.

It then desends ____ w/in the fossa to do what?
Pterygopalatine Fossa

Desends Anteriorly in the ptyergopalatine fossa to pierce the INFRAtemporal Surface of the Maxilla. Travel under the mucosa of the maxillary sinus before sending branches to the Oral Cavity
The GSA information of the Posterior Superior Alveolar Nerve carries information from what structures?
Maxillary Sinus
Molar Teeth
Adjacent Gingival Tissue
The Infraorbital Nerve carries what type of fibers?
GSA
It is a continuation of the Maxillary Nerve as it enters the Inferior Orbital Fissure

-Name the Nerve
Infraorbital Nerve
After the Infraorbital Nerve passes through the Infraorbital Foramen what happens?
Passes through Infraorbital groove and canal in the Orbital floor

Will emerge on the Anterior face via the Infraorbital Foramen
Along its course what two nerves does the Infraorbital Nerve give off?
Middle Superior Alveolar
Anterior Superior Alveolar
Which nerve supplies GSA information regarding the Premolars and adjacent gingival tissue
Middle Superior Alveolar
Which nerve supplies GSA information for the Canines, and Incisior, Adjacent Gingival Tissue
Anterior Superior Alveolar Nerve
When the Infraorbital Nerve goes out onto the Anterior Face via the Infraorbital Foramen
What 3 branches does it terminate into and What structures do these branches innervate?
ALL GSA

Palpebral:Skin of Lower Eyelid

Nasal: Lateral Nose and Anterior Nasal Septum

Superior Labial:Skin of the Cheek, Upper Lip, and Labial Mucosa
T or F. The 2 communicating branches of the Pterygopalatine Ganglion are suspended from V2

-What type of information are these communicating branches carrying
True

Predominatly GSA Information to the Nasal and Oral Cavities
Can you name the branches of the Ptyergopalatine Ganglion (5)?
ALL ARE GSA!

Nasal Palatine Nerve

Medial and Lateral Posterior Superior Nasal Nerves

Greater and Lesser Palatine Nerves

Pharyngeal Nerve
Where do the GVE fibers of the Pterygopalatine Ganglion come into play?
Leave the Pterygopalatine Ganglion and Travel w/ the Zygomaticotemporal Nerve>> Lacrimal Nerve>>> Lacrimal Gland
The Pterygopalatine ganglion is a ____ ganglion so it recieves ______fibers.
Parasympathetic Ganglion
Preganglionic Parasympathetic Fibers
Where do the Cell bodies of the Preganglionic Parasympathetic fiber reside?
-How do they get to the PP Ganglion
Superior Salvatory Nucleus
-travel w/ CN VII
Prior to getting to the PP ganglion what meets the Preganglionic Parasympathetic Fibers in the Pterygoid Canal
Postganglionic Sympathetic Fibers (from the Superior Cervical Ganglion)
The Sympathetic and Parasympathetic Nerves of the PP canal are called what collectively?
Nerve of the Pterygoid Canal
-Greater Petrosal Nerve (Parasympathetic)
-Deep Petrosal Nerve (Sympathetic)
The Nasopalatine Nerve carries what type of fibers?
GSA, GVE, and SA
What foramen is associated w/ the Nasopalatine Nerve?
-What has it entered into after passing through this foramen
Sphenopalatine Foramen

Enters they Superior Nasal Cavity
-Desend in the Vomer
-Exit via the Incisive Canal in the Hard Palate
GSA information of the Nasopalatine Nerve is from what structures?
Post. Inferior Medial wall (Septum) of the Nasal Cavity

Anterior Hard Palate
GVE fibers of the Nasopalatine Nerves is from what structures?
Nasal and Palatine Glands
SA fibers of the Nasopalatine Nerves innervate what structures?
Taste to the Anterior Hard Palate
The Lateral Posterior Superior Nasal Nerves carries what type of fibers
GSA and GVE
What formamen is associated w/ the Lateral Posterior Superior Nasal Nerve?
Sphenopalatine Foramen
(Like Nasopalatine Foramen)

It then enters the Posterior Superior Nasal Cavity
The GSA fibers of the Lateral Posterior Superior Nasal Nerve innervates what structures?

-GVE?
Superior and Middle Conchae
(on the Lateral Posterior Superior wall of the Nasal Cavity)

GVE-Nasal Glands of the same area
The Medial Posterior Supeior Nasal Nerve has what fibers?
-What is its associated foramen?
GSA and GVE
-Sphenopalatine Foramen
The GSA fibers of the Medial Posterior Superior Nasal Nerve innervate what?

