Illustrated Anatomy of the Head And Neck 5th Edition By Fehrenbach RDH MS – Test Bank

Illustrated Anatomy of the Head And Neck 5th Edition By Fehrenbach RDH MS – Test Bank

Chapter 08: Nervous System

Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition

MULTIPLE CHOICE

1. Which of the following effects is prevented from occurring on the target nerve during the administration of a local anesthetic agent?

a.

Resting potential

b.

Action potential

c.

Refractory period

d.

Repolarization

ANS: B

Feedback

A

The resting potential occurs when the difference in charge exists and the outside of the nerve cell membrane has a positive charge, while the inside has a negative charge. It occurs in the nonstimulated nerve.

B

Local anesthetic agents are administered to prevent an action potential, which is a rapid depolarization of the nerve cell membrane resulting in generation of a nerve impulse. An action potential temporarily reverses the resting potential that exists.

C

The refractory period refers to a brief period after an action potential, during which the nerve CANNOT be stimulated.

D

The repolarization reestablishes the resting potential.

DIF: Comprehension REF: p. 174 OBJ: 2

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 2.0 Physiology

2. Sympathetic and parasympathetic nerves are antagonistic to one another. BOTH nerve systems function as part of the somatic nervous system.

a.

Both statements are true.

b.

Both statements are false.

c.

The first statement is true; the second is false.

d.

The first statement is false; the second is true.

ANS: C

Feedback

A

Although the nerves are antagonistic to one another, they are part of the autonomic nervous system, NOT the somatic nervous system.

B

Although the nerves are antagonistic to one another, they are part of the autonomic nervous system, NOT the somatic nervous system.

C

Although the nerves are antagonistic to one another, they are part of the autonomic nervous system, NOT the somatic nervous system.

D

Although the nerves are antagonistic to one another, they are part of the autonomic nervous system, NOT the somatic nervous system.

DIF: Recall REF: p. 176 OBJ: 3

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy

3. Which of the following actions could result from involvement by the efferent part of the fifth cranial nerve?

a.

Puckering the lips

b.

Feeling when biting the tongue

c.

Toothache in the jaw

d.

Chewing a piece of gum

ANS: D

Feedback

A

The muscles that surround the lip are muscles of facial expression such as that which occurs with puckering of the lips and are innervated by the seventh cranial nerve or facial nerve.

B

Sensations such as pain from biting the tongue are carried by the afferent or sensory component of the fifth cranial nerve or trigeminal nerve.

C

Sensations such as pain from a toothache are carried by the afferent or sensory component of the fifth cranial nerve or trigeminal nerve.

D

The efferent or motor part of the fifth cranial nerve or trigeminal nerve innervates the muscles of mastication such as that which occurs with chewing.

DIF: Comprehension REF: p. 179 OBJ: 4

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 2.0 Physiology

4. Which of the following skull foramina are associated with the pathway of the seventh cranial nerve from the brain to the facial region?

a.

Foramen ovale and foramen rotundum

b.

Foramen spinosum and external acoustic meatus

c.

Internal acoustic meatus and external acoustic meatus

d.

Internal acoustic meatus and stylomastoid foramen

ANS: D

Feedback

A

Both the foramen ovale and foramen rotundum are associated with the maxillary and mandibular nerves, the second and third divisions, respectively, of the fifth cranial nerve or trigeminal nerve.

B

Seventh cranial nerve or facial nerve is NOT associated with and does NOT travel through the foramen spinosum and external acoustic meatus.

C

Although the seventh cranial nerve or facial nerve enters the skull and travels through the temporal bone, it does NOT exit the temporal bone through the external acoustic meatus, which is the opening to the external ear.

D

The seventh cranial nerve or facial nerve leaves the brain through the internal acoustic meatus, travels through the temporal bone, and exits the skull through the stylomastoid foramen.

DIF: Recall REF: p. 180 OBJ: 4

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 2.0 Physiology

5. When a patient complains of pain associated with a thermal burn caused by hot coffee on the anterior dorsal surface of the tongue, which of the following nerves transmits this pain?

a.

Glossopharyngeal nerve

b.

Facial nerve

c.

Vestibulocochlear nerve

d.

Hypoglossal nerve

ANS: B

Feedback

A

The glossopharyngeal nerve or ninth cranial nerve provides sensory innervation to the posterior tongue, which is the base (posterior one-third) and NOT that as noted in the case study discussed.

