Soft Palate and Its Motor Innervation: a Brief Review
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Lingual Nerve Course and Its Communication with Hypoglossal
International Journal of Health and Clinical Research, 2021;4(5):117-122 e-ISSN: 2590-3241, p-ISSN: 2590-325X ____________________________________________________________________________________________________________________________________________ Original Research Article Lingual Nerve Course and Its Communication with Hypoglossal Nerve: Variations in Cadavers in Western India Javia Mayank Kumar1, Chhabra Prabhjot Kaur2*, Anand Mahindra Kumar3 1Associate Professor, Department of Anatomy, Banas Medical College & Research Institute, Palanpur, Gujarat,India 2Assistant Professor, Department of Anatomy,Jaipur National University Institute For Medical Sciences & Research Centre, Jaipur, Rajasthan,India 3Professor,Department of Anatomy, Banas Medical College & Research Institute, Palanpur,India Received: 22-12-2020 / Revised: 09-02-2021 / Accepted: 23-02-2021 Abstract Background:Locationand variations in branching pattern of lingual nerve makes it vulnerable to injury in various oral and dental surgical procedures. Awareness of variations in distribution pattern will reduce the chances of injury to lingual nerve and post-operative complications in excision of ranulas, extraction of third molar tooth, sub mental endotracheal intubationand during difficult suspension laryngoscopy. Present study was undertaken to describe the course, morphology and variationsof lingual nerve in infra-temporal and submandibular regions and to find out communication(s) if any with hypoglossal nerve.Methods: Head and neck dissection was performed in fifteen formalin -
Selecting Different Approaches for Palate and Pharynx Surgery
SPECIAL ISSUE 4: INVITED ARTICLE Selecting Different Approaches for Palate and Pharynx Surgery: Palatopharyngeal Arch Staging System Rodolfo Lugo-Saldaña1 , Karina Saldívar-Ponce2 , Irina González-Sáez3 , Daniela Hernández-Sirit4 , Patricia Mireles-García5 ABSTRACT The examination of the anatomical structures involved in the upper airway collapse in patients with the obstructive sleep apnea-hypopnea syndrome (OSAHS) is a key for integrated evaluation of patients. Our proposal is for a noninvasive classification system that guides us about the presence of anatomical differences between the palatopharyngeal muscle (PFM). The functions of the PFM are narrowing the isthmus, descending the palate, and raising the larynx during swallowing; these characteristics give the PFM a special role in the collapse of the lateral pharyngeal wall. Complete knowledge of the anatomy and classification of different variants can guide us to choose the appropriate surgical procedures for the lateral wall collapse. Until now there is not a consensus about description of the trajectory or anatomical variants of the PFM into oropharynx, the distance between both muscles, and the muscle tone. Here we also present the relationship between the lateral wall surgeries currently available (lateral pharyngoplasty by Cahali, expansion sphincteroplasty by Pang, relocation pharyngoplasty by Li, Roman blinds pharyngoplasty by Mantovani, and barbed sutures pharyngoplasty by Vicini) with the proposed classification of the palatopharyngeal arch staging system (PASS). Keywords: -
Numb Tongue, Numb Lip, Numb Chin: What to Do When?
