REVIEW FOR FINAL MATERIAL

* Mouth is divided into 4 quadrant , 8 teeth per quadrant : central

incisor, lateral incisor , canine , 1
st
premolar ,2
nd
premolar , 1
st
2
nd
3
rd

molar .
*In General Periodontal ligaments principal fibers are two types :
1- alveodental ligament (main type) which consists of five fiber
subgroups : alveolar crest fibers , horizontal fibers ,oblique fibers
,apical fibers and interradicualr fibers . 2-Transseptal fibers
*The ends of the principal fibers that are within either cementum or
alveolar bone are considered Sharpey fibers .
*Trigiminal nerve ( 5
th
cranial nerve ) has three major branches: the ophthalmic nerve (V1), the maxillary
nerve (V2), and the mandibular nerve (V3).












>> anterior superior alveolar nerve supplies anterior teeth (incisors & canine)
>>middle superior alveolar nerve supplies premolars and mesial root of 1
st
molar
>>posterior superior alveolar nerve supplies 1
st
molar except mesial root ,2
nd
and 3
rd
molar
SO if you want to anaesthetize the 1
st
molar your target nerves are both : middle and posterior superior
nerve
*Maxillary artery >> The larger terminal branch of the ECA.
*The inferior alveolar artery:
1- the mylohyoid artery -> suplies the floor of the mouth and the mylohyoid muscle
2- dental branches -> pulp tissue of mandibular posterior teeth
3- alveolar branches -> periodontium and gingiva of these teeth
4- the mental artery -> supplies the chin tissues
5- the incisive artery -> supplies mandibular anterior teeth
*The anterior superior alveolar artery: -> to supply the pulp and periodontium of the anterior maxillary
teeth




*Muscles of soft palate :
1- palatoglossus muscle : >> It elevates the base of the tongue and closes the oro-pharyngeal isthmus
2-Palatopharyngeal muscle : >> It elevates the larynx and pharynx & closes the pharyngeal isthmus
3-Tensor veli palatine: >> It stretches and depresses the anterior part of the soft palate, closes the pharyn-
geal isthmus , and dilate the auditory tube
4-Musculus uvulae : >> pulls the uvula forward to its own side
5-Levator veli palatine: >> elevate the soft palate and close the pharyngeal isthmus.

* Muscles are innervated by the pharyngeal plexus except for The tensor veli palatini muscle which is
innervated by the Nerve to medial pterygoid (branch of mandibular nerve )
*Sensory innervation: Mostly by the maxillary nerve through its branches: Greater palatine nerve - Lesser
palatine nerve - Nasopalatine nerve
-Glossopharyngeal nerve supplies the region of the soft palate
TONGUE
*Is attached by muscles to the hyoid bone, mandible, styloid processes, and pharynx.
* divided into : root(base) body apex (blade) // has two surface : dorsum and ventricle
*The dorsum >> oral part ( ant. 2/3 of tongue ) + pharyngeal
part (post. 3
rd
of tongue )
*lingual papillae :
- filiform papillae >> most numerous - extremely large and
rough
-fungiform papillae >> mushroom shaped structures
-Both fungiform and foliate papillae >> Carry taste buds - have a
core of connective tissue.
-circumvallate papillae >> easily visible with the naked eye








*Lingual muscles are extrinsic muscle (arise from attachment to the bone)and intrinsic muscles (no
attachment neither arising nor insertion)
*extrinsic muscle : Genioglossus muscle , Hyoglossus muscle , Styloglossus muscle ,Palatoglossus muscle
*Intrinsic muscle : Superior longitudinal muscle ,Inferior longitudinal muscle , Transverse muscle , Vertical
muscle







*Hypoglossal nerve is the motor nerve of all muscle except for palatoglossus muscle
*lingual nerve >> general sensation for ant 2/3
*chorda tympani branch of facial nerve >> taste from ant 2/3
*gloss pharyngeal nerve >> general and taste sensation for post. 1/3
internal laryngeal nerve >> general and taste sensation for post.1/3 and epiglottis

*Blood supply for tongue (primariliy) and floor of the mouth by : lingual artery
*tongue receive second blood supply by tonsillar branch of the facial arteryand the ascending pharyngeal
artery.
* The lingual veins drain into internal jugular vein.
pharynx
*The outer wall of the pharynx consist of :
1- mucus membrane 2- pharynx aponeurosis
3- muscular coat 4- bucco pharyngeal fascia