B

The facial nerve or seventh cranial nerve provides sensory innervation to the body of the tongue (anterior one-third) such as that noted in the case study discussed.

C

The vestibulocochlear nerve or eighth cranial nerve provides sensory innervation for hearing and balance and does NOT provide any innervation to or from the tongue.

D

The hypoglossal nerve or twelfth cranial nerve is a motor nerve for both the intrinsic and extrinsic tongue muscles.

DIF: Comprehension REF: p. 180 OBJ: 5

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, I. B. Preliminary Physical Examination | CDA: General Chairside, V. A. Oral Health Information

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.3 Individualized Patient Education

6. Discomfort from an infection of BOTH the frontal and ethmoidal sinuses would be associated with involvement of which of the following nerves?

a.

Facial nerve

b.

Frontal nerve

c.

Nasociliary nerve

d.

Optic nerve

ANS: C

Feedback

A

The facial nerve or seventh cranial nerve does NOT innervate the sinuses.

B

The frontal nerve, a branch off the ophthalmic nerve that is the first division of the trigeminal nerve or fifth cranial nerve, provides sensory innervation to the anterior scalp and forehead, as well as the bridge of the nose and part of the upper eyelid, but NOT the sinuses.

C

The nasociliary nerve, a branch off the ophthalmic nerve that is the first division of the trigeminal nerve or fifth cranial nerve, provides sensory innervation to the nasal cavity and paranasal sinuses.

D

The optic nerve or second cranial nerve provides sensory innervation necessary for vision.

DIF: Comprehension REF: p. 183 OBJ: 5

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy

7. Which of the following nerves listed below does NOT go on to form the maxillary nerve within the pterygopalatine fossa?

a.

Nasopalatine nerve

b.

Infraorbital nerve

c.

Incisive nerve

d.

Anterior superior alveolar nerve

ANS: C

Feedback

A

The nasopalatine nerve joins other branches of the maxillary nerve, the second division of the trigeminal nerve or fifth cranial nerve, within the pterygopalatine fossa.

B

The infraorbital nerve joins other branches of the maxillary nerve, the second division of the trigeminal nerve or fifth cranial nerve, in the pterygopalatine fossa.

C

The incisive nerve provides sensory innervation to the mandibular incisors and premolars along with their associated periodontium and is included as a branch of the inferior alveolar nerve. It is part of the mandibular nerve or third division, NOT the maxillary nerve or second division of the trigeminal nerve.

D

The anterior superior alveolar nerve joins other branches of the maxillary nerve, the second division of the trigeminal nerve or fifth cranial nerve, within the pterygopalatine fossa.

DIF: Recall REF: pp. 193-194 OBJ: 4

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy

8. During a dental procedure on the buccal surface of the maxillary molars, a patient reports discomfort in the buccal gingival tissue. Which of the following nerves carries this sensation to the brain and may need to be anesthetized?

a.

Buccal nerve

b.

Posterior superior alveolar nerve

c.

Zygomaticofacial nerve

d.

Chorda tympani nerve

ANS: B

Feedback

A

The buccal nerve, a branch of the mandibular nerve that is the third division of the trigeminal nerve or fifth cranial nerve, provides sensory innervation from the buccal gingival tissue of mandibular molars, NOT maxillary molars.

B

The maxillary buccal gingival tissue of the maxillary molars is innervated, along with the pulpal tissue of the maxillary molars and associated periodontium, by the posterior superior alveolar nerve, a branch of the maxillary nerve that is that is the second division of the trigeminal nerve or fifth cranial nerve.

C

The zygomaticofacial nerve, a branch of the zygomatic nerve that joins the maxillary nerve or second division of the trigeminal nerve or fifth cranial nerve, serves as a sensory nerve for the skin of the cheek.

D

The chorda tympani nerve, a branch of the facial nerve or seventh cranial nerve, is a parasympathetic efferent (motor) nerve to the submandibular and sublingual salivary glands.

DIF: Application REF: pp. 185-186 OBJ: 4

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, I. B. Preliminary Physical Examination | CDA: General Chairside, V. A. Oral Health Information

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 2.0 Physiology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.0 Performing Periodontal Procedures

9. During an oral surgical procedure on the posterior hard palate, which of the following nerves MUST be anesthetized to provide patient comfort?

a.

Nasopalatine nerve

b.

Posterior superior alveolar nerve

c.

Greater palatine nerve

d.

