Cranial nerves

INTRODUCTION
The face and the dental apparatus receive innervation from sensory
fibers, motor fibers, fibers of the special sense and parasymphatalie fibers,
the four modalities are carried by different cranial nerves.
The face and the dental structures also receive rich and extensive
blood supply through various blood vessels.
Apart from this 15% of the lymph nodes of the body are situated in
the head and neck region.
THE CRANIAL NERVES
The nerves of the body may be classified also by their functions.
Those nerves that supply muscles and structures of the body wall are called
somatic. Nerves to the internal organs (viscera) are termed visceral. Sensory
fibers that carry impulses toward the brain are designated as afferent. Motor
fibers are termed efferent. They carry impulses away from the brain to the
effector.
Cranial nerves are comprised of afferent fibers (taste, pain,
proprioception), as well as efferent fibers to the muscles, glands, and blood
vessels. Some nerves are highly specialized and do not carry all the
components.
The cranial nerves are released from the base of the brain, and exit
from the cranial cavity through various openings and foramina. They are
designated by Roman numerals, and all paired. There are 12 pairs of cranial
nerve. They are.
I Olfactory
II Optic
III Oculomotor
IV Trochlear

V Trigeminal
VI Abducent
VII Facial
VIII Vestibulocochlear
IX Glossopharyngeal
X Vagus
XI Accessory
XII Hypoglossal.
The cranial nerves involved in the innervation of dental apparatus are
TRIGEMINAL NERVE (V)
Not only in the fifth cranial nerve the largest of the cranial nerves, but
also is the single most important nerve to the members of the dental
profession.
It supplies almost all the pain and proprioception fibers to the face,
jaws and scalp. The trigeminal nerve also innervates muscles and carries
parasympathetic fibers to the salivary and the lacrimal glands.
The trigeminal nerve arises from the ventral surface of the cerebral
pons by a short trunk composed of too closely adapted roots; a thin motor
root and a thick sensory root. The two roots pass anteriorly together for a
short distance within the cranial cavity, a swelling or bulging of this
structure is then noted. This is the semilunar (gasserian) ganglion. In this
ganglion lie the cell bodies of the sensory fibers of the fifth cranial nerve.
The nerve divides into three branches; the ophthalmic, the maxillary
and the mandibular.
The ophthalmic nerve : The ophthalmic nerve is the first division of the
trigeminal nerve. It exists from the brain case and enters the orbit through
the superior orbital fissure. It supplies sensory fibers to the bulb of the eye,

the conjunctiva, the lacrimal gland, inside of the nose, and skin of the
eyelids, forehead and nose.
It divides into three branches – the lacrimal, frontal and nasocilliary.
The lacrimal nerve : This branch supplies the lacrimal gland with sensory
fibers. In its course towards the lacrimal gland, it receives a branch from the
zygomatic nerve of the second division. This connecting branch contains
postganglionic parasympathetic fibers from the pterygopalatine ganglion,
which reach the lacrimal gland via the lacrimal nerve. After passing through
or along the lacrimal gland, the lacrimal nerve reaches the upper eyelid near
the outer corner of the eye and supplies the lateral part of the upper eyelid
and a small adjacent area of the skin.
The frontal nerve : This is the largest of the three terminal branches of the
ophthalmic nerve. At the middle of the orbit it divides into a small
supratrochlear branch and a large supraorbital branch.
The supratrochlear nerve emerges from the orbit above the trochlea. It
supplies the conjunctiva, the upper eyelid, and a small area of the skin of the
forehead above the root of the nose.
The supraorbital nerve emerges from the orbit through the
supraorbital notch or foramen. It divides into medial and lateral branches
which run upwards over the forehead and scalp. It supplies the conjunctiva,
the central part of the upper eyelid, the frontal air sinus and the skin of the
forehead and scalp up to the vertex.
Nasocilliary nerve : This is one of the terminal branches of the ophthalmic
division of the trigeminal nerve. It runs along the medial wall of the orbit
and ends at the anterior ethmoidal foramen by dividing into infratrochlear
and anterior ethmoidal nerves. Its branches are:
- It sends a communicating branch through the cilliary ganglion, its
fibers continue through the ganglion into the eyeball.

- The next branches of the nasocilliary nerves are the two or three long
cilliary nerves that run directly into the orbit, pierce the sclera and
supply sensory nerves to the cornea, the iris and the cilliary body.
- The infratrochlear nerve is the smallest terminal branch of the
nasocilliary nerve. It emerges from the orbit below the trochlea. It
supplies the conjunctiva, the lacrimal sac, the medial ends of the
eyelids and upper half of the external nose.
- The anterior ethmoidal nerve is the larger terminal branch of the
nasocilliary nerve. It leaves the orbit by passing through the anterior
ethmoidal foramen. It descends to into the nose through a slit at the
side of the crista galli. In the nasal it gives off two internal nasal
branches (medial and lateral) to the mucosa of the nose. Finally it
emerges at the lower border of the nasal bone as the external nasal
nerve which supplies the skin of the lower half of the nose.
THE MAXILLARY NERVE :
The maxillary nerve is the second division of the trigeminal nerve, it
leaves the skull through the foramen rotandum. It passes into the
pterygopalatine fossa, where it splits into three major branches : The
pterygopalatine nerve, the infraorbital nerve and the zygomatic nerve.
Pterygopalatine nerve : This nerve turn straight downward after it has left
the trunk of the second division. The pterygopalatine ganglion is attached to
the medial side of the nerve. The pterygopalatine nerve seem to enter the
ganglion. The fibers of the pterygopalatine nerve have, however only a
topographic connection with the pterygopalatine ganglion and do not enter
into a synapse with its cell. The superior posterior nasal branches are given
off at the level of the ganglion. They enter the nasal cavity through the
sphenopalatine foramen. The lateral braches of the superior posterior nasal
nerves supply the upper and middle conchae. Medial branches pass over the

