REVIEW FOR FINAL MATERIAL
* Mouth is divided into 4 quadrant , 8 teeth per quadrant : central 
incisor, lateral incisor , canine , 1
st
 premolar ,2
nd
 premolar , 1
st
 2
nd
 3
rd 
molar .  
*In General Periodontal ligaments principal fibers  are two types :  
1- alveodental ligament (main type) which consists of five fiber 
subgroups : alveolar crest fibers , horizontal fibers ,oblique fibers 
,apical fibers and interradicualr fibers . 2-Transseptal fibers  
*The ends of the principal fibers that are within either cementum or 
alveolar bone  are considered Sharpey fibers . 
*Trigiminal nerve ( 5
th
 cranial nerve ) has three major branches: the ophthalmic nerve (V1), the maxillary 
nerve (V2), and the mandibular nerve (V3).                            
>> anterior superior alveolar nerve supplies anterior teeth (incisors & canine) 
>>middle superior alveolar nerve supplies premolars and mesial root of 1
st
 molar  
>>posterior superior alveolar nerve supplies 1
st
 molar except mesial root ,2
nd
 and 3
rd
 molar  
SO if you want to anaesthetize the 1
st
 molar your target nerves are both : middle and posterior superior 
nerve  
*Maxillary artery  >>  The larger terminal branch of the ECA. 
*The inferior alveolar artery:  
1- the mylohyoid artery  -> suplies the floor of the mouth and the mylohyoid muscle 
2- dental branches -> pulp tissue of mandibular posterior teeth  
3- alveolar branches -> periodontium and gingiva of these teeth  
4- the mental artery   -> supplies the chin tissues  
5- the incisive artery  -> supplies mandibular anterior teeth  
*The anterior superior alveolar artery:  -> to supply the pulp and periodontium of the anterior maxillary 
teeth       
*Muscles of soft palate :  
1- palatoglossus muscle : >> It elevates the base of the tongue and closes the oro-pharyngeal isthmus  
2-Palatopharyngeal muscle : >> It elevates the larynx and pharynx & closes the pharyngeal isthmus 
3-Tensor veli palatine:   >> It stretches and depresses the anterior part of the soft palate, closes the pharyn-
geal isthmus , and dilate the auditory tube 
4-Musculus uvulae : >> pulls the uvula forward to its own side 
5-Levator veli palatine: >> elevate the soft palate and close the pharyngeal isthmus.  
*  Muscles are innervated by the pharyngeal plexus except for The tensor veli palatini muscle which is 
innervated by the Nerve to medial pterygoid (branch of mandibular  nerve ) 
*Sensory innervation:  Mostly by the maxillary nerve through its branches: Greater palatine nerve - Lesser 
palatine nerve - Nasopalatine nerve  
-Glossopharyngeal nerve supplies the region of the soft palate 
TONGUE 
*Is attached by muscles to the hyoid bone, mandible, styloid processes, and pharynx. 
* divided into : root(base) body  apex (blade)  //  has two surface : dorsum and ventricle  
*The dorsum >> oral part ( ant. 2/3 of tongue )  + pharyngeal 
part (post. 3
rd
 of tongue ) 
*lingual papillae :  
- filiform papillae >> most numerous - extremely large and 
rough 
-fungiform papillae >> mushroom shaped structures   
-Both fungiform and foliate papillae >> Carry taste buds - have a 
core of connective tissue. 
-circumvallate papillae >> easily visible with the naked eye            
*Lingual muscles are extrinsic muscle (arise from attachment to the bone)and intrinsic muscles (no 
attachment neither arising nor insertion) 
*extrinsic muscle : Genioglossus muscle , Hyoglossus muscle , Styloglossus muscle ,Palatoglossus muscle 
*Intrinsic muscle : Superior longitudinal muscle ,Inferior longitudinal muscle , Transverse muscle , Vertical 
muscle                                                  
*Hypoglossal nerve is the motor nerve of all muscle except for palatoglossus muscle  
*lingual nerve >> general sensation for ant 2/3  
*chorda tympani branch of facial nerve >> taste from ant 2/3  
*gloss pharyngeal nerve >> general and taste sensation for post. 1/3  
internal laryngeal nerve >> general and taste sensation for post.1/3 and epiglottis   
*Blood supply for tongue (primariliy) and floor of the mouth by : lingual artery  
*tongue receive second blood supply by tonsillar branch of the facial arteryand the ascending pharyngeal 
artery. 
* The lingual veins drain into internal jugular vein.  
pharynx  
*The outer wall of the pharynx consist of :  
1- mucus membrane      2- pharynx aponeurosis  
3- muscular coat          4- bucco pharyngeal fascia          
* The inner wall of pharynx consist of :  Superior constrictor  Middle constrictor  inferior constrictor . 
