Anatomy Exam 5, CH 32, 33, 35
How many branches are there in the Maxillary artery?
15 Branches
How many branches are there in the Maxillary Artery? How many of them are actually discussed in the textbook?
15 Branches; apparently 12 but I can't count because I only have an associates degree
What are the Temporal branches and what do they supply?
2 Temporal branches arises from the Maxillary artery; suppling the Temporal muscle; Anterior Deep Temporal Arteries Posterior Deep Temporal Arteries
What does the Upper Deep Cervical nodes drain?
3rd molar areas Base of the tongue Tonsillar area Soft palate Posterior nasal cavity
How many branches does the Pterygopalatine Fossa Branches divide into?
5 Branches, and divides in different directions from the Pterygopalatine Fossa Backward to the nasal pharynx Down to the palate Medially into the nasal cavity and eventually to the anterior palatal area Laterally to the Maxillary Tuberosity Forward into the infraorbital area of the face
A pressure point for facial bleeding is found on the lower border of the mandible. This is the point where the facial artery and the facial vein cross the mandible and enters gang territory aka the wrong hood. A. Both statements are true B. Both statements are false C. The first statement is true; the second is false D. The first statement is false; the second is true
A. Both statements are true
Which of the following describes "Anastomosis"? A. Communication of blood vessels with another connecting blood vessel/channel B. Foreign material within the blood vessel C. A large network of blood vessels within the head and neck region D. Clot that forms on the inner blood vessel walls
A. Communication of blood vessels with another connecting blood vessel/channel
Which of the following arteries supplies the oral mucosa and glands of BOTH the hard and soft palates? A. Greater and Lesser Palatine Arteries B. Posterior Superior Alveolar Artery C. Anterior Superior Alveolar Artery D. Inferior Alveolar Artery
A. Greater and Lesser Palatine Arteries
What is the term when a blood vessel lesion occurs within a blood vessel and blood escapes into the surrounding tissue(s) without clotting? A. Hematoma B. Thrombus C. Bacteremia D. Hemorrhage
A. Hematoma
A new patient, a 65-year-old man, comes into the office with a medical history that indicates 40 years of heavy pipe smoking. The intraoral examination evidences a small white lesion in the foliate papillary area of the tongue. A biopsy determines that the lesion is oral cancer. Which are the tertiary nodes of invasion? A. Lower Cervical Nodes B. Upper Cervical Nodes C. Submental Nodes D. Submandibular Nodes
A. Lower Cervical Nodes
Which of the following arteries arises from the Inferior Alveolar Artery before the artery enters the mandibular canal? A. Mylohyoid Artery B. Incisive Artery C. Mental Artery D. Posterior Superior Alveolar Artery E. Submental Artery
A. Mylohyoid Artery
The ______ gland is located lateral, posterior, and medial to the ramus. A. Parotid B. Submandibular C. Sublingual D. Lingual
A. Parotid
The _____ artery supplies blood to the Maxillary molars. A. Posterior Superior Alveolar B. Pterygopalatine C. Maxillary D. Infraorbital
A. Posterior Superior Alveolar
Which of the following is NOT a branch of the Maxillary artery? A. Pterygoid B. Buccal branch of the maxilary artery C. Deep temportal artery D. Masseteric artery E. They are all bracnhes of the Maxillary artery
A. Pterygoid
Oral cancer in which of the theese sites would tend to have the highest mortality rate? A. Root of the Tongue B. Hard Palate C. Midline of the Mandibular Lip D. Floor of the Mouth
A. Root of the Tongue
The submandibular gland is also called the _____ gland. A. Submaxillary B. Mandibular C. Sublingual D. Lingual
A. Submaxillary
Which of the following arteries is a branch from the facial artery? A. Superior Labial B. Ascending Pharyngeal C. Posterior Auricular D. Transverse Facial
A. Superior Labial
About at what level does the Common Carotid Artery divides?
About the level of the larynx
What are the general role(s) for Lymph Nodes?
Acts as a filter of fluids; the lymphocytes produced fights infections that may spread through lymphatic channels
What is the function of Lymph Nodes?
Acts as filters for the fluids Produces lymphocytes to combat infections that may spread through lymphatic channels
If a hematoma occurs when attempting to block the Posterior Superior Alveolar Nerve what should you do to alleviate it?
After the initial use of cold packs, apply moist heat to dissipate the swelling and discoloration
What does the Posterior Superior Alveolar Artery supply?
All Maxillary Posterior teeth, part of the Maxillary Sinus, and some branches also supply the posterior buccal mucosa of the upper posterior teeth
What does the Submandibular nodes drain specifically?
All of the Maxillary Teeth (Except 3rd Molars) Maxillary Sinus Mandibular Canines All of the Mandibular Teeth (May or may not drain the 3rd molars) Floor of the mouth Most of the tongue Cheek area Hard Palate Anterior Nasal Cavity
The Lingual gland are divided into several groups, name them
Anterior Lingual Posterior Lingual Lingual glands of von Ebner
List 3 groups of Lingual salivary glands
Anterior lingual glands Middle lingual glands (von Ebner) Posterior lingual glands
What can physically occur (but is normal) to the sublingual gland if a patient has lost all their teeth and most of their mandibular ridge of bone?
