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Reso Dental Anatomy

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Reso these are notes on dental anatomy
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Reso
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Head and Neck

Anatomy
Contents:

� Introduction to Nervous system

� Cranial nerves
� Other nerves
� ArterioVenous Circulation in Head & Neck
� Muscles
� Bones
� Foramen
� Glands

Introduction to Nervous system

Nervous System Components:

Central Nervous system - Brain and Spinal cord.

Peripheral Nervous system.
Autonomic nervous system - Sympathetic and Parasympathetic

Cranial Nervous system:

� Number: 12 pairs of cranial nerves
� Origin from: Brain
� Innervation to : supply head and neck

Functions:
o Motor - to muscles of head and neck
o Sensory - collect sensations from head and neck to brain
Special senses- vision, smell, hearing, taste
General senses- touch, pain, pressure, vibration, proprioception
� Other functions: Carry parasympathetic fibres to glands - stimulate secretions
Also carries sympathetic fibres.
 Cranial nerves, their functions and associated
symptomology

Classification of Cranial nerves

o Sensory � I, II, VIII

o Motor -- III, IV, VI, XI, XII
o Mixed -- V, VII, IX, X

*Tip to remember: nose, eye, ear are sensory organs so I, II, VIII are sensory
V, VII, IX, X are mixed, rest are motor nerves

C Name TYP FUNCTION SYMPTO

N E MS
 entries/ exits of
the CN

I OLFACTORY SEN SMELL- from

Cribriform SOR nasal epithelium .
plate Y Anosmia

II OPTIC SEN VISION-from

Optic SOR retina � Loss
canal Y of light
reflex
� Visual
field
defects

II OCULOMOTOR MUSCLES OF � Diplop

I Superior MOT EYE BALL ia
orbital OR � Superior (external
fissure rectus squint)
� Inferior � Loss
rectus of
� Medial moveme
rectus most nt of the
important eyeball
function(move internally
ment of eyeball -
internally) therefore
� Inferior the
oblique eyeball
 � Eyelid remains
(levator outwardl
palpebrae y)
superioris) � Copyi
ng eye
downwar
d,
outward
� Ptosis

I TROCHLEAR MUSCLES OF
V Superior MOT EYE BALL � Weak
orbital OR � Superior ness
fissure oblique looking
down
� Troubl
e
going do
wnstair
s

V TRIGEMINAL V1- general

� V1- MIX sensation- V1: loss
OPHTHALMIC ED touch, pain & of
(general temperature sensation
sensory) from forehead, on scalp,
Superior scalp, cornea forehead
V2- general and
orbital sensation from cornea-
fissure � palate, nasal loss of
� V2- cavity, maxillary blink
MAXILLARY(g face, maxillary reflex/cor
eneral sensory) teeth neal
Foramen V3 - general reflex
rotundum sensation from
anterior 2/3rd of
� V3-
tongue, V2: loss
MANDIBULAR
mandibular face, of
(general
mandibular sensation
sensory &
teeth on skin
motor)
only sensory over
Foramen maxilla,
nerves of
ovale maxillary
V3: BAIL
B-Buccal teeth
A-Auriculo-
temporal V3: loss
I-Inferior of
alveolar sensation
L-Lingual over
Motor supply- mandible
V3 �to 4 ,
muscles of mandibul
mastication ar teeth,
(temporalis, tongue
masseter,
medial
pterygoid,
lateral
 pterygoid)
Anterior belly of
digastric,
mylohyoid,
tensor tympani,
tensor palati

� Jaw
deviation
towards
one side
� Weak
ness in
chewing
Note:
trigemina
l
neuralgia
due to
intractabl
e pain in
V2 and
V3

V ABDUCENS MUSCLES OF Diplopia

I Superior MOT EYEBALL (Internal
orbital OR � Lateral rectus squint)
fissure (function is Lateral
movement of gaze is
the eye ball lost -
laterally/outside Patient is
) unable to
move the
eye ball
outside
while
reversing
the car