   >Superior  Constrictor  : lines the wall of nasopharynx and oropharnx  
    > Inferior constrictor : The Thickest  ,, two muscles :  
Thyropharyngeus (obliquely displaced)  +   Cricopharyngeus (transversly displaced )     
*PHARYNGEAL SPACES :    
1- Retropharyngeal space :  behind pharynx ,, extend : base of skull  ->  bifurcation of trachea 
2- Parapharyngeal space :   on the side of pharynx  ,,  Contains carotid vessels, jugular veins, last four 
cranial nerves & cervical sympathetic chain  
*Most of all nerves that supplies the pharynx come from pharyngeal plexus (pharyngeal branches of the 
glossopharyngeal + vagus nerves + superior cervical sympathetic ganglion. ) 
  pharyngeal branches + vagus nerve : all muscles  of pharynx except for stylopharyngeus thats 
supplies by glossopharyngeal nerve  
    *NASOPHARYNGEAL TONSIL(ADENOIDS) 
         >> At the junction of roof and posterior wall of nasopharynx  
         >> Increases in size up to the age of six years and then gradually disappears.  
    *Abscess in Nasopharyngeal Bursa >> : Thornwaldts disease 
    * Tubal tonsil : Collection of subepithelial  lymphoid tissue Sit.  at tubal elevation that is Continuous with 
adenoid tissue and forms a part of Waldeyers ring 
   *Boundaries  of OROPHARYNGEAL ISTHMUS  :  
     Above >> soft palate                Below >> upper surface of the tongue  
       Palatoglossal arch on either sides. 
   *Valleculae is Bounded medially by the median glossoepiglottic fold  and Laterally by  
         pharyngoepiglottic fold  
    *Drainage :  
                > Pyriform sinus drains intoupper jugular chain 
                >Rich lymphatics  high frequency of nodal metastasis in carcinoma of this region 
                >Post cricoid   parapharyngeal nodes 
                >Post wall  parapharyngeal nodes or lateral pharyngeal nodes                                                                                                  
NOSE  
*Nose consists of bony & cartilaginous framework above by the:  
  Nasal bones 
  Frontal processes of maxillae 
  Nasal part of frontal bone 
*Formed below by plates of hyaline cartilage, which include upper & lower nasal cartilages and the septal 
cartilage 
*Divided into right & left halves by the nasal septum , Each half has a: 
  Floor, Roof, Lateral wall & Medial wall (septum) 
*Medial Wall (Nasal Septum) is Formed: 
  Superiorly by the vertical (perpendicular) plate of ethmoid bone 
  Posteriorly by the vomer bone 
  Anteriorly by the septal cartilage 
*The cavity below each concha is called a meatus and are named as superior, middle & inferior 
corresponding to the conchae  
*Superior and middle conchae are part of ethmoidal 
labyrinth .   
* Sphenoethmoidal recess: Receives the opening of 
the sphenoidal sinus 
*Superior meatus: Receives the opening of the 
posterior ethmoidal sinus 
*Inferior meatus: Receives the opening of the 
nasolacrimal duct. The opening is guarded by a valve, a fold of mucous membrane 
*Linging of nasal cavity :   
  -   vestibule >> modified skin and has vibrissae 
  -  Roof , upper part of septum ,upper surface of the superior concha, and the sphenoethmoidal recess >> 
olfactory mucosa 
 - The rest of the cavity  >> respiratory mucosa 
*Nasal cavity receives sensory & visceral innervation 
*Olfactory mucosa supplied by olfactory nerves 
*Nerves of general sensation are derived from opthalmic (ant. Part ) & maxillary nerves (post. Part ) 
*Visceral Innervation :     Sympathetic fibers   +   Parasympathetic fibers  
                        supplies vascular smooth muscle          supply the mucosal gland 
*Arterial Supply : Sphenopalatine artery  + Alar and septal branches of superior labial artery  + Anterior & 
posterior ethmoidal arteries .  
*Venous Drainage into the facial, ophthalmic, and sphenopalatine veins. 
*Lymphatic Drainage:   submandibular lymph nodes &  upper deep cervical lymph nodes .  
*Maxillary Sinuses Opens into the middle meatus 
through the hiatus semilunaris & Supplied by 
superior alveolar & infraorbital nerves. 
*Frontal Sinuses Opens into the middle meatus 
through the infundibulum  & Supplied by the 
supraorbital nerve.  
*Ethmoidal Sinuses : Anterior group opens into the 
infundibulum, middle opens on the bulla, and 
posterior into the superior meatus ,,, Supplied by 
the anterior and posterior ethmoidal nerves 
*Sphenoidal Sinuses Open into the 
sphenoethmoidal recess & Supplied by the posterior ethmoidal nerve.  
The End  
WISH YOU THE BEST   
MADE BY : FARAH EDWAN