TEST BANK Illustrated Anatomy of the Head and Neck 5th Edition Fehrenbach. All Chapters 1-12 by QuentinAxel

TEST BANK

Chapter 01: Introduction to Head and Neck Anatomy Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition MULTIPLE CHOICE 1. Which surface of the body is visualized by the clinician when performing an extraoral

examination of the patient’s eyes? a. Anterior b. Posterior c. Superior d. Lateral ANS: A

A B C D

Feedback The patient’s eyes are visualized on the anterior surface of the patient’s body. The patient’s eyes would NOT be easily visualized on the posterior of the patient’s body. The patient’s eyes would NOT be easily visualized on the superior surface of the patient’s body. The patient’s eyes would NOT be easily visualized on the lateral surface of the patient’s body.

DIF: Comprehension REF: p. 3 OBJ: 2 TOP: CDA: General Chairside, I. B. Preliminary Physical Examination MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy 2. Which of the following is CORRECT concerning the sagittal plane of the body? a. Parallel to the median plane b. Parallel to the frontal plane c. Parallel to the horizontal plane d. Parallel to the coronal plane ANS: A

A B C

Feedback A sagittal plane is parallel to the median plane. A sagittal plane is NOT parallel to the frontal plane but perpendicular. A horizontal plane is perpendicular to the median plane. A sagittal plane is parallel to the median plane. Thus a horizontal plane is perpendicular to a sagittal plane. A sagittal plane is NOT parallel to the coronal plane but perpendicular.

3. When a patient is in anatomic position, what is the surface of the palms of the hand

considered? a. Anterior b. Lateral c. Medial d. Posterior ANS: A

A B

C D

Feedback The palms of the hands in anatomic position are facing toward the front and are anterior (or ventral). The palms of the hands in anatomic position are NOT facing lateral or away from the median plane but are facing toward the front and are anterior (or ventral). The palms of the hands in anatomic position are NOT facing medial or toward the median plane but are facing toward the front and are anterior (or ventral). The palms of the hands in anatomic position are NOT facing toward the posterior or back of the body but are facing toward the front and are anterior (or ventral).

DIF: Recall REF: p. 3 OBJ: 2 TOP: CDA: General Chairside, I. B. Preliminary Physical Examination MSC: NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics 4. What is the anatomic relationship of the right arm to the left leg? a. Sagittal b. Contralateral c. Ipsilateral d. Midsagittal ANS: B

A B C

Feedback The two legs are contralateral to each other. Sagittal describes a plane of division of the body created by an imaginary plane parallel to the median plane. Contralateral structures are located on the opposite side of the body, which is the anatomic relationship of the right arm to the left leg. Ipsilateral refers to structures on the same side of the body; in contrast, the two legs are contralateral to each other and thus are located on the opposite side of the body. The two legs are contralateral to each other. Midsagittal describes a plane that divides the body into right and left halves.

a. b. c. d.

Anterior External Deep Superficial

ANS: C

A B C D

Feedback Muscles are deep to the skin. Muscles are deep to the skin. Muscles are located inward, away from the body surface, deep to the skin. Muscles are deep to the skin.

DIF: Comprehension REF: p. 3 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 6. What is the anatomic relationship of the shoulders to the hips? a. Deep b. Medial c. Inferior d. Superior ANS: D

A B C D

Feedback The shoulders are superior to the hips. The shoulders are superior to the hips. The shoulders are superior to the hips. The shoulders are superior to or closer to the head than the hips.

DIF: Comprehension REF: p. 3 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 7. Which of the following is meant by the term “ventral”? a. Back of an area of the body b. Front of an area of the body c. Inner side of an area of the body d. Outer side of an area of the body ANS: B

A B C D

Feedback The back of an area of the body is referred to as the posterior surface. The front of an area of the body is referred to as the ventral surface. The inner side of an area of the body, away from the body surface, is referred to as deep. The outside of an area of the body, toward the surface, is referred to as

superficial. DIF: Recall REF: p. 3 OBJ: 1 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. Which of the following describes a patient’s eyes when they are in anatomic position? a. Closed tightly b. Looking toward the lateral c. Looking toward the medial d. Looking straight forward ANS: D

A B C D

Feedback The patient’s eyes in anatomic position are open and look forward. The patient’s eyes in anatomic position are open and look forward. The patient’s eyes in anatomic position are open and look forward. The patient’s eyes in anatomic position are open and look forward.

DIF: Recall REF: p. 2 OBJ: 2 TOP: CDA: General Chairside, I. B. Preliminary Physical Examination MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy 9. What is the anatomic relationship of the maxillary arch to the mandibular arch? a. Deep b. Inferior c. Superior d. Superficial ANS: C

A B C D

Feedback The maxillary arch is superior to the mandibular arch. Deep refers to structures that are located away from the body surface. The maxillary arch is superior to the mandibular arch. Inferior refers to surfaces closer to the feet or that face toward the feet. The maxillary arch is superior to the mandibular arch. The maxillary arch is superior to the mandibular arch. Superficial refers to structures located toward the surface of the body.

DIF: Comprehension REF: p. 3 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, 1.1.1 Head and Neck Anatomy 10. What is the anatomic relationship of the teeth located in the front of the mouth to the teeth

located in the back of the mouth? a. Anterior b. Medial

c. Posterior d. Superficial ANS: C

A B C D

Feedback Teeth located in the back of the mouth are considered posterior. Teeth located in the front of the mouth are considered anterior. Medial refers to structures located closer to the median plane. Teeth located in the back of the mouth are considered posterior to teeth located in the front of the mouth, which are considered anterior. Superficial refers to structures located closer to the surface of the body.

DIF: Comprehension REF: p. 3 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, 1.1.2 Dental Anatomy 11. The inner side of the wall of a hollow structure is referred to as internal. In contrast, the outer

side of the wall of a hollow structure is external. 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: A

A B C D

Feedback Both statements are true. The inner side of the wall of a hollow structure is referred to as internal. The outer side of the wall of a hollow structure is external. Both statements are true. The inner side of the wall of a hollow structure is referred to as internal. The outer side of the wall of a hollow structure is external. Both statements are true. The inner side of the wall of a hollow structure is referred to as internal. The outer side of the wall of a hollow structure is external. Both statements are true. The inner side of the wall of a hollow structure is referred to as internal. The outer side of the wall of a hollow structure is external.

DIF: Recall REF: p. 3 OBJ: 1 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 12. What is another term for a transverse section? a. Vertical section b. Horizontal section c. Anterior section d. Posterior section ANS: B

Feedback

A B C D

The transverse section or horizontal section is a division through a horizontal plane. The transverse section or horizontal section is a division through a horizontal plane. The transverse section or horizontal section is a division through a horizontal plane. The transverse section or horizontal section is a division through a horizontal plane.

DIF: Recall REF: p. 3 OBJ: 1 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 13. An area closer to the median plane is considered to be distal, and an area farther from the

median plane is considered proximal. 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: B

A B C D

Feedback Both statements are false. An area closer to the median plane is considered to be proximal, and an area farther from the median plane is considered distal. Both statements are false. An area closer to the median plane is considered to be proximal, and an area farther from the median plane is considered distal. Both statements are false. An area closer to the median plane is considered to be proximal, and an area farther from the median plane is considered distal. Both statements are false. An area closer to the median plane is considered to be proximal, and an area farther from the median plane is considered distal.

DIF: Recall REF: p. 3 OBJ: 1 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 14. Structures on the same side of the body are considered ipsilateral. Structures on the opposite

side of the body are considered contralateral. 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: A

Feedback Both statements are true. Structures on the same side of the body are considered ipsilateral. Structures on the opposite side of the body are considered

contralateral. Both statements are true. Structures on the same side of the body are considered ipsilateral. Structures on the opposite side of the body are considered contralateral. Both statements are true. Structures on the same side of the body are considered ipsilateral. Structures on the opposite side of the body are considered contralateral. Both statements are true. Structures on the same side of the body are considered ipsilateral. Structures on the opposite side of the body are considered contralateral.

DIF: Recall REF: p. 3 OBJ: 1 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 15. The number of bones and muscles in the head and neck is NOT usually constant, and specific

details of these structures can vary from patient to patient. 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: D

Feedback The first statement is false; the second is true. The number of bones and muscles in the head and neck is usually constant, but specific details of these structures can vary from patient to patient. The first statement is false; the second is true. The number of bones and muscles in the head and neck is usually constant, but specific details of these structures can vary from patient to patient. The first statement is false; the second is true. The number of bones and muscles in the head and neck is usually constant, but specific details of these structures can vary from patient to patient. The first statement is false; the second is true. The number of bones and muscles in the head and neck is usually constant, but specific details of these structures can vary from patient to patient.

DIF: Comprehension REF: p. 3 OBJ: 3 TOP: CDA: General Chairside, I. B. Preliminary Physical Examination MSC: NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics 16. The median plane is created by an imaginary line dividing the body into equal right and left

halves. On the surface of the body, these halves are NEVER symmetric in structure. 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 The first statement is true; the second is false. The median plane or midsagittal plane is created by an imaginary line dividing the body into equal right and left halves. On the surface of the body, these halves are generally symmetric in structure, yet the same symmetry does NOT apply to all internal structures. The first statement is true; the second is false. The median plane or midsagittal plane is created by an imaginary line dividing the body into equal right and left halves. On the surface of the body, these halves are generally symmetric in structure, yet the same symmetry does NOT apply to all internal structures. The first statement is true; the second is false. The median plane or midsagittal plane is created by an imaginary line dividing the body into equal right and left halves. On the surface of the body, these halves are generally symmetric in structure, yet the same symmetry does NOT apply to all internal structures. The first statement is true; the second is false. The median plane or midsagittal plane is created by an imaginary line dividing the body into equal right and left halves. On the surface of the body, these halves are generally symmetric in structure, yet the same symmetry does NOT apply to all internal structures.

DIF: Recall REF: p. 3 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 17. An area closer to the median plane of the body or structure is considered lateral. An area

farther from the median plane of the body or structure is considered proximal. 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: B

Feedback Both statements are false. An area closer to the median plane of the body or structure is considered medial. An area farther from the median plane of the body or structure is considered lateral, and an area closer to the median plane is considered to be proximal. Both statements are false. An area closer to the median plane of the body or structure is considered medial. An area farther from the median plane of the body or structure is considered lateral, and an area closer to the median plane is considered to be proximal. Within the dentition, the proximal surface would be considered mesial. Both statements are false. An area closer to the median plane of the body or structure is considered medial. An area farther from the median plane of the body or structure is considered lateral, and an area closer to the median plane is considered to be proximal. Both statements are false. An area closer to the median plane of the body or structure is considered medial. An area farther from the median plane of the

body or structure is considered lateral, and an area closer to the median plane is considered to be proximal. DIF: Recall REF: p. 3 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 18. What is another term for coronal plane? a. Frontal plane b. Coronal section c. Horizontal plane d. Horizontal section ANS: A

A B C D

Feedback A frontal plane or coronal plane is created by an imaginary line dividing the body at any level into both anterior and posterior parts. The frontal plane or coronal section is a division through any frontal plane. A horizontal plane is created by an imaginary line dividing the body at any level into superior and inferior parts and is always perpendicular to the median plane. The transverse section or horizontal section is a division through a horizontal plane.

DIF: Recall REF: p. 3 OBJ: 1 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 19. Muscles may differ in size and details of their attachments. Joints, vessels, nerves, glands,

lymph nodes, fasciae, and spaces of an individual can vary in size, location, and even presence. 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: A

Feedback Both statements are true. Muscles may differ in size and details of their attachments. Joints, vessels, nerves, glands, lymph nodes, fasciae, and spaces of an individual can vary in size, location, and even presence. Both statements are true. Muscles may differ in size and details of their attachments. Joints, vessels, nerves, glands, lymph nodes, fasciae, and spaces of an individual can vary in size, location, and even presence. Both statements are true. Muscles may differ in size and details of their attachments. Joints, vessels, nerves, glands, lymph nodes, fasciae, and spaces of an individual can vary in size, location, and even presence.

Both statements are true. Muscles may differ in size and details of their attachments. Joints, vessels, nerves, glands, lymph nodes, fasciae, and spaces of an individual can vary in size, location, and even presence.

DIF: Comprehension REF: p. 3 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 20. What is another term for midsagittal plane? a. Median plane b. Coronal plane c. Frontal plane d. Horizontal plane ANS: A

A B C D

Feedback The median plane or midsagittal plane is created by an imaginary line dividing the body into equal right and left halves. A frontal plane or coronal plane is created by an imaginary line dividing the body at any level into anterior and posterior parts. A frontal plane or coronal plane is created by an imaginary line dividing the body at any level into anterior and posterior parts. A horizontal plane is created by an imaginary line dividing the body at any level into superior and inferior parts and is always perpendicular to the median plane.

DIF: Recall REF: p. 3 OBJ: 1 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 21. A horizontal plane is created by an imaginary line dividing the body at any level into both

superior and inferior parts and is ALWAYS _______ to the median plane. a. anterior b. posterior c. parallel d. perpendicular ANS: D

Feedback A frontal plane or coronal plane is created by an imaginary line dividing the body at any level into both anterior and posterior parts. A horizontal plane is created by an imaginary line dividing the body at any level into both superior and inferior parts and is always perpendicular to the median plane. A frontal plane or coronal plane is created by an imaginary line dividing the body at any level into both anterior and posterior parts. A horizontal plane is created by an imaginary line dividing the body at any level into both superior and inferior parts and is always perpendicular to the median plane.

A sagittal plane is any plane created by an imaginary plane parallel to the median plane. A horizontal plane is created by an imaginary line dividing the body at any level into both superior and inferior parts and is always perpendicular to the median plane. A horizontal plane is created by an imaginary line dividing the body at any level into both superior and inferior parts and is always perpendicular to the median plane.

DIF: Recall REF: p. 3 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 22. The ventral part is directed toward the anterior and is considered the opposite of the dorsal

part when considering the entire body. 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: A

A B C D

Feedback Both statements are true. The ventral part is directed toward the anterior and is the opposite of the dorsal part when considering the entire body. Both statements are true. The ventral part is directed toward the anterior and is the opposite of the dorsal part when considering the entire body. Both statements are true. The ventral part is directed toward the anterior and is the opposite of the dorsal part when considering the entire body. Both statements are true. The ventral part is directed toward the anterior and is the opposite of the dorsal part when considering the entire body.

DIF: Recall REF: p. 3 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 23. The transverse section is a division through a _____ plane. a. horizontal b. frontal c. sagittal d. coronal ANS: A

A B C

Feedback The transverse section or horizontal section is a division through a horizontal plane. The frontal section or coronal section is a division through any frontal plane. A sagittal plane is any plane created by an imaginary plane parallel to the median

plane. A frontal plane or coronal plane is created by an imaginary line dividing the body at any level into anterior and posterior parts.

DIF: Recall REF: p. 3 OBJ: 1 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 24. The dental professional MUST have a thorough understanding of head and neck anatomy

when performing patient examination procedures, both extraoral and intraoral. Certain terms can be used to give information about the depth of a structure in relationship to the surface of the body. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A

Feedback Both the statement and the reason are correct and related. The dental professional MUST have a thorough understanding of head and neck anatomy when performing patient examination procedures, both extraoral and intraoral. Certain terms can be used to give information about the depth of a structure in relationship to the surface of the body. Both the statement and the reason are correct and related. The dental professional MUST have a thorough understanding of head and neck anatomy when performing patient examination procedures, both extraoral and intraoral. Certain terms can be used to give information about the depth of a structure in relationship to the surface of the body. Both the statement and the reason are correct and related. The dental professional MUST have a thorough understanding of head and neck anatomy when performing patient examination procedures, both extraoral and intraoral. Certain terms can be used to give information about the depth of a structure in relationship to the surface of the body. Both the statement and the reason are correct and related. The dental professional MUST have a thorough understanding of head and neck anatomy when performing patient examination procedures, both extraoral and intraoral. Certain terms can be used to give information about the depth of a structure in relationship to the surface of the body. Both the statement and the reason are correct and related. The dental professional MUST have a thorough understanding of head and neck anatomy when performing patient examination procedures, both extraoral and intraoral. Certain terms can be used to give information about the depth of a structure in relationship to the surface of the body.

DIF: Comprehension REF: p. 3 OBJ: 2 TOP: CDA: General Chairside, I. B. Preliminary Physical Examination | CDA: General Chairside, II.

C. Describe how to perform and/or assist with intraoral procedures MSC: NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics 25. The face is on the anterior side of the head, and the neck is superior and posterior to the face. 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 The first statement is true; the second is false. The face is on the anterior side of the head, and the neck is inferior and posterior to the face. The hair is superior to the face as well. The first statement is true; the second is false. The face is on the anterior side of the head, and the neck is inferior and posterior to the face. The hair is superior to the face as well. The first statement is true; the second is false. The face is on the anterior side of the head, and the neck is inferior and posterior to the face. The hair is superior to the face as well. The first statement is true; the second is false. The face is on the anterior side of the head, and the neck is inferior and posterior to the face. The hair is superior to the face as well.

DIF: Comprehension REF: p. 3 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, 1.1.1 Head and Neck Anatomy MULTIPLE RESPONSE 1. From the following list of anatomic terms, select which terms are DIRECTLY associated with

the planes that can be noted with the body. (Select all that apply.) a. Medial or distal b. Median or sagittal c. Frontal or horizontal d. Lateral or proximal ANS: B, C Feedback Correct Incorrect

Median, sagittal, frontal, and horizontal actually are planes, so they are DIRECTLY associated with planes that can be noted with the body. Medial, distal, lateral, and proximal are descriptions for parts of the body in relationship to the planes, so they are NOT DIRECTLY associated with the planes themselves.

DIF: Recall REF: p. 4, Figure 1-4 OBJ: 1 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 2. From the following list of anatomic terms, select which terms can be used to give information

about the depth of a structure in relationship to the surface of the body. (Select all that apply.) a. Medial b. Superficial c. Deep d. External e. Internal ANS: B, C Feedback Correct Incorrect

Superficial and deep are both used to give information about the depth of a structure in relationship to the surface of the body. Medial is closer to the median plane (and lateral is farther away from the median plane). Internal is on the inner side of the wall of a hollow structure, and external is on the outer side of the wall of a hollow structure. Both do NOT give information about the depth of a structure in relationship to the surface of the body.

DIF: Recall REF: p. 3 OBJ: 1 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. From the following list of anatomic terms, select which terms are DIRECTLY related to the

median plane of the body. (Select all that apply.) a. Medial b. Lateral c. Ipsilateral d. Contralateral ANS: A, B Feedback Correct Incorrect

Medial is closer to the median plane, and lateral is farther away from the median plane, so they both are DIRECTLY related to the median plane. Ipsilateral is on the same side of the body, and contralateral is on the opposite side of the body, so they both are NOT DIRECTLY related to the median plane.

DIF: Recall REF: p. 3 OBJ: 1 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 4. From the following list of anatomic terms, select which terms are DIRECTLY related to either

an inner OR an outer side of a wall of a hollow organ. (Select all that apply.) a. Superficial

b. Deep c. Internal d. External ANS: C, D Feedback Correct

Incorrect

Internal is on the inner side of the wall of a hollow structure, and external is on the outer side of the wall of a hollow structure; both are DIRECTLY related to either an inner OR an outer side of a wall of a hollow organ. Superficial and deep are both used to give information about the depth of a structure in relationship to the surface of the body; both are NOT DIRECTLY related to either an inner OR an outer side of a wall of a hollow organ.

DIF: Recall REF: p. 3 OBJ: 1 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 5. From the following list of anatomic terms, select which terms are related to a structure being

either on the same side of the body OR on the opposite side of the body. (Select all that apply.) a. Medial b. Lateral c. Ipsilateral d. Contralateral ANS: C, D Feedback Correct

Incorrect

Ipsilateral is on the same side of the body, and contralateral is on the opposite side of the body; both are related to a structure being either on the same side of the body OR on the opposite side of the body. Medial is closer to the median plane, and lateral is farther away from the median plane; both are NOT related to a structure being either on the same side of the body OR on the opposite side of the body.

DIF: Recall REF: p. 3 OBJ: 1 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 6. Which of the following statements listed are CORRECT concerning the body in anatomic

position? (Select all that apply.) a. The body can be standing erect. b. The patient’s head and neck when sitting upright in a dental chair. c. The arms are at the sides with the palms directed forward. d. The toes directed forward and the eyes looking forward. ANS: A, B, C, D

In anatomic position, the body can be standing erect. The arms are at the sides with the palms and toes directed forward and the eyes looking forward. This position is assumed with respect to the position of the patient’s head and neck when sitting upright in a dental chair. DIF: Comprehension REF: p. 2 OBJ: 2 TOP: CDA: General Chairside, I. B. Preliminary Physical Examination MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.0 Assessing Patient Characteristics 7. Which of the following definitions of anatomic terms listed are CORRECT? (Select all that

apply.) a. An area that faces away from the head and toward from the feet is its superior part. b. The ventral part is directed toward the posterior. c. An area closer to the median plane is considered to be proximal. d. An area closer to the median plane of the body or structure is considered medial. ANS: C, D Feedback Correct Incorrect

An area closer to the median plane is considered to be proximal. An area closer to the median plane of the body or structure is considered medial. An area that faces away from the head and toward the feet is its inferior part and NOT its superior part that faces toward the head and away from the feet. The dorsal part is directed toward the posterior and NOT toward the anterior like the ventral part.