V FACIAL SPECIAL Alteratio

II Enters MIX SENSORY:ante n in the
internal ED rior 2/3 of taste
auditory tongue, palate Pain
meatus and GENERAL behind
leaves via SENSORY : fro the ear
stylomastoi m skin behind Cannot
d foramen the ear close
MOTOR: TO eye,
MUSCLES OF cannot
FACIAL wrinkle
EXPRESSION forehead,
� Posterior loss of
belly of blink/cor
digastric, neal
stylohyoid, reflex,
 � Nerve to corner of
stapedius in the
middle ear mouth
OTHER: drops
carries Hyperacu
parasympathe sis
tic fibres to (inability
stimulate to bear
salivation to: loud
� Submandibul noise)
ar gland Eye dry
(Pterygopalatine and red
ganglion) BELL'S
� Sublingual PALSY
gland
(Submandibular
ganglion)
Carries
parasympathe
tic fibres to
stimulate
tears to
� Lacrimal
gland

V VESTIBULOCOC SEN HEARING Hearing

II HLEAR SOR loss
I Internal Y Loss of
balance
 acoustic
meatus

I GLOSSOPHARY SPECIAL Loss of

X NGEAL MIX SENSORY:post GAG
Jugular ED erior 1/3rd of the reflex
foramen tongue
GENERAL
SENSORY:post
erior 1/3rd of the
tongue, oro-
pharyngeal
sensation
MOTOR:Stylop
haryngeus only
OTHER:
carries
parasymp
fibres to
stimulate
salivation
to: parotid
gland

X VAGUS GENERAL SEN Loss of

� Superior MIX SORY:larynx GAG
laryngeal nerve ED and laryngo- reflex
� Pharyngeal pharynx, all and
 branches to sensations from Cough
pharyngeal upper reflex
plexus gastrointestinal � Uvula
� Recurrent tract (GIT) pointing
laryngeal nerve MOTOR: To away
(intrinsic muscles of from the
muscles of swallowing(pal affected
larynx except ate & pharynx) sides,
crycothyroid) � All muscles of palate
Jugular palate except t drooped.
foramen ensor palati (V) � Food
� All muscles of regurgita
pharynx except tion
stylopharyngeus � Hoars
(IX) eness of
� All muscles of voice
larynx
OTHER: : carrie
s
parasympathetic
fibres to
stimulate secreti
ons in upper
GIT

X ACCESSORY Weaknes
I Jugular MOT � Sternocleido s turning
foramen OR mastoid muscle chin to
- head rotation the oppo
 � Trapezius - site side
shrugging of Shoulder
shoulder drop

X HYPOGLOSSAL To TONGUE Tongue

II Hypoglossa MOT MUSCLES points
l foramen OR � All intrinsic toward
tongue muscles the same
� Extrinsic side of
tongue muscles: the
Styloglossus lesion
Hyoglossus
Genioglossus
Geniohyoid
Thyrohyoid
Except palatogl
ossus (X)

12 CRANIAL NERVES
1. Olfactory
This is a type of sensory nerve that contributes in the sense of smell in
a human being. These basically provide the specific cells that are termed
as olfactory epithelium. It carries the information from nasal epithelium
to the olfactory center in the brain.
2. Optic Nerve
This again is a type of sensory nerve that transforms information about
vision to the brain. To be specific this supplies information to the retina
in the form of ganglion cells.