roof of the nasal cavity to the nasal septum. One long medial fibre, course
downward and forward along the nasal septum, it is the nasopalatine nerve.
The nasopalatine nerve supplies the septal mucosa and passes through
the incisive cannal into the oral cavity. It supplies the oral mucosa and
minor salivary glands behind the maxillary teeth and may participate in the
innervation of upper central incisors.
The main part of the pterygopalatine nerve continues below the
pterygopalatine ganglion in a straight downward course through the entire
height of the pterygopalatine fossa and then through the pterygopalatine
canal. These descending nerves are called Palatine nerves.
Two or three branches leave the palatine nerve enter the nasal cavity
and supply the inferior conchae and are known as inferior or posterior nasal
nerves.
Before reaching the lower, oral end of the pterygopalatine canal, the
palatine nerve divides into one larger and two smaller terminal branches.
The large branch, the anterior palatine nerve, enters the oral cavity through
the major palatine foramen and turn anteriorly and soon splits into numerous
branches and supply the mucosa of the hard palate. The smaller middle and
posterior palatine nerves emerge into the oral cavity through the lesser
palatine foramina and oral cavity through the lesser palatine foramina and
supply the tonsil and soft palate with sensory twigs.
Infraorbital nerve : It is the continuation of the maxillary nerve. It enters
the orbit through the inferior orbital fissure. It then runs forward on the floor
of the orbit, at first in the infraorbital groove and then in the infraorbital
canal. It emerges on the face through the infraorbital foramen and
terminates by dividing into palpebral, nasal and labial branches.
The infraorbital nerve releases three sets of branches, before it
emerges at the infraorbital foramen. These branches are the superior

alveolar nerve, which supply the upper teeth, their periodontal membrane
and the gingiva on the outer surface of the upper jaw.
The posterior superior alveolar nerves arises from the infraorbital
nerve in the infratemporal fossa and enters the maxillary tuberosity through
posterior superior alveolar canal. The middle superior alveolar nerves which
is frequently absent run down in the lateral wall of the sinus to enter the
maxilla just before the infraorbital nerve exists from the infraorbital canal
through the infraorbital foramen releases the anterior superior alveolar
nerve, this nerve drops to the alveolar process through the canal situated in
the anterior wall of the maxillary sinus.
In the base of the alveolar process the superior alveolar nerves
exchange fibers and form a loose plexus, the superior alveolar or the
superior dental plexus. The terminal branches of the superior alveolar nerves
emerge from this plexus in two sets that accompany the corresponding
arteries. The first group are the dental nerves. Their number corresponds to
the number of roots of the superior teeth. Each dental nerve enters the apical
foramen of one of the roots and branches in the dental pulp. The second
group of the terminal branches of the superior alveolar nerves are the
interdental and interradicular nerves. Each interdental branch run through
the entire height of an interalveolar septum between two adjacent teeth and
supplies, during this part of its course, numerous branches to the periodontal
ligaments of the adjacent teeth through the alveolar bone proper. At the crest
of the interalveolar septum, the interdental nerves emerge into the gingiva
and supply the interdental papilla and the labial and buccal gingiva. The
interradicular nerves end in the periodontal ligament at the furcation of the
roots.
The terminal branches of the infraorbital nerve itself spread fanwise
from the intraorbital foramen towards the lower eyelid, nose, and upper lip.
The palpabral branches turn upward into the eyelid, the nasal branches

supply the lateral slope of the nose and the nasal wing. The superior labial
branches enter the upper lip and supply the mucous membrane, skin and
orbicularis Orin muscle.
Zygomatic nerve : It is the branch of the maxillary nerve given off in the
pterygopalatine fossa, it enter the orbit through the inferior orbital tissues,
and runs in the lateral wall to enter the zygomatic bone (through zygomatic
orbital foramen in the orbital surface of temporal bone. The zygomatic
nerve sends a branch upward to the lacrimal nerve; this communicating
branch consists of the postganglionic parasympathetic fibers, which arise
from the cells of the pterygopalatine ganglion. At first incorporated in the
zygomatic nerve, these visceral efferent fibers are shunted to the lacrimal
nerve and thus reach the lacrimal gland.
In the zygomatic bone the nerve divides into two branches. One
branch the zygomaticofacial nerve, emerges at the anterior or molar, surface
of the zygomatic bone and supplies the skin once the height of the right
cheek. The second branch, the zygomaticotemporal nerve emerges at the
posterior or temporal surface of the frontal process in the temporal fossa ; it
supplies a small anterior area of the skin in the temporal region.
MANDIBULAR NERVE :
The mandibular nerve is the third and the largest division of the
trigemenal nerve. It is also the only division to carry fibers from the motor
root to the skeletal muscle. Both the roots. The large sensory and a small
motor root, leave the skull through the foramen ovale and enters the
infratemporal fossa. The nerve then ramifies as it lies in the infratemporal
fossa, deep to the lateral pterygoid muscle. Most of the motor nerves to the
muscles of mastication are released here.
Masseteric nerve : It emerges at the upper border of the lateral pterygoid,
just in front of the temporomandibular point, passes laterally through the

mandibular notch and enters the deep surface of the masseter. It also
supplies the TMJ.
Deep Temporal nerves : There are two deep temporal nerves, anterior and
posterior. They pass between the skull and the lateral pterygoid and enter
the deep surface of the temporalis. The anterior nerve is often a branch of
the buccal nerve. The posterior nerve may arise in common with the
masseteric nerve.
Nerve to the medial pterygoid : It arises close to the otic ganglion and
supplies the medial pterygoid and also the tensor palati and tensor tympani
muscle.
Nerve to the lateral pterygoid : This nerve arises with the other nerves to
the muscles of mastication and enters the deep surface of the muscle.
Buccal nerve (Long Buccal Nerve ) : This is primarily a sensory nerve, but
it may carry a few motor fibers to the temporalis and lateral pterygoid
muscles (the buccinator receives motor fibers from the facial nerve) After
releasing the motor fibers, the buccal nerve passes laterally, between the
heads of the lateral pterygoid muscles and passes down and forward. It
crosses the anterior border of the vertical ramus of the mandible. When it
reaches the buccinator muscle, it turns forward and lies on the lateral
surface. The buccal nerve then ramifies, and the branches pierce the
buccinators muscle and supply the buccal mucosa of the cheek, buccal
gingiva of the mandibular molars, and sometimes a portion of the lip
mucosa breathes supply the skin of the cheek.
The lingual nerve : It is one of the two terminal branches of the posterior
division of the mandibular nerve. Below the foramen ovale, this nerve
united closely with the inferior alveolar nerve. The lingual nerve descends
between the lateral and medial pterygoid muscles and may be separated
from the inferior alveolar nerve by the pterygospinous ligament. At the
lower border of the lateral pterygoid the lingual nerve receives the chorda