From the following list of anatomic terms, match those terms with their CORRECT definitions. a. Area that is farther away from the median plane of the body or structure. b. Area that is closer to the median plane of the body or structure. c. Structure on the opposite side of the body. d. Structure on the same side of the body. 1. 2. 3. 4.

Medial Lateral Ipsilateral Contralateral

1. ANS: B DIF: Recall REF: p. 3 OBJ: 1 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 2. ANS: A DIF: Recall REF: p. 3 OBJ: 1 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. ANS: D DIF: Recall REF: p. 3 OBJ: 1 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 4. ANS: C DIF: Recall REF: p. 3 OBJ: 1 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

From the following list of anatomic terms, match those terms with their CORRECT alternative terms. a. Coronal plane b. Midsagittal plane c. Horizontal section d. Coronal section 5. 6. 7. 8.

Median plane Frontal plane Transverse section Frontal section

5. ANS: B DIF: Recall REF: p. 3 OBJ: 1 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 6. ANS: A DIF: Recall REF: p. 3 OBJ: 1 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. ANS: C DIF: Recall REF: p. 3 OBJ: 1 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. ANS: D DIF: Recall REF: p. 3 OBJ: 1 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 OTHER 1. Place the following in the CORRECT order suggested when studying diagrams or associated

photographs of anatomic structures, especially those of dissections. a. Note any familiar structures. b. Note any overall descriptions. c. Look to areas highlighted. ANS:

B, A, C Feedback

Correct Order

It is important to keep in mind when studying diagrams or associated photographs of anatomic structures, especially those of dissections, to first note any overall descriptions (e.g., view, section) as well as any nearby directional pointers. Then note any familiar structures (e.g., apex of tongue or nose, maxilla or mandible) to allow for basic orientation. Next look to the areas highlighted, if noted and, of course, those structures that are labeled. Incorrect This process in the correct order will help overall in the study of the head and neck. DIF: Application REF: p. 3 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

Chapter 02: Surface Anatomy Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition MULTIPLE CHOICE 1. The dental professional MUST be thoroughly familiar with the surface anatomy of the head

and neck in order to examine patients BECAUSE features of the surface provide essential landmarks for deeper anatomic structures. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A

C D E

Feedback Both the statement and reason are correct, and they are also both related. Dental professionals MUST have knowledge of healthy structures in order to identify and locate deeper anatomic landmarks that are necessary in order to perform certain dental procedures such as administration of local anesthetic or radiographic exposures. Both the statement and the reason relate to each other. The dental professional MUST have knowledge of anatomic structures in order to complete certain dental procedures. The reason is correct. The dental professional MUST have knowledge of anatomic structures in order to complete certain dental procedures. The statement is correct. The dental professional MUST have knowledge of anatomic structures. The statement and the reason are both correct. Dental professionals MUST have knowledge of healthy structures in order to identify and locate deeper anatomic landmarks that are necessary in order to perform certain dental procedures.

DIF: Comprehension REF: p. 11 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, 1.1.1 Head and Neck Anatomy 2. Which of the following is the CORRECT definition of the term labial? a. Structures closest to the inner cheek b. Structures closest to the facial surface c. Structures closest to the lips d. Structures closest to the palate e. Structures closest to the tongue ANS: C

Feedback This is the definition of the term buccal.

B C D E

This is the definition of the term facial. This is the definition of the term labial. This is the definition of the term palatal. This is the definition of the term lingual.

DIF: Recall REF: p. 15 OBJ: 1 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, 1.1.1 Head and Neck Anatomy 3. The regions of the head include specific anatomic structures. Which region listed below is

NOT included in the regions of the head? a. Frontal b. Parietal c. Orbital d. Zygomatic e. Submental ANS: E

A B C D E

Feedback The frontal region is included in the regions of the head that consist of the forehead and the area superior to the eyes. The parietal region is included in the regions of the head that consist of the area of the skull just posterior to the frontal region. The orbital region is included in the regions of the head that consist of the bony socket where the eyeball and all its supporting structures are located. The zygomatic region is included in the regions of the head that overlie the cheekbone. The submental region is included in the regions of the neck and is one of the cervical triangles.

DIF: Recall REF: p. 14 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, 1.1.1 Head and Neck Anatomy 4. The superior and posterior free margin of the auricle is the helix, which ends inferiorly at the

lobule. The lobule is a small flap of tissue that is the part of the auricle anterior to the external acoustic meatus. 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 The second statement is false. The lobule is the fleshy protuberance of the earlobe.

B C

The first statement is true. The superior and posterior free margin of the auricle is known as the helix, which ends inferiorly at the lobule. The first statement is true. The superior and posterior free margin of the auricle is known as the helix, which ends inferiorly at the lobule. The second statement is false. The second statement is the definition of the tragus, NOT the lobule. The first statement is true, and the second statement is false.

DIF: Recall REF: p. 13 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, 1.1.1 Head and Neck Anatomy 5. The eyeball is located in the orbital region of the head. On the eyeball is a white area with a

central area of coloration. What is the term for the white area? a. Sclera b. Iris c. Pupil d. Orbit ANS: A

A B C D

Feedback The sclera is the white area on the eyeball. The iris is the central area of coloration on the eyeball. The pupil is the opening in the center of the iris that appears black. The orbit is the bony socket where the eyeball is contained.

DIF: Recall REF: p. 13 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, 1.1.1 Head and Neck Anatomy 6. Which part of the nasal region will feel flexible when palpated during an extraoral

examination by a clinician? a. Root of the nose b. Apex of the nose c. Bridge of the nose d. Nasion of the nose ANS: B

A B C D

Feedback The root of the nose is a bony structure located between the eyes. The apex of the nose is formed by cartilage located at the tip of the nose. The bridge of the nose is a bony structure located inferiorly to the nasion. The nasion is a midline junction between the nasal and frontal bones.

DIF: Comprehension REF: p. 14 OBJ: 3 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

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | 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 7. The buccal region of the head is composed of soft tissue of the cheek. Most of the upper cheek

is fleshy, mainly formed by a mass of fat and muscle. Which is the strong muscle felt in this area when the patient clenches his or her teeth together during an extraoral examination? a. Corrugator supercilii muscles b. Temporalis muscles c. Masseter muscles d. Hyoid muscles ANS: C

A B C D

Feedback The corrugator supercilii muscles are located within the orbital region. The temporalis muscles are located within the temporalis fossa within the temporal region. The masseter muscles are located within the buccal region just inferior to the zygomatic arch. The hyoid muscles are located within the neck region and attach to the hyoid bone.

DIF: Application REF: p. 15 OBJ: 3 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 MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy 8. One structure within the oral cavity is the tongue, which is known as the gateway to the oral

region BECAUSE the tongue is a prominent feature of the oral cavity. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: D

A B C D E

Feedback The statement is NOT correct, even though the reason is correct. The lips are the gateway to the oral region. The statement is NOT correct, even though the reason is related because the tongue and the lips are part of the oral region. The statement is NOT correct, but the reason is correct. The lips are the gateway to the oral region. The tongue is a prominent feature of the oral region. The statement is NOT correct, but the reason is correct. The tongue is NOT the gateway to the oral region. The reason is correct. The tongue is a prominent structure of the oral region. But

the statement is NOT correct, even though the reason is correct. The lips are the gateway to the oral region. DIF: Comprehension REF: p. 15 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, 1.1.1 Head and Neck Anatomy 9. The jaws are within the oral cavity and deep to the lips. Underlying the upper lip is the

mandible, while the maxillae underlies the lower lip. 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

A B C

Feedback The second statement is false. The maxillae or upper jaw is under the upper lip, and the mandible underlies the lower lip. The first statement is true. The jaws are within the oral cavity and deep to the lips. The first statement is true, and the second statement is false. The maxillae or upper jaw is under the upper lip, and the mandible or lower jaw underlies the lower lip. The first statement is true. The jaws are located within the oral region, which consists of the oral cavity. The second statement is false. The maxillae or upper jaw is under the upper lip, and the mandible or lower jaw underlies the lower lip.

DIF: Comprehension REF: p. 15 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, 1.1.1 Head and Neck Anatomy 10. What is the landmark located in the oral cavity that appears as a small elevation of tissue

located on the inner part of the buccal mucosa, just opposite the maxillary second molar? a. Parotid papilla b. Maxillary tuberosity c. Labial frenum d. Retromolar pad ANS: A

B C

Feedback The parotid papilla is located on a small elevation of tissue containing the duct opening from the parotid gland on the inner part of the buccal mucosa opposite the maxillary second molar. The maxillary tuberosity is located posterior to the maxilla. The labial frenum is a fold of tissue located at the midline between the labial mucosa and alveolar mucosa of the maxilla and mandible.

The retromolar pad is a dense pad of tissue distal to the most distal tooth of the mandible.

DIF: Recall REF: p. 16 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, 1.1.1 Head and Neck Anatomy 11. The palate or roof of the mouth has two parts: an anterior part and a posterior part. The firmer,

whiter posterior part is the hard palate. 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

A B C

Feedback The second statement is false. The firmer, whiter anterior part is the hard palate. The posterior part is the soft palate. The first statement is true. The palate has two parts: an anterior part and a posterior part. The first statement is true, while the second statement is false. The second statement is false because the firmer, whiter anterior part is the hard palate. The posterior part is the soft palate. The first statement is true, and the second statement is false. The first statement is true because the palate has two parts: an anterior part and a posterior part. The second statement is false because the firmer, whiter anterior part is the hard palate. The posterior part is the soft palate.

DIF: Recall REF: p. 17 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, 1.1.1 Head and Neck Anatomy 12. What is the term for the top surface of the tongue? a. Lateral b. Dorsal c. Ventral d. Root ANS: B

A B C D

Feedback The lateral surface(s) is/are located on the sides of the tongue. The dorsal surface of the tongue is located on the topside of the tongue. The ventral surface of the tongue is located on the underside of the tongue. The root of the tongue is also the base of the tongue.

DIF: Recall

REF: p. 19

OBJ: 1

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, 1.1.1 Head and Neck Anatomy 13. What is the flap of cartilage located posterior to the base of the tongue and anterior to the

oropharynx? a. Fauces b. Mental protuberance c. Palatine tonsils d. Epiglottis ANS: D

A B C D

Feedback The fauces is located laterally at the junction or the opening between the oral region and the oropharynx. The mental protuberance is located in the mental region and is part of the chin. The palatine tonsils are located between the fauces, which consists of the anterior faucial pillar and the posterior faucial pillar. The epiglottis is a flap of cartilage located posterior to the base of the tongue and anterior to the oropharynx.

DIF: Recall REF: p. 20 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, 1.1.1 Head and Neck Anatomy 14. Which muscle of the neck region divides each side of the neck diagonally into BOTH the

anterior cervical triangle and the posterior cervical triangle? a. Sternocleidomastoid muscle b. Digastric muscle c. Omohyoid muscle d. Trapezius muscle ANS: A

A B C D

Feedback The sternocleidomastoid muscle is a large paired strap muscle that divides each side of the neck. The digastric muscle is a suprahyoid muscle located underneath the chin. The omohyoid muscle is an infrahyoid muscle that divides the posterior cervical triangle into the occipital triangle. The trapezius muscle is a cervical muscle that covers the lateral and posterior surfaces of the neck.

DIF: Recall REF: p. 21 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, 1.1.1 Head and Neck Anatomy

15. During the extraoral examination, palpating inferior to and medial to the angles of the

mandible is important BECAUSE this will allow the dental professional to effectively palpate the hyoid bone. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A

A B

C D E

Feedback The hyoid bone is located in the anterior midline, superior to the thyroid cartilage where the angles of the mandible are located. The statement and the reason are related. During the extraoral examination, palpating inferior to and medial to the angles of the mandible is important because this will allow the dental professional to effectively palpate the hyoid bone. The reason is correct. The angle of the mandible is the landmark used to locate the hyoid bone. The statement is correct. Palpation of the angles of the mandible is part of the extraoral examination. The statement and the reason are correct. The hyoid bone is located in the anterior midline, superior to the thyroid cartilage where the angles of the mandible are located.

DIF: Application REF: p. 21 OBJ: 2 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 MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | 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 16. What is the vertical groove located at the midline superior to the upper lip that extends

downward on the skin from the nasal septum? a. Philtrum b. Tubercle c. Labial commissure d. Nasolabial sulcus ANS: A

A B C

Feedback The philtrum is the vertical groove that extends downward on the skin from the nasal septum at the midline superior to the upper lip. The tubercle is a thicker area on the upper lip inferior to where the philtrum on the skin terminates. The labial commissure is also known as the corner of the mouth. This is where

the upper and lower lips meet. The nasolabial sulcus is the groove that runs upward between the labial commissure and the ala of the nose.

DIF: Recall REF: p. 15 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, 1.1.1 Head and Neck Anatomy 17. Where are foliate lingual papillae located within the oral cavity? a. Dorsal surface of the tongue b. Buccal mucosa c. Anterior hard palate d. Lateral border of the tongue ANS: D

A B C D

Feedback The dorsal surface of the tongue has the filiform, fungiform, and circumvallate lingual papillae. The foliate lingual papillae are located on the lateral border of the tongue. The foliate lingual papillae are located on the lateral border of the tongue. The foliate lingual papillae are located on the lateral border of the tongue.

DIF: Recall REF: p. 19 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, 1.1.1 Head and Neck Anatomy 18. Trying to fully survey the areas of the scalp during an extraoral examination is NOT very

important because lesions are easily visualized by the patient and then can be shared with the clinician. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: E

Feedback Neither the statement nor the reason is correct. Trying to fully survey these areas of the scalp during an extraoral examination is important because lesions may be hidden visually from the clinician as well as the patient by the patient’s hair. Neither the statement nor the reason is correct. Trying to fully survey these areas of the scalp during an extraoral examination is important because lesions may be hidden visually from the clinician as well as the patient by the patient’s hair. Neither the statement nor the reason is correct. Trying to fully survey these areas of the scalp during an extraoral examination is important because lesions may be hidden visually from the clinician as well as the patient by the patient’s hair.

Neither the statement nor the reason is correct. Trying to fully survey these areas of the scalp during an extraoral examination is important because lesions may be hidden visually from the clinician as well as the patient by the patient’s hair. Neither the statement nor the reason is correct. Trying to fully survey these areas of the scalp during an extraoral examination is important because lesions may be hidden visually from the clinician as well as the patient by the patient’s hair.

DIF: Application REF: p. 13 OBJ: 2 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 MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | 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 19. The frontal eminence is usually MORE pronounced in males, and the supraorbital ridge is

MORE prominent in females and children. 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: B

Feedback Both statements are false. The frontal eminence is usually more pronounced in children and adult females, and the supraorbital ridge is more prominent in adult males. Both statements are false. The frontal eminence is usually more pronounced in children and adult females, and the supraorbital ridge is more prominent in adult males. Both statements are false. The frontal eminence is usually more pronounced in children and adult females, and the supraorbital ridge is more prominent in adult males. Both statements are false. The frontal eminence is usually more pronounced in children and adult females, and the supraorbital ridge is more prominent in adult males.

DIF: Recall REF: p. 12 OBJ: 2 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, 1.1.1 Head and Neck Anatomy | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 3.3 Individualized Patient Education 20. The eyes are usually near the midpoint of the vertical height of the head. The width of each

eye is usually the same as the distance between the ears. 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 The first statement is true; the second is false. The eyes are usually near the midpoint of the vertical height of the head. The width of each eye is usually the same as the distance between the eyes. The first statement is true; the second is false. The eyes are usually near the midpoint of the vertical height of the head. The width of each eye is usually the same as the distance between the eyes. The first statement is true; the second is false. The eyes are usually near the midpoint of the vertical height of the head. The width of each eye is usually the same as the distance between the eyes. The first statement is true; the second is false. The eyes are usually near the midpoint of the vertical height of the head. The width of each eye is usually the same as the distance between the eyes.

DIF: Recall REF: p. 13 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, 1.1.1 Head and Neck Anatomy 21. Loss of height in the lower third of the face, which contains the teeth and jaws, can occur in

certain circumstances such as with growth and effective orthodontic therapy. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: C

Feedback The statement is correct, but the reason is NOT. Loss of height in the lower third of the face, which contains the teeth and jaws, can occur in certain circumstances such as with aging and periodontal disease. It does NOT occur with growth or effective orthodontic therapy. The statement is correct, but the reason is NOT. Loss of height in the lower third of the face, which contains the teeth and jaws, can occur in certain circumstances such as with aging and periodontal disease. The statement is correct, but the reason is NOT. Loss of height in the lower third of the face, which contains the teeth and jaws, can occur in certain circumstances such as with aging and periodontal disease. The statement is correct, but the reason is NOT. Loss of height in the lower third of the face, which contains the teeth and jaws, can occur in certain circumstances such as with aging and periodontal disease. The statement is correct, but the reason is NOT. Loss of height in the lower third of the face, which contains the teeth and jaws, can occur in certain circumstances

such as with aging and periodontal disease. DIF: Comprehension REF: p. 15 OBJ: 2 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | 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 22. Both the labial and buccal mucosa may vary in coloration, as do other regions of healthy oral

mucosa, in individuals with _______ skin. a. thinner b. pigmented c. thicker d. transparent ANS: B

A B C D

Feedback Both the labial and buccal mucosa may vary in coloration, as do other regions of healthy oral mucosa, in individuals with pigmented skin. Both the labial and buccal mucosa may vary in coloration, as do other regions of healthy oral mucosa, in individuals with pigmented skin. Both the labial and buccal mucosa may vary in coloration, as do other regions of healthy oral mucosa, in individuals with pigmented skin. Both the labial and buccal mucosa may vary in coloration, as do other regions of healthy oral mucosa, in individuals with pigmented skin.

DIF: Recall REF: p. 16 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, 1.1.1 Head and Neck Anatomy 23. The yellower and looser posterior part of the palate is the hard palate; it is the larger part of

the palate since it comprises approximately 85% of the total surface. 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: D

Feedback The first statement is false; the second is true. The yellower and looser posterior part of the palate is the soft palate; it is the smaller part of the palate since it only comprises approximately 15% of the total surface. The first statement is false; the second is true. The yellower and looser posterior part of the palate is the soft palate; it is the smaller part of the palate since it only comprises approximately 15% of the total surface. The first statement is false; the second is true. The yellower and looser posterior

part of the palate is the soft palate; it is the smaller part of the palate since it only comprises approximately 15% of the total surface. The first statement is false; the second is true. The yellower and looser posterior part of the palate is the soft palate; it is the smaller part of the palate since it only comprises approximately 15% of the total surface.

DIF: Recall REF: p. 18 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, 1.1.1 Head and Neck Anatomy 24. What is the dense pad of tissue just posterior to the most distal tooth of the mandible? a. Pterygomandibular fold b. Maxillary tuberosity c. Parotid papilla d. Retromolar pad ANS: D

B C D

Feedback The pterygomandibular fold is a fold of tissue that extends from the junction of hard and soft palates down to the mandible, just posterior to the most distal mandibular molar. An elevation on the posterior aspects of the maxilla just posterior to the most distal maxillary molar is the maxillary tuberosity. On the inner part of the buccal mucosa, just opposite the maxillary second molar, the parotid papilla is a small elevation of tissue. The area just posterior to the most distal mandibular molar is a dense pad of tissue, the retromolar pad.

DIF: Recall REF: p. 16 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, 1.1.1 Head and Neck Anatomy 25. The line of demarcation between the firmer and pinker attached gingiva and the movable and

redder alveolar mucosa is the a. interdental gingiva. b. gingival sulcus. c. mucogingival junction. d. vestibular fornix. ANS: C

A B C

Feedback The gingival tissue between the teeth is an extension of attached gingiva and is the interdental gingiva. The inner surface of the marginal gingiva faces a space or gingival sulcus. The line of demarcation between the firmer and pinker attached gingiva and the movable and redder alveolar mucosa is the scallop-shaped mucogingival

junction. Deep within each vestibule is the vestibular fornix, where the pink and thick labial or buccal mucosa meets the redder and thinner alveolar mucosa.

DIF: Recall REF: p. 17 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, 1.1.1 Head and Neck Anatomy 26. Which of the following borders of the oral cavity are listed CORRECTLY? a. Cheeks are the lateral borders b. Lips are the inferior border c. Pharynx is the anterior border d. Floor of the mouth is the superior border ANS: A Feedback A B C D

Cheeks of the face are the lateral borders of the oral cavity. The lips are the anterior border of the oral cavity and NOT its inferior border. The pharynx is the posterior border of the oral cavity and NOT its anterior border. The floor of the mouth is the inferior border of the oral cavity and NOT its superior border.

DIF: Comprehension REF: p. 15 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, 1.1.1 Head and Neck Anatomy MULTIPLE RESPONSE 1. From the following list of structures, select which structures are located within the nasal

region of the head. (Select all that apply.) a. Masseter muscle b. Angle of mandible c. Alae d. Antitragus e. Nasion ANS: C, E Feedback Correct Incorrect

Both the alae and nasion are located within the nasal region of the head. Both the masseter muscle and angle of the mandible are located within the buccal region of the head. The antitragus is located within the temporal region of the head. NONE of these structures are within the nasal regions of the head.

DIF: Recall REF: p. 14 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, 1.1.1 Head and Neck Anatomy 2. From the following list of structures, select which structures are located within the buccal

region of the head. (Select all that apply.) a. Masseter muscle b. Angle of mandible c. Alae d. Antitragus e. Nasion ANS: A, B Feedback Correct Incorrect

Both the masseter muscle and angle of the mandible are located within the buccal region of the head. Both the alae and nasion are located within the nasal region of the head. The antitragus is located within the temporal region of the head. NONE of these structures are located within the buccal region of the head.

