The tongue is derived embryologically in a distinct manner ○ Different blood supply and innervation ○ Anterior ⅔ VS. posterior ⅓ ● V3 branches inside the mandible to the infratemporal fossa and enters the mandibular foramen ○ Running through center of the mandible and continues all the way forward and gives off branches to the mandibular teeth ■ Inferior alveolar nerve ● Mental nerve emerges from mental foramen and provides sensation to chin and lower lip ○ It is the very end of inferior alveolar nerve of V3 ● Nerve block for teeth drilling ○ If lower jaw, numb the nerve to lower teeth, which means a needle in the deep surface of oral cavity near the mandibular foramen ■ Since 1 nerve, allows dental work on many lower teeth ○ Chin and lower lip gets numb also- a byproduct of doing inferior alveolar nerve block ● Chorda tympani ● Cervical spinal nerves provide sensation to back of ear, back of scalp, and back of neck behind mandible ● Vertex-ear-chin line ○ Everything anterior to that is trigeminal nerve ○ Posterior to it is upper cervical nerves ● Shingles in trigeminal nerve CASE STUDY ○ Chickenpox lives in trigeminal ganglion ○ Occurs in one of the dermatomes of a trigeminal division branch ○ V1 distribution, forehead, cornea, lateral part of nose ■ Shingles that affect cornea ● Viral eruption on cornea ⇒ blindness ○ Cornea- part of V1 and lateral part of nose- part of V2 ● Since the upper teeth is innervated by individual branches of superior alveolar nerve ○ Must do nerve block on individual teeth ● CASE STUDY of removing molar in African chief’s wife ● Cranial Nerve test
○ CN 1: close one nostril and take a smell; alternate nostrils ○ CN 2: cover up one eye, keep eyeglasses on and check ■ Take glasses off ⇒ pinhole correction ● Takes all light rays and makes them straight through the middle of lens where there is least amount of distortion ● Tells if optic nerve problem or refractive problem ■ Visual field testing for retina ● Cover one eye and determine the field of vision ● Tells if optic nerve and retina are working ○ CN 3: look at finger and follow doctor’s fingers without moving head ■ Look at fingers out and in ● See if pupils constrict to determine autonomic function ○ CN 4: Sympathetic Shine light in the eye and determine pupillary constriction ○ CN 5: sensory in the face ■ Check if same on both sides for V1, V2, V3 ○ CN 6: Clench the teeth to determine muscles of mastication ● Cranial Nerve VII: has sensory and motor function ○ MOTOR: Travel through facial canal and exit base of skull between the mastoid and styloid process → stylomastoid foramen ■ Mastoid behind the ear ■ The nerve then branches into temporal, zygomatic, buccal, mandibular, and cervical ■ Innervates a lot of tiny fine motor muscles in face; ends in skin of facial muscles ● Allows facial expressions ○ SENSORY: to the tongue; distributed to same region as lingual nerve, but that nerve contains general sensation ■
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- Spring '08
- phrenic nerve, lingual nerve, posterior abdominal wall, Posterior Mediastinum