-GVE?
Medial Posterior Superior wall of the Nasal Septum

GVE-Nasal Glands of Medial Posterior Superior Area
What type of fibers are the Greater and Lesser Palatine Nerves?
-What are there associated foramina
GSA, GVE, and SA

Greater and Lesser Palatine Foramina
The Greater Palatine Formania carries ___ information from what structure?

What nerve does the greater palatine meet up w/ Anteriorly?

-GVE//SA fibers of the G. Palatine Nerve innervate what?
GSA; Hard Palate
Nasopalatine Nerve

GVE:Palatine Glands
SA:Taste to the Hard palate (like Nasopalatind Nerve)
What nerve comes off of the Greater Palatine Nerve after it goes through the Greater Palatine Foramen
Lateral Posterior INFERIOR Nasal Nerve

(GSA and GVE)
GSA: From the Lateral Posterior Inferior walls of the Nasal Cavity

GVE: Glands around that area
The Lesser Palatine Nerves have what type of fibers?
GSA,GVE, SA

GSA: Soft Palate, Uvula, and Tonsil

GVE: Glands of that area

SA: Taste from Soft Palate
Lastly,..The Pharyngeal Nerve has what type of fibers

What is its associated foramina?

Where is it going
GSA and GVE

Palatovaginal Canal>>>Nasopharynx

GSA: Mucosa of the Upper Pharynx

GVE: Glands of that area
SA fibers cell bodies in the __ ganglion and travel w/ CN __.

Which of the Nerves associated w/ V2 have taste (SA) fibers?
Facial; CN VII

Nasopalatine, Greater and Lesser Palatine Nerves
Summary:
All the nerves associated w/ the Pterygopalatine Ganglion are GSA and GVE

The only ones that have SA
are Nasopalatine, and the Greater and Lesser Palatine Nerve
What is unique about the Mandibular division of CNV
It is the ONLY division w/ a MOTOR ROOT (SVE)!
What is the foramen that V3 exits the cranium in?

Where are they after they exit this foramen?
Foramen Ovale>>> Infratempral Fossa
Once in the Infratemporal Fossa V3 gives off a ___ branch which will re-enter the cranial cavity via the ___.

What fibers are the Meningeal Branch carrying/
Meningeal Branch; Foramen Spinosum

GSA to the Dura of the Middle Cranial Fossa
After entering the Infratemporal fossa a 2nd branch is given off. It is quite small. What is it?

-What fibers does it carry
-What does it do?
Nerve to the Medial Pterygoid
-Soley SVE

Innervates the Medial Pterygoid, Tensor Tympani, and Tensor Veli Palatini
T or F. After giving off its first 2 branches V3 divides into an ANTERIOR AND POSTERIOR division

-How many branches of the Anterior and Posterior Divisions exsist
True

Anterior: 4 Branches

Posterior: 3 Branches
Name the 4 branches of the Anterior Division?
-What type of fibers do they carry?
GSA:Buccal Nerve

All the Rest are SVE:
Masseteric Nerve
Deep Temporal Nerve
Lateral Pterygoid Nerve
This branch of the Anterior division of the Mandibualar Nerve of CN V:

Desends between the two heads of the Lateral Pterygoid Muscle. Deep to the Mandible
Emerges Anterior to the Ramus of the Mandible and travels in the region of the Buccinator Muscle.

What structures does it innervate?
Buccal Nerve (GSA)
-Skin overlying the Anterior part of the Buccinator Muscle

-Buccal Mucosa

-Buccal Gingiva (next to the 2nd and 3rd Molars)
The 3 SVE Nerves of the Anterior Division:

Name the Nerve and its associated Structures/
Masseteric Nerve: Moves the Massenteric Muscle

Deep Temporal Nerve: Move the Temporalis Muscle

Lateral Pterygoid Muscle: Moves the Lateral Pterygoid Muscle
The Posterior Division V3 has 3 branches. Name them?
Auriculotemporal
Lingual Neve
Inferior Alveolar
The Auriculotemporal Nerve has what type of fibers?
GSA and GVE
The Auriculotemporal Nerve emerges in the ____ by 2 roots that encircle the ____ artery
Infratemporal Fossa
Middle Menigeal Artery
What doe the Auriculotemporal Nerve pass between?

Where does it emerge?