DIF: Recall REF: pp. 14-15 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, 1.1.1 Head and Neck Anatomy 3. From the following list of structures, select which structures are located within the oral region

of the head. (Select all that apply.) a. Alae b. Antitragus c. Nasion d. Vermilion zone e. Philtrum ANS: D, E Feedback Correct Incorrect

Both the vermilion zone and philtrum are located within the oral region of the head. Both the alae and nasion are located within the nasal region of the head. The antitragus is located within the temporal region of the head. NONE of these structures are located within the oral region of the head.

DIF: Recall REF: p. 15 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, 1.1.1 Head and Neck Anatomy 4. From the following list of structures, select which structures are NOT located within the

temporal region of the head. (Select all that apply.) a. Alae b. Antitragus

c. Nasion d. Vermilion zone e. Philtrum ANS: A, C, D, E Feedback Correct

Incorrect

The alae and nasion are located within the nasal region of the head. The vermilion zone and philtrum are located within the oral region of the head. NONE of these structures are located within the temporal region of the head. The antitragus is located within the temporal region of the head.

DIF: Recall REF: p. 13 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, 1.1.1 Head and Neck Anatomy 5. From the following list of structures, select which structures are considered part of the

eyeball. (Select all that apply.) a. Sclera b. Iris c. Conjunctiva d. Orbit e. Lacrimal gland ANS: A, B Feedback Correct Incorrect

Both the sclera and iris are considered part of the eyeball. The conjunctiva is part of the eyelid. The orbit is the bony socket containing the eyeball, and the lacrimal gland is within the orbit. NONE of these structures are part of the eyeball.

DIF: Recall REF: p. 13 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, 1.1.1 Head and Neck Anatomy 6. Which of the following needs to occur in order to effectively visually inspect and bidigitally

palpate the vestibular area and gingival tissue during an intraoral examination on patient? (Select all that apply.) a. Retracting buccal mucosa b. Placing mouth mirror on dorsal surface of tongue c. Retracting labial mucosa d. Having patient say “ah” ANS: A, C Feedback Correct

During an intraoral examination, retract both the buccal mucosa and labial mucosa in order to visually inspect and bidigitally palpate the vestibular

Incorrect

area and the gingival tissue. Placing the mouth mirror with mirror side down on the middle of the dorsal surface of tongue allows for visual inspection of the soft palate with uvula and visible parts of the pharynx; next ask the patient to say “ah.”

DIF: Application REF: p. 17 OBJ: 2 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | 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 7. Which of the following needs to occur in order to effectively examine the dorsal surface of the

tongue during an intraoral examination on a patient? (Select all that apply.) a. Extending tongue slightly b. Wrapping gauze around tongue c. Grasping of tongue firmly d. Digitally palpating surface ANS: A, B, C, D

To examine the dorsal surface of the tongue, have the patient slightly extend the tongue and wrap gauze around the anterior third of the tongue in order to obtain a firm grasp. First, visually inspect and then digitally palpate the dorsal surface. DIF: Application REF: p. 20 OBJ: 2 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, 1.1.1 Head and Neck Anatomy | 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 8. Which of the following are palpable landmarks of the midline of the neck during an extraoral

examination by a dental professional? (Select all that apply.) a. Thyroid cartilage b. Vocal cords or ligaments c. Superior thyroid notch d. Hyoid bone ANS: A, C, D Feedback Correct

Incorrect

The thyroid cartilage and its superior thyroid notch as well as the hyoid bone are palpable landmarks of the midline of the neck during an extraoral examination. The vocal cords or ligaments of the larynx or “voice box” are attached to the posterior surface of the thyroid cartilage and thus are not palpable during an extraoral examination. Instead, a laryngoscopy is an examination by medical personnel that examines the posterior surface of

the pharynx as well as the vocal cords or ligaments of the larynx using a laryngoscope. DIF: Application REF: p. 21 OBJ: 2 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 MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | 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 9. Which of the following needs to occur in order to effectively examine the floor of the mouth

during an extraoral examination on a patient? (Select all that apply.) a. Observe salivary flow from sublingual caruncle ducts b. Check midline lingual frenum c. Observe salivary flow from parotid papillae ducts d. Check midline labial frenum ANS: A, B Feedback Correct

Incorrect

When examining the floor of the mouth during an intraoral examination, check the lingual frenum at the midline and then dry each sublingual caruncle with gauze to observe salivary flow from the ducts. When examining the buccal mucosa during an intraoral examination and NOT the floor of the mouth, observe the salivary flow from each duct near the parotid papillae after drying it with gauze. When examining the labial mucosa and NOT the floor of the mouth, check the labial frenum on both the maxilla and mandible at each one’s midline.

DIF: Application REF: p. 20 OBJ: 2 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 MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | 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

Chapter 03: Skeletal System Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition MULTIPLE CHOICE 1. Which of the following bony features listed does NOT serve as an opening in bone? a. Foramen b. Canal c. Sulcus d. Fissure ANS: C

A B C D

Feedback A foramen is a short windowlike opening in bone. A canal is a tubelike opening in bone. A sulcus is a shallow depression or groove on bony surface and NOT an opening in bone. A fissure is a narrow cleftlike opening in bone.

DIF: Recall REF: p. 33 OBJ: 1 | 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, 1.1.1 Head and Neck Anatomy 2. Which of the following bones listed is the ONLY movable bone of the skull? a. Hyoid bone b. Mandible c. Palatine d. Vomer ANS: B

A B

C D

Feedback Even though the hyoid bone is movable and has no bony articulations, it is a bone located in the neck and NOT the skull. The mandible is the only skull bone that moves; it moves at the temporomandibular joint. Within this joint, the mandibular condyle moves within the articular fossa of the temporal bone. The palatine bone may be a skull bone, but it does NOT move. The vomer may be a skull bone, but it does NOT move.

DIF: Recall REF: p. 33 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, 1.1.1 Head and Neck Anatomy 3. The squamosal suture is BEST observed from which view of the skull? a. Anterior view

b. Inferior view c. Lateral view d. Superior view ANS: C

A B C

Feedback It is difficult to see the squamosal suture on the lateral skull surface from an anterior view. It is difficult to see the squamosal suture on the lateral skull surface from an inferior view. The squamosal suture is the suture between the parietal bones and temporal bones on each side of the skull. This suture is BEST viewed from the lateral view. It is difficult to see the squamosal suture on the lateral skull surface from a superior view.

DIF: Comprehension REF: p. 40 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, 1.1.1 Head and Neck Anatomy 4. Which of the following openings within the orbit connects the orbit with the cranial cavity? a. Cribriform plate b. Infraorbital foramen c. Inferior orbital fissure d. Superior orbital fissure ANS: D

A B C D

Feedback The cribriform plate is a passageway for olfactory nerves from the nasal cavity to the brain. The infraorbital foramen is located inferior to the orbit on the facial surface of the maxilla. The inferior orbital fissure connects the orbit with both the infratemporal and pterygopalatine fossae and NOT the cranial cavity. The superior orbital fissure is a slitlike opening between the lesser and greater wings of the sphenoid bone and serves as a passageway for blood vessels and nerves from the cranial cavity into the orbit, thus connecting the two.

DIF: Recall REF: pp. 46-47 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, 1.1.1 Head and Neck Anatomy 5. After the seventh cranial nerve travels through the petrous part of the temporal bone, through

which opening does it exit onto the face? a. External auditory meatus b. Jugular notch

c. Foramen spinosum d. Stylomastoid foramen ANS: D

A B C D

Feedback The external acoustic meatus is the short external canal that leads to the tympanic cavity. The jugular notch, formed by the articulation of temporal and occipital bones, is associated with the jugular vein and the ninth, tenth, and eleventh cranial nerves. The foramen spinosum is more posterior and is associated with the middle meningeal artery. The seventh cranial nerve enters the temporal bone through the internal acoustic meatus, travels within the temporal bone, and exits through the stylomastoid foramen onto the face.

DIF: Recall REF: p. 46 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, 1.1.1 Head and Neck Anatomy 6. Which of the following external foramina can ONLY be observed from an inferior view of the

skull? a. Hypoglossal canal b. Foramen ovale c. Foramen spinosum d. Stylomastoid foramen ANS: D

A B C D

Feedback The hypoglossal canal can be viewed from both inferior and superior aspects of the skull. The foramen ovale can be viewed from both inferior and superior aspects of the skull. The foramen spinosum can be viewed from both inferior and superior aspects of the skull. The stylomastoid foramen is NOT visible from a superior view of the skull and can ONLY be observed from an inferior view of the skull. It is located between the mastoid process and the styloid process on the inferior surface of the petrous part of the temporal bone.

DIF: Comprehension REF: p. 46 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, 1.1.1 Head and Neck Anatomy 7. Through which of the following openings in the skull does the twelfth cranial nerve pass? a. Internal acoustic meatus b. Foramen rotundum

c. Foramen spinosum d. Hypoglossal canal ANS: D

A B C D

Feedback The internal acoustic meatus is located on the superior internal surface of the temporal bone and is associated with both the seventh and eighth cranial nerves. The foramen rotundum is located within the sphenoid bone and is associated with the maxillary nerve or second division of the fifth cranial nerve. The foramen spinosum is located within the sphenoid bone and is associated with the middle meningeal artery. The twelfth cranial nerve passes through the hypoglossal canal, an opening in the skull that is located in the occipital bone on each side of the foramen magnum.

DIF: Recall REF: p. 47 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, 1.1.1 Head and Neck Anatomy 8. Why is the pterygoid process of the sphenoid bone an important feature of the skull to the

dental professionals? a. Serves as an attachment for the muscles of mastication b. Serves as an attachment for muscles involved in swallowing c. Serves as a landmark observed on maxillary posterior periapical radiographs d. Serves as a landmark observed on mandibular posterior periapical radiographs ANS: A

A B C D

Feedback The pterygoid process is an attachment for both the lateral and medial pterygoid muscles, which are two muscles of mastication. The pterygoid process does NOT provide attachment for the muscles involved in swallowing. The pterygoid process is NOT a landmark usually observed on maxillary periapical radiographs. The pterygoid process is NOT a landmark observed on mandibular periapical radiographs.

DIF: Application REF: p. 53 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, 1.1.1 Head and Neck Anatomy | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care 9. Through which of the following bony landmarks is the sense of smell carried by olfactory

nerves? a. Crista galli of the ethmoid bone b. Frontal sinuses of the frontal bone

c. Cribriform plate of the ethmoid bone d. Perpendicular plate of the ethmoid bone ANS: C

A B C D

Feedback The crista galli is the vertical projection of the ethmoid bone into the cranial cavity. It is an area of attachment for the meninges. The frontal sinuses of the frontal bone do NOT have openings for passage of the olfactory nerves to the brain. The cribriform plate is the superior horizontal part of the ethmoid bone that is perforated for passage of olfactory nerves for the sense of smell. The perpendicular plate of the ethmoid bone forms part of the nasal septum.

DIF: Recall REF: p. 57 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, 1.1.1 Head and Neck Anatomy 10. Which of the following bony features increases the surface area within the nasal cavity? a. Perpendicular plate of the ethmoid bone b. Inferior nasal conchae c. Lacrimal bones d. Nasal bones ANS: B

A B C D

Feedback The vertical plate is straight and serves as part of the nasal septum. The scroll-like shape of the inferior nasal conchae assists in increasing the surface area since it is covered with mucous membranes. The lacrimal bones are small, fragile bones that form a part of the anterior medial wall of the orbit. The nasal bones form the bridge of the nose.

DIF: Recall REF: p. 40 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, 1.1.1 Head and Neck Anatomy 11. Which of the following skull bones are considered to be paired cranial bones? a. Nasal bones b. Temporal bones c. Lacrimal bones d. Zygomatic bones ANS: B

A B

Feedback The nasal bones are paired facial bones but NOT cranial bones. The temporal bones are paired cranial bones.

C D

The lacrimal bones are paired facial bones but NOT cranial bones. The zygomatic bones are paired facial bones but NOT cranial bones.

DIF: Recall REF: p. 47 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, 1.1.1 Head and Neck Anatomy 12. Through which bony opening do BOTH the right and left nasopalatine nerves exit onto the

palate? a. Posterior superior alveolar foramina b. Incisive foramen c. Greater palatine foramina d. Lesser palatine foramina ANS: B

A B C

Feedback The posterior superior alveolar foramina are passageways for the posterior superior alveolar nerves and blood vessels and NOT the nasopalatine nerves. Both the right and left nasopalatine nerves and blood vessels travel from the nasal cavity to the anterior palate through the incisive foramen. The greater palatine foramina are located in the posterolateral region of the palatine bones and are NOT passageways for the nasopalatine nerves and blood vessels but for the greater palatine nerve and blood vessels. The lesser palatine foramina are located in the palatine bones and are NOT passageways for the nasopalatine nerves nor blood vessels but for the lesser palatine nerve and blood vessels.

DIF: Recall REF: p. 64 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, 1.1.1 Head and Neck Anatomy 13. Which of the following landmarks needs to be noted during the administration of a local

anesthetic agent to the maxillary posterior teeth? a. Infraorbital foramen b. Retromolar pad c. Maxillary tuberosity d. Zygomatic process of the maxilla ANS: C

A B

Feedback The infraorbital foramen is located on the facial surface of the maxilla and is NOT a passageway for nerves to the maxillary posterior teeth. The retromolar pad is located on the mandible posterior to the mandibular molars and is NOT used as a landmark for administration of maxillary local anesthesia. The posterior superior alveolar foramina serve as openings for the passage of the

posterior superior alveolar nerve and blood vessels. These foramina are posterosuperior and medial to the maxillary tuberosity and perforate the infratemporal surface of the maxilla multiple times. They need to be noted during the administration of a local anesthetic agent to the maxillary posterior teeth. The zygomatic process of the maxilla does NOT serve as a landmark for the administration of local anesthesia to maxillary posterior teeth.

DIF: Comprehension REF: p. 63 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, 1.1.2 Dental Anatomy 14. Which of the following sutures of the skull is an immovable articulation between the occipital

bone and the parietal bones? a. Coronal suture b. Lambdoidal suture c. Sagittal suture d. Squamosal suture ANS: B

A B C D

Feedback The coronal suture is an immovable articulation between the frontal bone and the parietal bones. The lambdoidal suture is an immovable articulation between the occipital bone and the parietal bones meet. The sagittal suture is an immovable articulation between the two parietal bones. The squamosal suture is an immovable articulation between the temporal bones and parietal bones on each side.

DIF: Recall REF: p. 40 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, 1.1.1 Head and Neck Anatomy 15. Which of the following bony landmarks is a depression located between the coronoid process

and the mandibular ramus? a. Coronoid notch b. Mandibular notch c. Mandibular foramen d. Submandibular fossa ANS: B

A B

Feedback The coronoid notch is a depression located on the anterior border of the mandibular ramus inferior to the coronoid process. The depression between the coronoid process and the mandibular ramus is the mandibular notch.

C D

The mandibular foramen is located on the medial surface of the mandibular ramus. The submandibular fossa is a depression located inferior to the mylohyoid line or ridge on the medial surface of the body of the mandible.

DIF: Recall REF: p. 68 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, 1.1.1 Head and Neck Anatomy 16. Which of the following paranasal sinuses can be palpated during an extraoral examination by

a clinician? a. Frontal and sphenoidal sinuses b. Sphenoidal and ethmoidal sinuses c. Ethmoidal and maxillary sinuses d. Maxillary and frontal sinuses ANS: D

B C D

Feedback The frontal sinuses can be palpated during an extraoral examination, but the sphenoidal sinuses CANNOT be palpated as part of the extraoral examination due to their location within the sphenoid bone. NEITHER the sphenoidal NOR ethmoidal sinuses can be palpated during an extraoral examination due to their location within their respective bones. The ethmoidal sinuses CANNOT be palpated during the extraoral examination due to their location within the ethmoid bone. Both the maxillary and frontal sinuses can be palpated during an extraoral examination.

DIF: Application REF: p. 71 OBJ: 3 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 MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care 17. How does the mandibular condyle move in relationship to the temporal bone? a. Articular eminence b. Coronoid notch c. Articular fossa d. Mandibular fossa ANS: C

A B C

Feedback The mandibular condyle does NOT move within the articular eminence of the temporal bone. The coronoid notch is part of the mandible. The articular fossa of the temporal bone is the articulation area for movement of

the mandibular condyle as part of the temporomandibular joint. The mandibular notch is part of the mandible.

DIF: Comprehension REF: p. 71 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, 1.1.1 Head and Neck Anatomy 18. When viewing the medial surface of the mandible, which of the following bony landmarks

CANNOT be observed? a. Internal oblique ridge b. Genial tubercles c. Mandibular foramen d. Mental foramen ANS: D

A B C D

Feedback The internal oblique ridge can be observed on the medial surface of the mandible. The genial tubercles can be observed on the medial surface of the mandible. The mandibular foramen can be observed on the medial surface of the mandibular ramus. When viewing the medial surface of the mandible, ALL of the other structures can be observed. The mental foramen is located on the lateral surface of the mandible and CANNOT be viewed on the medial surface of the mandible.

DIF: Comprehension REF: p. 68 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, 1.1.1 Head and Neck Anatomy 19. Which of the following landmarks is the MOST inferiorly located on the mandible? a. Lingula b. Mylohyoid line c. Submandibular fossa d. Retromolar triangle ANS: C

A B C

Feedback The lingula is located on the medial surface of the mandibular ramus, which is superior to the body of the mandible. The mylohyoid line is located on the medial surface of the body of the mandible, which is superior to the submandibular fossa. The submandibular fossa is located on the medial surface of the mandible and is inferior to the other landmarks listed: the lingula, mylohyoid line, and retromolar triangle, so overall it is the most inferiorly located mandibular landmark. The retromolar triangle is located on the posterior part of the alveolar ridge of the mandible, which is located superior to the submandibular fossa.

DIF: Comprehension REF: p. 70 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, 1.1.1 Head and Neck Anatomy 20. Which of the following bony landmarks is formed by the vertical plates of the palatine bones? a. Nasal septum b. Posterior hard palate c. Lateral walls of the nasal cavity d. Superior wall of the orbit ANS: C

A B C D

Feedback The nasal septum is located in the midline of the nasal cavity, and the palatine bones are NOT located there. The posterior hard palate is formed by the horizontal plates of the palatine bones. The vertical plates of the palatine bones form the posterior lateral walls of the nasal cavity. The palatine bones are NOT located superior to the orbit and therefore do NOT form the superior orbital wall.

DIF: Recall REF: p. 60 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, 1.1.1 Head and Neck Anatomy 21. Which of the following processes forms the lateral part of the infraorbital rim? a. Temporal process of the zygomatic bone b. Maxillary process of the zygomatic bone c. Frontal process of the maxilla d. Alveolar process of the maxilla ANS: B

A B C D

Feedback The temporal process of the zygomatic bone articulates with a part of the temporal bone and forms the zygomatic arch. The maxillary process of the zygomatic bone is the part that articulates with the maxilla and forms the lateral part of the infraorbital rim. The frontal process of the maxilla forms the medial infraorbital rim. The alveolar process of the maxilla is the part that surrounds the teeth by way of the alveoli or tooth sockets.

DIF: Recall REF: pp. 59-60 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, 1.1.1 Head and Neck Anatomy 22. Where is the pterygoid process of the skull located?

a. b. c. d.

Inferior to the greater wing of the sphenoid bone Posterior to the greater wing of the sphenoid bone Anterior to the greater wing of the sphenoid bone Anterior to the body of the sphenoid bone

ANS: A

A B C D

Feedback The pterygoid process is located inferior to the greater wing of the sphenoid bone. The pterygoid process is located inferior to the greater wing of the sphenoid bone. The pterygoid process is located inferior to the greater wing of the sphenoid bone. The pterygoid process is located inferior to the greater wing of the sphenoid bone.

DIF: Recall REF: p. 53 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, 1.1.1 Head and Neck Anatomy 23. The pterygopalatine fossa communicates with the middle cranial fossa via the a. foramen rotundum. b. superior orbital fissure. c. foramen ovale. d. inferior orbital fissure. ANS: A

A B

C D

Feedback Pterygopalatine fossa communicates with the middle cranial fossa via the foramen rotundum; more specifically, the pterygoid canal. Lateral to the optic canal is the curved and slitlike superior orbital fissure, between the greater and lesser wings of the sphenoid bone. Similar to the optic canal, the superior orbital fissure connects the orbit with the cranial cavity. The third cranial or oculomotor nerve, the fourth cranial or trochlear nerve, the sixth cranial or abducens nerve, and the ophthalmic nerve or first division from fifth cranial or trigeminal nerve and vein travel through this fissure. The larger anterior oval opening on the sphenoid bone is the foramen ovale for the mandibular nerve or third division of the fifth cranial or trigeminal nerve. The inferior orbital fissure can also be noted between the greater wing of the sphenoid bone and the maxilla. The inferior orbital fissure connects the orbit with the infratemporal and pterygopalatine fossae. The infraorbital and zygomatic nerves, branches of the maxillary nerve, and infraorbital artery enter the orbit through this fissure. The inferior ophthalmic vein travels through this fissure to join the pterygoid plexus of veins.

DIF: Recall REF: p. 76 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, 1.1.1 Head and Neck Anatomy 24. . The ______ is resorbed with tooth loss, and this loss can be noted on patients

radiographically. a. body of the maxillae b. body of the mandible c. base of the mandible d. alveolar process of the mandible ANS: D

A B C D

Feedback The body of the maxillae is NOT resorbed with tooth loss. The body or base of the mandible is NOT resorbed with tooth loss. The base or body of the mandible is NOT resorbed with tooth loss. The alveolar process of the mandible can be resorbed with tooth loss and can be noted on patients to some extent radiographically.