Appear to bulge up into the floor of the mouth when the mouth is opened wide
What does the Posterior Auricular Artery supply?
Area behind the ear
What is the Previsceral Space?
Area surrounding the trachea and lying against the anterior wall of the esophagus
Where is the location of the Posterior lingual glands?
Around the lingual tonsils on the posterior dorsal areas of the tongue
List the Medial Branches of the Common Carotid Artery
Ascending Pharyngeal artery
Where does the Facial Artery travel to and what does its supply?
Ascends the side of the neck to run deep to the submandibular gland and crosses the lower border of the mandible in front of the angle; supplies the submandibular gland,
What are von Ebner's glands?
Associated with circumvallate papillae on the posterior tongue; serous
Where does the fluid from the Lower Deep Cervical nodes drain to?
At the junction of the subclavian and internal jugular veins
Where does the Maxillary Artery diverge from the External Carotid Artery?
At the level of the neck of the condyle on its deep surface
What is the nervous system that controls the Salivary glands regardless of major or minor?
Autonomic Nervous System; Parasympathetic Nervous System
Which structure does NOT have minor salivary glands? A. Tongue B. Anterior Hard Palate C. Labial Mucosa D. Buccal Mucosa
B. Anterior Hard Palate
Which of the following structures is a smaller vessel that branches off an arteriole to supply blood directly to tissue? A. Artery B. Capillary C. Vein D. Venule
B. Capilary
Which of the following accurately describes the Maxillary Artery? A. Arises from the Internal Carotid Artery B. Enters the Pterygopalatine Fossa and forms the Terminal Branches C. Aries from the Zygomaticofacial Foramen to emerge onto the face D. Has a Mandibular, Maxillary, Nasal, Palatine, and Occipital branches
B. Enters the Pterygopalatine Fossa and forms the Terminal branches
The tongue is MAINLY supplied by which artery? A. Internal Carotid Artery B. External Carotid Artery C. Sublingual Artery D. Facial Artery
B. External Carotid Artery
Which of the following is not primarily drained by the Upper Deep Cerivcal nodes? A. Third Molars B. Hard Palate C. Soft Palate D. Base of Tongue E. Tonsils
B. Hard Palate
After blood travels through the pulmonary veins it goes to the: A. Aorta B. Left Atrium C. Pulomary Valve D. Lungs
B. Left Atrium
If you see a patient with an eye that is swollen because of a dental infection, which tooth is most likely involved? A. Mandibular Canine B. Maxillary Canine C. Maxillary First Molar D. Mandibular First Molar
B. Maxillary Canine
Which of the following artery and foramen pairs are a correct match? A. Buccal Artery - Infraorbital Foramen B. Middle Meningeal Artery - Foramen Spinosum C. Incisive Artery - Mental Foramen D. Inferior Labial Artery - Mandibular Foramen E. Submental Artery - Mental Foramen
B. Middle Meningeal Artery - Foramen Spinosum
Which of the following arteries anastomoses with the Anterior Superior Alveolar Artery (ASA)? A. Mylohyoid Artery B. Posterior Superior Alveolar Artery (PSA) C. Facial Artery D. Lingual Artery
B. Posterior Superior Alveolar Artery (PSA)
Where is the location of the Middle lingual glands (von Ebner)?
Beneath the vallate papillae
The Internal Carotid Artery has no branches in the neck and travels up to enter the skull. Inside the skull the Internal Carotid Artery branches to supply the eyes, brain, and some limited regions of the covering of the brain. Are the statements provided... Both True Both False First Statement is True; Second Statement is False First Statement is False; Second Statement is True
Both Statements are true
There may be one or more Pterygoid branches, which extend to the medial and lateral Pterygoid muscles. Their courses and directions may vary among individuals. The statements above are... Both True Both False The first statement is true; the second statement is false The first statement is false; the second statement is true
Both true
Where does the Lingual Artery branch off the External Carotid Artery?
Branches off the External Carotid Artery just below the Facial Artery
What are gumboils?
Buccal swellings that lead to the swelling in the vestibule of the oral cavity
A young woman comes into the office as a new patient with a dental emergency. She has a large purplish bruise and some swelling under her eye and across the upper cheek to her nose. She states that her late night activities has nothing to do with this and that she had a "deep cavity" which her dentist gave her an injection to fill the tooth (#6). Her dentist is away on a spirtiual journey and she is worried that she may have an infection. You suspect that the lesion is A. The result of an assult (lenny face here) B. A cavernous sinus infection C. A Hematoma D. An allergic reaction to anesthesia
C. A Hematoma
A Venous Sinus within the vascular system is a A. Network of blood vessels B. Clot on the inner vessel wall C. Blood-filled space between two tissue layers D. Smaller vein or venule
C. Blood-filled space between two tissue layers
Which of the following describes the function of the Pterygoid Plexus accurately? A. Located around the Infrahyoid Muscles B. Protects the Superficial Temporal Artery C. Drains the Maxillary and Mandibular Dental Tissue D. Contains valves to prevent backflow of blood
C. Drains the Maxillary and Mandibular Dental Tissue
Which of the follow vascular lesions may result when a clot on the inner blood vessel wall becomes dislodged and travels in the vessel? A. Hematoma B. Venous Sinus C. Embolus D. Hemorrhage
C. Embolus
Which of the following is NOT true of minor salivary glands? A. Less branching B. Short ducts C. Fewer glands have individual duct openings D. Help keep mucous membranes moist
C. Fewer glands have individua duct openings
Where does the submandibular duct open into the mouth? A. Lingual to the mandibular first molar B. Along the sublingual fold C. Onto the sublingual caruncle D. Opposite the mandibular second molar
C. Onto the sublingual caruncle
Where would the secondary nodes of involvement be in a posterior throat wall infection? A. Submandibular B. Submental C. Upper Deep Cervical D. Lower Deep Cervical
C. Upper Deep Cervical
What are the different types of Papilla found on the tongue?
