Nerve supply of head and neck /certified fixed orthodontic courses by Indian dental academy

Nerve Supply Of Head And
Neck
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com


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


Introduction


Neuron
•Perikaryon
•Dendrites
•Axon
•Myelin sheath
•Synapse


Nerve structures
•Multipolar
•Bipolar
•Unipolar

Classes of nerve
fibres
•Type A, B,C
•Myelinated & Unmyelinated
•Sensory & Motor

Sensory receptors
•Free nerve endings
•epidermal
•dermal
•Meissner’s corpuscle
•Merkel disc endings
•Pacinian corpuscle
•Ruffini terminal
•Golgi tendon organ


CUTANEOUS SUPPLY OF HEAD
AND NECK


Cutaneous supply
of :
Head – Trigeminal nerve
Neck – Cervical plexus


Trigeminal
nerve


Trigeminal nuclei
•Mesencephalic nucleus
•Principal sensory nucleus
•Nucleus of spinal tract
•Motor nucleus


Functional components


Branches


Distribution
•Branches
•Relation with ganglions


Ophthalmic
nerve
•Branches
•Lacrimal
•Frontal
•Nasociliary
•Ciliary ganglion


Ophthalmic Nerve


M
a
x
i
l
l
a
r
y


N
e
r
v
e

Pterygopalatine ganglion



M
a
n
d
i
b
u
l
a N
r e
r
v
e

Otic
Ganglio
n


Submandibu
lar Ganglion


Cervical
Plexus
•Lesser occipital
•Greater auricular
•Transverse cervical
•Supra clavicular


MOTOR SUPPLY OF HEAD
AND NECK


Facial
Nerve


Facial nerve nuclei


Within petrous temporal


Branches of
communicati
on


Branches
on the
face


Relati
on
with
paroti
d


Various
types of
branching


Ansa cervicalis


Accessory
nerve


NERVE SUPPLY OF
STRUCTURAL UNITS


Extra ocular muscles
Oculomotor nerve


LR6

SO4


Nasal cavity


Motor supply

Palate except tensor
- Pharyngeal plexus

Gen. sensory

- Palatine and glossopharyngeal

palati

Special sensory – Lesser palatine nerves
Secretomotor

– Lesser palatine nerves


Tongue
• Sensory – Lingual and Glossopharyngeal
• Special sensory– Chorda tympani and Glossopharyngeal
• Motor – Hypoglossal except palatoglossus


Pharynx
Sensory

– Pharyngeal plexus
(Ph. br. of IX, X, XI n.
and sup. cer. sym. gang.)

Motor

- Pharyngeal plexus
except stylopharyngeus

Special sensory – Internal laryngeal
Secretomotor

– Lesser palatine


Larynx

Sensory – Up to the level of vocal cords – internal laryngeal n.
Below the level of vocal cords – Recurrent laryngeal n.
Motor

– Reccurent laryngeal except cricothyroid


Teeth and related structures


Special sensory innervation


Special sensation from
•Tongue
•Soft palate
•Pharynx


Brachial
plexus


Care during maxillofacial
surgeries


VII n. damage


UMN
vs
LMN

Facial n. nucleus


Bell’s Palsy


Submandibular surgery

‘Facial

asymmetry is evident
only when the patient talks and
that bilateral section abolishes
the
asymmetry
without
interfering with speech’

Frey’s syndrome


Radical neck dissections


Radical neck dissections

Horner’s
syndrome

Thyroid surgeries


Pathologic conditions affecting
nerves


Pathologic conditions affecting
• Infective – Herpesnerves
zoster
• Traumatic
• Degenerative – Parkinsonism, Gullian barre’
• Demyelinating – Multiple sclerosis
• Vascular
• Neoplastic – Cerebropontine angle tumour

Herpes zoster

Herpes zoster is an acute, localized infection with
varicella-zoster virus, which causes a painful,
blistering rash

Traumatic injuries
• Neuropraxia
• Axonotemesis
• Neurotemesis


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

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

autoimmune attack of Ach receptors


following

an

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 palsy

Paresis, paralysis and spasticity

Motor neuron
disease


Conclusion


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

Thank you…


Nerve supply of head and neck /certified fixed orthodontic courses by Indian dental academy

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Nerve supply of head and neck /certified fixed orthodontic courses by Indian dental academy