DIF: Application REF: p. 65 OBJ: 4 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.2 Dental Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care 25. The differences in alveolar process density determine the easiest and MOST clinically

effective region for bony fracture used during tooth extraction, if needed. Thus the maxillary teeth are surgically BEST removed by fracturing the thinner facial cortical plate rather than the thicker lingual cortical plate. a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A

Feedback Both the statement and reason are correct and related. The differences in alveolar process density determine the most clinically effective region for bony fracture used during tooth extraction. Thus the maxillary teeth are surgically BEST removed by fracturing the thinner facial cortical plate rather than the thicker lingual cortical plate, if needed. Both the statement and reason are correct and related. The differences in alveolar process density determine the most clinically effective region for bony fracture used during tooth extraction. Thus the maxillary teeth are surgically BEST removed by fracturing the thinner facial cortical plate rather than the thicker lingual cortical plate, if needed. Both the statement and reason are correct and related. The differences in alveolar

process density determine the most clinically effective region for bony fracture used during tooth extraction. Thus the maxillary teeth are surgically BEST removed by fracturing the thinner facial cortical plate rather than the thicker lingual cortical plate, if needed. Both the statement and reason are correct and related. The differences in alveolar process density determine the most clinically effective region for bony fracture used during tooth extraction. Thus the maxillary teeth are surgically BEST removed by fracturing the thinner facial cortical plate rather than the thicker lingual cortical plate, if needed. Both the statement and reason are correct and related. The differences in alveolar process density determine the most clinically effective region for bony fracture used during tooth extraction. Thus the maxillary teeth are surgically BEST removed by fracturing the thinner facial cortical plate rather than the thicker lingual cortical plate, if needed.

DIF: Application REF: p. 65 OBJ: 4 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.2 Dental Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care MULTIPLE RESPONSE 1. From the following list of structures, select which structures are associated with the nasal

cavity. (Select all that apply.) a. Nasion b. Conchae c. Meatus d. Fissure e. Canal ANS: A, B, C Feedback Correct Incorrect

The nasion, nasal conchae, and nasal meatus are associated with the nasal cavity. The fissure and canal are associated with the orbit (superior and inferior orbital fissure as well as the optic canal) and NOT the nasal cavity; fissure and canal are also associated with other areas of the skull but NOT the nasal cavity.

DIF: Recall REF: pp. 38-40 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, 1.1.1 Head and Neck Anatomy 2. From the following list of structures, select which structures are associated with the occipital

bone. (Select all that apply.)

a. b. c. d. e.

Condyle Tubercle Notch Glabella Eminence

ANS: A, B, C Feedback Correct Incorrect

The occipital condyle, pharyngeal tubercle, and jugular notch are associated with the occipital bone. The supraorbital notch, glabella, and frontal eminence are associated with the frontal bone and NOT the occipital bone.

DIF: Recall REF: pp. 47-49 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, 1.1.1 Head and Neck Anatomy 3. From the following list of structures, select which structures are associated with the frontal

bone. (Select all that apply.) a. Condyle b. Tubercle c. Notch d. Glabella e. Eminence ANS: C, D, E Feedback Correct Incorrect

The supraorbital notch, glabella, and frontal eminence are associated with the frontal bone. The occipital condyle, pharyngeal tubercle, and jugular notch are associated with the occipital bone and NOT the frontal bone.

DIF: Recall REF: p. 49 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, 1.1.1 Head and Neck Anatomy 4. From the following list of skull bones, select which skull bones are associated with the

paranasal sinuses. (Select all that apply.) a. Occipital bone b. Mandible c. Maxillary bone d. Sphenoid bone e. Ethmoid bone ANS: C, D, E Feedback Correct

The maxilla, sphenoid bone, and ethmoid bone are associated with

Incorrect

paranasal sinuses. The occipital bone and mandible are NOT associated with paranasal sinuses.

DIF: Recall REF: p. 71 OBJ: 2 | 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, 1.1.1 Head and Neck Anatomy 5. From the following list of skull bones, select which skull bones articulate with the ethmoid

bone. (Select all that apply.) a. Frontal bone b. Sphenoid bone c. Lacrimal bones d. Occipital bones e. Parietal bones ANS: A, B, C Feedback Correct Incorrect

The frontal bone, sphenoid bone, and lacrimal bones articulate with the ethmoid bone. The occipital bone and parietal bones do NOT articulate with the ethmoid bone.

DIF: Recall REF: pp. 54-57 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, 1.1.1 Head and Neck Anatomy 6. From the following list of structures, select which structures are associated with the petrous

part of the temporal bone. (Select all that apply.) a. Articular fossa b. Postglenoid fossa c. External acoustic meatus d. Mastoid process e. Carotid canal ANS: D, E Feedback Correct Incorrect

The mastoid process and carotid canal are associated with the petrous part of the temporal bone. The articular fossa and postglenoid fossa are associated with the squamous part of the temporal bone and NOT the petrous part. The external acoustic meatus is associated with the tympanic part of the temporal bone and NOT the petrous part.

DIF: Recall REF: p. 46 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, 1.1.1 Head and Neck Anatomy 7. Inadequate or disproportionate bone growth of the upper face or mandible may leave

inadequate room for the developing dentition and cause occlusal complications. How can these difficulties with growth involving the dentition BEST be addressed? (Select all that apply.) a. Performing osseous surgery b. Checking for underlying endocrine disorder c. Undergoing orthodontic therapy d. Extracting third molars ANS: A, B, C Feedback Correct

Incorrect

These difficulties with growth involving the dentition can BEST be addressed by orthodontic therapy and osseous surgery, if needed, after ruling out any underlying endocrine disorder. Extracting third molars to accommodate growth is a controversial procedure.

DIF: Comprehension REF: p. 33 OBJ: 4 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 | CDA: General Chairside, II. D. Patient Management | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care 8. From the list below, choose the factors that cause the sphenoid bone to be one of the more

difficult bones of the skull to describe and visualize. (Select all that apply.) a. Bone is only noted from one viewpoint b. Centrally located within the skull c. Complex with body and processes d. Few features and openings ANS: B, C Feedback Correct

Incorrect

Since this bone is complex and centrally located, parts of the sphenoid are encountered in almost every significant juncture of the skull. The bone itself consists of a body and its processes along with a number of features and openings. Both of these factors allow the sphenoid bone to be noted from various viewpoints of the skull. Thus it is one of the more difficult bones of the skull to describe and visualize. Since this bone is complex and centrally located, parts of the sphenoid are encountered in almost every significant juncture of the skull. The bone itself consists of a body and its processes along with a number of features and openings and NOT few features or openings. Both of these factors allow the sphenoid bone to be noted from various viewpoints of the skull and NOT one viewpoint. Thus it is one of the more difficult bones of the

skull to describe and visualize. DIF: Comprehension REF: p. 52 OBJ: 4 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 | CDA: General Chairside, II. D. Patient Management | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care 9. From recent studies concerning chronic sinus infection, new concepts of its etiology and

treatment have been discovered. What are these new concepts? (Select all that apply.) a. Cause lies in the nasal mucus b. Targeting nasal and sinus tissue c. Cause lies in the bacterial infection d. Targeting underlying damaging inflammation ANS: A, D Feedback Correct

Incorrect

Recent studies have found that the cause of chronic sinus infections lies in the nasal mucus. This suggests a beneficial effect of treatments that target primarily the underlying and presumably damage-inflicting nasal and sinus membrane inflammation. Recent studies have found that the cause of chronic sinus infections lies NOT in the nasal and sinus tissue targeted by standard treatment. This suggests that treatments should NOT target the secondary bacterial infection that has been the primary target of past treatments for the disease.

DIF: Comprehension REF: p. 74 OBJ: 4 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 | CDA: General Chairside, II. D. Patient Management | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care MATCHING

From the following list of foramina and openings of the sphenoid bone, match these openings with the CORRECT nerve within. a. Maxillary nerve b. Ophthalmic nerve c. Mandibular nerve d. Meningeal branch nerve 1. Superior orbital fissure 2. Foramen rotundum

3. Foramen ovale 4. Foramen spinosum 1. ANS: B DIF: Recall REF: p. 35, Table 3-3 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, 1.1.1 Head and Neck Anatomy 2. ANS: A DIF: Recall REF: p. 35, Table 3-3 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, 1.1.1 Head and Neck Anatomy 3. ANS: C DIF: Recall REF: p. 35, Table 3-3 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, 1.1.1 Head and Neck Anatomy 4. ANS: D DIF: Recall REF: p. 35, Table 3-3 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, 1.1.1 Head and Neck Anatomy

Chapter 04: Muscular System Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition MULTIPLE CHOICE 1. The ______ of a muscle is generally attached to the LEAST movable structure. a. insertion b. origin c. middle d. beginning ANS: B

A B C D

Feedback The insertion of a muscle is generally attached to the more movable structure. The origin of a muscle is generally attached to the least movable structure. The insertion is the end of a muscle attached to the more movable structure. The insertion is the end of a muscle attached to the more movable structure.

DIF: Recall REF: p. 92 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, 1.1.1 Head and Neck Anatomy 2. Which of the following muscles originates on the inferior border of the mandible and inserts

at each of the labial commissures? a. Levator anguli oris muscle b. Depressor labii inferioris muscle c. Depressor anguli oris muscle d. Orbicularis oris muscle ANS: C

A B C

Feedback The levator anguli oris muscle originates on the canine fossa of the maxilla and inserts into each labial commissure, elevating the labial commissure. The depressor labii inferioris muscle inserts into the skin of the lower lip. The depressor anguli oris muscle originates on the inferior border of the mandible. It inserts into each labial commissure and pulls each labial commissure down. The orbicularis oris muscle encircles the mouth.

DIF: Recall REF: p. 101 OBJ: 2 | 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, 1.1.1 Head and Neck Anatomy 3. Which of the following muscles is NOT considered a suprahyoid muscle? a. Digastric muscle

b. Mylohyoid muscle c. Stylohyoid muscle d. Sternothyroid muscle ANS: D

C D

Feedback The digastric muscle has two bellies; one that is an anterior and one that is a posterior suprahyoid muscle. The anterior belly originates on a tendon on the body of the hyoid bone and inserts onto the mandibular symphysis on the medial surface of the mandible. The posterior belly originates on the mastoid notch and inserts into the intermediate tendon on the hyoid bone. The mylohyoid muscle is a suprahyoid muscle that forms the floor of the mouth. It originates on the mylohyoid line of the mandible and inserts medially into the opposite mylohyoid muscle and onto the hyoid bone. The stylohyoid muscle is a suprahyoid muscle that originates on the styloid process and inserts onto the hyoid bone. The sternothyroid muscle is located inferior to the hyoid bone. It originates on the sternum and inserts into the thyroid gland and cartilage.

DIF: Recall REF: p. 107 OBJ: 2 | 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, 1.1.1 Head and Neck Anatomy 4. Which of the following muscles raises each labial commissure of the lips to contribute to a

patient’s smile? a. Zygomaticus major muscle b. Buccinator muscle c. Platysma muscle d. Epicranius muscle ANS: A

C D

Feedback The zygomaticus major muscle elevates each labial commissure and pulls it laterally. It originates on the zygomatic bone and inserts into each labial commissure. The buccinator muscle forms the anterior part of the cheek and lateral wall of the oral cavity. It pulls each labial commissure laterally and compresses the cheek to force food onto the occlusal table during chewing. The platysma muscle is located inferior to the mouth and acts to pull each labial commissure down. The epicranius muscle is located within the scalp area and does NOT insert into either labial commissure.

DIF: Comprehension REF: p. 101 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, 1.1.1 Head and Neck Anatomy

5. Which of the following intraoral landmarks is one of the origins of the buccinator muscle? a. Maxillary tuberosity b. Pterygomandibular raphe c. Glossopalatine arch d. Internal oblique ridge ANS: B

A B C D

Feedback The buccinator muscle does NOT originate on the maxillary tuberosity. The three origins for the buccinator muscle are the alveolar processes of the maxilla and mandible as well as the pterygomandibular raphe. The pterygomandibular raphe does NOT originate on the glossopalatine arch. The pterygomandibular raphe does NOT originate on the internal oblique ridge.

DIF: Recall REF: p. 99 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, 1.1.1 Head and Neck Anatomy 6. Which of the following muscles is considered an extrinsic tongue muscle that retracts the

tongue? a. Palatoglossus muscle b. Inferior longitudinal muscle c. Styloglossus muscle d. Genioglossus muscle ANS: C

A B C D

Feedback The palatoglossus muscle elevates the tongue against the soft palate during swallowing but is an extrinsic tongue muscle. The inferior longitudinal muscles are intrinsic tongue muscles. The styloglossus muscle moves the tongue superiorly and posteriorly and is an extrinsic tongue muscle. The genioglossus muscle acts to protrude the tongue but is an extrinsic tongue muscle.

DIF: Recall REF: p. 112 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, 1.1.1 Head and Neck Anatomy 7. All three pharyngeal constrictors work to raise the pharynx and larynx during a. swallowing. b. gagging. c. sneezing. d. chewing. ANS: A

A B C D

Feedback All three pharyngeal constrictors work to raise the pharynx and larynx during swallowing. All three pharyngeal constrictors work to raise the pharynx and larynx during swallowing. All three pharyngeal constrictors work to raise the pharynx and larynx during swallowing. All three pharyngeal constrictors work to raise the pharynx and larynx during swallowing.

DIF: Recall REF: p. 112 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, 1.1.1 Head and Neck Anatomy 8. Which of the following muscles inserts onto the coronoid process? a. Lateral pterygoid muscle b. Masseter muscle c. Medial pterygoid muscle d. Temporalis muscle ANS: D

A B C D

Feedback The lateral pterygoid muscle inserts onto the pterygoid fovea of the neck of the condyle, and some fibers insert onto the capsule of the temporomandibular joint. The masseter muscle inserts onto the mandibular ramus and angle of the mandible. The medial pterygoid muscle inserts both heads onto the medial surface of the mandibular ramus and angle of the mandible. The temporalis muscle, which originates on the temporal fossa, inserts onto the coronoid process of the mandible, working to elevate the mandible.

DIF: Recall REF: p. 104, Table 4-3 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, 1.1.1 Head and Neck Anatomy 9. When a patient swallows, how are the suprahyoid muscles involved? a. Elevate the hyoid bone b. Depress the hyoid bone c. Retract the hyoid bone d. Depress the mandible ANS: A

Feedback The suprahyoid muscles will elevate the hyoid bone and larynx if the mandible is stabilized when swallowing.

B C D

The suprahyoid muscles do NOT depress the hyoid bone during swallowing. The suprahyoid muscles do NOT retract the hyoid bone during swallowing. The suprahyoid muscles do NOT depress the mandible during swallowing.

DIF: Comprehension REF: p. 107 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, 1.1.1 Head and Neck Anatomy 10. Into which of the following categories of head and neck muscles is the omohyoid muscle

placed? a. Intrinsic tongue muscle b. Extrinsic tongue muscle c. Suprahyoid muscle d. Infrahyoid muscle ANS: D

A B C D

Feedback The omohyoid muscle is NOT located within the tongue, so it is NOT an intrinsic tongue muscle. The omohyoid muscle does NOT insert into the tongue, so it is NOT an extrinsic tongue muscle. The omohyoid muscle is located inferior to the hyoid bone and thus is NOT a suprahyoid muscle. The omohyoid muscle is located inferior to the hyoid bone, so it is an infrahyoid muscle. It originates on the scapula; travels deep to the sternocleidomastoid muscle, where it attaches to a short tendon; and inserts on the hyoid bone.

DIF: Recall REF: p. 108 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, 1.1.1 Head and Neck Anatomy 11. Which of the following muscles originates on the inferior border of the mandible and inserts

into the skin tissue of the chin? a. Depressor labii inferioris muscle b. Mentalis muscle c. Depressor anguli oris muscle d. Orbicularis oris muscle ANS: B

A B

Feedback The depressor labii inferioris muscle originates on the inferior border of the mandible but inserts into the lower lip. The mentalis muscle originates on the inferior border of the mandible and inserts into the skin of the chin, wrinkling the chin and protruding the lower lip when activated. The depressor anguli oris muscle originates on the inferior border of the

mandible but inserts into each labial commissure. The orbicularis oris muscle encircles the mouth.

DIF: Recall REF: p. 101 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, 1.1.1 Head and Neck Anatomy 12. Which of the following muscles works to protrude the tongue on a patient? a. Hyoglossus muscle b. Styloglossus muscle c. Genioglossus muscle d. Superior longitudinal muscles ANS: C

A B C

Feedback The hyoglossus muscle depresses the tongue. The styloglossus muscle retracts the tongue. The genioglossus muscle originates on the genial tubercles and inserts into the tongue. Its action is to pull the insertion area toward the origin, which will result in pulling the tongue anterior and protruding it. Superior longitudinal muscles work with the inferior longitudinal muscles to shape the tongue by shortening and thickening it. These muscles will also curl the tongue in various ways when activated individually.

DIF: Comprehension REF: p. 112 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, 1.1.1 Head and Neck Anatomy 13. Extrinsic tongue muscles are innervated by the _____ cranial nerve. a. fifth b. seventh c. ninth d. twelfth ANS: D

A B C D

Feedback The fifth cranial nerve is the trigeminal nerve and does NOT innervate the extrinsic tongue muscles. The seventh cranial nerve is the facial nerve and does NOT innervate the extrinsic tongue muscles. The ninth cranial nerve is the glossopharyngeal nerve and does NOT innervate the extrinsic tongue muscles. The twelfth cranial nerve is the hypoglossal nerve and innervates the extrinsic tongue muscles.

DIF: Recall

REF: p. 112

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, 1.1.1 Head and Neck Anatomy 14. Which of the following muscles BOTH elevates the tongue and depresses the soft palate

during swallowing? a. Levator veli palatini muscle b. Palatoglossus muscle c. Palatopharyngeal muscle d. Muscle of the uvula ANS: B

A B

C D

Feedback The levator veli palatini muscle raises the soft palate and does NOT elevate the tongue. The palatoglossus muscle’s action is to elevate the base of the tongue as the soft palate is depressed toward the tongue. This action helps separate the soft palate and pharynx during swallowing to prevent movement of the food bolus into the nasal cavity. The palatopharyngeal muscle moves the soft palate posteroinferiorly and the posterior pharyngeal wall anterosuperiorly and does NOT elevate the tongue. The muscle of the uvula muscle shortens and broadens the uvula, helping to close off the nasopharynx during swallowing. It does NOT elevate the tongue.

DIF: Comprehension REF: pp. 114-115 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, 1.1.1 Head and Neck Anatomy 15. Which of the following muscles can show enlargement due to repetitive muscle contraction

associated with clenching of the teeth in a patient? a. Buccinator muscle b. Masseter muscle c. Temporalis muscle d. Zygomatic muscle ANS: B

A B

Feedback The buccinator muscle is NOT actively involved in closing the mouth while grinding (bruxing) or clenching the teeth. The masseter muscle, a strong muscle of mastication involved in elevating the mandible and closing the mouth, can become enlarged in people who habitually clench or grind their teeth (bruxism). The temporalis muscle, while involved in elevating and retracting the mandible when closing the mouth, does NOT become enlarged as a result of clenching the teeth. The zygomatic muscle is a muscle of facial expression associated with lifting each labial commissure when smiling.

DIF: Application REF: p. 104 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, 1.1.1 Head and Neck Anatomy 16. Which of the following muscles divides the neck region into anterior and posterior cervical

triangles? a. Omohyoid muscle b. Platysma muscle c. Sternocleidomastoid muscle d. Trapezius muscle ANS: C

A B C

Feedback The omohyoid muscle, which is located more inferiorly, serves to further divide the anterior and posterior triangles of the neck into smaller triangles. The platysma muscle is located anteriorly in the neck within the anterior cervical triangle and does NOT divide the neck into anterior and posterior triangles. The sternocleidomastoid muscle, which originates on the medial part of the clavicle and the sternum and inserts into the mastoid process, is prominently positioned on the side of the neck to divide the neck region into anterior and posterior cervical triangles. The trapezius muscle is a flat, triangular-shaped muscle that is located on the lateral and posterior surfaces of the neck and does NOT divide the neck region into anterior and posterior triangles.

DIF: Recall REF: p. 93 OBJ: 2 | 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, 1.1.1 Head and Neck Anatomy 17. Which of the following muscles listed below does NOT serve to elevate the upper lip? a. Levator anguli oris muscle b. Levator labii superioris alaeque nasi muscle c. Risorius muscle d. Zygomaticus major muscle ANS: C

A B C

Feedback Levator anguli oris muscle does elevate each labial commissure, helping to lift the lip as in a smile. The levator labii superioris alaeque nasi muscle does work to elevate the upper lip. The risorius muscle does NOT elevate the upper lip. Instead it works to retract the corners of the lip as in a grimace and has some fibers that connect with the platysma muscle. The zygomaticus major muscle does work to elevate each labial commissure,

helping to lift the lip as in a smile. DIF: Recall REF: pp. 99-101 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, 1.1.1 Head and Neck Anatomy 18. Which of the following muscles when unilaterally contracted deviates the mandible to one

side? a. Masseter muscle b. Lateral pterygoid muscle c. Medial pterygoid muscle d. Temporalis muscle ANS: B

A B

C D

Feedback The masseter muscle works only to elevate the mandible. An action of both of the lateral pterygoid muscles is to protrude the mandible. If only one lateral pterygoid muscle contracts, the lower jaw shifts toward the opposite side, causing lateral deviation of the mandible. The medial pterygoid muscle only works to elevate the mandible. The temporalis muscle only works to elevate and retract the mandible.

