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Nerve Supply Of Head And Neck
INDIAN DENTAL ACADEMY
Leader in continuing dental education www.indiandentalacademy.com
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Contents • Introduction• Basics of nervous system• Cutaneous supply of head and neck
• Trigeminal nerve• Cervical plexus
• Motor supply to head and neck• Facial nerve• Ansa cervicalis• Spinal accessory nerve
• Nerve supply of :• Extra ocular muscles• Nasal cavity• Palate • Tongue • Pharynx• Larynx• Teeth
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Introduction
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Neuron•Perikaryon•Dendrites•Axon•Myelin sheath•Synapse
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Nerve structures
•Multipolar•Bipolar•Unipolar
Classes of nerve fibres
•Type A, B,C•Myelinated & Unmyelinated•Sensory & Motorwww.indiandentalacademy.com
Sensory receptors
•Free nerve endings•epidermal •dermal
•Meissner’s corpuscle•Merkel disc endings•Pacinian corpuscle•Ruffini terminal•Golgi tendon organ
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CUTANEOUS SUPPLY OF HEAD AND NECK
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Cutaneous supply of:
Head – Trigeminal nerve Neck – Cervical plexus
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Trigeminal nerve
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Trigeminal nuclei
•Mesencephalic nucleus•Principal sensory nucleus•Nucleus of spinal tract•Motor nucleus
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Functional components
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Branches
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Distribution
•Branches
•Relation with ganglions
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Ophthalmic nerve
•Branches•Lacrimal•Frontal•Nasociliary
•Ciliary ganglion
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Ophthalmic Nerve
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Maxillary
Nervewww.indiandentalacademy.com
Pterygopalatine ganglion
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Man d i b u l a r Ne r v e
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Otic Gangl
ion
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Submandibular
Ganglion
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Cervical Plexus
•Lesser occipital•Greater auricular•Transverse cervical•Supra clavicular
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MOTOR SUPPLY OF HEAD AND NECK
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Facial Nerve
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Functional components
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Facial nerve nuclei
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Within petrous temporal
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Branches of
communication
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Branches on
the face
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Relation
with parot
id
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Various types
of branchi
ng
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Ansa cervicalis
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Accessory nerve
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NERVE SUPPLY OF STRUCTURAL UNITS
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Extra ocular musclesOculomotor nerve
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LR6
SO4www.indiandentalacademy.com
Nasal cavity
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PalateMotor supply - Pharyngeal plexus except tensor palatiGen. sensory - Palatine and glossopharyngealSpecial sensory – Lesser palatine nervesSecretomotor – Lesser palatine nerves
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Tongue• Sensory – Lingual and Glossopharyngeal• Special sensory– Chorda tympani and Glossopharyngeal• Motor – Hypoglossal except palatoglossus
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Pharynx
Sensory – Pharyngeal plexus (Ph. br. of IX, X, XI
n. and sup. cer. sym. gang.)Motor - Pharyngeal plexus
except stylopharyngeusSpecial sensory – Internal laryngealSecretomotor – Lesser palatine
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LarynxSensory – Up to the level of vocal cords – internal laryngeal n.
Below the level of vocal cords – Recurrent laryngeal n.Motor – Reccurent laryngeal except cricothyroid
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Teeth and related structures
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Special sensory innervation
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Special sensation from •Tongue•Soft palate•Pharynx
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Brachial plexus
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Care during maxillofacial surgeries
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VII n. damage
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VII n. damage
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UMN vsLMN
Facial n. nucleus
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Bell’s Palsy
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Submandibular surgery
‘Facial asymmetry is evident only when the patient talks and that bilateral section abolishes the asymmetry without interfering with speech’
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Frey’s syndrome
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Radical neck dissections
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Radical neck dissections
Horner’s syndrome
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Thyroid surgeries
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Pathologic conditions affecting nerves
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• Infective – Herpes zoster• Traumatic • Degenerative – Parkinsonism, Gullian
barre’• Demyelinating – Multiple sclerosis• Vascular• Neoplastic – Cerebropontine angle tumour
Pathologic conditions affecting nerves
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Herpes zoster
Herpes zoster is an acute, localized infection with varicella-zoster virus, which causes a
painful, blistering rash www.indiandentalacademy.com
Traumatic injuries
• Neuropraxia
• Axonotemesis
• Neurotemesis www.indiandentalacademy.com
Multiple sclerosis• Chronic autonomic disease of
the CNS in which gradual destruction of myelin occurs in patches throughout the brain or spinal cord or both, interfering with the nerve pathways and causing muscular weakness, loss of coordination and speech and visual disturbances
• If there is destruction of axons – permanent disability
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Myasthenia gravis
• A disease characterized by progressive fatigue
and generalized weakness of the skeletal muscles
esp. those of face, neck, arms and legs caused by
impaired transmission of nerve impulses following
an autoimmune attack of Ach receptors
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Parkinsonism
• A progressive nervous disease occurring most often
after the age of 50, asso. with the destruction of brain
cells that produce dopamine and characterized by
muscular tremor, slowing of movement, partial facial
paralysis, pecularity of gait and posture and
weakness.
• Paralysis agitans, shaking palsywww.indiandentalacademy.com
Paresis, paralysis and spasticity
Motor neuron diseasewww.indiandentalacademy.com
Conclusion
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References• Gray’s anatomy; 36th edition; Williams and Warwick• Anatomy and Physiology: The unity of form and function;
Kenneth S. Saladin• Clinical neuroanatomy for medical students; 4th edition;
Richard S. Snell• Chaurasia’s human anatomy; 4th edition• Anatomy for surgeons volume 1: The head and neck; 3rd edition; Hollinshead• Human anatomy; Prives, Lysenkov, Bushkovich• Grants atlas of anatomy• Colour atlas of applied anatomy; Mc. Minn• Complications in maxillofacial surgery; Kaban
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