Lesser palatine nerve

ANS: C

Feedback

A

The nasopalatine nerve, a branch off the maxillary nerve or second division of the trigeminal nerve or fifth cranial nerve, is the sensory nerve for the anterior hard palate that is mesial to both maxillary premolars.

B

The posterior superior alveolar nerve, a branch off the maxillary nerve or second division of the trigeminal nerve or fifth cranial nerve, is the sensory nerve for the maxillary molars, their periodontium, and associated buccal gingival tissue.

C

The greater palatine nerve, a branch off the maxillary nerve or second division of the trigeminal nerve or fifth cranial nerve, is the sensory nerve for the posterior palatal gingival tissue and posterior hard palate. It needs to be anesthetized to provide patient comfort during an oral surgical procedure on the posterior hard palate.

D

The lesser palatine nerve, a branch off the maxillary nerve or second division of the trigeminal nerve or fifth cranial nerve, is the sensory nerve for the soft palate and palatine tonsils; it sometimes is anesthetized with the greater palatine nerve, leading to a heightened gag response.

DIF: Application REF: p. 186 OBJ: 6

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, II. C. Describe how to perform and/or assist with intraoral procedures

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Provision of Clinical Dental Hygiene Services, 4.0 Performing Periodontal Procedures

10. Which of the following nerves communicates with the lingual nerve within the submandibular ganglion?

a.

Chorda tympani nerve

b.

Hypoglossal nerve

c.

Greater petrosal nerve

d.

Mylohyoid nerve

ANS: A

Feedback

A

The chorda tympani nerve, a branch off the facial nerve or seventh cranial nerve, travels alongside the lingual nerve, communicates with it within the submandibular ganglion, and provides parasympathetic motor innervation to the submandibular and sublingual salivary glands.

B

The hypoglossal nerve or twelfth cranial nerve provides efferent (motor) innervation for the extrinsic and intrinsic muscles of the tongue.

C

The greater petrosal nerve, a branch of the facial nerve, provides afferent (sensory) nerve fibers for taste from the palate.

D

The mylohyoid nerve, a branch of the inferior alveolar nerve that is of the mandibular nerve off the trigeminal nerve or fifth cranial nerve, serves as an efferent nerve to the mylohyoid muscle and anterior belly of the digastric muscle after it exits the mandibular foramen.

DIF: Recall REF: p. 192 OBJ: 6

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 2.0 Physiology

11. After administration of an inferior alveolar nerve block, the patient reports that the lingual gingival tissue of the mandibular premolars and molars is still sensitive. Which nerve usually provides sensation from the gingival tissue in this area?

a.

Mylohyoid nerve

b.

Lingual nerve

c.

Mental nerve

d.

Incisive nerve

ANS: B

Feedback

A

The mylohyoid nerve, a branch of the inferior alveolar nerve that is of the mandibular nerve off the trigeminal nerve or fifth cranial nerve, is the motor nerve to the inferior mylohyoid and anterior digastric muscles. In some cases, it may provide some sensory innervation from the lingual gingival tissue of the mandibular first molar but NOT from the mandibular premolars and other mandibular molars.

B

The lingual nerve, a branch of the mandibular nerve off the trigeminal nerve or fifth cranial nerve, is the sensory nerve for the body of the tongue, floor of the mouth, and lingual gingival tissue of ALL the mandibular teeth. As it travels superiorly, it eventually runs anterior and slightly medial to the inferior alveolar nerve and is usually anesthetized along with the nearby inferior alveolar nerve due to diffusion. Possibly the inferior alveolar block has NOT been correctly administered.

C

The mental nerve, a branch of the inferior alveolar nerve of the mandibular nerve off the trigeminal nerve or fifth cranial nerve, is the sensory nerve from the chin, lower lip, and labial mucosa of the mandibular anterior teeth and premolars.

D

The incisive nerve, a branch of the inferior alveolar nerve of the mandibular nerve off the trigeminal nerve or fifth cranial nerve, is sensory from the mandibular anterior teeth and premolars, their surrounding periodontium, and facial gingival tissue.

DIF: Application REF: pp. 189, 192 OBJ: 7

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, I. B. Preliminary Physical Examination | CDA: General Chairside, II. C. Describe how to perform and/or assist with intraoral procedures | CDA: General Chairside, V. A. Oral Health Information

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 2.0 Physiology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.3 Individualized Patient Education | NBDHE, Provision of Clinical Dental Hygiene Services, 4.0 Performing Periodontal Procedures

12. Which of the following nerve branches of the facial nerve supplies motor innervation to the buccinator, risorius, and upper lip muscles?

a.