DIF: Recall REF: pp. 106-107 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, 1.1.1 Head and Neck Anatomy 19. Which of the following muscles when contracted dilates the nostrils? a. Orbicularis oris muscle b. Levator labii superioris muscle c. Levator anguli oris muscle d. Levator labii superioris alaeque nasi muscle ANS: D

A B C D

Feedback The orbicularis oris muscle encircles the mouth. The levator labii superioris muscle inserts into the skin of the upper lip, NOT into the ala of the nose. The levator anguli oris muscle inserts into the labial commissure and does NOT insert into the ala of the nose. Some fibers of the levator labii superioris alaeque nasi muscle insert into the skin tissue of the ala of the nose and thus can dilate the nose when the muscle contracts.

DIF: Recall REF: p. 97, Table 4-2 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, 1.1.1 Head and Neck Anatomy

20. Which of the following muscles will serve to depress the lower lip? a. Depressor labii inferioris and depressor anguli oris muscles b. Depressor labii inferioris and orbicularis oris muscles c. Depressor labii inferioris and mentalis muscles d. Depressor labii inferioris and risorius muscles ANS: A

A B C D

Feedback Both the depressor labii inferioris and the depressor anguli oris muscle serve to depress a part of the lower lip. The orbicularis oris muscle does NOT serve to depress the lower lip. The mentalis muscle does NOT serve to depress the lower lip. The risorius muscle does NOT serve to depress the lower lip.

DIF: Recall REF: p. 101 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, 1.1.1 Head and Neck Anatomy 21. Which of the following muscles when contracted causes a surprised facial expression on a

patient? a. Corrugator supercilii muscle b. Epicranius muscle c. Orbicularis oculi muscle d. Zygomaticus major muscle ANS: B

A B C D

Feedback The corrugator supercilii muscle pulls the skin tissue of the eyebrow medially and inferiorly, as when one frowns. The epicranius muscle inserts into the skin tissue of the eyebrow and root of the nose and raises the eyebrows, as when surprised. The orbicularis oculi muscle encircles the eye and closes the eye. The zygomaticus major muscle lifts each labial commissure and contributes to a smile.

DIF: Comprehension REF: p. 98 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, 1.1.1 Head and Neck Anatomy 22. On what structure do BOTH heads of the masseter muscle originate? a. Zygomatic process of the maxilla b. Coronoid process c. Zygomatic process of the frontal bone d. Zygomatic arch ANS: D

A B C D

Feedback The masseter muscle does NOT originate on the maxilla alone. The masseter muscle does NOT originate on the coronoid process of the mandible. The masseter muscle does NOT originate on the frontal bone. Both heads of the master muscle originate on the zygomatic arch.

DIF: Recall REF: p. 104 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, 1.1.1 Head and Neck Anatomy 23. Which of the following muscles when contracted allows for the retraction of the mandible? a. Masseter muscle b. Temporalis muscle c. Lateral pterygoid muscle d. Medial pterygoid muscle ANS: B

A B

C D

Feedback The master muscle elevates the mandible. The temporalis muscle works to elevate the mandible and, if only the posterior part contracts, the muscle then retracts or moves the mandible backward. Retraction of the jaw often accompanies the closing of the jaw. The lateral pterygoid muscle protrudes and depresses the mandible. The medial pterygoid muscle elevates the mandible.

DIF: Comprehension REF: pp. 104-105 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, 1.1.1 Head and Neck Anatomy 24. What are the two parts of the epicranial muscle named? a. Frontal and occipital bellies b. Superior and inferior bellies c. Anterior and posterior bellies d. Superior and inferior heads e. Superficial and deep heads ANS: A

Feedback The frontal belly arises from epicranial aponeurosis. The epicranial aponeurosis is superficial to where the parietal and occipital bones meet, the most superior part of the skull. The frontal belly or frontalis muscle then inserts into the skin of the eyebrow and root of the nose. The occipital belly or occipitalis muscle originates from the superior nuchal line of the occipital bone and mastoid process of the temporal bone and then inserts in the epicranial aponeurosis.

The superior belly of the omohyoid muscle originates from the short tendon attached to the inferior belly and then inserts on the lateral border of the body of the hyoid bone. The inferior belly originates from the scapula. The inferior belly then passes anteriorly and superiorly, crossing the internal jugular vein deep to the sternocleidomastoid muscle, where it then attaches by a short tendon to the superior belly. The anterior belly of digastric muscle originates from the intermediate tendon, which is loosely attached to the body and greater cornu of the hyoid bone and then passes superiorly and anteriorly to insert close to the symphysis on the medial surface of the mandible. The posterior belly arises from the mastoid notch, medial to the mastoid process of the temporal bone, and then passes anteriorly and inferiorly to insert on the intermediate tendon. The superior head of the lateral pterygoid muscle originates from the infratemporal surface and infratemporal crest of the greater wing of the sphenoid bone and passes inferiorly to insert on the anterior surface of the neck of the mandible at the pterygoid fovea. The inferior head originates from the lateral surface of the lateral pterygoid plate of the sphenoid bone and inserts on the anterior margin of the temporomandibular joint disc and capsule. The superficial head of the masseter originates from the zygomatic process of the maxilla and from the anterior two thirds of the inferior border of the zygomatic arch. The deep head originates from the posterior one third and the entire medial surface of the zygomatic arch. Both of these heads then pass inferiorly to insert on different parts of the external surface of the mandible: the superficial head on the lateral surface of the angle and the deep head on the mandibular ramus superior to the angle of the mandible.

DIF: Recall REF: p. 98 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, 1.1.1 Head and Neck Anatomy 25. Which of the following are considered cervical muscles? a. Masseter and medial pterygoid muscles b. Medial and lateral pterygoid muscles c. Sternocleidomastoid and trapezius muscles d. Buccinator and epicranial muscles ANS: C

A B C D

Feedback Both the masseter and medial pterygoid muscles are muscles of mastication and are NOT considered cervical muscles. Both the medial and lateral pterygoid muscles are muscles of mastication and are NOT considered cervical muscles. Both the sternocleidomastoid and trapezius muscles are cervical muscles and are thus both located in the neck. Both the buccinator and epicranial muscles are muscles of facial expression and are NOT considered cervical muscles.

DIF: Recall

REF: p. 93

OBJ: 2 | 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, 1.1.1 Head and Neck Anatomy MULTIPLE RESPONSE 1. From the following list of muscles, select which are considered muscles of facial expression.

(Select all that apply.) a. Buccinator b. Risorius c. Platysma d. Temporalis e. Masseter ANS: A, B, C Feedback Correct Incorrect

Buccinator, risorius, and platysma muscles are muscles of facial expression. Both the temporalis and masseter muscles are muscles of mastication and are NOT muscles of facial expression.

DIF: Recall REF: p. 96, Table 4-1 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, 1.1.1 Head and Neck Anatomy 2. From the following list of muscles, select which are considered muscles of mastication.

(Select all that apply.) a. Buccinator b. Risorius c. Platysma d. Temporalis e. Masseter ANS: D, E Feedback Correct Incorrect

Both the temporalis and masseter muscles are muscles of mastication. Buccinator, risorius, and platysma muscles are muscles of facial expression and NOT mastication.

DIF: Recall REF: p. 104, Table 4-3 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, 1.1.1 Head and Neck Anatomy 3. From the following list of muscles, select which muscles are considered suprahyoid muscles.

(Select all that apply.) a. Digastric b. Mylohyoid

c. Stylohyoid d. Sternothyroid e. Omohyoid ANS: A, B, C Feedback Correct Incorrect

Digastric, mylohyoid, and stylohyoid muscles are considered suprahyoid muscles. Sternothyroid and omohyoid muscles are considered infrahyoid muscles and are NOT considered suprahyoid muscles.

DIF: Recall REF: p. 107, Box 4-1 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, 1.1.1 Head and Neck Anatomy 4. From the following list of muscles, select which are considered infrahyoid muscles. (Select all

that apply.) a. Digastric b. Mylohyoid c. Stylohyoid d. Sternothyroid e. Omohyoid ANS: D, E Feedback Correct Incorrect

Both the sternothyroid and omohyoid muscles are considered infrahyoid muscles. Digastric, mylohyoid, and stylohyoid are considered suprahyoid muscles and are NOT considered infrahyoid muscles.

DIF: Recall REF: p. 107, Box 4-1 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, 1.1.1 Head and Neck Anatomy 5. From the following list of muscles, select which muscles create the faucial pillars within the

oral cavity. (Select all that apply.) a. Palatoglossus b. Tensor veli palatini c. Palatopharyngeus d. Levator veli palatini ANS: A, C Feedback Correct Incorrect

Palatoglossus creates the anterior faucial pillar; palatopharyngeus creates the posterior faucial pillar within the oral cavity. Tensor veli palatini stiffens the soft palate; levator veli palatini raises the soft palate. Both do NOT create the faucial pillars within the oral cavity.

DIF: Comprehension REF: p. 115, Table 4-7 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, 1.1.1 Head and Neck Anatomy 6. Facial paralysis can be present with a patient, either temporary or permanent, when involving

which of the following patient case histories? (Select all that apply.) a. Trigeminal neuralgia b. Cerebrovascular accident c. Parotid salivary gland cancer d. Peripheral neurectomy ANS: B, C Feedback Correct

Incorrect

Facial paralysis involves damage to the facial nerve as presented in cerebrovascular accident (stroke) and parotid salivary gland cancer (malignant neoplasm) since the facial nerve travels within the gland. Trigeminal neuralgia involves damage to the trigeminal nerve and NOT the facial nerve that could lead to paralysis; peripheral neurectomy is a possible treatment for trigeminal neuralgia and thus does NOT involve the facial nerve involved when damaged in facial paralysis.

DIF: Application REF: p. 97, Table 4-2 OBJ: 5 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | 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 | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.1 Medical and Dental History | NBDHE, Provision of Clinical Dental Hygiene Services, 3.3 Individualized Patient Education 7. During an extraoral examination of a patient, which of the following needs to be considered

with the sternocleidomastoid muscle? (Select all that apply.) a. If one of the muscles contracts, the head and neck bend to the contralateral side. b. Effective palpation of the muscle occurs when the patient moves the head to the contralateral side. c. If both muscles contract, the head will flex at the neck and extend at the junction between the neck and skull. d. If one of the muscles contracts, the face and anterior part of the neck rotate to the ipsilateral side. ANS: B, C Feedback Correct

If one of the muscles contracts, the head and neck bend to the ipsilateral side, and the face and anterior part of the neck rotate to the contralateral

Incorrect

side. If both muscles contract, the head will flex at the neck and extend at the junction between the neck and skull. It is effectively palpated on each side of the neck when the patient moves the head to the contralateral side. If one of the muscles contracts, the head and neck do NOT bend to the contralateral side but to the ipsilateral side. If one of the muscles contracts, the face and anterior part of the neck do NOT rotate to the ipsilateral side but to the contralateral side.

DIF: Application REF: p. 93 OBJ: 4 | 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, II. C. Describe how to perform and/or assist with intraoral procedures | 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 | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 3.3 Individualized Patient Education 8. Which of the following are considerations when dealing with a history of cervical muscle

pathology in a dental setting? (Select all that apply.) a. Patients always can be made to sit themselves in an ergonomically correct position in the dental chair. b. Patients may not be able to raise the chin as requested during treatment. c. Patients may possibly have related headaches in the anterior skull region. d. Additional supports and stabilizers such as pillows may make the patient more comfortable. ANS: B, D Feedback Correct

Incorrect

Patients may not be able to raise the chin as requested during treatment. Additional supports and stabilizers such as pillows may make the patient more comfortable. Patients may possibly have related headaches in the posterior skull region and NOT in the anterior skull region. Patients may NOT be able to always sit themselves in an ergonomically correct position in the dental chair.

DIF: Application REF: p. 95 OBJ: 5 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | 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 | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.1 Medical and Dental History | NBDHE, Provision of Clinical Dental Hygiene Services, 3.3 Individualized Patient Education

9. Which of the following are considerations when dealing with a history of facial paralysis in a

dental setting? (Select all that apply.) a. Inability to form facial expressions on one side of the face may be present. b. Twitching, spasms, and weakness can be evident. c. Loss of voluntary muscle action is always permanent. d. Reduced drooling and the usual taste sensations are evident. ANS: B, D Feedback Correct Incorrect

Inability to form facial expressions on one side of the face may be present. Twitching, spasms, and weakness can be evident. Loss of voluntary muscle action can be either temporary or permanent; it is NOT always permanent. Excessive drooling and altered taste sensations are evident, NOT reduced drooling and the usual taste sensations.

From the following list of lip-related movements of the orbicularis oris muscle, match those movements with their CORRECT facial action. a. With pursing lips b. With pouting and kissing c. With grimacing d. With closing lips 1. 2. 3. 4.

With pressing together With tightening and thinning Rolling inward between the teeth With thrusting outward

1. ANS: D DIF: Comprehension REF: p. 99 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, 1.1.1 Head and Neck Anatomy 2. ANS: A DIF: Comprehension REF: p. 99 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, 1.1.1 Head and Neck Anatomy 3. ANS: C DIF: Comprehension REF: p. 99 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, 1.1.1 Head and Neck Anatomy 4. ANS: B DIF: Comprehension REF: p. 99 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, 1.1.1 Head and Neck Anatomy

Chapter 05: Temporomandibular Joint Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition MULTIPLE CHOICE 1. The temporal bone and mandible come together to form the temporomandibular joint

BECAUSE a joint is defined as a junction or union between two or more bones. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A

B C D E

Feedback The statement is correct. The temporomandibular joint is a junction between the temporal bone and the mandible. The reason is correct. A joint is defined as a union between two or more bones. The statement and the reason are related. The temporal bone and mandible form the temporomandibular joint, which is a union between two bones. The reason is correct. A joint is formed by the union of two or more bones. The statement is correct. The temporal bone and the mandible join to form the temporomandibular joint. The statement and the reason are correct. The temporomandibular joint is a junction between the temporal bone and the mandible, and a joint is defined as a union between two or more bones.

DIF: Comprehension REF: p. 123 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, 1.1.1 Head and Neck Anatomy 2. The temporomandibular joint is innervated by the maxillary nerve or second division of the

fifth cranial or trigeminal nerve. The blood supply to the joint is from branches of the external carotid artery. 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: D

A B C

Feedback The first statement is false. The temporomandibular joint is innervated by the mandibular nerve or third division of the fifth cranial or trigeminal nerve. The second statement is true. The temporomandibular joint receives blood supply from branches of the external carotid artery. The first statement is false. The temporomandibular joint is innervated by the

mandibular nerve or third division of the fifth cranial or trigeminal nerve. The second statement is true because the temporomandibular joint receives blood supply from branches of the external carotid artery. The first statement is false. The temporomandibular joint is innervated by the mandibular nerve or third division of the fifth cranial or trigeminal nerve, NOT the maxillary nerve or second division. The second statement is true because the temporomandibular joint receives blood supply from branches of the external carotid artery.

DIF: Recall REF: p. 123 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, 1.1.1 Head and Neck Anatomy 3. What is another term used for articular fossa of the temporomandibular joint? a. Submandibular b. Mandibular c. Pterygoid d. Temporal ANS: B

A B C D

Feedback The submandibular fossa is located on the medial surface of the mandible, inferior to the mylohyoid line. The mandibular fossa or articular fossa is located on the temporal bone that articulates with the mandible at the temporomandibular joint. The pterygoid fossa is located between the medial and lateral pterygoid plates of the sphenoid bone. The temporal fossa is located on the lateral surface of the skull that contains the body of the temporalis muscle.

DIF: Recall REF: p. 124 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, 1.1.1 Head and Neck Anatomy 4. What is the depression located between the condyle and coronoid process of the

temporomandibular joint? a. Sublingual fossa b. Supraorbital notch c. Temporal space d. Mandibular notch ANS: D

A B

Feedback The sublingual fossa is located on the medial surface of the mandible, superior to the mylohyoid line. The supraorbital notch is located on the frontal bone superior to the orbit.

C D

The temporal space is formed by the temporal fascia covering the temporalis muscle. The mandibular notch is located on the mandible between the condyle and the coronoid process.

DIF: Recall REF: p. 128 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, 1.1.1 Head and Neck Anatomy 5. The joint disc of the temporomandibular joint is a fibrous disc located between the temporal

bone and the coronoid process of the mandible on each side. This disc conforms to the shape of the bones and is related to joint movement. 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: D

A B

Feedback The first statement is false. The joint disc of the temporomandibular joint is located between the temporal bone and the condyle, NOT the coronoid process. The second statement is true. The shape of the joint disc conforms to the shape of the adjacent articulating bones of the temporomandibular joint and is related to joint movements. The first statement is false. The joint disc of the temporomandibular joint is located between the temporal bone and the condyle, NOT the coronoid process. The second statement is true. The shape of the joint disc conforms to the shape of the adjacent articulating bones of the temporomandibular joint and is related to joint movements. The first statement is false. The joint disc of the temporomandibular joint is located between the temporal bone and the condyle, NOT the coronoid process. The second statement is true. The shape of the joint disc conforms to the shape of the adjacent articulating bones of the temporomandibular joint and is related to joint movements.

DIF: Comprehension REF: p. 125 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, 1.1.1 Head and Neck Anatomy 6. Including examination of the temporomandibular joint during the extraoral examination is

important to detect changes such as disc perforation BECAUSE disc perforation is commonly found in females and males during puberty. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

A B C

Feedback The reason is NOT correct. Disc perforation is caused by the age process or from traumatic injury. The reason is incorrect. Disc perforation is caused by the age process or from traumatic injury. Also, the statement and reason are related. The statement is correct. Examination of the temporomandibular joint must be part of the extraoral examination in order to determine if changes or deviations within the joint have occurred. The disc perforation is caused by the age process or traumatic injury. The statement is correct. Examination of the temporomandibular joint must be part of the extraoral examination in order to determine if changes or deviations within the joint have occurred. The statement is correct. Examination of the temporomandibular joint must be part of the extraoral examination in order to determine if changes or deviations within the joint have occurred.

DIF: Application REF: p. 125 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, 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, 1.1.1 Head and Neck 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, 3.0 Planning and Managing Dental Hygiene Care 7. Which of the following ligaments is NOT associated with the temporomandibular joint? a. Temporomandibular joint ligament b. Sphenomandibular ligament c. Stylomandibular ligament d. Stylohyoid ligament ANS: D

C D

Feedback The temporomandibular joint ligament is associated with the temporomandibular joint. The oblique, or outer, component goes from the articular tubercle to the neck of the mandible. The horizontal, or inner, component goes from the lateral pole of the condyle and the posterior aspect of the joint disc to the articular tubercle. The sphenomandibular ligament is associated with the temporomandibular joint. It attaches the angular spine of the sphenoid bone superiorly to the lingula of the mandible foramen. The stylomandibular ligament is associated with the temporomandibular joint. It connects the styloid process of the temporal bone with the angle of the mandible. The stylohyoid ligament is NOT associated with the temporomandibular joint. It connects the styloid process with the lesser horn of the hyoid bone.

DIF: Recall REF: pp. 125-127 OBJ: 2 | 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, 1.1.1 Head and Neck Anatomy 8. Which ligament associated with the temporomandibular joint prevents excessive retraction or

moving backward of the mandible? a. Temporomandibular joint ligament b. Sphenomandibular ligament c. Stylomandibular ligament d. Stylohyoid ligament ANS: A

B C D

Feedback The temporomandibular joint ligament prevents excessive retraction or moving backward of the mandible, a situation that might lead to problems with the temporomandibular joint. The sphenomandibular ligament becomes accentuated and taut when the mandible is protruded. The stylomandibular ligament is also engaged when the mandible is protruded. The stylohyoid ligament is NOT associated with the temporomandibular joint.

DIF: Comprehension REF: p. 125 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, 1.1.1 Head and Neck Anatomy 9. Which ligament associated with the temporomandibular joint is a landmark for the

administration of inferior alveolar local anesthetic nerve block? a. Temporomandibular joint ligament b. Sphenomandibular ligament c. Stylomandibular ligament d. Stylohyoid ligament ANS: B

A B

C D

Feedback The temporomandibular joint ligament is NOT a landmark for the administration of inferior alveolar local anesthetic nerve block. The sphenomandibular ligament is a landmark for the administration of the inferior alveolar local anesthetic nerve block. The injection site for the inferior alveolar block injection is at the depth of the pterygomandibular space, which is lateral to both the pterygomandibular fold and the sphenomandibular ligament. The stylomandibular ligament is NOT a landmark for the administration of the inferior alveolar local anesthetic nerve block. The stylohyoid ligament is NOT a landmark for the administration of the inferior alveolar local anesthetic nerve block.

DIF: Application

REF: p. 127

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, 1.1.1 Head and Neck Anatomy 10. The temporomandibular joint allows for movement of the mandible during speech and

mastication. Two basic types of movement are performed by the joint and its associated muscles: a gliding movement and a rotational movement. 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: A

A B C D

Feedback Both statements are true. The temporomandibular joint does allow for movement during speech and mastication with a gliding and rotational movement. Both statements are true. The temporomandibular joint does allow for movement during speech and mastication with a gliding and rotational movement. The second statement is true. The temporomandibular joint moves with gliding and rotational movements. The first statement is true. The temporomandibular joint allows for movement of the mandible during speech and mastication.