NUMB TONGUE, NUMB LIP, NUMB CHIN: WHAT TO DO WHEN? Ramzey Tursun, DDS, FACS Marshall Green, DDS Andre Ledoux, DMD Arshad Kaleem, DMD, MD Assistant Professor, Associate Fellowship Director of Oral, Head & Neck Oncologic and Microvascular Reconstructive Surgery, DeWitt Daughtry Family Department of Surgery, Division of Oral Maxillofacial Surgery, Leonard M. Miller School of Medicine, University of Miami INTRODUCTION MECHANISM OF NERVE Microneurosurgery of the trigeminal nerve INJURIES has been in the spotlight over the last few years. The introduction of cone-beam When attempting to classify the various scanning, three-dimensional imaging, mechanisms of nerve injury in the magnetic resonance neurography, maxillofacial region, it becomes clear that endoscopic-assisted surgery, and use of the overwhelming majority are iatrogenic allogenic nerve grafts have improved the in nature. The nerves that are most often techniques that can be used for affected in dento-alveolar procedures are assessment and treatment of patients with the branches of the mandibular division of nerve injuries. Injury to the terminal cranial nerve V, i.e., the trigeminal nerve. branches of the trigeminal nerve is a well- The lingual nerve and inferior alveolar known risk associated with a wide range of nerve are most often affected, and third dental and surgical procedures. These molar surgery is the most common cause 1 injuries often heal spontaneously without of injury. medical or surgical intervention. However, they sometimes can cause a variety of None of these nerves provide motor symptoms, including lost or altered innervation. However, damage to these sensation, pain, or a combination of these, nerves can cause a significant loss of and may have an impact on speech, sensation and/or taste in affected patients. -
The Role of the Tensor Veli Palatini Muscle in the Development of Cleft Palate-Associated Middle Ear Problems
Clin Oral Invest DOI 10.1007/s00784-016-1828-x REVIEW The role of the tensor veli palatini muscle in the development of cleft palate-associated middle ear problems David S. P. Heidsieck1 & Bram J. A. Smarius1 & Karin P. Q. Oomen2 & Corstiaan C. Breugem1 Received: 8 July 2015 /Accepted: 17 April 2016 # The Author(s) 2016. This article is published with open access at Springerlink.com Abstract Conclusion More research is warranted to clarify the role of Objective Otitis media with effusion is common in infants the tensor veli palatini muscle in cleft palate-associated with an unrepaired cleft palate. Although its prevalence is Eustachian tube dysfunction and development of middle ear reduced after cleft surgery, many children continue to suffer problems. from middle ear problems during childhood. While the tensor Clinical relevance Optimized surgical management of cleft veli palatini muscle is thought to be involved in middle ear palate could potentially reduce associated middle ear ventilation, evidence about its exact anatomy, function, and problems. role in cleft palate surgery is limited. This study aimed to perform a thorough review of the lit- Keywords Cleft palate . Eustachian tube . Otitis media with erature on (1) the role of the tensor veli palatini muscle in the effusion . Tensor veli palatini muscle Eustachian tube opening and middle ear ventilation, (2) ana- tomical anomalies in cleft palate infants related to middle ear disease, and (3) their implications for surgical techniques used in cleft palate repair. Introduction Materials and methods A literature search on the MEDLINE database was performed using a combination of the keywords Otitis media with effusion is very common in infants with an Btensor veli palatini muscle,^ BEustachian tube,^ Botitis media unrepaired cleft palate under the age of 2 years. -
Anatomy of Maxillary and Mandibular Local Anesthesia
Anatomy of Mandibular and Maxillary Local Anesthesia Patricia L. Blanton, Ph.D., D.D.S. Professor Emeritus, Department of Anatomy, Baylor College of Dentistry – TAMUS and Private Practice in Periodontics Dallas, Texas Anatomy of Mandibular and Maxillary Local Anesthesia I. Introduction A. The anatomical basis of local anesthesia 1. Infiltration anesthesia 2. Block or trunk anesthesia II. Review of the Trigeminal Nerve (Cranial n. V) – the major sensory nerve of the head A. Ophthalmic Division 1. Course a. Superior orbital fissure – root of orbit – supraorbital foramen 2. Branches – sensory B. Maxillary Division 1. Course a. Foramen rotundum – pterygopalatine fossa – inferior orbital fissure – floor of orbit – infraorbital 2. Branches - sensory a. Zygomatic nerve