What does it asend w/
Lateral Pterygoid Muscle and emerges behind the TMJ

Asends w/ the Superfical Temproral Artery and Vein
(Vein to the Parotid and Temporal Regions)
The GSA fibers of the Auriculotemporal Nerve innervate what
Skin of the Temporal Region
Anterior Auricle
External Acoustic Meatus
The GVE fibers of the Auriculotemporal Nerve are ____ fibers from ____.
Parasympathetic Fibers
(GVE) from the Lesser Petrosal branch of CN IX (Glossalpharyngeal)via the Otic Ganglion

They travel w/ the Auriculotemproal Nerve and provide Secretomotor Innervation to the Parotid Gland
The Lingual Nerve is the 2nd branch of V3 in the Posterior Division.

What fibers does it carry?
GSA, SVE, and SVA

GSA: from the Ant 2/3 of the tongue, floor of oral cavity, lingual gingival tissue

Recieves the Chordae Tympani (cm from the Foramen Ovale)
-These are Preganglionic Parasympathetic GVE fibers from CN VII and SA fibers

GVE fibers:Sublingual and Submandibular Salivary Glands
(Preganglionic parasympathetic fibers synapse in the Submandibular Ganglion which is suspended from the lingual nerve by rootlets

SA fibers: Taste to anter 2/3 of the tongue
What does the Lingual nerve pass between?
Between the Tensor Veli Palatini and Lateral Pterygoid Muscle

Below the Lateral Pterygoid

Between the Medial Pterygoid and Ramus of the Mandible, Inferior Alveolar Nerve
Where does the Lingual Nerve Lie
Medial Surface of the Mandible near the 3rd Molar

Covered by MUCOSA ONLY
-passes to the LATERAL TOUNGE
What type of fibers do the Inferior Alveolar Nerve have?
GSA and SVE

GSA:Mandibular teeth and adjacent gingival tissue
The inferior alveolar nerve runs ____ to the Lingual Nerve and passes between the ____ and the ramus of the mandible. Enters the Mandibular canal via the ___ foramen
Posterior
Sphenomandibular Ligament
Mandibular Foramen
What nerve emerges from the Mental Foramen
Mental Nerve
-Supplies the Skin of chin, lower lip,labial mucosa and labial gingival tissue
The inferior alveolar nerve gives a branch off before it enters the Mandibular foramen,..what is it called
Nerve to Mylohyoid
-Motor Innervation to the Mylohyoid Muscle and the Anterior Belly of the Diagastric
When you give an Inferior Alveolar Block via the ___ foramen what will be numb?
Mandibular Foramen
-Mandible on Ispilateral Side
-Mental Nerve (skin of the chin, labial mucosa and labial gingival tissue
How does one numb the Superior Alvolar Nerves (Anterior, Middle and Posterior)
Via the Terminal Branches
(injection is given to tissues surrounding the root of the tooth)
If you give an extraction you must be careful b/c this nerve is very close to the 3rd molar
Lingual Nerve
What can happen if you mess up CNV
Paralysis of Muscles of Mastication and Mandible w/ deviate toward the side of the Lesion

Will not be able to have GSA to face

Loss of Corneal Blink Reflex
-stimulus: touch cornea
-response: blink

Loss of Sneeze Reflex
stimulus: Irritant in Nasal cavity
response: Sneeze
Triangles of the NECK
Triangles of the NECK
Triangles of the NECK
SCM divides the neck into __ and ___ triangles
Anterior and Posterior
What are the Boundaries of the Posterior Triangle
SCM, Trapezius, and Clavicle (medial 1/3)
What is in the Posterior Triangle
External Jugular Vein
Cervical and Brachial Plexus
Transverse Cervical Artery
Cervical Lymph Nodes
Subclavian Artery and Vein
Suprascapular Artery
Suprascapular Lymph Nodes
Which of the two things in the posterior triangle are from the thyrocervical trunk
Suprascapular Artery and Transvers Cervical
Anterior Triangle is Subdivided into 4 other triangles.

Name them?
Submandibular
Submental
Carotid
Muscular

Submental is not paired
The Muscular Triangles borders?

What are the contents of the Muscular Triangle
Superior Omohyoid
SCM
Midline of Neck

Contents:
Sternothyroid
Sternohyoid
Thyroid and Parathyroid Gland
What are the borders of the Anterior Triangle (not subdivided)
Anterior border of the SCM
Inferior border of the Mandible
Midline of the Neck
The Carotid Triangle Boundaries?