Circumvallate AKA Vallate Papillae Fungiform Papillae Filiform Papillae Foliate Papillae
What is the histology of secretory cells?
Clusters of secretory cells called acini; Serous, mucous, or mixed Lumen of acinus is continuous with a duct system
What type of cells are in the Striated ducts?
Columnar Epithelium
What is the Infraorbital Artery considered as and what branch does it send down the bone in front of the maxillary sinus?
Considered the end part of the Maxillary Artery; from the floor of the orbit the Anterior Superior Alveolar Artery
Which nerve innervates the salivary glands? What type of nervous system does it belong to?
Cranial Nerve VII; Autonomic Nervous System
After giving off the Submental branch, what does the Facial artery and vein continue?
Crosses the mandible, travels across the face, and ending near the corner of the eye as the Angular Artery
Which of the following arteries is a direct branch of the Aorta? A. Common Carotid Artery B. External Carotid Artery C. Pterygoid Artery D. Brachiocephalic Artery
D. Brachiocephalic Artery
The opening of the duct for the parotid gland is in the _____ muscle. A. Laterial Pterygoid B. Zygomatic C. Masseter D. Buccinator
D. Buccinator
The _____ artery has a branch taht supplies Maxillary anterior teeth and Maxillary premolars. A. Greater Palatine artery B. Anterior Superior Alveolar C. Posterior Superior Alveolar D. Infraorbital
D. Infraorbital
Which of the following is a branch of the maxillary artery? A. Lower inferior alveolar B. Massester C. Buccal D. All the Above
D. Lower inferior alveolar, Masseter, and Buccal are all branches from the Maxillary artery
The pterygoid plexus of veins flows directly into the A. Superficial temporal vein B. External jugular vein C. Internal jugular vein D. Maxillary vein
D. Maxillary vein
A new patient, a 65-year-old man, comes into the office with a medical history that indicates 40 years of heavy pipe smoking. The intraoral examination evidences a small white lesion in the foliate papillary area of the tongue. A biopsy determines that the lesion is oral cancer. Which are the primary nodes of invasion for this lesion? A. Lower Cervical Nodes B. Upper Cervical Nodes C. Submental Nodes D. Submandibular Nodes
D. Submandibular Nodes
Drainage of the mandibular incisors is accomplished by the submandibular nodes. The submandibular nodes also drain the floor of the mouth. A. Both statements are true B. Both statements are false C. The first statemnt is true; the second statement is false D. The first statement is false; the second statement is true
D. The first statement is false; the second statement is true
What are the possible symptoms of Radiation treatment in regards to salivary glands?
Decrease salivary Dry mouth Possible pain while eating due to decrease salivary and dry mouth Difficulty swallowing DOES NOT necessarily causes a swollen gland or tenderness
Mixed Serous glands have cells that are shaped like a semi moon, these are called what?
Demilune
Trace the path of blood (through chambers, valves, and vessels) from the time it first enters the heart until it gets back to the heart
Deoxygenated Blood from Superior and Inferior Vena Cava --> Right Atrium of the Heart Right Atrium --> Tricuspid valve into Right Ventricle Right Ventricle --> Pulmonary valve into Pulmonary arteries Pulmonary arteries --> Right and Left Lungs (Deoxygenated blood gets exchanged for oxygenated blood here) Lungs --> Pulmonary veins into Left Atrium Left Atrium --> Bicuspid/Mitral valve into Left Ventricle Left Ventricle --> Aortic valve into Aorta Aorta --> large arteries > small arteries > arterioles > arterial capillaries Arterial capillaries --> tissues Tissues --> Venous capillaries Venous capillaries --> Venules > small veins > large veins > Superior and Inferior Vena Cava Super and Inferior Vena Cava --> Right Atrium of the Heart
What are the 3 branches of the Lingual Artery and what do they supply?
Dorsal Lingual Artery - Deep Posterior part of the Tongue Deep Lingual Artery - Deep Anterior part of the Tongue Sublingual Artery - Ventral surface of the Tongue and Floor of the Mouth
Where does the Inferior Alveolar Artery travel to?
Down to enter the Mandibular Foramen and into the Mandibular Canal
If a patient presents with a swollen parotid gland, pain upon eating, tendernes upon palpation, and diminished salivary flow, what are some of the possible causes? A. Blocked Salivary Gland B. Mumps C. Radiation Treatment D. Dehydration E. All the Above
E. All the Above: Blocked Salivary Gland, Mumps, Radiation Treatment, and Dehydration However, may be caused by another factor such as medication and even the process of aging diminishes salivary flow
What does the Inferior Alveolar Artery branches off and supply?