DIF: Recall REF: p. 127 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, 1.1.1 Head and Neck Anatomy 11. The gliding movement of the temporomandibular joint allows the lower jaw to move forward

or backward. What movement of the mandible is involved when the lower jaw moves forward? a. Retraction b. Protrusion c. Elevation d. Depression ANS: B

A B C D

Feedback Bringing the lower jaw backward involves retraction of the mandible. Bringing the lower jaw forward involves protrusion of the mandible. Lowering the lower jaw involves depression of the mandible. Raising the lower jaw involves elevation of the mandible.

DIF: Comprehension REF: p. 127 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, 1.1.1 Head and Neck Anatomy

12. What movement of the temporomandibular joint occurs MAINLY between the joint disc and

the condyle of the mandible in the lower synovial cavity? a. Retraction b. Protrusion c. Rotation d. Gliding ANS: C

A B C D

Feedback Retraction is a gliding movement that occurs between the joint disc and the articular eminence of the temporal bone in the upper synovial cavity. Protrusion is a gliding movement that occurs between the joint disc and the articular eminence of the temporal bone in the upper synovial cavity. The rotation movement of the temporomandibular joint occurs mainly between the joint disc and the condyle of the mandible in the lower synovial cavity. Gliding movements of the temporomandibular joint occur between the joint disc and the articular eminence of the temporal bone in the upper synovial cavity.

the mandible. When the jaws close, this involves BOTH depression and protrusion of the mandible. 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: B

C D

Feedback Both statements are false. The opening of the jaws during speech and mastication involves both depression and protrusion of the mandible. When the jaws close, this involves both elevation and retraction of the mandible. Both statements are false. The opening of the jaws during speech and mastication involves both depression and protrusion of the mandible. When the jaws close, this involves both elevation and retraction of the mandible. The first statement is false. The opening of the jaws during speech and mastication involves both depression and protrusion of the mandible. The second statement is false. When the jaws close, this involves both elevation and retraction of the mandible.

DIF: Comprehension REF: pp. 127-128 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, 1.1.1 Head and Neck Anatomy

14. What type of temporomandibular joint movement(s) occurs during lateral deviation of the

mandible or shifting of the lower jaw to one side? a. Gliding movement on both sides b. Rotational movement on both sides c. Gliding movement on one side and no movement on the other side d. Gliding movement on one side and rotational movement on the other side ANS: D

A B C D

Feedback Lateral deviation involves both the gliding and rotational movements of the opposing temporomandibular joints in their respective joint cavities. Lateral deviation involves both the gliding and rotational movements of the opposing temporomandibular joints in their respective joint cavities. Movement is required of the opposing temporomandibular joints in their respective joint cavities. Lateral deviation involves both the gliding and rotational movements of the opposing temporomandibular joints in their respective joint cavities. During lateral deviation, one disc plus the condyle glide forward and medially on the articular eminence in the upper synovial cavity, while the other condyle and disc remain relatively stable in position, producing a rotation around the more stable condyle.

DIF: Comprehension REF: p. 128 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, 1.1.1 Head and Neck Anatomy 15. The rest position of the temporomandibular joint is NOT with the teeth biting together

BECAUSE as we observe during mastication of food, the mandible returns to the center. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: B

C D

Feedback Even though the statement and reason are correct, they are NOT related. The statement describes the rest position of the temporomandibular joint, while the reason describes the power stroke that occurs during mastication. Both statements are true but are NOT related. The statement describes the rest position of the temporomandibular joint, while the reason describes the power stroke that occurs during mastication. The reason is correct. The mandible is brought back to the center during mastication due to the power stroke or the teeth crunching the food. The statement is correct. The teeth are NOT occluding or biting together when the temporomandibular joint is at rest.

The statement and the reason are both correct. The teeth are NOT occluding or biting together when the temporomandibular joint is at rest. The mandible is brought back to the center during mastication due to the power stroke or the teeth crunching the food.

DIF: Application REF: p. 128 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, 1.1.1 Head and Neck Anatomy 16. The dental professional plays an important role in the recognition, treatment, and maintenance

of patients with temporomandibular disorder. All signs and symptoms related to temporomandibular disorder need to be recorded by the dental professional, as well as any parafunctional habits and related systematic diseases. 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: A

Feedback Both statements are true. The dental professional is skilled and has knowledge of the temporomandibular joint, which is examined during the extraoral examination. All relevant information, such as the amount of the mandibular opening and facial pain, needs to be recorded by the dental professional. Both statements are true. The dental professional is skilled and has knowledge of the temporomandibular joint, which is examined during the extraoral examination. All relevant information, such as the amount of the mandibular opening and facial pain, needs to be recorded by the dental professional. The second statement is true. All relevant information, such as the amount of the mandibular opening and facial pain, needs to be recorded by the dental professional. The first statement is true. The dental professional is skilled and has knowledge of the temporomandibular joint, which is examined during the extraoral examination.

DIF: Application REF: p. 129 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, 1.1.1 Head and Neck 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, 3.0 Planning and Managing Dental Hygiene Care 17. When examining the joint, joint sounds may be heard because of disc derangement. Joint

sounds are a reliable indicator of temporomandibular disorder. 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

A B

Feedback The second statement is false. Joint sounds are NOT a reliable indicator of temporomandibular disorder because they can change over time. The first statement is true. Joint sounds occur because of disc derangement. The posterior portion of the joint disc gets caught between the condyle head and the articular eminence. The first statement is true: joint sounds occur because of disc derangement. The second statement is false because joint sounds are NOT a reliable indicator of temporomandibular disorder since they can change over time. The first statement is true; the second statement is false. Joint sounds occur because of disc derangement. Joint sounds are NOT a reliable indicator of temporomandibular disorder because they can change over time.

DIF: Application REF: p. 129 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, 1.1.1 Head and Neck Anatomy 18. What occurs with the dislocation of BOTH the temporomandibular joints on a patient? a. Subluxation b. Cellulitis c. Paresthesia d. Thrombus ANS: A

A B C D

Feedback Subluxation occurs when the head of the condyle moves too far anterior on the articular eminence. Cellulitis is the diffuse inflammation of soft tissue spaces. Paresthesia is an abnormal sensation from an area such as burning or prickling. Thrombus is an intravascular clot.

DIF: Application REF: p. 129 OBJ: 4 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy 19. What is the fossa located on the temporal bone that articulates with the mandible? a. Temporal fossa b. Infratemporal fossa c. Pterygopalatine fossa d. Articular fossa ANS: D

A B C D

Feedback The temporal fossa is a flat, fan-shaped paired depression on the lateral surface of the skull. The infratemporal fossa is a paired depression that is inferior to the anterior part of the temporal fossa. The pterygopalatine fossa is a cone-shaped paired depression deep to the infratemporal fossa and posterior to the maxilla on each side of the skull. The articular fossa is posterior to the articular eminence and consists of an ovalshaped depression on the temporal bone, posterior and medial to the zygomatic process of the temporal bone.

DIF: Recall REF: p. 124 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, 1.1.1 Head and Neck Anatomy 20. The joint disc of the temporomandibular joint is attached to the lateral and medial poles of the

mandibular condyle. The disc is fully attached to the temporal bone to all sides of the bone. 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 The first statement is true; the second is false. The joint disc of the temporomandibular joint is attached to the lateral and medial poles of the mandibular condyle. The disc is NOT attached to the temporal bone anteriorly, except indirectly through the capsule. The first statement is true; the second is false. The joint disc of the temporomandibular joint is attached to the lateral and medial poles of the mandibular condyle. The disc is NOT attached to the temporal bone anteriorly, except indirectly through the capsule. The first statement is true; the second is false. The joint disc of the temporomandibular joint is attached to the lateral and medial poles of the mandibular condyle. The disc is NOT attached to the temporal bone anteriorly, except indirectly through the capsule. The first statement is true; the second is false. The joint disc of the temporomandibular joint is attached to the lateral and medial poles of the mandibular condyle. The disc is NOT attached to the temporal bone anteriorly, except indirectly through the capsule.

DIF: Comprehension REF: p. 125 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, 1.1.1 Head and Neck Anatomy 21. As a person ages or undergoes trauma to the area, the joint disc of the temporomandibular

joint can become thicker or even perforated. Perforation can lead to clinical problems.

a. b. c. d.

Both statements are true. Both statements are false. The first statement is true; the second is false. The first statement is false; the second is true.

ANS: D

Feedback The first statement is false; the second is true. As a person ages or undergoes trauma to the area, the joint disc of the temporomandibular joint can become thinner or even perforated. Perforation can lead to clinical problems. The first statement is false; the second is true. As a person ages or undergoes trauma to the area, the joint disc of the temporomandibular joint can become thinner or even perforated. Perforation can lead to clinical problems. The first statement is false; the second is true. As a person ages or undergoes trauma to the area, the joint disc of the temporomandibular joint can become thinner or even perforated. Perforation can lead to clinical problems. The first statement is false; the second is true. As a person ages or undergoes trauma to the area, the joint disc of the temporomandibular joint can become thinner or even perforated. Perforation can lead to clinical problems.

DIF: Application REF: p. 125 OBJ: 4 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy 22. The sphenomandibular ligament is a landmark for the administration of (long) buccal nerve

block and is also involved in troubleshooting the injection due to its location. 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: B

Feedback Both statements are false. The sphenomandibular ligament is a landmark for the administration of inferior alveolar nerve block and is also involved in troubleshooting the inferior alveolar nerve block due to its location since it may actually block the injection if the needle does NOT contact the mandible. Both statements are false. The sphenomandibular ligament is a landmark for the administration of inferior alveolar nerve block and is also involved in troubleshooting the inferior alveolar nerve block due to its location since it may actually block the injection if the needle does NOT contact the mandible. Both statements are false. The sphenomandibular ligament is a landmark for the administration of inferior alveolar nerve block and is also involved in troubleshooting the inferior alveolar nerve block due to its location since it may actually block the injection if the needle does NOT contact the mandible. Both statements are false. The sphenomandibular ligament is a landmark for the administration of inferior alveolar nerve block and is also involved in

troubleshooting the inferior alveolar nerve block due to its location since it may actually block the injection if the needle does NOT contact the mandible. DIF: Application REF: p. 127 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, 1.1.1 Head and Neck Anatomy 23. The base of the triangular temporomandibular ligament is attached to the zygomatic process

of the temporal bone and the articular tubercle; its apex is fixed to the lateral side of the neck of the mandible. This ligament prevents the excessive protrusion or moving forward for the mandible, a situation that might lead to problems with the temporomandibular joint. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: C

Feedback The statement is correct, but the reason is NOT. The base of the triangular temporomandibular ligament is attached to the zygomatic process of the temporal bone and the articular tubercle; its apex is fixed to the lateral side of the neck of the mandible. This ligament prevents the excessive retrusion or moving backward of the mandible, a situation that might lead to problems with the temporomandibular joint. The statement is correct, but the reason is NOT. The base of the triangular temporomandibular ligament is attached to the zygomatic process of the temporal bone and the articular tubercle; its apex is fixed to the lateral side of the neck of the mandible. This ligament prevents the excessive retrusion or moving backward of the mandible, a situation that might lead to problems with the temporomandibular joint. The statement is correct, but the reason is NOT. The base of the triangular temporomandibular ligament is attached to the zygomatic process of the temporal bone and the articular tubercle; its apex is fixed to the lateral side of the neck of the mandible. This ligament prevents the excessive retrusion or moving backward of the mandible, a situation that might lead to problems with the temporomandibular joint. The statement is correct, but the reason is NOT. The base of the triangular temporomandibular ligament is attached to the zygomatic process of the temporal bone and the articular tubercle; its apex is fixed to the lateral side of the neck of the mandible. This ligament prevents the excessive retrusion or moving backward of the mandible, a situation that might lead to problems with the temporomandibular joint. The statement is correct, but the reason is NOT. The base of the triangular temporomandibular ligament is attached to the zygomatic process of the temporal bone and the articular tubercle; its apex is fixed to the lateral side of the neck of the mandible. This ligament prevents the excessive retrusion or moving backward of the mandible, a situation that might lead to problems with the

temporomandibular joint. DIF: Comprehension REF: p. 125 OBJ: 4 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy 24. The resting position of the temporomandibular joint can be noted with the teeth _____ so as to

allow a physiologic rest for the mandible. a. biting gently together b. apart at approximately 2 to 4 mm c. resting firmly together d. apart at approximately 6 to 10 mm ANS: B

Feedback The resting position of the temporomandibular joint is not with the teeth biting together. Instead, the muscular balance and proprioceptive feedback allow a physiologic rest for the mandible, an interocclusal clearance or freeway space, which is approximately 2 to 4 mm between the teeth. The muscular balance and proprioceptive feedback allow a physiologic rest for the mandible, an interocclusal clearance or freeway space, which is approximately 2 to 4 mm between the teeth. The resting position of the temporomandibular joint is NOT with the teeth resting together. Instead, the muscular balance and proprioceptive feedback allow a physiologic rest for the mandible, an interocclusal clearance or freeway space, which is approximately 2 to 4 mm between the teeth. The muscular balance and proprioceptive feedback allow a physiologic rest for the mandible, an interocclusal clearance or freeway space, which is approximately 2 to 4 mm between the teeth.

DIF: Comprehension REF: p. 128 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, 1.1.1 Head and Neck Anatomy 25. When considering temporomandibular disorders, MOST symptoms seem to originate from the

nerve surrounding the joint. In addition, MOST recent studies support the role of temporomandibular disorders in directly causing headaches, neck or back pain, or instability. 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: B

Feedback Both statements are false. Most symptoms seem to originate from the muscles. Most recent studies do NOT support the role of temporomandibular disorders in

directly causing headaches, neck or back pain, or instability; headaches are usually caused by muscle tension or vascular changes. Both statements are false. Most symptoms seem to originate from the muscles. Most recent studies do NOT support the role of temporomandibular disorders in directly causing headaches, neck or back pain, or instability; headaches are usually caused by muscle tension or vascular changes. Both statements are false. Most symptoms seem to originate from the muscles. Most recent studies do NOT support the role of temporomandibular disorders in directly causing headaches, neck or back pain, or instability; headaches are usually caused by muscle tension or vascular changes. Both statements are false. Most symptoms seem to originate from the muscles. Most recent studies do NOT support the role of temporomandibular disorders in directly causing headaches, neck or back pain, or instability; headaches are usually caused by muscle tension or vascular changes.

DIF: Comprehension REF: p. 129 OBJ: 4 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy MULTIPLE RESPONSE 1. From the following list of actions involving the temporomandibular joint, select those that are

DIRECTLY associated with lateral deviation of the joint. (Select all that apply.) a. Single lateral pterygoid muscle contraction b. Gliding movement c. Rotational movement d. Both lateral pterygoid muscle contractions ANS: A, B, C Feedback Correct

Incorrect

Lateral deviation is directly associated with a single lateral pterygoid muscle contraction and gliding movement but also includes rotational movement of the temporomandibular joint. Lateral deviation is directly associated with a single lateral pterygoid muscle contraction and NOT contractions of both lateral pterygoid muscles, as well as including both gliding and rotational movements of the temporomandibular joint.

DIF: Comprehension REF: p. 128 OBJ: 3 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | 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 2. From the following list of actions, select the procedures USUALLY used during an

examination of the temporomandibular joint. (Select all that apply.)

a. b. c. d. e.

Patient biting on wax impression Bilateral palpation of all joint movements Digital palpation of external acoustic meatus Ausculation of the joint Extraoral radiography of the joint region

ANS: B, C, D Feedback Correct

Incorrect

The usual procedures for the examination of the temporomandibular joint include the bilateral palpation of all joint movements, digital palpation of the external acoustic meatus, and possibly auscultation. The patient biting on wax impression and extraoral radiography of the joint are NOT a part of the usual procedures for examining the temporomandibular joint.

DIF: Application REF: p. 128 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, 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, 1.1.1 Head and Neck 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, 3.0 Planning and Managing Dental Hygiene Care 3. From the following list of descriptions, select those that can occur with aging of the joint disc

of the temporomandibular joint. (Select all that apply.) a. Thinner b. Perforated c. Dislocated d. Thicker ANS: A, B Feedback Correct Incorrect

When the joint disc of the temporomandibular joint ages, it can become thinner and even perforated. When the joint disc of the temporomandibular joint ages, it does NOT become thicker but thinner and even perforated. At any age, the disc may become dislocated by injury to its attachments and NOT just due to aging but instead injury to the joint.

DIF: Application REF: p. 128 OBJ: 4 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck 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, 3.0 Planning and Managing Dental Hygiene Care

4. From the following list of descriptions, select those descriptions that can be applied to the

joint capsule of the temporomandibular joint. (Select all that apply.) a. Wraps around only the superior part b. Wraps around articular eminence and fossa c. Wraps around the condyle circumference d. Wraps around the coronoid process circumference e. Wraps around only the inferior part ANS: B, C Feedback Correct

Incorrect

The joint capsule of the temporomandibular joint encloses the entire joint and NOT just its superior or inferior parts; it wraps around the temporal bone’s articular eminence and articular fossa as well as the circumference of the mandibular condyle, including the condyle’s neck. The joint capsule of the temporomandibular joint encloses the entire joint and NOT just the superior or inferior parts, and it does NOT wrap around the circumference of the coronoid process but the circumference of the mandibular condyle, including the condyle’s neck as well as the temporal bone’s articular eminence and articular fossa.

DIF: Recall REF: p. 125 OBJ: 2 | 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, 1.1.1 Head and Neck Anatomy 5. From the following list of descriptions, select those descriptions that can be applied to the

stylomandibular ligament of the temporomandibular joint. (Select all that apply.) a. Anatomically variable ligament b. Formed from sphenomandibular ligament extension c. Formed from thickened area cervical fascia d. Consistent ligament anatomically e. Becomes taut with mandibular protrusion ANS: A, C, E Feedback Correct

Incorrect

The stylomandibular ligament of the temporomandibular joint is a variable ligament anatomically, formed from thickened area cervical fascia, and becomes taut with mandibular protrusion. The stylomandibular ligament of the temporomandibular joint is NOT formed from a sphenomandibular ligament extension and is NOT consistent anatomically as a ligament but is a variable ligament anatomically and formed from thickened area cervical fascia.

DIF: Recall REF: pp. 125-127 OBJ: 3 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | 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 6. If your patient has a history of impaired movement of the temporomandibular joint, what may

be occurring? (Select all that apply.) a. Disc degeneration may be involved b. Calcifications may be present c. Joint disc may be thinner or even perforated d. Aging or trauma may be involved ANS: A, B, C, D

With aging or trauma to the area, the joint disc of the temporomandibular joint can become thinner or even perforated. Recent studies suggest this disc degeneration may also cause calcifications within the disc, changes that may lead to impaired movement of the joint. DIF: Application REF: p. 125 OBJ: 4 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck 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, 3.0 Planning and Managing Dental Hygiene Care 7. Which of the following needs to be included during an effective extraoral examination of the

temporomandibular joint of a patient? (Select all that apply.) a. Opening and closing the mouth several times b. Moving the jaw only forward and backward c. Palpating the depression inferior to the zygomatic arch d. Placing a finger over the maxillary sinus region during movement ANS: A, C Feedback Correct

Incorrect

The temporomandibular joint is palpated laterally at a depression inferior to the zygomatic arch during an extraoral examination. This includes asking the patient to open and close the mouth several times and then to move the opened lower jaw to the left, then to the right, and then forward. To further assess the mandible moving, use digital palpation by gently placing a finger into the outer part of the external acoustic meatus. Moving the jaw only forward and backward is NOT effective in the extraoral examination of the temporomandibular joint NOR is placing a finger over the maxillary sinus region during movement.

Chapter 06: Vascular System Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition MULTIPLE CHOICE 1. Which term is BEST used to describe a blood vessel that travels to the heart carrying blood? a. Arteriole b. Artery c. Capillary d. Vein ANS: D

A B C D

Feedback An arteriole is a smaller artery that branches off an artery and connects with a capillary. An artery is a type of blood vessel that carries blood away from the heart. A capillary is a smaller blood vessel that branches off an arteriole blood supply directly to the tissue. A vein is a type of blood vessel that travels to the heart carrying blood.

DIF: Recall REF: p. 133 OBJ: 1 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 2. The dental professional MUST be able to locate the larger blood vessels of the head and neck

BECAUSE these vessels may become compromised due to a disease process or during a dental procedure such as a local anesthetic injection. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A

C D E

Feedback The statement and the reason are correct and related. The dental professional must be familiar with the location of large blood vessels of the head and neck so as to NOT compromise the patient’s health during certain dental procedures. The statement and reason are correct, but they are also related. Having knowledge of blood vessels will avoid injury or disease transmission through the blood system during dental procedures. The reason is correct. Blood vessels may become compromised due to a disease process or during a dental procedure, such as a local anesthetic injection. The statement is correct. The dental professional must be able to locate the larger blood vessels of the head and neck. Both the statement and the reason are correct. The dental professional must be

able to locate the larger blood vessels of the head and neck mainly because blood vessels may become compromised due to a disease process or during a dental procedure such as a local anesthetic injection. DIF: Application REF: p. 134 OBJ: 3 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 | CDA: General Chairside, II. D. Patient Management | 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, 4.0 Performing Periodontal Procedures 3. Blood vessels are MORE numerous than lymphatic vessels. However, the venous blood

vessels MAINLY parallel the lymphatic vessels. 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: D

A B C

Feedback The first statement is false. Blood vessels are less numerous than lymphatic vessels. The second statement is true. The venous part mainly parallels the lymphatic vessels. The first statement is false. Blood vessels are less numerous than lymphatic vessels. The second statement is true. The venous blood vessels mainly parallel the lymphatic vessels. The first statement is false. Blood vessels are less numerous than lymphatic vessels. The second statement is true. The venous blood vessels mainly parallel the lymphatic vessels.