3. Oculomoter nerve
This is a form of motor nerve that supplies to different centres along
the midbrain. Its functions include superiorly uplifting eyelid, superiorly
rotating eyeball, construction of the pupil on exposure to light and
operating several eye muscles.
4. Trochlear
This motor nerve also supplies to the midbrain and performs the
function of handling the eye muscles and turning the eye.
5. Trigeminal
This is the largest cranial nerve of all and performs many sensory
functions related to the nose, eyes, tongue and teeth. It is basically
further divided in three branches that are the ophthalmic, maxillary and
mandibular nerve. This is a type of mixed nerve that performs sensory
and motor functions in the brain.
6. Abducent
This is again a type of motor nerve that supplies the pons and performs
the function of turning the eye laterally.
7. Facial
This motor nerve is responsible for different types of facial expressions.
This also performs some functions of sensory nerve by supplying
information about touch on the face and senses of tongue in mouth. It is
basically present over the brain stem.
8. Vestibulocochlear
This motor nerve is basically functional in providing information related
to balance of the head and sense of sound or hearing. It carries
vestibular as well as cochlear information to the brain and is placed near
inner ear.
9. Glossopharyngeal
This is a sensory nerve which carries sensory information from pharynx
(initial portion of throat) and some portion of tongue and palate. The
information sent is about temperature, pressure and other related facts.
It also covers some portion of taste buds and salivary glands. The nerve
also carries some motor functions such as helping in swallowing food.

10. Vagus
This is also a type of mixed nerve that carries both motor and sensory
functions. This basically deals with the area of pharynx, larynx,
esophagus, trachea, bronchi, some portion of heart and palate. It works
by constricting muscles of the above areas. In sensory part, it
contributes in the tasting ability of the human.

11. Spinal accessory nerve

This motor nerve supplies information about spinal cord, trapezius and
other surrounding muscles. It also provides muscle movement of the
shoulders and surrounding neck.
12. Hypoglossal nerve
This is a typical motor nerve that deals with the muscles of tongue.
These are the 12 cranial nerves that carry many important functions in
body

NOTES: LOSS OF SENSATION ON THE SKIN OVER PAROTID IS DUE TO C2 AND

C3 ROOTS.

TRIGEMINAL NERVE (5th cranial nerve):

responsible for sensation in the face and motor functions such as biting and
chewing.

each trigeminal nerve (one on each side of the pons) has three major branches:
the ophthalmic nerve (V1), the maxillary nerve (V2), and the mandibular nerve
(V3).

the ophthalmic and maxillary nerves are purely sensory, and the mandibular
nerve has cutaneous and motor functions.

Sensory supply Motor supply parasympathetic

ophthalmic (V1) *Forehead and Lacrimal gland:

scalp Post ganglionic
fibres from the
*frontal and pterygopalatine
 ethmoidal sinus ganglion (derived
from the facial
*upper eyelid and nerve), travel
its conjunctiva the zygomatic
branch of V2 and
*cornea then join the
lacrimal branch of
*dorsum of the V1. The fibres
nose. supply
parasympathetic
innervation to the
lacrimal gland.

maxillary (V2) *lower eyelid and Gives fibers to

its conjunctiva lacrimal gland.

*cheeks and Nasal glands

maxillary sinus Parasympathetic
fibres are also
*nasal cavity and carried to the
lateral nose. mucous glands of
the nasal mucosa.
*upper lip Post-ganglionic
fibres travel with
 *upper the nasopalatine
molar,incisor and and greater palatine
canine teeth and nerves (branches of
associated gingiva. V2)

*superior palate.

mandibular (V3) *mucous membrane * Muscles of *Submandibular

and floor of oral mastication; medial and Sublingual
cavity pterygoid, lateral glands:
pterygoid, masseter, ganglionic fibres
*external ear from the
temporalis
*lower lip submandibular
*Anterior belly of ganglion (derived
*chin the digastric muscle from the facial
(part of nerve), travel with
*Anterior 2/3 of the suprahyoid the lingual nerve
the tongue (only muscles to innervate these
general sensation; glands.
*Tensor veli
special taste
palatine. *
sensation supplied
by the chorda gland:
*Tensor tympani
tympani, a branch ganglionic fibres
 of the facial from the otic
nerve. ganglion (derived
from the
*Lower molar, glossopharyngeal
incisor and canine nerve, CN IX),
teeth and the travel with the
associated gingiva auricotemporal
branch of the V3
to innervate the
parotid gland.