Each of the Mandibular teeth and their periodontal ligaments, and bone
What are some developmental characteristics of Salivary glands?
Ectoderm forms secretory and ductal parenchyma Mesenchyme forms the connective tissue stroma Formation begins in 6-12th week
Where does the remainder of the Infraorbital Artery supply?
Emerging through the infraorbital foramen, it travels onto the face and supplies the maxillary lip, mucosa, labial gingiva, lower eyelid, and sides of the nose
What does the Internal Jugular Vein drain?
Entire brain area via the Jugular Foramen, area from the front of the ear to the front of the face
Where does the Posterior Superior Alveolar Artery exit from and enter to supply blood?
Exiting the pterygomaxillary fissure, descending the maxillary tuberosity and into the bone behind the 3rd molar
What type of glands are Salivary glands?
Exocrine glands that open onto the mucosal surfaces through ducts
Where does the Descending Palatine Artery travel to and where does it split into two other branches?
Extending down from the Maxillary artery to the posterior hard palate and through the pterygopalatine canal; Splits into the: Greater and Lesser Palatine Arteries
Which of the external carotid artery branch further into separate arteries to supply all the teeth and oral cavity?
External carotid artery ends and becomes the Maxillary artery which supplies different areas of the face and oral cavity
T/F The submandibular salivary gland provides about 25% of the resting salivary volume.
False; It provides 60% to 65% of the resting volume.
T/F An abscess of the mandibular premolars would drain into the submental nodes.
False; It would drain into the submandibular nodes
T/F Mumps becomes more painful when the parotid gland decreases its secretion.
False; Mumps becomes more painful when the gland secretes
T/F Infections in the Posterior Mediastinum is not fatal
False; Posterior Mediastinum infections may be fatal
T/F The submandibular lymph nodes drain the parotid glands
False; The auricular nodes drain the parotid glands
T/F The anterior retromandibular vein and the facial vein form the internal jugular vein.
False; They form the common facial vein
T/F The glands of von Ebner are found around the base of the fungiform papillae.
False; They're found around the base of the circumvallate papillae
T/F The common carotid artery divides into the superior and inferior carotid branches.
False; it divides into the Internal and External carotid arteries
T/F Ludwig's angina is an infection in the sublingual space.
False; it is the infection within in the submental space
T/F The first posterior branch off of the external carotid artery is the posterior auricular artery.
False; it is the occipital artery
T/F The Internal and External Carotid veins drain most of the blood of the head and neck
False; the Internal and Jugular Veins drains most of the blood of the head and neck
T/F Both the masseter artery and the mental artery are branches of the inferior alveolar artery.
False; the Masseter artery is part of the Maxillary Artery The Mental artery is part of the Inferior Alveolar Artery
T/F The Sympathetic Nervous System has NO role in salivary production
False; the Sympathetic Nervous System controls blood flow to the salivary glands, which slows the production of saliva
T/F There is minor salivary glands in the anterior part of the hard palate to keep it most
False; the anterior part of the hard palate has no salivary glands, therefore, the epithelium there are more keratinized than the posterior and lateral parts of the hard palate
T/F The right side of the heart carries oxygenated blood; the left side carries deoxygenated blood.
False; the left side carries oxygenated blood
T/F The duct for the parotid gland is opposite to the maxillary first molar.
False; the parotid duct is opposite to the maxillary second molar.
T/F The arterial and venous pathways of the left and right side of the head and neck region are exactly the same
False; they are slightly different
What are the spaces between muscles and tissue layers referred as?
Fascial Layers/ Fascial Planes
What is another way for infections to spread besides through the lymph nodes?
Fascial spaces; although less common, they have more dramatic clinical symptoms
What causes the infection of Fascial spaces to spread?
Gravity
What does the Nasopalatine Artery anastomose with?
Greater Palatine Artery
Where does the Inferior Alveolar Artery sends a small branch that exits from the mandible and through the Mental Foramen? What is that branch called and what does it supply?
In the Mandibular Premolar region; The Mental Artery supplies the mandibular buccal gingiva and mucosa from the premolars to the incisors, and the mucosa of the mandibular lip and chin
What is Lugwig's Angina? Who is Lugwig? And why does he have an angina? More importantly, how is Lugwig? But even better, What is Lugwig?
Infection of the Sublingual spreading to the Submental Space
Where may fascial space infections eventually end up if left untreated? How serious could this be?
Infections following predictable pathways depending on location, infection continue to spread by gravity if left untreated Eventually reaching the side of the neck next to the pharynx (aka lateral pharyngeal or parapharyngeal space) and results in the swelling in the neck if left untreated If continually left untreated/ignored the infection may spread around the pharynx to its posterior border (aka retropharyngeal space) From the retropharyngeal space, the infection can travel to the posterior mediastinum (back of the chest or thoracic cavity Once the infection reaches the posterior mediastinum, the infected individual may die within a short period of time
What are considered the "more important" branches of the Maxillary Artery in the Infratemporal Fossa?
Inferior Alveolar Temporal Massesteric Pterygoid Middle Meningeal Buccal
What group of nodes could be palpated as being painful in a throat infection?
Initial throat infections begins with the retropharyngeal nodes (b/c they're behind the throat wall) Due the impracticability of palpating these nodes, the Upper Deep Cervical nodes are next to the noticed Typically people with sore thoats often notice the tenderness in the Upper Deep Cervical nodes
About at the level of the larynx, what 2 arteries does the Common Carotid Artery divide into?
