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Note no innervation to palatoglossus muscle which

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NOTE: no innervation to palatoglossus muscle, which innervated by CN X."Palate AWAY, tongueTOWARDS" -CN IX and X unilateral palsy:palate moves AWAY from the affected side when the patient says "Aah." -CN XII unilateral lesion: tongue deviates TOWARDS the affected side when it is protruded because the non-paralyzed genioglossus muscle protrudes the tongue out while the other side lags behind. Multiple CN abnormalitiesCavernous Sinus lesion: Unilateral lll, lV, V1, VlCerebellopontine angle lesion: Unilateral V, Vll, VlllJugular foramen syndrome:Unilateral lX, X, XlTemporomandibular Joint (TMJ, synovial)-Head of mandible (taut) + articular disc + temporal bone (lax)-Ligments: fibrous capsule, lateral (prevents posterior dislocation), stylomandibular, sphenomandibular (spine of sphenoid – lingua, mylohyoid n. & a. near lingua, chorda tympani near spine of sphenoid, auriculotemporal n. lateral to this ligament)-innervation: auriculotemporal, masseteric n.-dislocation: unable to close the mouth due to dislocation of the headof the mandible anteriorly by contraction of lateral pterygoid muscle Clinical CorrelationsMumps (epidemic parotitis): Parotid gland disease (painful swelling) often causes pain in the auricle, external acoustic meatus and TMJ because the auriculotemporal nerve (branch of CN V3) supplies sensory nerve fibers to parotid gland as well as the skin over the temporal fossa and auricle. Parotidectomy:The facial nerve is in jeopardy during surgery. It is important to identify, dissect, isolate and preserve the facial nerve during surgery.Frey’s syndrome:Nerve regeneration problem. Auriculotemporal nerve carries 3 types of fibers, a) to sweat glands (sympathetic), b) to parotid gland (parasympathetic), c) to the skin of the auricle and temporal region (sensory). Following nerve injury, during regeneration the wrong ends may get connected to the sweat glands (normally
Shin 5Bulbar palsy (LMN), pseudobulbar palsy (UMN):Bilateral X, Xl, XlIduring yawning or big biting.-dysfunction: ear/dental/neck pain, clicking (crepitus), headache, stiffness. Muscular disorder: common, stress, tension of mastication, muscle spasmJoint disorder: arthritis, neoplasm, internal derangementinnervated only by sympathetic) – sympathtic uses acethylcoline as mediator in sweat glands, which is the usual mediator for parasympathetic. In that case, whenever there is taste stimulation, it results in the redness and sweating of the skin over the area of the distribution of auriculotemporal nerve.Head & Face musclesMusclesOriginInsertionActionNerveBloodTempolarisTemporal fossaCoronoid process of mandibleMastication (elevates, retracts (posterior fiber)mandible)MandibularCN V3Deep temporal artery maxillary arteryexternal carotid common carotid aortaMedial pterygoidsuperficialMaxillaMedial surface of angle of mandible below the mandibular foramenMastication (elevates, side-to-side, protracts mandible)pterygoid branches of maxillary arteryPterygoid venous plexsus maxillary vein

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Term
Spring
Professor
STANGER-HALL
Tags
Arteries of the head and neck, vagus nerve, Shin, spinal accessory nerve

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