tympani, the chorda tympani carries visceral efferent and taste fibers from
the facial nerve.
Below the lateral pterygoid muscle the lingual nerve courses
downwards and follows the lateral surface of the medial pterygoid muscle.
At the level of the upper end of the mylohyoid line the nerve turns in a sharp
curve anteriorly to continue horizontally on the superior surface of the
mylohyoid muscle into the oral cavity. At this point it releases fibers to the
submandibular ganglion.
At the posterior part of the oral cavity, above the mylohyoid line, at
the level of the third and the second lower molars, gives off gingival
branches that supply the mucous membrane on the inner side of the
mandible and the gingiva on the lingual surface of the teeth. Farther
anteriorly the lingual nerve is in close relation to the posterior part of the
sublingual gland, which receives several fine branches. When it enters the
substance of the tongue, the branches of the lingual nerve perforate the
muscles of the tongue lateral to the genioglossus muscle and end in the
mucous membrane of the lower and upper mucous membrane of the body of
the tongue. Posteriorly circumvallat papillae.
At its origin the lingual nerve carries only the fibers of general sense,
that is fibers for the perception of touch, pressure, pain and temperature. The
taste fibers for the anterior two thirds of the tongue, derived from the facial
nerve, are carried to the lingual nerve by the chorda tympani nerve and are
distributed to the taste buds in the branches of the lingual nerve.
Inferior alveolar nerve : It is the larger branch of the posterior division of
the mandibular nerve. This nerve descends with the lingual nerve in the
pterygomandibular space between the two pterygoid muscles. It winds
around the lower border of the lateral pterygoid muscle, which separates the
alveolar nerve from the mandibular ramus and then turns sharply outward

and downward to reach the inner surface of the mandible at the mandibular
foramen.
Before the nerve disappears into the canal of the mandible, it releases
the mylohyoid nerve (contain motor fibers also) it pierces the
sphenomandibular ligament runs in the mylohyoid groove, and supplies the
mylohyoid muscle and the anterior belly of the diagnostic.
The inferior alveolar nerve passes through the length of the
mandibular canal and divides in the premolar region into two unequal
terminal branches the incisive and mental nerves. The mental nerve leaves
the body of the mandible through the mental canal; emerging at the mental
foramen, the nerve usually divides into three branches. One branch turn
forward and downward to the skin of the chin. The other two branches
course anteriorly and upward into the lower lip and mucosa on the labial
alveolar surface. The incisive branch in one of the dental branches of the
inferior alveolar nerve.
The dental branches of the inferior alveolar nerve vary in number and
are arbitrarily divided into posterior, middle and anterior sets. The posterior
dental branch leaves the alveolar nerve in the most posterior part of the
mandibular canal ; the middle branches separate from the nerve trunk below
the first molar on the second premolar the anterior dental nerve is the
incisive nerve. Before the lower dental nerves send out their terminal
branches they exchange fibers and form a loose inferior alveolar plexus and
are arranged divided and supplied in a similar way as in the upper jaw.
Auriculotemporal nerve : This nerve turns backwards from the trunk of
the mandibular nerve, arising shortly after the mandibular nerve exits from
the foramen ovale. It splits encircling the middle meningial artery, fuses,
and rums posteriorly. When it reaches the rear of the neck of the mandible,
it turns upwards and accompanies the superficial temporal artery, it then

passes under the parotid gland and over the root of the zygomatic arch. The
auriculotemporal nerve supplies the skin of the car and the temporal region
with sensory fibers. It also supplies sensation to the temporamandibular
joint, sends a few fibers to the zygomatic portion of the cheek, and carries
postgangliomic secretory fibers from the glossophragneeal nerve to the
parotid gland.
Applied anatomy :
1) The sensory distribution of the trigeminal nerve explain why
headache is a uniformly common symptom in involvements of the
nose (common cold, boils), the paranasal air sinuses (Sinusitis), the
teeth and gums (infections C inflammation), eyes (refractive errors,
glaucoma etc), the meanings (meningitis) and so on.
2) Trigeminal neuralgia : May involve or more of the three division of
the trigeminal nerve. It causes attacks of very severe, burning and
scalding pain along the distribution of the affected nerve.
Pain is relieved either a) by injecting 90% alcohol into the affected
division of the trigeminal ganglion b) by sectioning the affected nerve, the
main, sensory root, or the spinal tract of the trigeminal (medullary
tractotomy)
FACIAL NERVE (VII)
The facial nerve is an interesting and complex structure. The facial
nerve in reality consists of two nerves, the facial nerve proper and the
intermediate nerve.
The facial nerve proper consists of the somatized motor fibers, which
are destined for the muscles of facial expression, the occipital, auricular,
platsyma and stepedius, the posterior belly of diagastric, and the stylohyoid
muscle. The intermediate nerve contain propioceptive sensory fibers. Which
serve the deep sensitivity of the face, and special sensory fibers mediating

the taste sensation to the anterior 2/3rd
of the tongue and the palate, and
afferent parasympathetic preganglionic fibers to the mucous glands of the
nose and salivary glands of the mouth.
Both roots fuse and pass into the internal auditory meatus and enter
the substance of the petrous portion of the temporal bone. While still in the
temporal bone, the facial nerve enters the facial canal. It takes a tortuous
course within the bone in the facial canal, a channel inside the temporal
bone. While still inside the one, the nerve encounters the sensory ganglion
of the facial nerve, the geniculate ganglion. Also while in the facial canal of
the temporal bone, the facial nerve releases several branches.
The first important branch of the facial nerve leaves at the knee of the
facial nerve. It is the
Greater petrosal nerve : This nerve contain taste some fibers for the
palate, but mainly it contain the preganglionic parasympathetic ganglion,
whence they are relayed to the lacrimal gland and some nasal and palatine
glands this nerve leaves the cranial cavity by a complex route, after joining
the deep petrosal nerve from the sympathetic plexus of the internal carotid
artery, the greater petrosal nerve and the deep petrosal nerve form the nerve
of the pterygoid canal, which passes through the pterygoid canal into the
pteygopalatine fossa to the pterygopalatine ganglion.
The next branch of the facial nerve given off in the descending part of
the facial canal is a small motor nerve for the stapedius muscle, called the
nerve to the stapedius muscle.
One more branch leaves the facial nerve in its canal above the
stylomostoid foramen, that is the
Chorda tympani nerve : After arising from the facial nerve, and taking a
tortuous course, the chorda tympani nerve exists from the skill from the base
of the sphenoid bone near the angle of the spine. It then courses downward

