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43 Cards in this Set

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what bones form the hard palate?
the maxilla and palatine bones (covered by mucous membrane and glands)
what 2 nerves provide sensory innervation to the hard palate?
anteriorly: the nasopalatine n. (V2 via the incisive foramen)
posteriorly: the greater palatine n. (V2 via the greater palatine foramen)
blood supply to the hard palate is from the 3rd part of the maxillary a.
anteriorly: sphenopalatine a
posteriorly: greater palatine a. (terminal branch of descending palatine a. via the incisive foramen)
what structures form the musculomembraneous soft palate?
1) the palatine aponeurosis (from the tensor veli palatini m) attached to the posterior margin of the hard palate
2) the palatine uvula
3) levator veli palatini m.
4) tensor veli palatini m.
what does the tensor veli palatini m. do, and what is it innervated by?
tenses the soft palate

trigeminal n. (V3) innervates

***has apponeurosis that attaches to posterior hard palate***
what does the levator veli palatini m. do, and what is it innervated by?
elevates the soft palate

vagus n. (x) via the pharyngeal plexus
what is the blood supply to teh soft palate?
lesser palatine a. (branch of descending palatine a.)

ascending palatine artery (branch of facial a.)
what is the sensory innervation to the soft palate?
the lesser palatine n. (V2; via the lesser palatine foramen)
how many palates are involved in the development of the palate?
2:
primary and secondary palates
what composes the primary and secondary palates during palatal development
primary: part of intermaxillary segment, from fused medial nasal prominences (anterior part of palate)
secondary: two lateral palatine processes from an outgrowth of maxillary prominence (more posterior palate)
what week(s) does this occur:
palatine processes become horizontal and fuse; this fusion occurs at the midline, posteriorly with the primary palate, and superiorly with the nasal septum (from frontonasal prominence)
7th to 11th weeks
what week(s) does this occur:
2 lateral palatine processes grow obliquely on either side of the tongue, the lower jaw develops, and the tongue moves inferiorly
the 6th week: development of the secondary palate
what week(s) does this occur:
hard palate forms from the primary palate and the anterior portion of the secondary palate, and the soft palate forms from the posterior portion of the secondary palate and the uvula
12th week: bone development
what structures form the hard palate in development?
the primary palate and anterior portion of the secondary palate
what structure form the soft palate (no bone) in development?
the posterior portion of the secondary palate and the uvula
cleft lip and palate disorders are classified according to the location of the cleft and its relation to the incisive foramen, describe.
anterior clefts: anterior to the incisive foramen- cleft lips and clefts bewteen primary and secondary palates

posterior clefts: posterior to the incisive foramen- cleft between two lateral palatine processes
what is the distribution of cleft lip vs. cleft palate in males vs females?
cleft palate is higher in females
cleft lip is higher in males
there are a number (5+) of combinations of cleft lips and palates that can occur
1) unilateral cleft lip
2) unilateral anterior cleft lip and palate
3) bilateral anterior cleft lip and palate
4) isolated posterior cleft palate
5) cleft palate combines with unilateral cleft lip (anterior and posterior)
which one, cleft lip or cleft palate, has a higher incidence with increasing maternal age?
cleft lip
embryological explanation: cleft lip or palate?

failure of maxillary prominences to merge and fuse with medial nasal prominance(s) on affected side
cleft lip
embryological explanation: cleft lip or palate?