b. Pterygopalatine nerves [nasal (nasopalatine), orbital, palatal (greater and lesser palatine), pharyngeal] c. Posterior superior alveolar nerves d. Infraorbital nerve (middle superior alveolar nerve, anterior superior nerve) C. Mandibular Division 1. Course a. Foramen ovale – infratemporal fossa – mandibular foramen, Canal -> mental foramen 2. Branches a. Sensory (1) Long buccal nerve (2) Lingual nerve (3) Inferior alveolar nerve -> mental nerve (4) Auriculotemporal nerve b. Motor (1) Pterygoid nerves (2) Temporal nerves (3) Masseteric nerves (4) Nerve to tensor tympani (5) Nerve to tensor veli palatine (6) Nerve to mylohyoid (7) Nerve to anterior belly of digastric c. Both motor and sensory (1) Mylohyoid nerve III. Usual Routes of innervation A. Maxilla 1. Teeth a. Molars – Posterior superior alveolar nerve b. Premolars – Middle superior alveolar nerve c. Incisors and cuspids – Anterior superior alveolar nerve 2. Gingiva a. Facial/buccal – Superior alveolar nerves b. Palatal – Anterior – Nasopalatine nerve; Posterior – Greater palatine nerves B. -
Abbreviations - Diagnosis
Abbreviations - Diagnosis AB abrasion AT attrition CA caries CFL cleft lip CFP cleft palate CLL cervical line lesion - See TR CMO craniomandibular osteopathy DT deciduous (primary) tooth DTC dentigerous cyst E enamel E/D enamel defect E/H enamel hypocalcification or hypoplasia FB foreign body FORL feline odontoclastic resorptive lesion - See TR FX fracture (tooth or jaw) G granuloma G/B buccal granuloma (cheek chewing lesion) G/L sublingual granuloma (tongue chewing lesion) G/E/L eosinophilic granuloma - lip G/E/P eosinophilic granuloma - palate G/E/T eosinophilic granuloma - tongue GH gingival hyperplasia GR gingival recession LAC laceration LAC/B laceration buccal (cheek) LAC/L laceration lip LAC/T laceration tongue MAL malocclusion MAL/1 class 1 malocclusion (neutroclusion - normal jaw relationship, specific teeth are incorrectly positioned) MAL/2 class 2 malocclusion (mandibular distoclusion - mandible shorter than maxilla) MAL/3 class 3 malocclusion (mandibular mesioclusion - maxilla shorter than mandible) BV buccoversion (crown directed towards cheek) CXB caudal crossbite DV distoversion (crown directed away from midline of dental arch) LABV labioversion (crown directed towards lip) LV linguoversion (crown directed towards tongue) MV mesioversion (crown directed towards midline of dental arch) OB open bite RXB rostral crossbite MN mandible or mandibular MN/FX mandibular fracture MX maxilla or maxillary MX/FX maxillary fracture OM oral mass OM/AD adenocarcinoma OM/EPA acanthomatous ameloblastoma (epulis) OM/EPF fibromatous epulis -
Risks and Complications of Orthodontic Miniscrews
SPECIAL ARTICLE Risks and complications of orthodontic miniscrews Neal D. Kravitza and Budi Kusnotob Chicago, Ill The risks associated with miniscrew placement should be clearly understood by both the clinician and the patient. Complications can arise during miniscrew placement and after orthodontic loading that affect stability and patient safety. A thorough understanding of proper placement technique, bone density and landscape, peri-implant soft- tissue, regional anatomic structures, and patient home care are imperative for optimal patient safety and miniscrew success. The purpose of this article was to review the potential risks and complications of orthodontic miniscrews in regard to insertion, orthodontic loading, peri-implant soft-tissue health, and removal. (Am J Orthod Dentofacial Orthop 2007;131:00) iniscrews have proven to be a useful addition safest site for miniscrew placement.7-11 In the maxil- to the orthodontist’s armamentarium for con- lary buccal region, the greatest amount of interradicu- trol of skeletal anchorage in less compliant or lar bone is between the second premolar and the first M 12-14 noncompliant patients, but the risks involved with mini- molar, 5 to 8 mm from the alveolar crest. In the screw placement must be clearly understood by both the mandibular buccal region, the greatest amount of inter- clinician and the patient.1-3 Complications can arise dur- radicular bone is either between the second premolar ing miniscrew placement and after orthodontic loading and the first molar, or between the first molar and the in regard to stability and patient safety. A thorough un- second molar, approximately 11 mm from the alveolar derstanding of proper placement technique, bone density crest.12-14 and landscape, peri-implant soft-tissue, regional anatomi- During interradicular placement in the posterior re- cal structures, and patient home care are imperative for gion, there is a tendency for the clinician to change the optimal patient safety and miniscrew success. -