and joins the lingual nerve where the lingual nerve passes between the
pterygoid muscles.
The chorda tympani continues with the lingual nerve, when the
lingual nerve lies close to the upper pole of the submandibular gland, the
preganglionic parasympathetic secretory fibers contained in the chorda
tympani, leave the lingual nerve and enter the submandibular ganglion. The
taste fibers of the chorda tympani follow the lingual nerve into the substance
of the tongue and are distributed to the taste buds on the anterior 2/3rd
of the
tongue. Taste buds signal sweet and salt from the tip of the tongue, sour
(acid) from the sides, and bitter from the base. The dorsum is silent.
Immediately after emerging from the stylomastoid foramen, the facial
nerve gives of two branches. One of these, the posterior auricular branch,
turns backwards and upwards between the mastoid process and the auricle
and supplies the posterior auricular and occipital muscles.
The other branch, the diagastric branch turns downwards and supply
the posterior belly of the diagastic muscle.
At the stylomastoid foramen the main trunk of the facial nerve enters
the substance of the parotid gland, in which its ramification takes place. It
enters the posteromedial surface of the parotid gland, runs through the gland
crossing the retromandibular vein and the external carotid artery. Behind the
neck of the mandible it divides into its five terminal branches. From above
downwards these branches are the temporal, zygomatic, buccal, mandibular
and cervical branches.
The temporal branches : emerge from the parotid grand, cross the
zygomatic arch, and supply the auricularis muscles, frontalis, orbicularis
occuli and corrugator muscles.
The zygomatic branches of the facial nerve supply the inferior part
of the orbicularis oculi muscle.

The buccal branches of the facial nerve are often divided into upper
and lower group. The upper buccal branches supply the muscle of the upper
lip and muscles of the nose. The lower buccal branches supply the
buccinator muscle and risorius muscle as well as orbicularis oris.
The mandibular branch passes forward and downward and curves
anteriorly at the level of the inferior border of the mandible. It supplies the
muscles of the lower lip and chin.
The cervical branch emerges from the apex of the parotid gland, and
runs downwards and forwards in the neck, to supply the platysma.
The branches of the facial nerve exchange fibers with almost all the
sensory cutaneous branches of the trigeminal nerve. The connection
between the facial and trigeminal branches results in the formation of small
mixed terminal nerves, which carry motor and sensory fibers to the limited
area of the face.
Applied anatomy :
• In the infranuclear lesion of the facial nerve (ex : Bell’s palsy) the whole
of the face is paralysed. The face becomes asymmetrical and is drawn
towards the normal side. The affected side is motionless. wrinkles
disappear from the forehead, the eye cannot be closed, any attempt to
smile draws the face to the normal side. During mastication, food
accumulated between the teeth and the cheek. Articulation of labials is
impaired.
• In supranuclear lesions of facial nerve (usually a part of hemiplegia) only
the lower part of the face is paralysed.

GLOSSOPHARYNGEAL NERVE (IX)
The glossophryngeal nerve emerges from the brain on the lateral
surface of the medulla oblongata. The glossophryngeal nerve supplies the
tongue and the pharynx, it is composed of variety of fibers, both afferent
and efferent. It leaves the skill through the jugular foramen, at which point
its two sensory ganglion are locate. Those ganglia are known as the superior
petrosal and inferior petrosal ganglia. The glossophryngeal nerve has
several branches.
The tympanic nerves : The tympanic nerve leaves the inferior sensory
ganglion. It carries preganglionic parasympathetic secretory fibers and
sensory fibers to the mucosa of the middle ear. After leaving the sensory
ganglion, it enters the tympanic cavity. The tympanic nerve them perforates
the root of the cavity and having lost its sensory fibers, is known as the
lesser petrosal nerve. Its preganglionic parasympathetic secretory fibers then
synapse at the otic ganglion second order neurons then go to the parotid
salivary gland after joining the auriculotemporal nerve.
Carotid branch : At a variable level below the jugular foramen, the carotid
branch in released. It supplies afferent fibers to the carotid sinus and carotid
bodies. These two tiny organs are blood pressure regulatory mechanisms
that are located close to the bifurcation of the common carotid artery the
carotid nerve plays an important role in the reflex regulation of respiration,
heart action and blood pressure.
Stylopharyngeal nerve : With the stylopharygeal branch the
glossophragnogeal nerve supplies the motor fibers to the stylophrayngeas
muscle.
Pharyngeal branches : On the lateral wall of the pharynx and above the
stylopharyngeas muscle the pharyngeal branch are released. Some of which
join the branches of the vagus nerve to from the pharyngeal plexus. And

other of which perforate the middle constrictor of the pharynx to supply its
mucous membrane.
The glossopharyngeal nerve itself enter the base of the tongue below
the styloglossus muscle and deep to the hyoglossus muscle. Its terminal
branches supply the base of the tongue (posterior 1/3), including the vallate
and foliate papillae, with fibers of general sense and taste fibers.
Branches are also sent to the palatine tonsils; which are called the
tonsillar branches that supply the tonsil and join the lesser palatine nerves to
form a plexus from which fibers are distributed to the soft palate and to the
palatoglossal arches.
Applied Anatomy :
Taste sensation in posterior 1/3rd
of the tongue is lost in the IX nerve
lesion.
HYPOGLOSSAL NERVE (XII)
The twelfth cranial nerve supplies motor fibers to all the intrinsic and
extrinsic muscles of the tongue. No other nerve supplies these muscles with
motor fibers. In addition, the hypoglossal nerve carries proprioceptive
impulses from the muscles of the tongue to the brain.
The hypoglossal nerve arises from the anterior surface of the medulla
oblongata in the form of rootlets. These rootlets merge into a trunk, which
passes out from the brain case via the hypoglossal canal. At the level of the
mandibular foramen, as the nerve is passing downward, it turns anteriorly
and superficially, it courses forward and is almost horizontal as it reaches a
deep level to the angle of the mandible. Passing deep to the posterior belly
of the diagastric and stylohyodius muscle it ramifies to supply the muscles
of the tongue.
Intrinsic muscles – longitudinal, transverse and vertical
Extrinsic muscles – styloglossus, hyglossurs and genioglossus

As the nerve descends from the hypoglossal canal, it picks up fibers
from the first cervical nerve. It carries these fibers to a short distance and
then drops them off to the geniohyoid and thyrohyoid muscles.
Applied anatomy :
A lesion of the hypoglossal nerve produces paralysis of the tongue on
that side. It will not be able to move the tongue on that side. When the
patient attempts to protrude the tongue, the tongue will deviate towards the
affected side.
All the muscles of the palate – palatophargngeus, leveator palati,
palatoglossus supplied by phargngeal plexus. The fibres of this plexus are
derived from cranial part of accessory nerve (XI), through the vagus
nerve (X) except tensor palati which is supplied by mandibular division of
the trigeminal nerve (V3).
Applied Anatomy :
Lesions in the vagus and cranial part of the accessory nerve produce
- Nasal regurgitation of liquids
- Flattening of the palatal arch
- Nasal twang in the voice

