Head and Neck Pskg#

8/9/2019 Head and Neck Pskg#

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HEAD AND NECK Innervation, vascularisation


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Nerves of the Head and Neck

• Four cranial nerves innervate the face and oralcavity:

• trigeminal, (NC !• facial, (NC II!• glosso"haryngeal, (NC I#!• Hy"oglossal (NC #II!


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Nerves of the Head and Neck

• $he largest cranial nerve and the most im"ortant to dental au%iliaries is the trigeminal nerve ,

• innervates the ma%illa and the mandi&le'• $he trigeminal nerve divides at the semi lunar

(gasserian! ganglion into three &ranches:• o"hthalmic nerve,• ma%illary nerve, and• mandi&ular nerve'


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Trigeminal nerve


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Maxillary Branch of theTrigeminal Nerve

• )ensory nerve that innervates• the nose,• chee*s,• "alate,• gingiva,• +a%illary teeth ,• ma%illary sinus,• tonsils,•

naso"haryn%, and• ther facial structures


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-terygo"alatine Nerve/ranch

• $his &ranch divides into• greater "alatine nerve,• lesser "alatine nerve,• naso"alatine nerve


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0' 1reater "alatine nerve• $he greater "alatine nerve e%tends do2n2ard

from the "terygo"alatine nerve and reaches the"alate through the greater "alatine foramen '

• $his nerve serves• soft "alate,• hard "alate,• medial gingiva, and• mucous mem&rane

as far for2ard as the anterior teeth'


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3' lesser "alatine nerve• $he lesser "alatine nerve is a smaller &ranch that

innervates• the soft "alate,• uvula, and• tonsils


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4' Naso"alatine nerve• $he naso"alatine nerve e%tends anteriorly from

the "terygo"alatine nerve and e%its through theincisive foramen '

• $his nerve innervates• $he anterior hard "alate,• gingiva,• mucous mem&rane, and• the anterior teeth from the cus"ids for2ard '


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Infraorbital Nerve• $2o nerves come from the infraor&ital nerve

&efore it e%its through the infraor&ital foramen '• $hese are the middle su"erior alveolar nerve and

the anterior su"erior alveolar nerve'


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Infraorbital Nerve• $he middle su"erior alveolar nerve su""lies• the lateral 2all of the ma%illary sinus, gingiva,

mesial &uccal root of the 5rst molar , and all theroots of the &icus"ids ("remolars!'


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Infraorbital Nerve• $he anterior su"erior alveolar nerve is the ne%t

nerve to come from the infraor&ital nerve'• It innervates the anterior ma%illary sinus, gingiva,

cus"ids , laterals, and central incisors '


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Posterior Superiorlveolar Nerve!

• $he "osterior su"erior alveolar nerve &ranchesdo2n2ard from the ma%illary nerve'

• It su""lies the gingiva, ma%illary sinus, chee*s,and ma%illary molars 2ith the e%ce"tion of the

mesial &uccal root of the 5rst molar , 2hich isinnervated &y the middle su"erior alveolar nerve'


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"ygomatic Nerve• $he 6ygomatic nerve innervates the or&icularis

oculi , the area around the eye and the areaaround and &ehind the 6ygomatic arch'


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Mandibular Branch ofthe Trigeminal Nerve

• $he mandi&ular nerve &ranch is com"osed of &othsensory and motor neurons and is the largestdivision of the trigeminal nerve'

• $here are three &ranches of the mandi&ular

nerve: &uccal, lingual, and inferior alveolar


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• $he &uccal nerve &ranch "asses through the&uccinator muscle to the chee* , 2here itinnervates the &uccal mucosa and &uccal gingiva ,as 2ell as the &uccal of the mandi&ular molars'


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• $he lingual nerve &ranch descends from themandi&ular nerve to the underside of the tongue and e%tends from the "osterior to the anterior ofthe mouth'

•

$his nerve innervates the 7oor of the mouth, theventral side of the tongue , taste &uds on theanterior t2othirds of the tongue, and the lingualgingiva '


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Inferior lveolar NerveBranch

• $he inferior alveolar nerve &ranch descends fromthe mandi&ular nerve and runs "arallel to thelingual nerve'