Angina Bullosa Haemorrhagica (Oral Blood Blister) (PDF)
Patient Information Maxillo-facial Angina Bullosa Haemorrhagica (Oral Blood Blister) What is Angina Bullosa Haemorrhagica? Angina Bullosa Hemorrhagica (ABH) is a condition where an often painful, but benign blood-filled blister suddenly develops in the mouth. The blisters are generally not due to a blood clotting disorder or any other medical disorder. It is a fairly common, sudden onset and benign blood blistering oral (mouth) disorder. It mainly affects people over 45 years and both males and females are equally affected. Usually there is no family history of the condition. It may be associated with Type 2 Diabetes, a family history of diabetes or Hyperglycaemia. What are the signs and symptoms of ABH? The first indication is a stinging pain or burning sensation just before the appearance of a blood blister The blisters last only a few minutes and then spontaneously rupture (burst), leaving a shallow ulcer that heals without scarring, discomfort or pain They can reach an average size of one to three centimetres in diameter The Soft Palate (back of the mouth) is the most affected site If they occur on the palate and are relatively big, they may need to be de-roofed (cut and drained) to ease the sensation of choking Patient Information Occasionally blisters can occur in the buccal mucosa (cheek) and tongue Approximately one third of the patients have blood blisters in more than one location. What are the causes of ABH? More than 50% of cases are related to minor trauma caused by: hot foods, restorative dentistry (fillings, crowns etc) or Periodontal Therapy (treatment of gum disease). -
Lecture 2 – Bone
Oral Histology Summary Notes Enoch Ng Lecture 2 – Bone - Protection of brain, lungs, other internal organs - Structural support for heart, lungs, and marrow - Attachment sites for muscles - Mineral reservoir for calcium (99% of body’s) and phosphorous (85% of body’s) - Trap for dangerous minerals (ex:// lead) - Transduction of sound - Endocrine organ (osteocalcin regulates insulin signaling, glucose metabolism, and fat mass) Structure - Compact/Cortical o Diaphysis of long bone, “envelope” of cuboid bones (vertebrae) o 10% porosity, 70-80% calcified (4x mass of trabecular bone) o Protective, subject to bending/torsion/compressive forces o Has Haversian system structure - Trabecular/Cancellous o Metaphysis and epiphysis of long bone, cuboid bone o 3D branching lattice formed along areas of mechanical stress o 50-90% porosity, 15-25% calcified (1/4 mass of compact bone) o High surface area high cellular activity (has marrow) o Metabolic turnover 8x greater than cortical bone o Subject to compressive forces o Trabeculae lined with endosteum (contains osteoprogenitors, osteoblasts, osteoclasts) - Woven Bone o Immature/primitive, rapidly growing . Normally – embryos, newborns, fracture calluses, metaphyseal region of bone . Abnormally – tumors, osteogenesis imperfecta, Pagetic bone o Disorganized, no uniform orientation of collagen fibers, coarse fibers, cells randomly arranged, varying mineral content, isotropic mechanical behavior (behavior the same no matter direction of applied force) - Lamellar Bone o Mature bone, remodeling of woven -
Vestibule Lingual Frenulum Tongue Hyoid Bone Trachea (A) Soft Palate
Mouth (oral cavity) Parotid gland Tongue Sublingual gland Salivary Submandibular glands gland Esophagus Pharynx Stomach Pancreas (Spleen) Liver Gallbladder Transverse colon Duodenum Descending colon Small Jejunum Ascending colon intestine Ileum Large Cecum intestine Sigmoid colon Rectum Appendix Anus Anal canal © 2018 Pearson Education, Inc. 1 Nasopharynx Hard palate Soft palate Oral cavity Uvula Lips (labia) Palatine tonsil Vestibule Lingual tonsil Oropharynx Lingual frenulum Epiglottis Tongue Laryngopharynx Hyoid bone Esophagus Trachea (a) © 2018 Pearson Education, Inc. 2 Upper lip Gingivae Hard palate (gums) Soft palate Uvula Palatine tonsil Oropharynx Tongue (b) © 2018 Pearson Education, Inc. 3 Nasopharynx Hard palate Soft palate Oral cavity Uvula Lips (labia) Palatine tonsil Vestibule Lingual tonsil Oropharynx Lingual frenulum Epiglottis Tongue Laryngopharynx Hyoid bone Esophagus Trachea (a) © 2018 Pearson Education, Inc. 4 Visceral peritoneum Intrinsic nerve plexuses • Myenteric nerve plexus • Submucosal nerve plexus Submucosal glands Mucosa • Surface epithelium • Lamina propria • Muscle layer Submucosa Muscularis externa • Longitudinal muscle layer • Circular muscle layer Serosa (visceral peritoneum) Nerve Gland in Lumen Artery mucosa Mesentery Vein Duct oF gland Lymphoid tissue outside alimentary canal © 2018 Pearson Education, Inc. 5 Diaphragm Falciform ligament Lesser Liver omentum Spleen Pancreas Gallbladder Stomach Duodenum Visceral peritoneum Transverse colon Greater omentum Mesenteries Parietal peritoneum Small intestine Peritoneal cavity Uterus Large intestine Cecum Rectum Anus Urinary bladder (a) (b) © 2018 Pearson Education, Inc. 6 Cardia Fundus Esophagus Muscularis Serosa externa • Longitudinal layer • Circular layer • Oblique layer Body Lesser Rugae curvature of Pylorus mucosa Greater curvature Duodenum Pyloric Pyloric sphincter antrum (a) (valve) © 2018 Pearson Education, Inc. 7 Fundus Body Rugae of mucosa Pyloric Pyloric (b) sphincter antrum © 2018 Pearson Education, Inc. -
The Articulatory System Chapter 6 Speech Science/ COMD 6305 UTD/ Callier Center William F. Katz, Ph.D
The articulatory system Chapter 6 Speech Science/ COMD 6305 UTD/ Callier Center William F. Katz, Ph.D. STRUCTURE/FUNCTION VOCAL TRACT CLASSIFICATION OF CONSONANTS AND VOWELS MORE ON RESONANCE ACOUSTIC ANALYSIS/ SPECTROGRAMS SUPRSEGMENTALS, COARTICULATION 1 Midsagittal dissection From Kent, 1997 2 Oral Cavity 3 Oral Structures – continued • Moistened by saliva • Lined by mucosa • Saliva affected by meds 4 Tonsils • PALATINE* (laterally – seen in oral periph • LINGUAL (inf.- root of tongue) • ADENOIDS (sup.) [= pharyngeal] • Palatine, lingual tonsils are larger in children • *removed in tonsillectomy 5 Adenoid Facies • Enlargement from infection may cause problems (adenoid facies) • Can cause problems with nasal sounds or voicing • Adenoidectomy; also tonsillectomy (for palatine tonsils) 6 Adenoid faces (example) 7 Oral structures - frenulum Important component of oral periphery exam Lingual frenomy – for ankyloglossia “tongue-tie” Some doctors will snip for infants, but often will loosen by itself 8 Hard Palate Much variability in palate shape and height Very high vault 9 Teeth 10 Dentition - details Primary (deciduous, milk teeth) Secondary (permanent) n=20: n=32: ◦ 2 incisor ◦ 4 incisor ◦ 1 canine ◦ 2 canine ◦ 2 molar ◦ 4 premolar (bicuspid) Just for “fun” – baby ◦ 6 molar teeth pushing in! NOTE: x 2 for upper and lower 11 Types of malocclusion • Angle’s classification: • I, II, III • Also, individual teeth can be misaligned (e.g. labioversion) Also “Neutrocclusion/ distocclusion/mesiocclusion” 12 Dental Occlusion –continued Other terminology 13 Mandible Action • Primary movements are elevation and depression • Also…. protrusion/retraction • Lateral grinding motion 14 Muscles of Jaw Elevation Like alligators, we are much stronger at jaw elevation (closing to head) than depression 15 Jaw Muscles ELEVATORS DEPRESSORS •Temporalis ✓ •Mylohyoid ✓ •Masseter ✓ •Geniohyoid✓ •Internal (medial) Pterygoid ✓ •Anterior belly of the digastric (- Kent) •Masseter and IP part of “mandibular sling” •External (lateral) pterygoid(?)-- also protrudes and rocks side to side. -
Head and Neck
DEFINITION OF ANATOMIC SITES WITHIN THE HEAD AND NECK adapted from the Summary Staging Guide 1977 published by the SEER Program, and the AJCC Cancer Staging Manual Fifth Edition published by the American Joint Committee on Cancer Staging. Note: Not all sites in the lip, oral cavity, pharynx and salivary glands are listed below. All sites to which a Summary Stage scheme applies are listed at the begining of the scheme. ORAL CAVITY AND ORAL PHARYNX (in ICD-O-3 sequence) The oral cavity extends from the skin-vermilion junction of the lips to the junction of the hard and soft palate above and to the line of circumvallate papillae below. The oral pharynx (oropharynx) is that portion of the continuity of the pharynx extending from the plane of the inferior surface of the soft palate to the plane of the superior surface of the hyoid bone (or floor of the vallecula) and includes the base of tongue, inferior surface of the soft palate and the uvula, the anterior and posterior tonsillar pillars, the glossotonsillar sulci, the pharyngeal tonsils, and the lateral and posterior walls. The oral cavity and oral pharynx are divided into the following specific areas: LIPS (C00._; vermilion surface, mucosal lip, labial mucosa) upper and lower, form the upper and lower anterior wall of the oral cavity. They consist of an exposed surface of modified epider- mis beginning at the junction of the vermilion border with the skin and including only the vermilion surface or that portion of the lip that comes into contact with the opposing lip.