Internal and External Carotid Artery
what are the two divisions of the common carotid artery?
Internal and External Carotid Artery
What is the Pterygoid plexus of veins?
Intertwining network of veins close to the Maxillary tuberosity, injections to the posterior superior alveolar nerve can have the potential risk to cause hematoma (swelling and discoloration)
What does the External Jugular vein joins once it combines with the Subclavian veins? From there what does it flow into?
Joining with the Internal Jugular veins to form the Brachiocephalic veins to flow into the Superior Vena Cava
What does the Anterior Retromandibular vein join and form?
Joins the facial vein and forms the common facial vein which enters the Internal Jugular Vein
What does the Posterior Retromandibular vein joins and forms?
Joins with the Posterior Auricular vein to form the External Jugular Vein
What node is found at the angle of the mandible and borders on the posterior of the parotid gland? What are some of the nodes that it receives?
Jugulodigastric node; receives from nodes that drain the Anterior ear, Anterolateral scalp, Upper face, Gingiva, Eyelids, and Cheek region
What are some Minor Salivary Glands, their location, and the type of secretion?
Labial - Lips; Mixed Buccal - Cheeks; Mixed Palatine - Hard and Soft Palates; Mucous Lingual - Anterior (Mixed) / Middle (Serous) / Posterior (Mucous) Tongue
What are the minor salivary glands?
Labial Glands Buccal Glands Palatine Glands Lingual Glands
Where are minor salivary glands are typically located?
Labially, buccally, palatally, glossopalatally, and lingually
Infections that occur either above or below the mylohyoid muscle will reach what space regardless?
Lateral Pharyngeal AKA Parapharyngeal Space
What is the First Site of severity during the infection of the mandibular molar fascial?
Lateral Pharyngeal Space
Where do the infections of fascial spaces around the eye or cheek spread next if left untreated?
Lateral Pharyngeal Space > Retropharyngeal > Posterior Mediastinum
What does the Descending Palatine of the Maxillary artery separates into and what do they supply?
Lesser Palatine Artery - soft palate Greater Palatine Artery - hard palate, palatal muscle, maxillary lingual gingiva
Where is the location of the Mastoid nodes and where do they drain?
Located behind the ear, some into the larger node below, a bit behind the parotid gland, and some along the facial artery Drains into the posterior side of the scalp
Where is the location of the Occipital nodes and where do they drain?
Located behind the ear; drain the crown of the head
Where is the location of the Submandibular nodes and where do they drain?
Located below and behind the chin; drains and follow the course of the facial artery from the forehead; draining the gingiva, teeth, and tongue
Where is the location of the Preauricular/Parotid node and where do they drain?
Located in front of the ear and slightly below; drains the anterior head above the eyes into the nodes on the lateral side of the parotid gland
Where is the Lower Deep Cervical Nodes located?
Located on the lateral surface of the internal jugular vein and beneath the anterior border of the sternomastoid muscle; about 2 inches above the clavicle
Where are the Upper Deep Cervical Nodes located?
Located on the lateral surface of the internal jugular vein and beneath the anterior border of the sternomastoid muscle; about 2 inches below the ear
Where is the location of the Carotid sheath and what fascia is it part of?
Located posterior to the Sternocleidomastoid muscle and is part of the Deep Cervical Fascia of the neck; consisting of all three fascial layers of the neck: pretracheal, investing, and prevertebral
Where is the location of the Submental nodes and where do they drain?
Located under the chin; drains the inferior chin, floor of the mouth, tongue tip, and lower incisors
What type of cells are in the Intercalated ducts?
Low cuboidal cells
What is the tenderness and enlargement of lymph nodes referred as?
Lymphadenopathy
Submental space infections come from which group of teeth?
Mandibular molar infections tend to break out of the bone below the mylohyoid line and spread to the submental space beneath the chin
What does the Inferior Alveolar Artery of the Maxillary artery supply?
Mandibular teeth, bone, periodontal ligament, mandibular buccal gingiva and mucosa
What does the Masseteric Artery supply?
Masseter and Temporalis muscle
What does the External Carotid Artery ends and divides into?
Maxillary Artery Superficial Temporal Arteries
What tooth is typically correlated with swelling below the eye?
Maxillary Canine
What are the Terminal Branches of the External Carotid Artery?
Maxillary and Superficial Temporal Artery
What does the Anterior Superior Alveolar Artery (branch of the masseteric artery) supply?
Maxillary anterior teeth, lip, mucosa and facial gingiva
What does the Posterior Superior Alveolar Artery (branch of the masseteric artery) supply?
Maxillary posterior teeth, buccal gingiva and maxillary sinuses
What does the Pterygoid branches of the Maxillary artery supply?
Medial and lateral pterygoid muscles
What are Minor Salivary Glands?
Minute duct openings scattered over the mucosa; most mucous
What is the function of saliva?
Mixes with food to allow the ease of swallowing and begins the break down of starches into smaller carbohydrate units; further food breakdown within the stomach Aids in keeping the mucosa in the oral cavity from drying out Aids in swallowing and speech
What does the Pterygopalatine (Sphenopalatine) Artery supply?