DIF: Comprehension REF: p. 134 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 4. Which of the following statements BEST explains why BOTH facial and dental infections can

lead to serious complications for the patient? a. Antibiotics do NOT work well to combat facial and dental infections. b. Communication by way of anastomoses and blood flow direction is involved in the spread of infection in the head and neck. c. Both facial and dental infections have been found to be difficult to detect and treat early. d. Blood supply is based on a one-to-one relationship of blood vessel to muscle. ANS: B

A B

Feedback Antibiotics are available to treat facial and dental infections effectively. Communication by way of anastomoses and blood flow direction is involved in the spread of infection in the head and neck. This is the reason that facial or dental infections can lead to serious complications. Both facial and lingual infections can be detected early by completing a comprehensive medical history, taking vital signs, and conducting extraoral and intraoral examination on patients. Blood supply is regional, unlike that for innervation supplied by the nerves to the muscles, which is a one-to-one relationship.

DIF: Application REF: p. 134 OBJ: 3 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, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 4.0 Performing Periodontal Procedures 5. What does the term anastomosis mean? a. Communication of blood vessels with another connecting channel b. Foreign material in the blood c. A large network of blood vessels d. Clot that forms on the inner blood vessel walls ANS: A

A B C D

Feedback Anastomosis is communication of blood vessels with another connecting channel. A foreign material in the blood is an embolus. A large network of blood vessels is a plexus. A clot that forms on the inner blood vessel wall is a thrombus.

DIF: Recall REF: p. 133 OBJ: 1 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 6. Which are the MAJOR arteries that supply the head and neck? a. Aorta, brachiocephalic b. Common carotid, subclavian c. Posterior auricular, occipital d. Superficial temporal, facial ANS: B

Feedback The aorta is a major artery that gives rise to the common carotid and subclavian arteries on the left side of the body and to the brachiocephalic artery on the right

side. The brachiocephalic artery is an artery that branches directly off the aorta on the right side of the body and gives rise to the right common carotid and subclavian arteries. The common carotid and subclavian arteries are the major supply of arterial blood to the head and neck. The common carotid artery travels in the carotid sheath superiorly along the neck to branch into the internal and external carotid arteries. The subclavian arteries arise from the aorta on the left and the brachiocephalic artery on the right and give off branches to supply both intracranial and extracranial structures, as well as the arm. The posterior auricular artery is a posterior arterial branch from the external carotid artery that supplies the tissue around the ear. The occipital artery is also a posterior arterial branch from the external ear. The superficial temporal artery is a terminal arterial branch from the external carotid artery that arises in the parotid salivary gland and gives off the transverse facial and middle temporal arteries, as well as frontal and parietal branches. The facial artery is an anterior arterial branch from the external carotid artery with a complicated path as it gives off the ascending palatine, submental, inferior and superior labial, and angular arteries.

DIF: Recall REF: p. 134 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 7. Which of the following arteries is a DIRECT branch off of the aorta? a. Common carotid artery b. External carotid artery c. Pterygoid artery d. Brachiocephalic artery ANS: D

A B C D

Feedback The common carotid artery travels in the carotid sheath superiorly along the neck to branch into the internal and external carotid arteries. The external carotid artery arises from the common carotid artery and supplies the extracranial tissue of the head and neck, including the oral cavity. The pterygoid artery is a branch of arteries from the maxillary artery that supplies the pterygoid muscles. The brachiocephalic artery is an artery that branches directly off the aorta on the right side of the body and gives rise to the right common carotid and subclavian arteries.

8. The common carotid artery is branchless and travels superiorly along the neck, lateral to the

trachea and larynx to the superior border of the thyroid cartilage. The common carotid artery travels in a sheath deep to the superior, middle, and inferior pharyngeal constrictor muscle. 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

A B

Feedback The second statement is false. The common carotid artery travels in a sheath deep to the sternocleidomastoid muscle. The first statement is true. The common carotid artery is branchless and travels superiorly along the neck, lateral to the trachea and larynx to the superior border of the thyroid cartilage. The first statement is true. The common carotid artery is branchless and travels superiorly along the neck, lateral to the trachea and larynx to the superior border of the thyroid cartilage. The second statement is false. The common carotid artery travels in a sheath deep to the sternocleidomastoid muscle. The first statement is true. The common carotid artery is branchless and travels superiorly along the neck, lateral to the trachea and larynx to the superior border of the thyroid cartilage. The second statement is false. The common carotid artery travels in a sheath deep to the sternocleidomastoid muscle.

DIF: Recall REF: p. 134 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 9. What is the MAJOR destination of the subclavian artery as it travels in the body? a. Intracranial structures b. Upper extremity or arm c. Tissue inferior to the hyoid bone d. External scalp tissue ANS: B

A B C D

Feedback The intracranial structures are supplied by the internal carotid artery. The subclavian artery also supplies the upper extremity or arm, so that is its major destination. The superior thyroid artery supplies tissue inferior to the hyoid bone. The occipital artery supplies the suprahyoid and sternocleidomastoid muscles, as well as the external scalp and meningeal tissue in the occipital region.

DIF: Recall REF: pp. 135-136 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

10. Which of the following structures listed is NOT supplied by the lingual artery? a. Suprahyoid muscles b. Floor of the mouth c. Mylohyoid muscle d. Tongue ANS: C

A B C D

Feedback The lingual artery supplies the suprahyoid muscles. The lingual artery supplies the floor of the mouth. The lingual artery does NOT supply the mylohyoid muscle. The sublingual artery supplies the mylohyoid muscle. Branches of the lingual artery supply the tongue.

DIF: Recall REF: p. 139 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 11. Which of the following listed is NOT a branch of the external carotid artery? a. Middle meningeal b. Facial c. Ascending pharyngeal d. Posterior auricular ANS: A

A B C D

Feedback The middle meningeal artery is a branch of the maxillary artery, which supplies the meninges of the brain and bones of the skull. The facial artery is part of the anterior branch of the external carotid artery. The ascending pharyngeal artery is a medial branch of the external carotid artery. The posterior auricular artery is a posterior branch of the external carotid artery.

DIF: Recall REF: p. 137, Figure 6-4 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 12. During the extraoral examination of a patient, an artery is visually noted under the skin of the

patient in the temporal region. Which artery can be visualized in this manner during the examination? a. Middle temporal artery b. Transverse facial artery c. Superficial temporal artery d. Maxillary artery ANS: C

A B C D

Feedback The middle temporal artery is small and supplies the temporalis muscle along with parts of the scalp in the frontal and parietal regions. The transverse facial artery supplies the parotid salivary gland and nearby facial tissue. The superficial temporalis artery branches off into several directions in the area of the temporalis bone. The maxillary artery begins at the neck of the mandibular condyle within the parotid salivary gland.

DIF: Application REF: p. 140 OBJ: 2 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, II. D. Patient Management MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 4.0 Performing Periodontal Procedures 13. Which branch of the maxillary artery supplies the maxillary anterior teeth by way of each

tooth’s apical foramen? a. Infraorbital artery b. Inferior alveolar artery c. Sphenopalatine artery d. Anterior superior alveolar artery ANS: D

B C D

Feedback Although the infraorbital artery supplies the maxillary anterior teeth, it does so by providing orbital branches to the orbit, as well as giving off the anterior superior alveolar artery, but it does NOT actually enter through the apical foramen of each tooth. The inferior alveolar artery supplies the mandibular teeth, the floor of the mouth, and mental region. The sphenopalatine artery supplies the nasal cavity and anterior hard palate. The anterior superior alveolar artery supplies the maxillary anterior teeth by entering each tooth’s apical foramen.

DIF: Recall REF: p. 144 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 14. The veins of the head and neck start out as large venules and become smaller as they near the

base of the neck on their way to the heart. The veins of the head and upper neck are usually symmetric in location with limited or NO variance regarding their location. 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: B

Feedback Both the first and second statements are false. Veins of the head and neck start out as small venules and become larger as they near the base of the neck on their way to the heart. The veins of the head and upper neck are usually symmetric in location; however, they have a greater variability in location than do the arteries. Both statements are false. Veins of the head and neck start out as small venules and become larger as they near the base of the neck on their way to the heart. The veins of the head and upper neck are usually symmetric in location; however; they have a greater variability in location than do the arteries. The first statement is false. Veins of the head and neck do NOT start out as large venules. They also become larger as they near the base of the neck on their way to the heart. The second statement is false. The veins of the head and upper neck are usually symmetric in location and have greater variability regarding their location than do arteries.

DIF: Comprehension REF: p. 145 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 15. Which of the following oral structures or regions is NOT drained DIRECTLY by the facial

vein? a. Upper lip b. Lower lip c. Submental space d. Lateral scalp ANS: D

A B C D

Feedback The facial vein drains the upper lip by way of the superior labial drainage vein. The facial vein drains the lower lip by way of the inferior labial drainage vein. The facial vein drains the submental space by way of the submental drainage vein. The facial vein does NOT drain the lateral scalp. The retromandibular and external jugular veins drain this area.

DIF: Recall REF: p. 145 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 16. Which of the following blood vessels NOT only protects the maxillary artery from being

compressed during mastication but also accommodates changes in volume of the infratemporal fossa that occur when the mandible moves?

a. b. c. d.

Posterior superior alveolar veins Pterygoid plexus of veins Maxillary vein Middle meningeal vein

ANS: B

Feedback The posterior superior alveolar veins drain the pulp of the maxillary teeth by way of each tooth’s apical foramen. It also drains the periodontium of the maxillary teeth. The pterygoid plexus of veins is a collection of small anastomosing vessels located around the pterygoid muscles and surrounding the maxillary artery. It protects the maxillary from being compressed during mastication by allowing changes in volume of the infratemporal fossa that occur when the mandible moves. The maxillary vein is a deep vein that begins in the infratemporal fossa by collecting blood from the pterygoid plexus. The maxillary vein receives other veins from the nose and palate before draining into and from the retromandibular vein. Middle meningeal vein drains blood from the meninges of the brain into the pterygoid plexus of veins.

DIF: Comprehension REF: p. 146 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 17. Which of the following veins listed drains MOST of the head and neck? a. Internal jugular vein b. External jugular vein c. Inferior alveolar vein d. Anterior jugular vein ANS: A

B C D

Feedback The internal jugular vein originates in the cranial cavity and leaves the skull through the jugular foramen. It receives tributaries, including the veins, from the lingual, sublingual, and pharyngeal areas, as well as the facial vein. The external jugular vein moves inferiorly along the neck, terminating in the subclavian vein. The inferior alveolar vein drains the periodontium of the mandibular teeth, including the gingival tissue. The anterior jugular vein begins inferior to the chin, communicating with veins in the area, and moves inferiorly near the midline, within the superficial fascia, receiving branches from superficial cervical structures.

DIF: Recall REF: p. 148 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 18. What is a serious, life-threatening blood vessel lesion that occurs when a blood vessel is

seriously traumatized, allowing large amounts of blood to escape into the surrounding tissue without clotting? a. Hematoma b. Thrombus c. Bacteremia d. Hemorrhage ANS: D

B C

Feedback A hematoma is a bruise resulting from a blood vessel being injured and a small amount of blood escaping into and clotting into the surrounding tissue. It is NOT a serious, life-threatening blood vessel lesion. A thrombus is a clot that forms on the inner vessel wall. It is NOT a serious, lifethreatening blood vessel lesion unless it breaks away and becomes an embolus. A bacteremia occurs when bacteria travel within the blood system. It is NOT always a serious, life-threatening blood vessel lesion unless the patient is medically compromised. A hemorrhage occurs when large amounts of the blood escape into the surrounding tissue without clotting and thus is a serious, life-threatening blood vessel lesion.

DIF: Comprehension REF: p. 149 OBJ: 3 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, II. D. Patient Management | CDA: General Chairside, VI. A. 1. Identify medical conditions that can cause medical emergencies in patients 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 19. What is the blood supply that is DIRECTLY provided to the sternocleidomastoid muscle? a. Internal carotid artery b. Superior thyroid artery c. Lingual artery d. Angular artery ANS: B

B C

Feedback The internal carotid artery has NO branches in the neck but continues adjacent to the internal jugular vein within the carotid sheath to the skull base, where it enters the cranium. The internal carotid artery supplies intracranial structures and is the source of the ophthalmic artery, which supplies the eye, orbit, and lacrimal gland. The superior thyroid artery is an anterior branch from the external carotid artery that has a sternocleidomastoid branch to supply the sternocleidomastoid muscle. The lingual artery is an anterior branch from the external carotid artery and

arises superior to the superior thyroid artery at the level of the hyoid bone. The lingual artery travels anteriorly to the apex of the tongue by way of its inferior surface. The lingual artery supplies the tissue superior to the hyoid bone, including the suprahyoid muscles and floor of the mouth by the dorsal lingual, deep lingual, sublingual, and suprahyoid branches. The tongue is also supplied by branches of the lingual artery. The angular artery is the termination of the facial artery and supplies the side of the nose.

DIF: Recall REF: p. 136 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 20. A branch of the maxillary artery reaches the nasal cavity through the a. infraorbital foramen. b. incisive foramen. c. sphenopalatine foramen. d. greater and lesser palatine foramina. ANS: C

C D

Feedback After giving off branches in the infraorbital canal, the infraorbital artery emerges onto the face from the infraorbital foramen. The artery’s terminal branches supply parts of the infraorbital region of the face and anastomose with the facial artery. The sphenopalatine artery gives rise to the posterior lateral nasal branches and septal branches, including a nasopalatine branch that accompanies the nasopalatine nerve through the incisive foramen on the maxillae. The sphenopalatine artery is a branch of the maxillary artery that reaches the nasal cavity through the sphenopalatine foramen. The maxillary artery gives rise to the descending palatine artery, which travels to the palate through the pterygopalatine canal, which then terminates in both the greater palatine artery and lesser palatine artery by way of the greater and lesser palatine foramina to supply the hard and soft palates, respectively.

DIF: Recall REF: p. 144 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 21. What is the relationship of the maxillary vein to the superficial temporal vein? a. Shallower b. Deeper c. Superior d. Inferior ANS: B

Feedback The maxillary vein or internal maxillary vein is deeper than the superficial temporal vein and begins in the infratemporal fossa by collecting blood from the pterygoid plexus, accompanying the maxillary artery. The maxillary vein or internal maxillary vein is deeper than the superficial temporal vein and begins in the infratemporal fossa by collecting blood from the pterygoid plexus, accompanying the maxillary artery. The maxillary vein or internal maxillary vein is deeper than the superficial temporal vein and begins in the infratemporal fossa by collecting blood from the pterygoid plexus, accompanying the maxillary artery. The maxillary vein or internal maxillary vein is deeper than the superficial temporal vein and begins in the infratemporal fossa by collecting blood from the pterygoid plexus, accompanying the maxillary artery.

DIF: Recall REF: p. 145 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 22. The pterygoid plexus of veins is a collection of small anastomosing vessels located around the

pterygoid muscles and DIRECTLY surrounding which artery? a. External carotid artery b. Maxillary artery c. Inferior alveolar artery d. Internal carotid artery ANS: B

Feedback The pterygoid plexus of veins is a collection of small anastomosing vessels located around the pterygoid muscles and directly surrounding the maxillary artery. The pterygoid plexus of veins is a collection of small anastomosing vessels located around the pterygoid muscles and directly surrounding the maxillary artery. The pterygoid plexus of veins is a collection of small anastomosing vessels located around the pterygoid muscles and directly surrounding the maxillary artery. The pterygoid plexus of veins is a collection of small anastomosing vessels located around the pterygoid muscles and directly surrounding the maxillary artery.

DIF: Recall REF: p. 146 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 23. What is the relationship of the subclavian artery to the common carotid artery? a. Anterior b. Posterior

c. Medial d. Lateral ANS: D

A B C

Feedback The subclavian artery arises lateral to the common carotid artery. The subclavian artery arises lateral to the common carotid artery. The subclavian artery arises lateral to the common carotid artery. The external carotid artery travels superiorly in a more medial position (in relationship to the internal carotid artery) after arising from the common carotid artery. The subclavian artery arises lateral to the common carotid artery.

DIF: Recall REF: p. 135 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 24. What is the usual number of anterior branches that arise from the external carotid artery? a. One b. Two c. Three d. Four ANS: C

C D

Feedback There are three anterior branches from the external carotid artery: superior thyroid, lingual, and facial. Only one medial branch is from the external carotid artery: the small ascending pharyngeal artery. There are three anterior branches from the external carotid artery: superior thyroid, lingual, and facial. There are two posterior branches of the external carotid artery: occipital and posterior auricular. There are three anterior branches from the external carotid artery: superior thyroid, lingual, and facial. There are three anterior branches from the external carotid artery: superior thyroid, lingual, and facial. The external carotid artery has four sets of branches grouped according to their location relative to the main artery: anterior, medial, posterior, and terminal.

DIF: Recall REF: p. 136 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 25. With what nerve is the occipital artery closely associated at its origin? a. Trigeminal nerve b. Facial nerve c. Hypoglossal nerve d. Mandibular nerve

ANS: C

A B C D

Feedback At its origin, the occipital artery is closely associated with the twelfth cranial or hypoglossal nerve. At its origin, the occipital artery is closely associated with the twelfth cranial or hypoglossal nerve. At its origin, the occipital artery is closely associated with the twelfth cranial or hypoglossal nerve. The maxillary artery also has branches that are located near the muscle they supply. These arteries all accompany branches of the mandibular nerve or third division of the fifth cranial or trigeminal nerve.

DIF: Recall REF: p. 140 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 MULTIPLE RESPONSE 1. From the following list of descriptions, select which descriptions can be used for the pathway

of the external carotid artery. (Select all that apply.) a. Begins at inferior border of thyroid cartilage b. Travels upward medial to internal carotid artery c. Begins at the termination of common carotid artery d. Travels upward lateral to internal carotid artery ANS: B, C Feedback Correct

Incorrect

The external carotid artery travels upward medial to the internal carotid artery and begins at the termination of the common carotid artery; this artery does NOT begin at the inferior border of the thyroid cartilage and does NOT travel lateral to the internal carotid artery. The external carotid artery begins at the superior border of the thyroid cartilage and NOT its inferior border as well as traveling upward medial and NOT lateral to the internal carotid artery.

DIF: Recall REF: p. 136 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 2. From the following list of blood vessels, select those blood vessels that anastomose with the

pterygoid plexus of veins located around the pterygoid muscles. (Select all that apply.) a. Facial artery b. Maxillary artery c. Facial vein d. Retromandibular vein e. Maxillary vein

ANS: C, D Feedback Correct Incorrect

The pterygoid plexus of veins anastomoses with both the facial vein and retromandibular vein. The pterygoid plexus of veins surrounds the maxillary artery and does NOT anastomose with either the facial artery or maxillary artery; the plexus drains into the maxillary vein.

DIF: Recall REF: p. 145 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 3. From the following list of terms concerning compromised blood vessels, select the terms that

are associated DIRECTLY with clot formation. (Select all that apply.) a. Thrombus b. Embolus c. Hematoma d. Hemorrhage e. Varicosity ANS: A, B, C Feedback Correct

Incorrect

The terms concerning compromised blood vessels that are DIRECTLY associated with clot formation are thrombus (plural, thrombi), embolus (plural, emboli), and hematoma. The terms concerning compromised blood vessels that are NOT DIRECTLY associated with clot formation are hemorrhage and varicosity.

DIF: Comprehension REF: pp. 148-149 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 4. From the following list of descriptions, select which descriptions can be used for the pathway

of the external jugular vein. (Select all that apply.) a. Drains only a small part of extracranial structures b. Terminates in the subclavian vein c. Visible near the sternocleidomastoid muscle d. Usually only one vein is present ANS: A, B, C Feedback Correct

Incorrect

The external jugular vein drains only a small part of extracranial structures. It terminates in the subclavian vein and is visible as it crosses the sternocleidomastoid muscle in the neck. Usually there are two external jugular veins but there can be ONLY one anterior jugular vein.

DIF: Recall REF: p. 148 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 5. From the following list of descriptions, select which descriptions can be used for the pathway

of the maxillary artery. (Select all that apply.) a. May be superficial to lateral pterygoid muscle b. Runs between mandible and temporomandibular ligament c. May be deep to lateral pterygoid muscle d. Runs through infratemporal fossa ANS: A, C, D Feedback Correct Incorrect

The maxillary artery runs either superficial or deep to the lateral pterygoid muscle and through the infratemporal fossa superiorly. The maxillary artery runs between the mandible and the sphenomandibular ligament anteriorly and NOT the temporomandibular ligament.

DIF: Recall REF: p. 141 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

Chapter 07: Glandular Tissue Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition MULTIPLE CHOICE 1. At which of the following bony junctions does the nasolacrimal duct begin? a. Nasal and lacrimal bones b. Nasal and palatine bones c. Maxilla and nasal bone d. Maxilla and lacrimal bone ANS: D

A B C D

Feedback The nasal bones form the bridge of the nose and do NOT form part of the nasolacrimal duct. The nasal bones form the bridge of the nose, and the palatine bones are posterior to the lacrimal bones. Neither bone forms part of the nasolacrimal duct. The nasal bones do NOT form part of the nasolacrimal duct. The nasolacrimal duct begins at the junction of the maxilla and lacrimal bone.