BLOOD SUPPLY
The nutrients and oxygen necessary to sustain life are carried to all
the cells of all the tissues by the arteries. Vein and lymphatics pick up the
waste products of cell metabolism and together with deoxygenated red
blood cells, return them to various arras. The blood is then rejuvenated and
returns to the tissues for continued cell nutrition.
ARTERIAL SUPPLY
The arteries of the oral apparatus and adjacent regions are, with a few
exception, branches of the external carotid artery. Only parts of the nasal
cavity and upper parts of the face receive branches from the internal carotid
artery.
The common carotid as a rule is branches, runs lateral to the trachea
and the larynx to the level of the upper border of the thyroid cartilage, here
it gives side to internal carotid artery, situated posteromedially and external
carotid artery, situated posteromedially and external carotid situated
anterolaterally. At the division, of the internal carotid artery is slightly
widened to form a carotid sinus which is important for the reflex regulation
of blood pressure.
INTERNAL CAROTID ARTERY
The internal carotid artery ascends from its origin along the lateral
wall of the pharynx to the base of the skill, where the internal carotid artery
reaches the lateral wall of the pharynx, it is separated from the external
carotid artery by the styloglossal and stylopharyngeus muscles. At the base
of the skill, the internal carotid artery enters the carotid canal and passes
through it into the cranial cavity.

The internal carotid artery now enters the cavernous sinus, through
which it passes in a tight s-shaped curve – perforating the dura mater at the
roof of the cavernous sinus, the internal carotid artery reaches the intradural
space and the brain.
After emerging through the roof of the cavernous sinus, the internal
carotid artery releases the ophthalmic artery, which follows the optic nerve
into the orbit, then emits its cerebral branches.
The anterior cerebral artery turns medially and then anteriorly ;
where it bends it is connected with the anterior cerebral artery of the other
side by the anterior communicating artery. The middle cerebral artery
leaves the internal carotid at its lateral circumference to enter the deep
lateral, or syluian fissures between the frontal and temporal lobes of the
brain. The posterior communicating artery is given at the posterior
circumference of the internal carotid artery together with the anterior
choroid artery. The right and left posterior communicating arteries jein the
posterior cerebral arteries, which are the terminal braches of the unpaired
basilar artery. Thus an irregular hexagonal chain of anastomasing arteries,
the Circle of Willis, is around the optic chiasm and the stalk of the
hypophysis. Thus an elaborate, anastomotic, well – designed network of
arterial. Supply is available to the brain.
Ophthalmic artery : This branch of the internal carotid artery supplies the
eyeball, its muscles and the lacrimal gland and sends branches into the
eyelids and into the upper part of the face.
The central artery of the retina and the cilliary arteries are destined for
the eyeball. The lacrimal gland and the muscles of the eyeball are supplied
by the lacrimal artery and muscular branches.
Posterior and anterior ethmoid branches enter the nasal cavity through
the ethmoid foramina.

Medial and lateral palpebeal branches ; the latter arising from the
lacrimal artery, ramify in the eyelids. The superaorbital branch passing
through the superorbital foramen supplies the frontal muscle and the skin of
the forehead.
A frontal or supratrochlear branch leaves the orbit at the medial
corner of the eye and sends branches to the soft tissues of the forehead. The
supraorbital and frontal branches anastamose with each other and with the
branch of the superficial temporal artery.
The last facial branch of the ophthalmic artery in the nasal branch,
which courses downward on the lateral surface of the nose and anastomoses
with the angular artery, the terminal part of the facial artery, it also
anastamoses with the infraorbital artery.
EXTERNAL CAROTID ARTERY
The external carotid artery is the branch of the common carotid artery
that supplies the face, jaws and the scalp. It lies superficial to the internal
carotid artery.
The external carotid artery runs straight upwards, the artery
transverses the most posterior part of the submandibular triangle to enter the
retromandibular fossa. Here the external carotid artery changes its course
and ascends, embedded in the substance of the parotid gland, at the level of
the mandibular neck, the artery splits into two terminal branches the
superficial temporal artery and the maxillary artery.
According to the location of their origin, the branches of the external
artery can be divided into : anterior, posterior and medial branches, to which
the terminal branches of the artery have to be added.

Anterior branches of external carotid artery
Three arteries arise from the anterior wall of the external carotid
artery ; the superior thyroid artery, the lingual artery and the facial artery.
Superior thyroid artery : The bifurcation of the common carotid artery is
also the location for the origin of the superior thyroid artery, it curves
anteriorly and downward to supply the thyroid gland. The mucous
membrane and the muscles of the larges also receive blood from the
superior thyroid artery.
Lingual artery : Destined for the tip of the tongue via a tortuous course,
the lingual artery arises from the external carotid artery at the level of the
hyoid bone. Often in arises in common with the facial artery via the lingual
– facial trunk from its origin the lingual artery courses anteriorly to the
posterior border of the hyoglossus muscle. It passes deep to this muscle and
turns upwards to the mouth where it enter the base of the tongue. It
terminates at the tip of the tongue.
The lingual artery gives of sublingual artery to the floor of the
mouth, prior to entering the substance of the tongue. The sublingual artery
supplies the sublingual gland, mucosa of the floor of the mouth, the
mylohyoid muscle and the lingual gingiva. It anastamoses with the
submental branch of the facial artery. After giving off the sublingual artery,
the lingual artery, now in the body of the tongue, is termed the deep lingual
artery.
Facial artery :
The facial artery supplies, for the most part the superficial structure of
the face. It arises from the external carotid artery just above the origin of the
lingual artery at about the level of the angle of the mandible. It may arise
from the lingual – facial trunk. Passing forward and upward, it pass deep to
the diagastric muscle and enters the submandibular triangle. It then enters

the substance of the submandibular salivary gland. After it reaches superior
border of the gland, it arches upwards towards the floor of the mouth and
then turns downwards and laterally to pass below the inferior border of the
mandible. The artery then turns sharply upward on the lateral surface of the
mandible and crosses it in front of the anterior border of the masseter
muscle to enter the face. The facial part of this artery is characterized by the
course of the vessel, an adaptation to the varying expansion of the lip and
check. From the point where the artery crosses the lower border of the
mandible, it is directed towards the corner of the mouth and then follows the
lateral border of the nose to the inner corner of the eye. Here it ends as the
angular artery, anastamosing with branches of the ophthalmic artery of the
internal carotid artery.
The two most important branches of the facial artery under the jaws
are the ascending palatine and submental arteries.
The ascending palatine arises close to the origin of the facial artery
and supplies the soft palate, pharynx and the tonsils.
The submental artery originates from the facial artery before it turns
into the face. It supplies the submandibular region and anastamoses with the
sublingual artery.
The facial part of the artery gives off the inferior labial and superior
labial arteries, at the corner of the mouth. The inferior labial artery
anastomes with the mental artery to supply chin and lower lip.
The superior labial artery anastamoses with the terminal branches of
the ophthalmic artery and with the infraorbital arteries. The facial artery
then courses superiorly, giving branches to the side of the nose and check to
end at the medial cantus of the eye as the angular artery.