• $he 5rst &ranch is the mylohyoid nerve &ranch ,

2hich su""lies the mylohyoid muscle and theanterior &elly of the digastric muscle '


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• $he inferior alveolar nerve then enters throughthe mandi&ular foramen and runs through themandi&ular canal '

• 8ithin the canal, the inferior alveolar nerve

su""lies the mandi&ular teeth (s"eci5cally themolars and the "remolars !, the gingiva, and themucosa'


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• It then su&divides into the mental nerve &ranchand the incisive nerve &ranch '

• $he mental nerve &ranch su""lies the chin and thelo2er li" area , and

•

the incisive nerve &ranch innervates the anteriorteeth and la&ial gingiva'


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#irculation of the Headand Neck Arteries of the Face and ral Cavity• $he common carotid su""lies &lood to most of the

head and nec*' As the common carotid ascendsu" the nec*, it divides into the internal and

e%ternal carotid arteries '• internal carotid artery su""lies &lood to the &rain

and eyes ,• e%ternal carotid artery su""lies &lood to the face and

oral cavity and has many&&ranches


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#irculation of the Headand Neck


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$xternal #arotid rtery• $he e%ternal carotid artery &ranches go to the

throat,tongue , face , and ears and to the 2all ofthe cranium'

• /ranches are named according to the areas they

su""ly and are nearer the surface (more su"er5cial!'• 9ingual Artery'• Facial Artery• +a%illary Artery

• +andi&ular Artery• -terygoid Artery• -terygo"alatine Artery


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%ingual rtery• $he lingual &ranch is a&out even 2ith the hyoid

&one and has several &ranches that su""ly theentire tongue, 7oor of the mouth, lingual gingiva,a "ortion of the soft "alate, and the tonsils'


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&acial rtery• $he facial artery is a&ove the lingual artery, near

the angle of the mandi&le


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&acial rtery• It &ranches across the mandi&le to the corners of

the mouth and then u"2ard to2ard the eye'• $he facial artery has si% &ranches that su""ly

• the "haryn% muscles,• soft "alate,• tonsils,• "osterior of the tongue,• su&mandi&ular gland,• muscles of the face,• nasal se"tum,• nose, and• eyelids'


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Maxillary rtery• $he maxillary artery is the largest of the

&ranches of the e%ternal carotid artery'• It moves anteriorly across the ramus of the

mandi&le, near the condyle, and su""lies facial

structures'• $he ma%illary artery divides into three sections:

mandi&ular, "terygoid, and "terygo"alatine'


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Maxillary rtery• $he ma%illary artery divides into three sections:

mandi&ular, "terygoid, and "terygo"alatine'• $he mandibular artery is &ehind the ramus of the

mandi&le and &ranches into 5ve arteries '•

$he inferior alveolar artery descends into the ramus,enters the mandi&ular foramen, and &ifurcates aroundthe 5rst "remolar tooth to form the incisive and themental arteries

• $he mylohyoid artery &ranches o the inferior alveolarartery &efore entering the mandi&ular canal' It su""lies the

mylohyoid muscle'• $he Dental arteries su""ly the roots and "eriodontalligaments of the molars and "remolars

• $he incisive arteries continue anteriorly to su""ly &lood tothe roots and "eriodontal ligaments of the anterior teeth '

• $he mental artery &ranches o the inferior alveolar artery,and then su""lies the chin and lo2er li"'


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Maxillary rtery• $he ma%illary artery divides into three sections:

mandi&ular, "terygoid, and "terygo"alatine'• $he "terygoid artery su""lies &lood to the tem"oral

muscle, masseter muscle, "terygoid muscles, and&uccinator muscles'

• $he "terygo"alatine artery divides into &ranches:• "osterior su"erior alveolar artery:

• ma%illary sinus, ma%illary molar teeth, and surrounding gingiva• infraor&ital artery:

• face•

middle su"erior alveolar artery:• ma%illary "remolar teeth

• anterior su"erior alveolar artery:• anterior teeth

• greater "alatine artery:• hard "alate and thema%illary lingual gingiva'


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'eins of the &ace and(ral #avity

• )ome of the veins of the face and oral cavity arelocated 2ith corres"onding arteries and have similarnames '

• $he veins are divided into the su"er5cial veins and thedee" veins'

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Head and Neck Pskg#