* The inner wall of pharynx consist of : Superior constrictor Middle constrictor inferior constrictor .
>Superior Constrictor : lines the wall of nasopharynx and oropharnx
> Inferior constrictor : The Thickest ,, two muscles :
Thyropharyngeus (obliquely displaced) + Cricopharyngeus (transversly displaced )



*PHARYNGEAL SPACES :
1- Retropharyngeal space : behind pharynx ,, extend : base of skull -> bifurcation of trachea
2- Parapharyngeal space : on the side of pharynx ,, Contains carotid vessels, jugular veins, last four
cranial nerves & cervical sympathetic chain
*Most of all nerves that supplies the pharynx come from pharyngeal plexus (pharyngeal branches of the
glossopharyngeal + vagus nerves + superior cervical sympathetic ganglion. )
pharyngeal branches + vagus nerve : all muscles of pharynx except for stylopharyngeus thats
supplies by glossopharyngeal nerve

*NASOPHARYNGEAL TONSIL(ADENOIDS)
>> At the junction of roof and posterior wall of nasopharynx
>> Increases in size up to the age of six years and then gradually disappears.
*Abscess in Nasopharyngeal Bursa >> : Thornwaldts disease
* Tubal tonsil : Collection of subepithelial lymphoid tissue Sit. at tubal elevation that is Continuous with
adenoid tissue and forms a part of Waldeyers ring
*Boundaries of OROPHARYNGEAL ISTHMUS :
Above >> soft palate Below >> upper surface of the tongue
Palatoglossal arch on either sides.
*Valleculae is Bounded medially by the median glossoepiglottic fold and Laterally by
pharyngoepiglottic fold
*Drainage :
> Pyriform sinus drains intoupper jugular chain
>Rich lymphatics high frequency of nodal metastasis in carcinoma of this region
>Post cricoid parapharyngeal nodes
>Post wall parapharyngeal nodes or lateral pharyngeal nodes








NOSE
*Nose consists of bony & cartilaginous framework above by the:
Nasal bones
Frontal processes of maxillae
Nasal part of frontal bone
*Formed below by plates of hyaline cartilage, which include upper & lower nasal cartilages and the septal
cartilage
*Divided into right & left halves by the nasal septum , Each half has a:
Floor, Roof, Lateral wall & Medial wall (septum)
*Medial Wall (Nasal Septum) is Formed:
Superiorly by the vertical (perpendicular) plate of ethmoid bone
Posteriorly by the vomer bone
Anteriorly by the septal cartilage
*The cavity below each concha is called a meatus and are named as superior, middle & inferior
corresponding to the conchae
*Superior and middle conchae are part of ethmoidal
labyrinth .

* Sphenoethmoidal recess: Receives the opening of
the sphenoidal sinus
*Superior meatus: Receives the opening of the
posterior ethmoidal sinus
*Inferior meatus: Receives the opening of the
nasolacrimal duct. The opening is guarded by a valve, a fold of mucous membrane
*Linging of nasal cavity :
- vestibule >> modified skin and has vibrissae
- Roof , upper part of septum ,upper surface of the superior concha, and the sphenoethmoidal recess >>
olfactory mucosa
- The rest of the cavity >> respiratory mucosa
*Nasal cavity receives sensory & visceral innervation
*Olfactory mucosa supplied by olfactory nerves
*Nerves of general sensation are derived from opthalmic (ant. Part ) & maxillary nerves (post. Part )
*Visceral Innervation : Sympathetic fibers + Parasympathetic fibers
supplies vascular smooth muscle supply the mucosal gland
*Arterial Supply : Sphenopalatine artery + Alar and septal branches of superior labial artery + Anterior &
posterior ethmoidal arteries .
*Venous Drainage into the facial, ophthalmic, and sphenopalatine veins.
*Lymphatic Drainage: submandibular lymph nodes & upper deep cervical lymph nodes .
*Maxillary Sinuses Opens into the middle meatus
through the hiatus semilunaris & Supplied by
superior alveolar & infraorbital nerves.
*Frontal Sinuses Opens into the middle meatus
through the infundibulum & Supplied by the
supraorbital nerve.
*Ethmoidal Sinuses : Anterior group opens into the
infundibulum, middle opens on the bulla, and
posterior into the superior meatus ,,, Supplied by
the anterior and posterior ethmoidal nerves
*Sphenoidal Sinuses Open into the
sphenoethmoidal recess & Supplied by the posterior ethmoidal nerve.

The End
WISH YOU THE BEST
MADE BY : FARAH EDWAN