Posterior branches of the external carotid artery
Two branches arise from the posterior wall of the external carotid
artery : the occipital artery and posterior auricular artery.
Occipital artery : The occipital artery arises dose to the origin of the facial
artery. It, however runs upwards and backwards towards the occipital area
of the scalp. After it crosses the mastoid process in the occipital groove of
the temporal bone, it becomes more superficial, it supplies the scalp.
Posterior auricular artery : The posterior auricular artery originates from
the external carotid artery at a level just opposite the lobe of the ear. It then
passes laterally and posteriorly to supply the outer ear and adjacent scalp
behind the ear. The superior temporal and occipital artery both give
branches that anastamose with the posterior auricular artery.
Medial branch of external carotid artery
Ascending pharyngeal artery : it usually arises immediately above the
bifurcation of the common carotid artery. It ascends along the lateral
pharyngeal wall to the skull. The blood supply to the pharynx and adjacent
muscles is provided in part by this vessel. It is small and anastamoses with
pharyngeal branches of other arteries.
Terminal branches of the external carotid artery
The terminal branches of the external carotid artery are the superficial
temporal artery and maxillary artery.
Superficial temporal artery : The superficially temporal artery is
anatomically, but not embryologically, the continuation of the external
carotid artery. It ascends vertically in front of the ear to the temporal region
of the scalp. It passes through the substances of the parotid gland in the
retromandibular fossa, releasing the transverse facial artery, which passes
horizontally and ends near the lateral canthus of the eye. Also it sends

branches to the outer ear and a middle temporal branch to the temporalis
muscle. In the scalp, the branches of the superficial temporal artery
anastome with branches of the occipital artery, surpraorbital artery and
across the midline with the arteries of the opposite side.
Maxillary artery : The maxillary artery arises from the external carotid
artery just below the level of the mandibular neck in the substance of the
pacolid gland. Although superficial temporal continues the course of the
external carotid artery upward, whereas the maxillary artery arises at a right
angle, the maxillary artery in embryologically and physiologically the
continuation of ECA, which applies the deep tissues of the face.
The course is horizontal and anterior as it heads to the pterygopalatic
fossa. It is close to the medial surface of the condylar neck when it first
originates, and as it passes deeply, it runs between the condylar neck and the
sphenomandibular ligament. Where, it lies either lateral or medial to the
lateral pterygoid muscle. If it lies lateral, it must reach the pterygopalatine
fossa by turning medially between the two heads of origin of the lateral
pterygoid muscle.
It is easy to understand the division of the maxillary artery if one
classifies it into sections and organizes its distribution. The maxillary artery
may arbitrarily be divided into four parts. The first, or mandibular, part is
that short section which lies medial to the mandibular neck. The second
part, the muscular, or pterygoid, part is the longest of the four and is in close
relation to the lateral pterygoid muscle. The third part is the maxillary part,
which is here in dose relation to the posterior surface of the maxilla. The
fourth and terminal part in best termed as the pterygopatatine part, because
the artery divides into its terminal branches in the pterygopalatine space,
which it enters through the pterygopalatine gap.

Mandibular part
The first, or mandibular segment of the maxillary artery gives off two
small branches to the ear.
The deep auricular artery supplies the external acoustic mantas the
tympanic membrane and the TMJ.
The anterior tympanic branch supplies the middle ear including the
medial surface of tympanic membrane.
Following these, the two main branches of this mandibular segment
are released, the middle meningeal artery and the inferior alveolar artery.
The middle meningral artery : Passes between the two roots of the
auriculotemporal nerve, runs straight up to enter the foramen spinosum into
the cranial cavity it supplies the dura mater and adjacent bones.
The inferior alveolar artery : from the origin, the inferior alveolar
artery turns almost vertically downward to reach the mandibular foramen,
the entrance to the mandibular canal, before entering the canal, the inferior
alveolar artery releases the mylohyoid artery which supplies the mylohyoid
muscle and anastomes with the mental artery.
In the mandibular canal, the inferior alveolar artery sends branches
into the marrow spaces of the bone and to the teeth and the alveolar process.
The mental artery, the larger of the two terminal branches is released
through the mental canal, it supplies the soft tissues of the chin and
anastamoses with inferior labial artery. The second smaller branch, the
incisive artery continues its course inside the mandible to the midline,
where it anastamoses with the artery of the other side.
The blood vessels that turn from the inferior alveolar artery upward
into the alveolar process are of two distinct types. One set of branches enter
the root canals through the apical foramina and supplies the dental pulps.

They can be termed dental arteries. A second set of branches, alveolar or
perforating, branches, enter the interdental and interradicular septa.
Many small branches arising at right angle from the interdental
arteries supply the periodontal ligaments of adjacent teeth. The
interradicular alveolar arteries and in the periodontal ligament at the
bifurcation of the molars.
The interdental alveolar arteries perforate the alveolar crest in the
interdental spaces and end in the gingival, supplying the interdental papilla
and the adjacent areas of the buccal and lingual gingival. In the gingiva
these branches anastamose with superficial branches of arteries, which
supply the oral and vestibular mucosa, for instance, with branches of the
lingual buccal, mental and palatine artery.
Muscular or pterygoid part.
This part supplies the muscles of mastication and buccinator. The
temporalis receives the posterior and anterior deep temporal arteries. The
messenteric artery passes laterally through the condylar notch to supply the
masseter muscle. A variable number of small pterygoid branches. Are
released to the pterygoid muscles. The last branch of this section is the
buccal artery; which turns downward and forward between the inferior
head of the lateral pterygoid and temporal muscle and reaches the space
between the buccinator and the masseter. At the outer surface of the
buccinator muscle, the buccal artery breaks up into terminal branches. They
supply the buccinator muscle and the mucous lining of the check and
anastaomose with branches of the facial artery and the transverse facial
artery.