Ophthalmic nerve (V1): *divides into three branches:

frontal, lacrimal and nasociliary.
Frontal Forehead and scalp.

Upper eyelid and its

conjunctiva
Lacrimal Lacrimal gland

Nasociliary Dorsum of the nose.

Frontal and ethmoidal sinus

Maxillary nerve (V2):

Principal functions of sensation from the maxillary, nasal cavity,

sinuses, the palate and subsequently that of the mid-face

Maxillary nerve branches and innervation:

BRANCH STRUCTURES
INNERVATED

Superior upper incisors and canine &

Anterior labial gingiva of these teeth
Alveolar nerve
 Superior Middle premolars, middle half of 1st
Alveolar nerve molar & buccal gingiva of these
teeth

Superior distal half of first molar and rest

Posterior of molars & buccal gingiva of
Alveolar nerve these teeth

Greater palatine palatal gingiva of molars &

nerve premolars

Sphenopalatine palatal gingiva of incisors &

or nasopalatine canines
nerve

It is made up of two roots:

a large sensory root proceeding from the inferior angle of the trigeminal ganglion.
a small motor root (the motor part of the trigeminal), which passes beneath the
ganglion, and unites with the sensory root, just after its exit through the foramen
Ovale.

The mandibular nerve gives off the following branches:

)

BRANCH STRUCTURES
INNERVATED

Inferior Dental nerve lower teeth and their

(ID nerve) buccal mucosa

Mental nerve In the area of the

premolars the ID nerve
gives off the mental nerve

which passes through

the mental foramen and
supplies the lower lip,

chin and buccal mucosa of

lower incisors

Lingual nerve half the tongue, lingual

gingiva of all lower teeth
 and sublingual tissues

Long buccal nerve Supplies the buccal

gingiva of lower molars
and the cheek

Auriculotemporal nerve Part of the ear and skin

over the ear

From the main trunk of the nerve (before the division)

muscular branches, which are efferent nerves for the medial pterygoid, tensor
tympani, and tensor veli palatini muscles (motor)[2]
meningeal branch (a sensory nerve)

From the anterior division

masseteric nerve (motor)

deep temporal nerve anterior and posterior (motor)
buccal nerve (a sensory nerve)
lateral pterygoid nerve (motor)

From the posterior division

auriculotemporal (a sensory nerve)
lingual nerve (a sensory nerve)
inferior alveolar (a motor nerve and a sensory nerve)

Summary of sensory, motor and secretory supply of certain head

regions:

Region SENSORY NERVE MOTOR NERVES

Upper Lip Superior Labial fibers of infra Buccal branches of VII
orbital nerve of V2. nerve
Corner of Mouth Superior Labial fibers of infra Buccal and mandibular
Oral nerve of V2 branches of VII nerve

Inferior Labial fibers of Mental

nerve of V3
Lower Lip Inferior Labial fibers of Mental Mandibular branch of VII
Nerve
Cheek Buccal nerve V3 Buccal branches of VII
Teeth: Posterior superior alveolar
Maxillary nerve of V2 to 6, 7, 8.
 Middle superior alveolar nerve
of V2 to 4, 5 and mesiobuccal
root of 6.
Anterior superior alveolar nerve
of V2 to 1, 2, 3.

Mandibular
Inferior alveolar nerve of V3 to
1, 2, 3, 4, 5, 6, 7, 8.
Gingivae:Maxillary Lateral side
Posterior superior alveolar
nerve of V2 .
Superior labial nerve of
infraOrbital nerve of V2
Palatal side
Greater palatine of V2.
Nasopalatine of V2.

Mandibular Lateral side

Long nerve of V3, Mental Nerve
of V3.
Lingual side
Lingual nerve of V3.
SECRETORY INNERV.
Mucus membrane Anterior, middle, posterior Mucus glands via
of Maxillary Sinus superior alveolar branches of V2. Sphenopalatine ganglion.
Greater superficial
Petrosal Nerve of VII.
cutaneous innervation of the face and scalp.
v