failure of lateral palatine process to fuse with each other, the primary palate, and/or nasal septum
cleft palate
what do the nasal cavities communicate with anteriorly and posteriorly?
anteriorly= nares
posterioly= pharynx via choanae
what 4 bones compose the roof of the nasal cavity?
1) nasal bone (anterior)
2) frontal bone
3) ethmoid bone
4) sphenoid bone (posterior)
whate 2 bones compose the floor of the nasal cavity?
1) maxilla
2) palatine
what 3 structures (2 bones & 1 cartilage) compose the medial wall of the nasal cavity?
1) vomer bone
2) perpendicular plate of ethmoid bone
3) septal cartilage
what 3 structures compose the lateral wall of the nasal cavity?
1) Superior nasal concha (ethmoid bone)
2) Middle nasal concha (ethmoid bone)
3) Inferior nasal concha (its own bone)
concha + muscosal membrane = ?
turbinates
what recess drains the sphnoid sinus?
the sphenoethmoid recess
there are 3 meatus', know what they drain:
superior meatus (1)
middle meatus (3)
inferior meatus (1)
1) superior meatus- drains posterior ethmoid sinus
2) middle meatus- drains anterior and middle ethmoid cells, frontal sinus, maxillary sinus
3) inferior meatus- drains the nasolacrimal duct
the ethmoid bulla (round elevation cause by bulging of middle ethmoidal cells) and the semilunar hiatus (curved cleft between the ethmoidal bulla and uncinate process) belong to which meatus?
middle meatus
special sensory innervation to nasal cavities is done by
olfactory n. (CN I)
T/F: the olfactory bulb is actually CN I
FALSE, the rootlets that come off of the olfactory bulb and go through the cribiform plate of ethmoid bone are actually CN I.
General sensation for the nasal sinus comes from what nerves?
V1 and V2
The nasal septum has 2 branches running through it underneath the mucosal layer:
1) naspalatine n. (V2)
2) branches of anterior ethmoidal n. (V1)
the later wall of the nasal cavity has three branches running through it
1) branches of the anterior ethmoidal n. (V1)
2) Lateral posterior superior branch of maxillary n. V2
3) Lateral posterior inferior branch of greater palatine n. (V2)
where does the lateral posterior superior branch come off of V2 vs. where does the lateral posterior inferior branch come off?
lateral posterior superior n comes off of the maxillary n. (V2) directly

the lateral posterior inferior n. comes off of the greater palatine n. (V2)
the superior 1/3 of the nasal cavity is supplied by branches of the _____ & _____ _______aa.

and the inferior 2/3 of the nasal cavity is supplied by branches of the __________ a. and ________ a.

what are their origins?
superior 1/3: branches of anterior and posterior ethmoidal aa. (from ophthalmic a. via the internal carotid a)

inferior 2/3: branches of sphenopalatine a. (from maxillary a) and branches of the facial a. (both maxillary and facial are branches of external carotid a.)
CC: Kiesselbach's area
highly vascularized region on the anterior nasal septum; common site for nosebleeds (epistaxis); arteries involved incl: anterior ethmoidal, superior labial, greater palatine, sphenopalatine aa.
***sphenopalatine--> worst***
name to 4 paranasal sinuses:

1) 4-17 small sinuses; located medial to orbit and lateral to nasal cavity
2) within the frontal bone
3) largest sinus within the maxilla; adjacent to maxillary teeth, orbit, and infratemporal region
4) located within the sphenoid bone; posteriorly located
1) ethmoidal
2) frontal
3) maxillary
4) sphenoid
name where the four paranasal sinuses drain to:
1) through an opening into the sphenoethmoidal recess
2) into superior or middle meatus
3) & 4) drains into middle meatus only
1) sphenoid sinus
2) ethmoidal sinus
3) maxillary sinus 4) frontal sinus
what bone is the sella turcica located in? what is contained in it? what covers it? what sinus is in close proximity to it inferoanteriorly? transphenoidal approach for surgery?
the sella turcica:
-is in the sphenoid bone
-contains the pituitary gland
-is covered by the diaphragma sellae
-is in close proximity to the sphenoidal sinus
-transphenoidal approad for getting to pituitary gland for surgery (up through sphenoidal sinus)
CC: maxillary sinus infections
-maxilllary sinus is the most frequently infected sinus.
-it darins through a superior opening and therefore only drains when completely filled therefor increasing risk of infection
-roots of some molars and premolars can extend close to the maxillary sinus and an abcess in one root can infect the sinus
-maxillary sinus pain can often cause tooth pain since it is innervated by branches of the superior alveolar n. (branches of V2)
CC: Rhinorrhea and CSF
Rhinorrhea (snot) testing positive for glucose (found in high concentrations in CSF) could indicate a fracture of the ethmoid sinuses