deep face

Question 1

what are the cartilaginous parts of the nose

Answer 1

• 2 lateral cartilages
• 2 major and minor alar cartilages
• 1 septal cartilage (nasal septum)

Question 2

the nasal cavity (except for vestibule of nose) are lined with nasal mucosa which divide into 2 parts which are

Answer 2

lower 2/3 = respiratory
-middle and inferior turbinate

upper 1/3 = olfactory
-superior turbinate with CN 1 nerve endings

Question 3

what are the 2 main branches that supply blood to the nasal cavity

Answer 3

• maxillary A. (sphenopalatine,, greater palatine)
• facial A. (inferior labial a. and lateral nasal)
• othalmic a. (from ICA) = ethmoidal a.

Question 4

what is the innervation of the TMJ joint

Answer 4

• branches of V3 (mandibular N.)

- capsule head = auriculotemporal N. , posterior deep temporal N. , massesteric N.

Question 5

bones of the external nose

Answer 5

• nasal bone
• frontal bone (nasal part and nasal spine)
• frontal part of the maxilla
• boney part of nasal septum (-medial line down the nose where where vomer and ethmoid bones are )

Question 6

what structures can be damages in a TMJ joint fracture

Answer 6

• paroitd gland,
• superficial temporal
• facial nerve

Question 7

what muscle attaches to the articular disc of the articular capsule of the TMJ joint

Answer 7

-superior head of the lateral pterygoid M..

Question 8

what are the 4 passage ways of the nasal cavity and where do they open

Answer 8

1. spheno-ethmoidal recess (opening to sphenoid sinus)
2. superior nasal meatus (opening to posterior ethmoidal sinuses)
3. middle nasal meatus
   -anterior semilunar hiatus opens into frontal sinus
   -ethmoidal bulba - opening to anterior and middle ethmoid sinus
   -posterior semilunar hiatus- opening to the maxillary sinus
   (semilunar hiatus is below the ethmoidal bulba)
4. inferior nasal meatus (opening to nasolacrimal duct)

Question 9

boundaries of the internal nose (nasal cavity)

Answer 9

Roof
-frontal, nasal, ethmoid, sphenoid

Floor
-palatine, maxila

lateral wall
-inferiror nasal concha and ethmoid (superrior and middle nasal concha)

medial (septum)
-vomer, ethmoid, palatine, maxilla, septal cartilage

Question 10

what happens to the TMJ joint when the mouth is opened <15 degrees, greater than 15 degrees ?

Answer 10

<15 = pivot of the joint with minimal sliding of the articular disc by the lateral pterygoid M.

> 15 = anterior dislocation of the joint (mandibular bone comes out of mandibular fossa on temporal bone). articular disc being pulled forward by the lateral pterygoid M. holding the joint together

Question 11

when does the nasal cavity drain venous blood

Answer 11

sphenopalatine, facial, and opthalmaic veins

Question 12

what are the two main types of epistaxis

Answer 12

• nose bleed
  1. anterior - bleeding out of nostrils
• most common
• source : kieseelbach plexus (anterior ethmoidal A. , superoir labial A. , sphenopalatine A. greater palatine A.)

2. posterior -bleeding down the throat
   - less common, harder to control
   - source: woodruffs plexus (posterior ethmoidal A. and sphenopalatine A. )
   - associated with bleed from both nostrils, flowing into pharynx, and increased risk of aspiration and airway compromise bc of difficulty controlling the bleed

primary cause: spontaneous, idiopathic
secondary cause: trauma

Question 13

what is the nerve and blood supply to the paranasal sinuses

Answer 13

1. frontal
   - blood: anterior ethmoidal, supraorbital
   - nerve- supraorbital (V1)
2. ethmoid
   - blood: ethmoidal A.
   - nerve- nasociliary N (V1)
3. sphenoid
   - blood: posterior ethmoidal A.
   - nerve- posterior ethmoid N. (V1)
4. maxillary
   - blood: superior alveolar a., greater palatine a.
   - nerve: superior alveolar n. (V2)

Question 14

what are the boundaries of the pterygopalatine fossa

Answer 14

anterior: maxilla
posterior: sphenoid
medial- palatine
lateral: infra temporal fossa
roof: sphenoid
floor: palatine

Question 15

where is an inferior alveolar dental nerve block inserted

Answer 15

*inside check part of the mouth
-between the pterygomandibular raphe and the coronoid notch inside the mouth.
(raphe is between buccinator and pharyngeal constrictor muscles)

Question 16

where do you inject a nerve block for the superior posterior, middle, and anterior alveolar N.

Answer 16

posterior (back upper molars )
-inject above the back 3 upper molars, above the gums

middle (premolar and middle teeth)
-inject anteriorly to the 3rd upper molar into the gums

anterior (front teeth and below nose area)
-inject up the lip in the front the hit the infraorbital N. (after it has branched of the middle superior alveolar N.)

Question 17

what bones meet to make the nasal septum

Answer 17

perpinducular plate of ethmoid and the vomer

nasal crests of maxillary and palatine

Question 18

what boney parts of the temporal bone are important in making the articular capsule of the TMJ joint

Answer 18

postglenoid tubercle, auricular tubercle
(have an anterior and posterior band on the inside to keep the mandible in place on the mandibular fossa of the temporal bone)

Question 19

what opening is located in the superior portion of the pterygopalatine fossa? and what foramen is located superiorly and posteriorly? and what canal is located posteriorly ?

Answer 19

inferior orbital fissure

• foramen rotundum
• pterygoid canal

Question 20

what are the parts of the nasal septum

Answer 20

• vomer
• cartilagionous part of septal cartilage
• perpindicular part of ethmoid

Question 21

what ligaments are associated with the TMJ joint

Answer 21

(these prevent anterior protrusion and inferior excursion of TMJ)
stylomandibular L.
shpenomandibular L.

-articular capsule (holds the articular disc)

Question 22

what innervates the tensor veli palatini and the tensor tympani ?

Answer 22

V3 (mandibular part) of CN 5

Question 23

contents of the pterygopalatine fossa

Answer 23

1. Maxillary N (v2) -
   - pterygopalatine nerves (synapse and make greater and lesser palatine)
   - zygomatic n.,
   - superior alveolar n.

2. maxillary a. (3rd part) --- 
sphenopalatine A. 
infraorbital A.
superior alveolar a. 
greater/lesser palatine

3. pterygopalatine ganglion
   - Vidian N.