What are the contents of this triangle
SCM
Superior Omohyoid
Posterior Diagastric

Carotid Sheath (Int Jugular, CC, Vagus Nerve)
External Carotid Artery
Hypoglossal Nerve and Accessory Nerves
Ansa Cervicalis
Thyroid Gland
Larynx and Pharynx
Deep Cervical Lymph Nodes
Submandibular Triangles border and contents
Anterior and Posterior Digastric and Inferior Border of the Mandibule

Contents:

Submandibular Gland and Lymph Nodes
CN 12
Mylohyoid Nerve
Facial Artery and Vein
Submental Triangle Borders and Contents?
Right and Left Anterior Diagastric and Hyoid Bone

Submental Lymph Nodes and Veins
Which triangle is important clinically in taking someone's pulse
Carotid
-Post Digastric
-Superior Omohyoid
-SCM
Palpate Lymph Nodes
Deep Cervical and Submandibular Nodes
-Can detect cancer
What is the Origin and Insertion of the Trapezius Muscle

Funtion?
O-External Occipital Protruberance and Cervical and Thoracic SPINOUS Process

I- Spin, Scapula (Acromium) and Clavicle

Function: Elevate Depress and Rotate the Scapula
What CN innervates this muscles
Accessory (CNIX)
What nerve innervates the SCM

What is the Orgin and Insertion of the SCM
Accessory (CNIX)

O-Mastoid Process of Skull

I-Sterum and Clavical

Function:

Uni- turns chin superior laterally

Bi- flex neck muscles
Scales Orgin an Insertion?

-Function?
-Anterior Function?
O-TRANSVERSE Process of Cervical Vetebrae

I-1st and 2nd Ribs

Function: Lateral Flexion of the Neck Muscles

Ant Funct: Elevates 1st ribs
What nerve passes ontop of the Anterior Scalene
Phrenic
What passes between the Anterior and Middle Scalene
Brachial Plexus and Subclavian Artery

If scalenes get tight you will get Throacic Outward Syndrome
Scalene Muscles are known as muscle of ___ and acessory muscles of ___
Expiration
Inspiration
What are the Infrahyoid Muscles

Where does there innervation come from?
Omohyoid
Sternothyroid
Sternohyoid
Thyrohyoid

All get there innervation from the Ansa Cervicalis (C1-C3) except for Thyrohyoid which is oly innervated by C1
Whats another name for the Infrahyoid Muscles

What is there purpose
Strap Muscles

Depress the Hyoid and larynx during swallowing
What are the Suprahyoid Muscles
Mylohyoid
Geniohyoid
Stylohyoid
Digastric
CRANIAL NERVE VII
CRANIAL NERVE VII
CRANIAL NERVE VII
What is Cranial Nerve VII
Facial Nerve
Where does CN VII Orginate
Vental Side of the Brain between the Pons and the Medulla
What are the 4 Associated Nuclei w/ CN VII
Motor Nucleus of Facial Nerve
-SVE fibers for the Muscles of Facial Expression

Superior Salivatory Nucleus (GVE)
-Preganglionic Parasympathetic for the Lacrimal,Submandibular, and Lingual Glands)

Nuclei of the Solitary Tract
-SVA (taste)

Spinal Nucleus of Trigeminal
-GSA
The Motor Nucleus of Facial Nerve has what type of fibers?
SVE that innervate the muscles of facial expression
The Superior Salivatory Nucleus has what type of fibers?
Preganglionic Parasympathetic
Fibers (GVE)
The Nuclei of the Solitary Tract
-What CN are associated w/ this nuclei
CN 7, CN 9, CN 10
(Taste to the Tongue)

7- anterior 2/3, soft palate

9-Post 1/3

10- Epiglottis
What type of fibers does the Spinal Nucleus of the Trigeminal have?
GSA fibers
What is the difference between a ganglion and a nucleus
Ganglion: Cell bodies Outside of the CNS

Nucleus: Cell bodies w/ in CNS
What are types of fibers are carried by the facial nerve
(Cranial Nerve Modalities)
GSA (Trigeminal)
SVA (Solitary)
GVE (Salvitory + Glands)
SVE(Motor + Facial Nerve)
Taste is by itself
GiVE "SYM"pathy and "Pa" on the back
SteVE is Mobile
SVE fibers innervate what type of muscles?
-Where are they derived from embryologically?