Temporal nerve branch

b.

Zygomatic nerve branch

c.

Buccal nerve branch

d.

Mandibular nerve branch

ANS: C

Feedback

A

The temporal branch of the facial nerve or seventh cranial nerve provides motor innervation to muscles located more superiorly. These muscles include the frontal belly of the epicranial muscle, muscles anterior to the ear, and the superior orbicularis oculi and corrugator muscles.

B

The zygomatic branch of the facial nerve or seventh cranial nerve innervates the orbicularis oculi and zygomatic muscles.

C

The buccal branch of the facial nerve or seventh cranial nerve supplies motor innervation to the muscles of the upper lip and nose, as well as the buccinator, risorius, and orbicularis oris muscles.

D

The mandibular branch of the facial nerve or seventh cranial nerve supplies the mentalis muscles, as well as the muscles of the lower lip.

DIF: Recall REF: p. 196 OBJ: 4

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 2.0 Physiology

13. Which of the following pairs of nerves merges posterior to the mental foramen to form the inferior alveolar nerve?

a.

Incisive and lingual nerves

b.

Incisive and mental nerves

c.

Mylohyoid and mental nerves

d.

Mylohyoid and inferior dental plexus nerves

ANS: B

Feedback

A

The lingual nerve does NOT travel within the mandibular canal and does NOT provide sensory innervation to the teeth and periodontium like the incisive nerve.

B

The incisive and mental nerves do merge posterior to the mental foramen to form the inferior alveolar nerve that travels within the mandibular canal.

C

The mylohyoid nerve does NOT travel within the mandibular canal like the mental nerve but provides innervation to the floor of the mouth. However, the mylohyoid does NOT merge with the mental nerve like the incisive nerve does.

D

The mylohyoid nerve does NOT travel within the mandibular canal like the mental nerve but travels along the medial surface of the mandible and provides innervation about the floor of the mouth. The mylohyoid nerve does NOT merge with the inferior dental plexus nerves.

DIF: Recall REF: p. 193 OBJ: 7

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 2.0 Physiology

14. Which of the following structures is/are innervated by the motor fibers within the mandibular nerve or third division of the trigeminal nerve?

a.

Muscles of mastication

b.

All parts of the tongue

c.

Sternocleidomastoid muscle

d.

Submandibular salivary glands

ANS: A

Feedback

A

The muscles of mastication do receive motor innervation from the mandibular nerve or third division of the trigeminal nerve or fifth cranial nerve.

B

The tongue receives motor innervation from the hypoglossal nerve or twelfth cranial nerve and NOT from the mandibular nerve or third division of the trigeminal nerve.

C

The sternocleidomastoid muscle is innervated by motor fibers from the accessory nerve or eleventh cranial nerve and NOT from the mandibular nerve or third division of trigeminal nerve or fifth cranial nerve.

D

Motor innervation to the submandibular salivary gland comes from the chorda tympani nerve, which is a branch of the facial nerve or seventh cranial nerve, and NOT from the mandibular nerve or third division of the trigeminal nerve or fifth cranial nerve.

DIF: Recall REF: p. 181 OBJ: 5

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 2.0 Physiology

15. After a serious car accident, a fracture of the patient’s mandibular ramus has damaged nerve tissue within the mandibular canal. The associated oral structures or tissue MOST likely to be affected by this nerve damage would be the

a.

tongue.

b.

posterior buccal mucosa.

c.

lingual alveolar mucosa.

d.

mandibular teeth.

ANS: D

Feedback

A

The lingual nerve does NOT travel within the mandibular canal but does innervate the tongue.

B

The buccal nerve does NOT travel within the mandibular canal but does innervate the posterior buccal mucosa.

C

The lingual nerve, which receives gives sensory innervation to the floor of the mouth and the lingual gingival tissue of the mandible, does NOT travel within the mandibular canal.

D

Sensory innervation from the mandibular teeth and their surrounding periodontium travels via the inferior alveolar nerve within the mandibular canal.

DIF: Application REF: p. 192 OBJ: 7

TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, I. B. Preliminary Physical Examination | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. A. 4. Describe how to respond to and assist in the management of the signs and symptoms related to specific medical conditions/emergencies likely to occur in the dental office

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 2.0 Physiology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care