Maxillary part
The third segment of the maxillary artery runs along the posterior
surface of the maxilla near its upper border. Here it gives of the posterior
superior alveolar and the infraorbital branches before entering the
pterygomaxillary fissure.
The posterior superior alveolar artery : crosses the maxillary tuberosity
and here gives off posterior superior arteries that enter the posterior superior
alveolar canals accompanied by posterior superior alveolar nerves. The
terminal, or gingival extensions of the posterior superior alveolar artery
continue to supply the mucosa covering the buccal surface of the alveolar
process of the molar and premolars up to their gingival margin several
branches extend into the checks.
The infraorbital artery : enters the orbit through the inferior orbital tissue
and runs anteriorly, fist in the infraorbital sulcus and then in the infraorbital
canal. Emerging through the infraorbital foramen, the infraorbital artery
supplies the anterior part of the check and the root of the upper lip and
anastamoses with the branches of the superior labial artery of the facial
artery and the angular artery. In the infraorbital canal, anterior superior
alveolar artery is given off before. Leaving through the infraorbital foramen.
The anterior superior alveolar artery follows the anterior superior
alveolar nerves through the narrow canals in the anterior wall of the
maxillary sinus to the alveolar process. There the anterior superior alveolar
artery anastamoses with branches of the posterior superior alveolar artery.
The branches that the superior alveolar artery release are, in principle
arranged like those in the mandible.

Pterygopalatine part
This part of the maxillary artery is short because the artery divides
into its terminal branches immediately after entering the pterygopalatine
fossa through the pterygomaxillary fissure, the gap between the maxilla and
the pterygoid process of the sphenoid bone.
The descending palatine artery : arises in the pterygopalatine fossa and
passes inferiorly to enter the oral cavity through the greater palatine
foramen. In the pterygopalatine canal it may give off small nasal
branches to the lateral wall of the nasal cavity. Also it gives off lesser
palatine branches which exit from the lesser palatine foramina and
supply the soft palate and tonsil once it exists from the greater palatine
foramen, the descending palatine artery is known as the major palatine
artery which turns forwards in the substance of the palatal mucosa and
passes anteriorly to the nasopalatine foramen. In its course it gives
branches to the associated bone, glands and mucosa. Once it reaches the
nasopalatine foramen, it turns upwards and passes through the
nasopalatine canal into the nose and anastamoses with sphenopalatine
artery on the septum.
Sphenopalatine artery : also arises in the pterygopalatine fossa. It enters
the nasal cavity through the sphenopalatine foramen there it divides into
branches supplying the lateral wall of the nasal cavity and septum. On the
septum it anastamoses with the septal branch of the anterior palatine artery.

VENOUS DRAINAGE
The venous blood of the head and neck is drained almost entirely by
the internal jugular vein. Veins usually accompany arteries and carry the
same or similar names.
Deep vein are united with the superficial vein by several anastamoses.
There multiple anastamoses present a potential danger by increasing the
number and availability of pathways for speed of infection. In addition,
because the vein of the face have few, if any, valves, backflow of blood can
easily occur deep veins prior to the advent of antibiotics, brain infection
secondary to facial and dental infection was not uncommon.
Once blood reaches the internal jugular vein, it drains inferiorly to the
brachiocephalic vein. The brachiocephalic vein is formed by the confluence
of the internal jugular vein and the subclavian vein, which drains the upper
extremity. The right and left brachiochephalic vein then join to form the
superior vena cava. The inferior vena cava, draining the lower portion of the
body, join the superior of vena cava in an area known as the confluence of
the cava, located at the right atrium.
VENOUS SINUSES
The sinuses of the duramater in the brain empty their contents into the
internal jugular vein which commences at the jugular foramen. Blood from
the eye and the brain is collected in the dural sinuses.
Superior sagittal sinus
The superior sagittal sinus begins in the area of the cribriform plate of
the ethmoid bone and passes posteriorly in the middle along the inner plate
of the frontal, parietal and occipital bones. It drains some of the vein of the
brain as it runs posteriorly.

Inferior sagittal sinus
The inferior sagittal sinus is enclosed in the lower for border of the
vertical fold of the dura which separates the two halves of the cerebreum.
Straight sinus
The straight sinus join the inferior and superior sagittal sinus. It lies in
a horizontal fold of dura, separating the cerebrum and cerebellum.
Transverse sinus
The transverse sinus begins where the straight sinus and superior
sagittal sinuses join. It passes laterally in a horizontal plane to become a s-
shaped sinus, the sigmoid sinus, and then into the internal jugular vein at the
jugular foramen.
Cavernous sinus
The cavernous sinuses, which lie on either side of the sella turcica,
are pools of venous blood, subdivided by thin trabacule of connective tissue.
The right and left cavernous sinuses communicate with one another via
anterior and posterior chambers known as intercavernous sinuses. The
cavernous sinus drain associated parts of the brain. Also, the ophthalmic
veins draining the eye empty posteriorly into the cavernous sinus.
Clinically, its of great importance to know that the internal carolid artery,
first two division o the trigeminal nerve, the abducent the occulomotor and
the trochlear nerve all pass through the cavernous sinus. Retrograde
infection into this sinus can lead to a grave clinical problem.
Petrosal sinuses
The blood in the cavernous sinus is drained posteriorly in the superior
and inferior petrosal sinuses. The superior petrosal sinus ends in the sigmoid
sinus. The inferior petrosal sinus empties more inferiorly, directly into the
jugular vein near the foramen.

INTERNAL JUGULAR VEIN
The blood from the brain empties into the internal jugular vein which
is formed by the confluence of various sinuses and exits the brain case
through the jugular foramen. The vein descends in the neck to the
brachiocephalic vein.
Contributing vein include the inferior petrosal sinus, communication
from the pharynx and tongue, common facial vein, veins of the larynx and
the thyroid gland, the external jugular vein and the anterior jugular vein.
Common facial vein
The common facial vein is a short, thick vessel resulting from a
merger of the anterior facial vein and retromandibular vein. It enters the
internal jugular vein at the level of the hyoid nerve.
Anterior facial vein
The anterior facial vein follows a course similar to that of the facial
artery. It originates from the vein of the forehead and nose. The frontal vein,
supraorbital vein, and vein from the lids and nose all contribute to first part
of the facial vein, the angular vein. The angular vein than becomes the facial
vein as it drain inferiorly. A wide anastamosis takes place between the
angular vein and the superior and inferior ophthalmic vein. As the facial
vein descends it picks up communicating branches from the associated area.
An anastamotic facial vein at the level of the upper lip. This communicating
vein is the deep facial vein once the facial vein has picked up the superior
and inferior labial vein, it reaches the inferior border of the mandible where
it terns posteriorly and deep. Here it receives the submental and palatine
veins and enters the common facial vein.
Ophthalmic vein
The inferior ophthalmic vein drains the floor and medical wall of the
orbit and associated tissues it empties into either the pterygoid plexus, the