Most parts of the nasal cavity
Is the Anterior Lingual Glands... Purely Serous, Mostly Serous, or Mostly Mucous?
Mostly Mucous
Is the Sublingual Gland... Purely Serous, Mostly Serous, or Mostly Mucous?
Mostly Mucous
Is the Submandibular Gland.... Purely Serous, Mostly Serous, or Mostly Mucous?
Mostly Serous
What does the Buccal artery branch of the masseteric artery supply?
Mucosa of the cheek and most buccal gingiva
Why is the soft tissue on the anterior hard palate more keratinized than that on the soft palate?
No minor salivary glands to keep the hard palate moist, the drying causes the epithelium to become more keratinzied The amount of trauma for mastication of food, temperature, and air, requires the tissues to be keratinized for protection
List the Posterior Branches of the Common Carotid Artery in the order of lowest to highest (from the neck to the head)
Occipital Artery Posterior Auricular Artery
What are the Superficial groups of lymph nodes in the head and neck?
Occipital Nodes Mastoid Nodes Preauricular/Parotid Node Submandibular Nodes Submental Nodes
What are the major groups of lymph nodes in the head and neck?
Occipital nodes Mastoid nodes Jugulodigastric nodes Submental nodes Submandibular nodes Upper Deep Cervical nodes Lower Deep Cervical nodes
What happens to the jugular veins if either the anterior or posterior retromandibular vein is missing?
Often, either the posterior or anterior branch of the retromandibular vein is missing. This causes more blood to shunt to the other, causing the remaining vein to increase in size and changes the volume of blood in each pathway back to the heart
What route does blood take from the heart into the head and neck region?
On the right side the Brachiocephalic artery branches off the Aorta The Right Common Carotid artery branches off the Brachiocephalic Artery to the right side of the head The Left Common Carotid Artery comes directly off the arch of the Aorta on the left side The Left Subclavian Artery comes off the arch of the Aorta lateral to the Left Common Carotid Artery At the level of the Larynx, the Common Carotid divides into the External and Internal Carotid Arteries The Internal Carotid Artery has no branches and enters the skull The External Carotid Artery has a number of branches within the neck and face
Where does the Buccal glands open and secrete?
Open into the inner surface of the cheeks and secrete mixed secretions
Where does the Submandibular (Submaxillary) Gland open?
Opens at the base of the lingual frenum called the sublingual caruncle on the floor of the mouth
Where does the Sublingual Gland open?
Opens in a line along a fold of tissue beneath the tongue called the sublingual folds
Where does the Parotid Gland open?
Opens into the buccal mucosa opposite the maxillary second molar
Where does the Labial glands open and secrete?
Opens into the inner surface of the lips and secrete mixed secretions, but mostly mucous
Where does the Palatine glands open and secrete?
Opens into the surface of the hard and soft palates and secrete mucous solutions
What are the symptoms of a Blocked Salivary Gland?
Pain with eating Swollen gland Pain with palpation Decrease salivary flow
What are the percentage of resting saliva between the 3 major salivary glands?
Parotid - 25% Submandibular - 60-65% Sublingual - 10%
What are the major salivary glands?
Parotid Gland Submandibular Gland Sublingual Gland
What are the 3 major salivary glands, their general location, and the secretion type?
Parotid Gland (Largest) - Anterior Ear; Serous (Watery) Submandibular (Middle/Just Right) - Angle of Mandible; Mix Serous Sublingual (Smallest) - Anterior Floor of the Mouth; Mucous
What does the common facial vein drains?
Part of the superficial temporal, maxillary, and part of the facial region
What does the Ascending Pharyngeal Artery supply?
Pharyngeal wall and Tonsil area
What area does the Ascending Pharyngeal Artery supply?
Pharyngeal wall and tonsils
What is the easiest way to located the Submandibular nodes?
Placing a finger on the inferior border of the mandibular near the angle and running the finger back and forth until you feel the depression in the inferior border of the mandible
What is the Third Site of severity during the infection of the mandibular molar fascial?
Posterior Mediastinum
If an infection pasts the Retropharyngeal Space, what space does it infect next?
Posterior Mediastinum (Back of the chest/thoracic cavity)
What tooth is typically correlated with the swelling in the cheek?
Posterior Teeth
If the infection from the Lateral Pharyngeal/Parapharyngeal space continues, what is the next space infecteed?
Posterior border of pharynx aka the Retropharyngeal Space
What are the symptoms of Dehydration in regards to salivary glands?
Prevention of salivary production which leads to dry mouth, pain while eating, and difficulty while swallowing DOES NOT necessarily causes swollen/tender glands
What are the terms used to describe the group of nodes that are affected in a disease process?
Primary Nodes Secondary Nodes Tertiary Nodes
What type of cells are in the Excretory ducts?
Pseudostratified Columnar that transitions to Stratified Epithelium closer to the orifice
Is the Glands of von Ebner... Purely Serous, Mostly Serous, or Mostly Mucous?
Purely Serous
Is the Parotid Gland... Purely Serous, Mostly Serous, or Mostly Mucous?
Purely Serous
What is the Second Site of severity during the infection of the mandibular molar fascial?
Retropharyngeal Space
What is the difference between arteries arising from the Aorta on the left and right side?