Just for kicks what are the fibers that innervate the same thing but are not brachial/pharyngeal arch derivatives?
Striated Muscles of the 2nd Brachial Arch

GSE
The GVE fibers of CNVII do what?
These are aka ___
Supply MOTOR to the Submandibular, Sublingual, and Lacrimal

Nervous Intermedius
-b/c this emerges between the motor root and the vestibular cholcher
Which fibers run is close association w/ the GVE fibers?
GVA
What do the GSA fibers associated w/ ____ nucleus innervate.
Small patch of skin on the surface of the ear
The SVA fibers associated w/ ___ nucleus innervate what?
Solitary
Taste to the anterior 2/3 of the tongue and the Soft Palate
What part of the brain does the Facial Nerve enter the skull
-What is travelling w/ it?
Internal Acoustin Meatus
-CN 7
-Vestibularchochlear Nerve
-Labrinthyne Artery
After it goes through the Internal Acoustic Meatus then where does it go/
Facial Canal>> Petrous Portion of the Temporal Bone>> Stylomastiod Foramen
What is the importance of the Labrinthyne Artery
Comes off Basillar Artery and supplies the inner ear
How many ganglion are associated w/ CN VII
-What is the only resident ganglion?

-What are the others and there relations to the facial nerve
3
-Geniculate (only resident)
-Ptyergopalatine (V2)
-Submandibular (V3)
The facial nerve is associated w/ what 3 things
All of the branches of the trigeminal (3)

2 ganglions that are residents of the trigeminal

CN 10
-GSA
Name the important bony landmarks of the facial nerve?
(7)
Petrous Portion of Temporal Bone
-Internal Acoustic Meatus
-Greater Hiatus
-Facial Canal
-Stylomastoid Foramen
-Posterior Canaliculi
-Anterior Caniliculi
-Tymapanic Fissure
Name the 4 Branches of the Facial Nerve
Greater Petrosal-Greater Hiatus

N to Stapedius-

Chordae Tympani-Petrous Tympanic Fissure

Facial Nerve 9 other branches out of the Stylomastoid Foramen
What CN innervates the Parotid
What is the associated ganglion
CN 9
Otic Ganglion
What muscles of facial expression does the Temporal Nerve Innervate
Frontalis
Orbicularis Oculi

Note It is not the temporalis!
What muscles of facial expression does the Zygomatic Nerve Innervate
Zygomaticus Major and Minor
Levator Labii Superioris
Nasalis
Buccal Nerve innervates what muscles of facial expression
Buccinator
Orbicularis Oris
Depressor Anguli Oris
Depressor Labii Inferioris
What muscles does the Mandibular Nerve innervate?
Menalis
Depressor Anguli ORIS
Depressor Labii Inferioris
What nerve innervates the Platysma
Cervical
What muscles of facial expression are innervated by 2 nerves of CN 7
Depressor Angli Oris
Depressor Labii Inferioris

-Buccal
-Mandibular
Give some clinical signs of Bell's Palsy

What CN is this associated w/
Droop on one side of the face
-due to Paralysis on 1 side of the face
-Damage to Stylomastoid Foramen

Facial Nerve (CN VII)
Oral Region Anatomy
Oral Region Antomy
Oral Region Anatomy

Surface Antomy: Define
-Philtrum
-Nasolabial Sulcus
-Tubercle of Superior Lip
-Mental Protruberence
-Commisure of Lips
-Labimental Groove
P- depression between your upper lip and nose

NLS- depression from your nose to your lip

TSL-Mid Line of the Upper Lip

MP- Outer most portion of the chin

CL-Angle where the lips come together

LMG-Groove between lower lip and the chin
Lips
-Are they muscles of facial expression

-What two structures apply to the lips
YES

Transition Zone and Vermillion Border (has no sweat of oil glands)
Surgeons use this structure on the surface of the oral cavity as a landmark
Philtrum
What CN innervates the Lips
CN VII
Buccal Branch- Obicularis Oris
Buccinator, Depressor Angli Oris, Depressor Labii Inferioris
Cheecks:
What CN innervates the Cheeks
CN VII
Buccal Branch
What structure is superfical to the buccinator?
-Describe it?
Buccal Fat Pad
-Has a vascualar and Arterial Plexus
-Petrudes into Oral Cavity if herniated
-Functions in stabilizes the teeth during suckling in children
-Stablized by ligaments
Oral Mucosa:

When the mucous membrane of the lip reflects on the alveolar bone it its called ___ . The actual reflection is termed what?