cavernous, the superior ophthalmic vein, or any combination of the three the
superior ophthalmic vein drains the area supplied by the ophthalmic artery
and empties into the cavernous sinus after passing through the superior
portion of the orbit.
Retromandibular vein
The areas supplied by the maxillary artery and superficial temporal
artery are drained by the retromandibular vein. It is formed by the union of
the superficial temporal vein with the deep vein of the maxilla. It emerges
from the substance of the parotid gland and courses vertically down to the
common facial vein.
Lingual vein
The lingual vein, 3 to 4 in number, drain the tongue and floor of the
mouth and empty into the anterior facial vein, the common facial vein or
retromandibular vein.
Pterygoid plexus
The venous network known as the pterygoid plexus lies between the
temporal and pterygoid muscles. It drains the muscles of mastication, the
nasal cavity, the TMJ, the external ear and a small portion of the dura. It
communicates with the facial vein by the way of the deep facial vein. Also,
it drains the maxillae and the palate and communicates with the cavernous
sinus. It empties posteroinferiorly joining the superficial temporal vein to
form the retromandibular vein.
External jugular vein
The external jugular vein is formed by the junction of the posterior
auricular vein with the occipital vein. It enters the internal jugular vein low
in the neck near the junction of the external jugular vein with the subcalvian
vein. It often anastamoses with the common facial vein or retromandibular
vein.

Anterior Jugular vein
Often absent, the anterior jugular vein may be a single midline vein or
two midline vein. It empties into the internal jugular vein near the junction
of the internal jugular vein with the subclavian vein. It drains the skin and
superficial fascia of a narrow anterior part of the neck close to the midline.
LYMPHATIC DRAINAGE
The lymphatic system represents an accessory route by which fluid
can flow from the interstitial spaces into the blood.
The fluid passing through the lymphatic vessels is called lymph
- It supplies nutrition and oxygen to those parts of the body where
blood cannot reach
- Drains away excess tissue fluid and metabolites
- Lymphocytes and monocytes of lymph acts as defensive cell of the
body.
Lymph nodes small bean shaped bodies, usually in groups are positioned
along the course of the lymph vessels. Their function is to filter the
lymphatic fluid flowing through them. Also they produce and discharge
lymphocytes.
As in the other parts of the body lymph in the head and neck is
carried by the very thin – walled lymph vessels to aggregation of nodes.
From the nodes it drains to other areas and ultimately into the thoracic duct.
The nodal system of the head and neck can be divided into groups of
nodes according to location.
Occipital nodes
Located near the occipital protuberance, the occipital nodes drain the
occipital portion of the scalp and empty into the cervical nodes.

Posterior auricular nodes
The posterior auricular nodes drain the mastoid region.
Anterior auricular nodes
The anterior auricular group drain the temporal region and skin of the
ear.
Parotid nodes
Several nodes are locate around and in parotid gland. They drain the
nasal cavities, eyelids, frontotemporal region, posterior palate, anterior
auricular nodes and parotid region.
Facial nodes
Several groups of nodes are located in the facial structures most of
these drain into submandibular nodes.
Sumandibular nodes
The submandibular nodes lie near the inferior border of the mandible.
They collect lymph from the submental region, upper and lower teeth,
tongue, lips and jaws and drain into deep cervical nodes.
Submental nodes
The submental group lies in the submental triangle between the
anterior bellies of diagastric muscle. These nodes drain the lower incisors
and empty into the submandibular and deep cervical nodes.
Cervical nodes
Various groups of nodes are located along the internal and external
jugular veins. They are divided into superficial and deep cervical nodes.
The superficial nodes are usually found in the upper region of the
neck. They receive lymph from the ear and adjacent region.
The deep cervical nodes are further sub divided into superior and
inferior deep cervical nodes. Lymph from the base of the tongue and
posterior floor of the mouth drain directly into these nodes, from the
auricular nodes, submandibular nodes, submental nodes, facial nodes,

occipital nodes and viscera of the neck, lymph drain into deep cervical
nodes.
On the right, lymph from the deep cervical nodes empties into the
right lymphatic duct. The thoracic duct collects the lymph from the left deep
cervical nodes.
Clinical implication
Knowledge of the lymph system and the geography of the various
groups of nodes is important in diagnosis in the normal state lymph nodes
are not palpable. Infection or cancer in an area drained by the vessels to
these nodes causes the nodes to become very active, and they become quite
firm and palpable. Palpable nodes are a most important sign of clinical
disease.
The cause of palpable lymph nodes should always be investigated
pain and swelling of the submandibular nodes are clearly indicative of oral
pathology. In addition we can predict the pathologic condition. If left
untreated, will spread involve the cervical nodes.
Malignancy is also common cause of palpable nodes cancer cells
often spread to regional lymph nodes and produce seeding and growth of the
tumor within the nodes.
Identification of palpable lymph nodes can result in early diagnosis
and thereby improve the prognosis.
CONCLUSION
As we being dentist dealing with the stomatognathic system, it is
imperative for us to have a sound knowledge about the nerve supply, blood
supply and the lymphatic drainage of the dental apparatus.

REFERENCES
1) Oral Anatomy - Lloyd Dubrul 8th
Edition
2) Anatomy of the head, neck, face and Jaws – Lawrence A. Fried 2nd
Edition
3) Grants Atlas of Anatomy 9th
Edition
4) Grays Anatomy 38th
Edition
5) Human Anatomy – B.D. Chaurasia 3rd
Edition
6) The Anatomical Basics of Dentistry – Bernard Liebgott 2nd
Eidtion

CRANIAL NERVES AND BLOOD SUPPLY
RELATED TO DENTAL APPARATUS INCLUDING
LYMPHATIC DRAINAGE
 INTRODUCTION
 CRANIAL NERVES – Trigeminal nerve
– Facial nerve
– Glossopharyngeal nerve
– Hypoglossal nerve.
 BLOOD SUPPLY – Arterial supply
– Venous drainage
 LYMPHATIC DRAINAGE
 CONCLUSION
 REFERENCES
Internal carotid artery
External carotid artery
Internal jugular vein

COLLEGE OF DENTAL SCINECES
DEPARTMENT OF PROSTHODONTICS
INCLUDING
CROWN & BRIDGE AND IMPLANTOLOGY
SEMINAR
ON
CRANIAL NERVES AND BLOOD
SUPPLY RELATED TO DENTAL
APPARATUS INCLUDING
LYMPHATIC DRAINAGE
PRESENTED BY
DR. SUNEEL G. PATIL

Cranial nerves

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