Right - Brachoiocephalic Artery branches off the aorta, from the Bracoiocephalic artery, the Subclavian artery branches off to the right arm and the Common Carotid artery branches off to the right side of the head Left - Subclavian artery and Common Carotid artery branches directly off the Aorta
Where does the Submental branch run along?
Running along the inferior border of the mandible to the chin
Where does the Masseteric branch travel to and what does it supply?
Running laterally through the coronoid notch of the ramus, enters and supplies the deep surface of the masseter muscle
What does the Buccal branch supply and what is its pathway?
Runs down and forward to supply the mucosa of the cheek, buccal, and gingiva of the Maxillary and Mandibular Posterior teeth
Where does the Pterygopalatine (Sphenopalatine) Artery travel through to supply blood?
Runs medially through the sphenopalatine foramen into the nasal cavity; then emerges from the incisive foramen as the nasopalatine artery
What does the Common Carotid Artery, on both sides, runs within and along? And lies beneath which muscle?
Runs within the Carotid Sheath, and along with the Internal Jugular vein and Vagus nerve; lies beneath the Sternocleidomastoid muscle
What happens when salivary ducts are blocked such as salivary stones? How do you treat it?
Saliva backs up causing pain upon eating and the swelling of the gland; treatment includes milking the salivary papilla, sucking on a lemon/acidic, or surgery
What is the difference between Major and Minor Salivary glands?
Size, Minor Salivary Glands are not only smaller but also have less branches compared to Major Salivary Glands
What also does the Facial Artery supply as it travels along it's lonely road alone?
Skin and muscles of facial expression
What does the Lesser Palatine Artery supply?
Soft palate and Palatine tonsils
The Upper Deep Cervical Nodes are particular effected by what type of infection? Where does this infection start?
Sore Throat; Retropharyngeal Nodes (Nodes behind the back throat wall)
What are fascial spaces?
Space between the muscles and tissue layers, AKA Fascial Layers/Planes One way infections, uncommon but dramatic clinical symptoms
What and where does the Parotid gland enters into the oral cavity?
Stenson's duct opens into the oral cavity opposite to the Maxillary 2nd Molar
What muscle does the External Jugular vein crosses and empties into?
Sternocleidomastoid muscle; empties into the subclavian vein which drains part of the temporal, maxillary, and posterior auricular areas
What is the space referred to when the infection of the premolars and anterior teeth break out of the bone above the mylohyoid line and spread into the spaces in the floor of the mouth?
Sublingual Spce
What does the Facial Artery supply?
Submandibular salivary glands, area beneath the chin, and the face
What does the Facial Artery supply?
Submandibular salivary glands, skin and muscles of facial expression
What is the space referred as when molar infections break out of the bone below the mylohyoid line and spread to the space beneath the chin??
Submental Space
What branches separate from the Facial Artery?
Submental, Angular, Maxillary, Mandibular lips, and sides of the Nose
What 2 veins form the Retromandibular vein? And what does it divide into?
Superficial Temporal vein and the Maxillary vein; Posterior and Anterior Retromandibular veins
List the Anterior Branches of the Common Carotid Artery in the order of lowest to highest (from the neck and up)
Superior Thyroid Artery Lingual Artery Facial Artery
What does the Anterior Superior Alveolar Artery supply and anastomoses with?
Supplies the maxillary anterior teeth; anastomoses with the Posterior Superior Alveolar Artery in the wall of the sinus
Swelling below the eye would come from the infection from which teeth?
Swelling below the eye is typically related to an infection from an anterior teeth, usually the maxillary canine
Trace the pathway of venous blood from the neck back to the heart
The Facial, Maxillary, and Retromandibular veins drain into the Common Facial Vein > Internal Jugular Vein > Subclavian vein Subclavian Vein --> Brachiocephalic > Superior Vena Cava > Right Atrium of the Heart A separate route from the Retromandibular veins would be to the External Jugular vein > Subclavian vein > Brachiocephalic > Superior Vena Cava > Right Atrium (The latter is more likely if part of the retromandibular vein is missing or blocked)
What is the area that the Maxillary Artery first runs forward into? From there, where does it enter?
The Infratemporal Fossa, then crosses the surface of the Lateral Pterygoid muscle and enters the Pterygopalatine Fossa behind/below the eye
What artery branches off the Inferior Alveolar Artery and what does it supply?
The Mental artery branches off from the Inferior Alveolar Artery and supplies the mucosa of the mandibular lip, chin, and facial gingiva of premolars and anteriors
What does the Occipital Artery supply?
The Occipital region
Which Maxillary artery supplies the Maxillary posterior teeth?
The Posterior Superior Alveolar artery supplies the Maxillary posterior teeth
What drains the 3rd molar regions?
The Upper Deep Cervical; as well as the base of the tongue,, tonsillar area, soft palate, and the posterior nasal cavity region
What does the Submental nodes drain?
The area under the chin
What does the Mastoid nodes drain?
The areas behind the ear
What does the Jugulodigastric nodes drain?
The areas posterior to the parotid gland
The Maxillary vein is formed by the intertwining network of veins known as the Pterygoid plexus of veins. Due to its location, there is no risk of piercing the plexus during posterior superior alveolar nerve blocking. The statements above are.... Both true Both false The first statement is true; the second statement is false The first statement is false; the second statement is true
The first statement is true; the second statement is false The Maxillary tuberosity is relatively close to the plexus, therefore, if the angulation of insertion is incorrect it can create a hematoma
Which Maxillary artery branch supplies the mandibular molars and further branches off to supply the mandibular premolars and anterior teeth?