Anteriorly to Posterior this fold changes names, what are its other names?
Alveolar Mucosa
Vestibular Fold

Mucolabial Anteriorly

Mucobuccal Posteriorly
High elastic content of the oral mucosa decrease as you approach what?
Teeth
As the Alveolar Mucosa approaches the teeth it changes __ and ___ and becomes what?
Color and Texture

Attatched Gingiva
Oral Cavity Proper has two components. What are they?
Vestible-space between teeth and mucosal lining of the lips
-Smaller


Oral Cavity Proper- space between the upper and lower dental arches
-Buccinator Functions to keep bolus of food in between teeth
Palate forms what
Roof of the Oral Cavity Proper
and the floor of the Nasal Cavity
What bones contribute to the Palate
Palatine Bones and Part of Maxilla-Palatine Process
What are the two parts of the palate
Hard and Soft
Where is the Palatine Tonsil Located
Between the Palatoglossus and the Palatopharyngeus
What is the Palatine Tonsil
Lymphoid Tissue covered by Mucous Membrane
What is the Blood Supply of the Palatine Tonsil
Tonsillar Branch of the Facial ARTERY
What are the Nerves of the Palatine Tonsil
CN 9 (Glossalpharyngeal)

Lesser Palatine (V2)
Tongue
What are the functions of the tongue
Mastication
Taste
Deglutination
Articulation
Oral Cleansing
What are the two division of muscles that the tongue has?
Intrinsic and Extrinsic
What is the Sulcus Terminalis of the Tongue
V-shaped groove that divides the ANTERIOR 2/3 of the tongue from the POSTERIOR 1/3
Where are the Circumvallete Papillae
Behind the Sulcus Terminalis
-Large Projections

HAVE TASTE BUDS!
Filiform and Fungiform Papillae are where?
On anterior aspect of the tongue
-FUNGIFORM has taste buds and are BIGGER than Filiform
Name the Extrisic Muscles of the Tongue (4)

-Which of these 4 muscle is also a muscle of the soft palate?
Genioglossus
Hypoglossus
Styloglossus
Palatoglossus

-Palatoglossus is also a muscle of the SOFT PALATE
What is the function of the Genioglossus

-Innervation
Depress and Protrudes the Tongue

Hypoglossal
What is the function of the Hyoglossus

-Innervation
Depresses and RETRACTS

Hypoglossal
What is the function of the Styloglossus

-Innervation
RETRACT the Tongue

Hypoglossal
What is the function of the Palatoglossus

-Innervation
Elevates the POSTERIOR part of the Tongue

Pharyngeal Plexus (CN 10, CN11)
What is the Lingual Frenulum
Attaches tongue to the floor of the mouth
Where is the Sublingual gland
Under Sublingual Fold
The submandibular duct is bilateral and is on both sides of what structure
Frenulum
Fimbriated Fold is related to what?
Landmark related to early embryological development
What makes a muscle of the tongue Extrinsic or Intrinsic
Extrinsic-begin outside and will insert on the tongue
-Control Mov't

Intrinsic-begin and end inside of the tongue
-Control Shape
What are the Intrisic Muscles of the Tongue?
Superior Longitudinal
Inferior Longitudinal
Transverse
Vertical
Which of the intrinsic muscle is associated w/ shortening the tounge

Narrow?

Flatten?
Shorten:Longitudinal

Narrow:Transverse

Flatten: Vertical
If I was like 5 and wanted to stick my tongue at someone,...what muscle would I be using?
Genioglossus
-Protrudes the Tongue
(Inferior and Middle Fibers)
Now if I wanted to take my tongue back in b/c i saw a teacher coming,..what muscles would I use?
Hyoglossus
Styloglossus
Genioglossus (superior fiber)
Now I'm at the doctor b/c I got SICK so when the doctor puts the Wooden stick in my mouth and checks out my throat the depression of my tongue is due to what muscles
Genioglossus
Hyoglossus
If I want to Elevate the tongue what muscles would I use?
Styloglossus will help from the palatoglossus muscles
What is the Major Artery of the Tongue

What are its branches
Lingual

-Dorsal:Posterior
-Deep:Anterior
-Sublingual:Sublingual Gland
What are the divisions of the Lingual Nerve
Sensory for the Anterior 2/3 of the tongue
What are the branches of the lingual veins
Dorsal
Deep
Sublingual

Go to Int. Jugular
Hypoglossal Nerve gives what to the intrinsic and extrinsic muscles of the tongue
Innervation
Name all the structures in the floor of the mouth
Lingual Artery
Lingual Nerve
Hypoglossal
Lingual Veins
The Lingual Nerve has what ganglion on it
Submandibular Ganglion
What is the relationship between the Submandibular duct and the Lingual Nerve
Submandibular Duct goes under the Lingual
What supplies the GSA (sensory) information to the ANTERIOR 2/3 of the Tongue
LINGUAL