The inferior alveolar artery supplies the mandibular molars the becomes the mental artery which supplies the mandibular premolars and anterior
Which Maxillary artery supplies the Maxillary anterior teeth?
The infraorbital artery from the Maxillary branch artery becomes the Superior Alveolar Artery, supplies the Maxillary anterior teeth
What is the major vein the drains most of the head and neck region?
The internal jugular drains most of the head and neck area
What is the sublingual fold?
The junction of the submandibular and several smaller ducts that open in a line along the fold of tissue beneath the tongue
What does the Submandibular nodes drain?
The maxillary teeth (minus the 3rd molar) Maxillary sinus Mandibular canine Mandibular posterior teeth (minus the 3rd molar) Tongue Cheek area Hard palate Anterior nasal cavity
Where does blood supply to the muscles of mastication originate?
The muscles of mastication receive blood supply from branches of the Maxillary artery
What does the Occipital nodes drain?
The posterior occipital region
What does the Superior Thyroid Artery supply?
The thyroid gland and larynx
Why does cancer within the tip of the tongue typically have a lower mortality rate compared to cancer in the posterior part of tongue or the throat?
The tip of the tongue generally drains to 3 or 4 groups before the cancer can spread to the bloodstream; oppose to the posterior and throat which drains into 2 groups before reaching the bloodstream
How many Superficial groups of lymph nodes are located in the head and neck?
There are 5 Superficial groups of lymph nodes located in the head and neck
What is the primary functions of minor salivary glands?
To keep surfaces of the mucosa moist
What area does the Lingual Artery supply?
Tongue and floor of the mouth
What does the Lingual Artery supply?
Tongue and the floor of the mouth
What does the Greater Palatine Artery supply?
Traveling along the lateral part of the hard palate to supply the palatal mucosa and maxillary lingual gingiva
Where does the Lingual Artery travel and what does it supply?
Travels forward and deep, going beneath the Hyoglossus muscle of the tongue; supplies the tongue and tissues in the floor of the oral cavity
T/F All lymph nodes are connected by lymphatic ducts or tubules.
True; All lymph nodes are connected by lymphatic ducts/tubules
T/F A buccal abscess of a mandibular molar usually drains into the buccal vestibule.
True; Buccal abscesses of the mandibular molars drains into the buccal vestibule
T/F Lymphatic vessels in the head and neck eventually drain into the junction of the internal jugular and subclavian veins.
True; Lymphatic vessels within the head and neck eventually drains into the junction of the internal jugular and subclavian veins
T/F Major salivary glands are compound tubuloalveolar glands.
True; Major salivary glands are compound tubuloalveolar glands
T/F Most minor salivary glands are purely or mostly mucous in nature.
True; Most salivary glands are purely or mostly mucous in nature
T/F Occasionally, the Lingual and Facial Arteries come off the External Carotid Artery as ONE branch then splits, this is referred to as the Linguofacial Trunk
True; The Linguofacial trunk is another variation of normal anatomy
T/F In a throat infection at the posterior wall, the upper deep cervical nodes will be tender and enlarged.
True; Throat infections at the posterior wall, the upper deep cervical nodes, will be tender and enlarged
T/F The tooth pulp has lymph vessels.
True; Tooth pulp does have lymph
T/F Veins follow the same pathways as arteries as well as the same names
True; Veins and Arteries generally share the same name and pathways
T/F Veins of the face usually have the same name as the arteries that travel with them
True; Veins within the face share the same names as their artery counterpart
T/F The differences in sizes of the Internal and External Jugular veins are notable when the Posterior or Anterior branch of the Retromandibular vein is missing
True; if one is missing, it causes more blood to shunt to either or External or Internal Jugular vein
T/F The internal carotid artery does not supply the oral cavity.
True; the Maxillary artery supplies the oral cavity; which branches off from the External Carotid artery
T/F The infraorbital artery is the most anterior branch of the maxillary artery.
True; the infraorbital artery is the most anterior branch of the maxillary artery
T/F The parasympathetic nervous system controls salivary gland secretion.
True; the parasympathetic nervous system controls salivary gland secretion
Where is the location of the Anterior lingual glands?
Under the tip of the tongue
The Middle Meningeal Artery comes off the Maxillary, generally opposite the inferior alveolar artery. Where does the Middle Meningeal Artery run and what does it supply?
Up through the Foramen Spinosum and acts as the MAJOR blood supply to the meninges of the brain
What does the Lower Deep Cervical Nodes drain?
Upper Deep Cervical Nodes Many nodes of the back of the neck (AKA Occipital nodes) Some of the anterior neck
What does the Lower Deep Cervical nodes drain?
Upper Deep Cervical nodes Most nodes within the neck region
What are the symptoms of Mumps?
Viral infection of the parotid gland causing: Swelling/tenderness of the gland Decreased salivary flow Pain with eating
What are the composition of Saliva?
Water, ions, and protein; average output is 1 liter per day
What and where does the Submandibular gland enters into the oral cavity?
Wharton's duct opens into the oral cavity beneath the tongue