DIF: Recall REF: p. 158 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, 1.1.1 Head and Neck Anatomy 2. Which of the following exocrine glands produces approximately 60% to 65% of the total

volume of saliva for the oral cavity? a. Sublingual gland b. Submandibular gland c. Parotid gland d. Lacrimal gland ANS: B

A B C D

Feedback The sublingual salivary gland produces approximately 10% of the total volume of saliva and is an exocrine gland. The submandibular salivary gland produces approximately 60% to 65% of the total volume of saliva and is an exocrine gland. The parotid salivary gland produces approximately 25% of the total volume of saliva and is an exocrine gland. The lacrimal gland is NOT a salivary gland but is an exocrine gland.

DIF: Recall REF: pp. 160-161 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, 1.1.1 Head and Neck Anatomy

3. Which of the following glands can be palpated as part of an extraoral examination by a

clinician? a. Lacrimal gland b. Thyroid gland c. Parathyroid gland d. Thymus gland ANS: B

A B C D

Feedback The lacrimal gland is located in the lacrimal fossa of the frontal bone, on the lateral portion of the supraorbital ridge inside the orbit. It CANNOT be palpated. The thyroid gland is palpated in the anterior neck region. The parathyroid glands are located on the posterior surface or inside the posterior surface of the thyroid gland. They CANNOT be palpated. The thymus gland is located in the thorax, deep to the sternum and to the sternohyoid and sternothyroid muscles. It CANNOT be palpated.

DIF: Application REF: pp. 164-165 OBJ: 2 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 MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy 4. Both the major and minor salivary glands are _______ glands. a. endocrine b. exocrine c. large d. small ANS: B

B C D

Feedback All of the salivary glands are exocrine. They secrete saliva into the oral cavity through ducts or directly into the oral cavity. They do NOT secrete saliva into the vascular system like exocrine glands. All of the salivary glands are exocrine, so this answer is correct. They do NOT secrete saliva into the vascular system like exocrine glands. Major glands are large glands, and minor glands are small glands. Major glands are large glands, and minor glands are small glands.

DIF: Recall REF: p. 160 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, 1.1.1 Head and Neck Anatomy 5. Which of the following nerves innervates the minor salivary glands? a. Fifth cranial nerve b. Seventh cranial nerve c. Ninth cranial nerve

d. Twelfth cranial nerve ANS: B

A B C D

Feedback The fifth cranial nerve does NOT innervate the minor salivary glands. It innervates the parotid salivary gland. The seventh cranial nerve innervates the minor salivary glands. The ninth cranial nerve does NOT innervate the minor salivary glands. It innervates the parotid salivary gland. The twelfth cranial nerve does NOT innervate the minor salivary glands. It innervates the extrinsic tongue muscles.

DIF: Recall REF: p. 163 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, 1.1.1 Head and Neck Anatomy 6. Which of the following glands listed below is NOT an endocrine gland? a. Lacrimal gland b. Parathyroid gland c. Thyroid gland d. Thymus gland ANS: A

B C D

Feedback The lacrimal gland is an exocrine gland. It secretes tears through the fine tubules that allow the tears to lubricate the eye. After lubricating the eye, the tears empty into the nasolacrimal duct. The parathyroid glands are endocrine glands. The thyroid gland is an endocrine gland. The thymus gland is an endocrine gland.

DIF: Recall REF: p. 158 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, 1.1.1 Head and Neck Anatomy 7. Which of the following glands can be palpated within the sublingual space in the floor of the

mouth during an extraoral examination by a clinician? a. Parotid gland b. Parathyroid gland c. Sublingual gland d. Submandibular gland ANS: C

Feedback The parotid salivary gland is located in the parotid fascial space, anterior and inferior to the ear and posterior to the mandibular ramus. It would NOT be

C D

palpated in the floor of the mouth. The parathyroid glands are located on the posterior surface or inside the posterior surface of the thyroid gland. They would NOT be palpated in the floor of the mouth. The sublingual salivary gland is located in the sublingual fossa in the anterior floor of the mouth and can be palpated within the sublingual space. The submandibular salivary gland is located more posterior along the submandibular fossa, in the submandibular space, inferior and posterior to the body of the mandible.

DIF: Application REF: p. 162 OBJ: 2 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 MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics 8. Which of the following glands wraps around the mylohyoid muscle? a. Parotid gland b. von Ebner glands c. Sublingual gland d. Submandibular gland ANS: D

A B C D

Feedback The parotid salivary gland is NOT located in the floor of the mouth and does NOT wrap around the mylohyoid muscle. The minor salivary glands, von Ebner glands, are associated with the circumvallate papillae located on the dorsum of the tongue. The sublingual salivary gland is located anterior in the floor of the mouth and does NOT wrap around the posterior border of the mylohyoid muscle. The submandibular salivary gland has two lobes, and the smaller lobe wraps around the posterior border of the mylohyoid muscle.

DIF: Recall REF: p. 161 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, 1.1.1 Head and Neck Anatomy 9. If there is an infection involving the submandibular salivary gland, what lymph nodes would

be initially involved? a. Submental nodes b. Submandibular nodes c. Superior deep cervical nodes d. Inferior deep cervical nodes ANS: B

Feedback

A B C D

The submental lymph nodes are NOT the primary nodes for the submandibular salivary gland. The submandibular lymph nodes are the primary nodes for the submandibular salivary gland. The superior deep cervical lymph nodes are NOT the primary nodes for the submandibular salivary gland. The inferior deep cervical lymph nodes are NOT the primary nodes for the submandibular salivary gland.

DIF: Comprehension REF: p. 162 OBJ: 3 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology 10. The lacrimal glands are considered exocrine glands because their secretion enters directly into

the vascular system without the use of any ducts. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: C

Feedback The reason is NOT correct, but the statement is correct. Secretions from the lacrimal glands do NOT enter into the vascular system but do use ducts, so they are considered exocrine glands. The lacrimal glands are considered exocrine glands, but their product (tears) is secreted onto the eye through ducts but does NOT enter directly into the vascular system, so the statement is correct, but the reason is NOT correct. The reason is NOT correct, but the statement is correct. Secretions from the lacrimal glands do NOT enter into the vascular system but do use ducts, so they are considered exocrine glands. The reason is NOT correct, but the statement is correct. Secretions from the lacrimal glands do not enter into the vascular system but do use ducts, so they are considered exocrine glands. The reason is not correct, but the statement is correct. Secretions from the lacrimal glands do not enter into the vascular system but do use ducts, so they are considered exocrine glands.

DIF: Recall REF: p. 160 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, 1.1.1 Head and Neck Anatomy 11. Which of the following glands secrete only a serous type of saliva? a. Parotid and submandibular glands

b. Sublingual and submandibular glands c. Parotid and von Ebner glands d. Sublingual and von Ebner glands ANS: C

A B C D

Feedback The parotid salivary glands produce a serous type of saliva but the submandibular salivary glands produce a mixed type of saliva. The submandibular salivary glands produce a mixed type of saliva, and the sublingual salivary glands produce a mixed, mostly mucous type of saliva. Both von Ebner glands and the parotid salivary glands produce a serous type of saliva. Of the minor glands, von Ebner glands produce a serous type of saliva, but the sublingual salivary glands produce a mixed, mostly mucous type of saliva.

DIF: Recall REF: pp. 160, 163 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, 1.1.1 Head and Neck Anatomy 12. Which type of secretion is produced from MOST minor salivary glands within the oral cavity? a. Only mucous secretion b. Only serous secretion c. Mainly mucous secretion d. Mainly serous secretion ANS: C

A B C D

Feedback Most of the minor salivary glands produce a mainly mucous type of saliva. Most of the minor salivary glands produce a mainly mucous type of saliva. The minor salivary glands produce a mainly mucous type of saliva. The minor salivary glands produce a mainly mucous type of saliva.

DIF: Recall REF: p. 163 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, 1.1.1 Head and Neck Anatomy 13. Which of the following lymph nodes are initially involved when the patient has contracted

mumps? a. Superior deep cervical nodes b. Deep parotid nodes c. Superficial parotid nodes d. Submandibular nodes ANS: B

Feedback The superior deep cervical lymph nodes are NOT the primary nodes for the

B C D

parotid salivary gland that becomes involved with mumps. The primary nodes for the parotid gland that becomes involved with mumps are the deep parotid lymph nodes. The superficial parotid lymph nodes are NOT the primary nodes for the parotid salivary gland that becomes involved with mumps. The submandibular lymph nodes are NOT the primary nodes for the parotid salivary gland that becomes involved with mumps.

DIF: Application REF: p. 161 OBJ: 3 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | 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, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics 14. What is the location for the parathyroid glands? a. On the anterior surface of the thyroid gland b. Inferior to the hyoid bone, superficial and lateral to the trachea c. On or within the posterior surface of the thyroid gland d. In the parotid space, posterior to the mandibular ramus ANS: C

A B C D

Feedback The parathyroid glands are NOT located on the anterior surface of the thyroid gland. The parathyroid glands are NOT located superficial and lateral to the trachea. The parathyroid glands are located on or within the posterior surface of the thyroid gland. The parathyroid glands are NOT located in the parotid space, posterior to the mandibular ramus.

DIF: Recall REF: p. 165 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, 1.1.1 Head and Neck Anatomy 15. Which of the following lingual papillae are DIRECTLY associated with salivary glands? a. Circumvallate papillae b. Filiform papillae c. Foliate papillae d. Fungiform papillae ANS: A

A B

Feedback The minor salivary glands, von Ebner glands, are associated with the circumvallate papillae. The filiform papillae are NOT associated with any salivary gland.

C D

The foliate papillae are NOT associated with any salivary gland. The fungiform papillae are NOT associated with any salivary gland.

DIF: Recall REF: p. 163 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, 1.1.1 Head and Neck Anatomy 16. Which of the following glands is associated with Wharton duct? a. Lacrimal gland b. Parotid gland c. Sublingual gland d. Submandibular gland ANS: D

A B C D

Feedback The lacrimal gland is associated with the nasolacrimal duct, NOT Wharton duct or the submandibular duct. The parotid salivary gland is associated with Stensen or the parotid duct. The sublingual salivary gland is associated with Bartholin or the sublingual duct. Wharton duct is another name for the submandibular duct, which is the duct of the submandibular salivary gland.

DIF: Recall REF: p. 161 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, 1.1.1 Head and Neck Anatomy 17. Which of the following nerves can be damaged during surgery on the submandibular salivary

gland? a. Cervical nerve b. Inferior alveolar nerve c. Lingual nerve d. Mental nerve ANS: C

A B

Feedback The cervical nerves are associated with the neck or deeper structures. The inferior alveolar nerve passes through the mandibular foramen on the mandibular ramus and runs within the mandibular canal. It is NOT in the vicinity of the submandibular salivary gland. The duct of the submandibular salivary gland, which begins in the deeper lobe, runs close to the lingual nerve, and there is the potential for damage to the lingual nerve during surgery in the area. The mental nerve is in the area of the chin and enters into the mandible through the mental foramen on the external surface of the mandible.

DIF: Comprehension

REF: p. 162

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, 1.1.1 Head and Neck Anatomy 18. Which of the following nerves when damaged can affect the production of the serous type of

saliva? a. Chorda tympani nerve b. Greater petrosal nerve c. Seventh cranial nerve d. Ninth cranial nerve ANS: D

B C D

Feedback The chorda tympani nerve innervates the sublingual salivary gland, which produces a mixed type of saliva but mostly a mucous type of saliva, and the submandibular salivary gland, which produces a mixed type of saliva, with NOT one type of saliva predominating. The greater petrosal nerve innervates the lacrimal gland, which is NOT a salivary gland. The seventh cranial nerve innervates the minor salivary glands, which produce a mostly mucous type of saliva. The ninth cranial nerve provides motor innervation to the parotid salivary gland, which produces only a serous type of saliva.

DIF: Comprehension REF: p. 160 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, 1.1.1 Head and Neck Anatomy 19. Which of the ducts when blocked is involved in the formation of a ranula in the posterior floor

of the mouth? a. Bartholin duct b. Nasolacrimal duct c. Stensen duct d. Wharton duct ANS: D

B C D

Feedback The sublingual salivary gland is located more anterior than the submandibular salivary gland associated with Wharton duct. Bartholin duct is shorter and does NOT travel in the posterior floor of the mouth. A ranula associated with this duct would be located more anterior in the floor of the mouth. The nasolacrimal duct is NOT located within the oral cavity. The Stensen duct, also called the parotid duct, is NOT located in the floor of the oral cavity. Wharton duct, which is the duct for the submandibular salivary gland, runs from the posterior floor of the mouth anterior to the sublingual caruncle. Blockage of the duct may cause a ranula in the posterior floor of the mouth.

DIF: Comprehension REF: p. 161 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, 1.1.1 Head and Neck Anatomy 20. Which of the following glands is associated with the pterygopalatine ganglion? a. Lacrimal gland b. Parotid gland c. Sublingual gland d. Submandibular gland ANS: A

B C D

Feedback The preganglionic and postganglionic parasympathetic fibers of the greater petrosal nerve synapse in the pterygopalatine ganglion as they provide innervation to the lacrimal gland. Nerves that innervate the parotid salivary gland are NOT associated with the pterygopalatine ganglion. Innervation of the sublingual salivary gland is NOT associated with the pterygopalatine ganglion. Innervation of the submandibular salivary gland is NOT associated with the pterygopalatine ganglion.

DIF: Recall REF: p. 159 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, 1.1.1 Head and Neck Anatomy 21. Which of the following arteries can be associated with bleeding with trauma to the sublingual

salivary glands? a. Inferior thyroid artery b. Sublingual artery c. Facial artery d. Lingual artery ANS: B

A B C

Feedback The inferior thyroid artery does NOT provide blood supply to the sublingual salivary gland. The sublingual salivary glands are innervated by the sublingual (and submental) arteries. The facial artery does NOT provide blood supply to the sublingual salivary gland. The facial artery gives off the submental artery and then passes over the inferior border of the mandible and travels up the anterior surface of the face. The lingual artery does NOT provide direct blood supply to the sublingual salivary gland.

DIF: Comprehension

REF: p. 159, Table 7-1

OBJ: 3 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, VI. A. 1. Identify medical conditions that can cause medical emergencies in patients MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 3.3 Individualized Patient Education 22. What is the relationship of the submandibular duct to the lingual nerve as it courses from

posterior to anterior? a. Inferior and posterior to superior and anterior b. Inferior and medial to superior and lateral c. Lateral and anterior to medial and posterior d. Superior and lateral to inferior and medial ANS: D

A B C D

Feedback The lingual nerve in relationship to the submandibular duct is first superior and lateral and then inferior and medial. The lingual nerve in relationship to the submandibular duct is first superior and lateral and then inferior and medial. The lingual nerve in relationship to the submandibular duct is first superior and lateral and then inferior and medial. The lingual nerve in relationship to the submandibular duct is first superior and lateral and then inferior and medial.

DIF: Recall REF: pp. 161-162 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, 1.1.1 Head and Neck Anatomy 23. The smaller palpebral part lies close to the eye, along the inner surface of the eyelid; if the

upper eyelid is everted, the palpebral part can be seen. 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: A

Feedback Both statements are true. The smaller palpebral part lies close to the eye, along the inner surface of the eyelid; if the upper eyelid is everted, the palpebral part can be seen. Both statements are true. The smaller palpebral part lies close to the eye, along the inner surface of the eyelid; if the upper eyelid is everted, the palpebral part can be seen. Both statements are true. The smaller palpebral part lies close to the eye, along the inner surface of the eyelid; if the upper eyelid is everted, the palpebral part can be seen.

Both statements are true. The smaller palpebral part lies close to the eye, along the inner surface of the eyelid; if the upper eyelid is everted, the palpebral part can be seen.

DIF: Comprehension REF: p. 158 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, 1.1.1 Head and Neck Anatomy 24. From the nasolacrimal sac, the lacrimal fluid continues into the nasolacrimal duct, ultimately

draining into the inferior nasal meatus. This connection explains why crying leads to extra saliva. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: C

Feedback The statement is correct, but the reason is NOT. From the nasolacrimal sac, the lacrimal fluid continues into the nasolacrimal duct, ultimately draining into the inferior nasal meatus. This connection explains why crying leads to a runny nose. The statement is correct, but the reason is NOT. From the nasolacrimal sac, the lacrimal fluid continues into the nasolacrimal duct, ultimately draining into the inferior nasal meatus. This connection explains why crying leads to a runny nose. The statement is correct, but the reason is NOT. From the nasolacrimal sac, the lacrimal fluid continues into the nasolacrimal duct, ultimately draining into the inferior nasal meatus. This connection explains why crying leads to a runny nose. The statement is correct, but the reason is NOT. From the nasolacrimal sac, the lacrimal fluid continues into the nasolacrimal duct, ultimately draining into the inferior nasal meatus. This connection explains why crying leads to a runny nose. The statement is correct, but the reason is NOT. From the nasolacrimal sac, the lacrimal fluid continues into the nasolacrimal duct, ultimately draining into the inferior nasal meatus. This connection explains why crying leads to a runny nose.

DIF: Comprehension REF: p. 159 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, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics

25. In contrast to the usual moisture of the eye or even crying, there can be persistent dryness,

scratching, and burning in the eyes of a patient. These are signs of xerostomia. 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 The first statement is true; the second is false. In contrast to the usual moisture of the eye or even crying, there can be persistent dryness, scratching, and burning in the eyes, which are signs of dry eye syndrome. Xerostomia is dry mouth. The first statement is true; the second is false. In contrast to the usual moisture of the eye or even crying, there can be persistent dryness, scratching, and burning in the eyes, which are signs of dry eye syndrome. Xerostomia is dry mouth. The first statement is true; the second is false. In contrast to the usual moisture of the eye or even crying, there can be persistent dryness, scratching, and burning in the eyes, which are signs of dry eye syndrome. Xerostomia is dry mouth. The first statement is true; the second is false. In contrast to the usual moisture of the eye or even crying, there can be persistent dryness, scratching, and burning in the eyes, which are signs of dry eye syndrome. Xerostomia is dry mouth.

DIF: Application REF: p. 163 OBJ: 3 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics 26. A new patient comes in for an emergency examination due to constant unilateral facial pain

after a five-year lapse in dental as well as medical appointments. The clinician also notes a change in the consistency of the parotid salivary gland to bony hard on that side of the face but no overall glandular enlargement. Which of the following may be the present status of this patient? a. Transient facial paralysis b. Glandular cancer c. Hyposalivation with xerostomia d. Mumps with parotitis e. Perineural invasion of facial nerve ANS: B Feedback A

The parotid salivary gland can be pierced and the facial nerve temporarily traumatized when an inferior alveolar block is incorrectly administered causing transient facial paralysis, but this does NOT involve constant pain. The parotid salivary gland can be involved in cancer that can change the consistency of the gland to bony hard and may, in a lesser number of cases,

D E

cause unilateral facial pain on the involved side because the facial nerve or seventh cranial nerve travels through the gland; there then is perineural invasion due to the cancer. Certain medications, disease, or destruction of salivary tissue by radiation therapy may result in hyposalivation by the salivary glands, which is a reduced production of saliva. This can result in xerostomia or dry mouth, but NO pain or change in salivary consistency is usually present unless DIRECTLY after radiation therapy or with an immune disorder that would involve glandular enlargement. The parotid salivary gland also becomes enlarged and tender when a patient has mumps but NOT bony hard or constantly painful. This contagious viral infection usually involves bilateral inflammatory enlargement or parotitis.

DIF: Application REF: p. 161 OBJ: 3 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. A. 1. Identify medical conditions that can cause medical emergencies in patients MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 3.3 Individualized Patient Education MULTIPLE RESPONSE 1. From the following list of descriptions, select which descriptions could CORRECTLY be used

to describe the lacrimal gland. (Select all that apply.) a. Secretes a mucous fluid b. Innervated by parasympathetic fibers c. Drains into superficial parotid lymph nodes d. Lubricates the inside of the eyelids ANS: B, C, D Feedback Correct Incorrect

The lacrimal gland is innervated by parasympathetic fibers, drains into the superficial parotid lymph nodes, and lubricates the inside of the eyelids. The lacrimal gland does NOT secrete a mucous fluid but a watery fluid instead.

DIF: Comprehension REF: p. 158 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, 1.1.1 Head and Neck Anatomy 2. From the following list of descriptions, select which descriptions could be used CORRECTLY

to describe the thyroid gland. (Select all that apply.) a. Produces parathyroid hormone b. Secretes thyroxine c. Visible and palpable if present d. Not visible or palpable

ANS: B, C Feedback Correct Incorrect

The thyroid gland produces and secretes thyroxine. The thyroid gland is both visible and palpable, if present. The thyroid gland does NOT produce parathyroid hormone; instead, the parathyroid gland produces and secretes parathyroid hormone. The thyroid gland is both visible and palpable, if present.

DIF: Comprehension REF: pp. 163-164 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, 1.1.1 Head and Neck Anatomy 3. From the following list of descriptions, select which descriptions could be used CORRECTLY

to describe the thymus gland. (Select all that apply.) a. Matures lymphocytes b. Undergoes involution c. Easily palpable in mandibular region d. Innervated by branches of vagus nerve ANS: A, B, D Feedback Correct Incorrect

The thymus gland matures T-cell lymphocytes, shrinks as an adult to undergo involution, and is innervated by branches of vagus nerve. The thymus gland is NOT easily palpated and is located in the thorax and anterior region of the base of the neck, inferior to the thyroid gland, and NOT the mandibular region.

DIF: Comprehension REF: p. 166 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, 1.1.1 Head and Neck Anatomy 4. From the following list of glands, select which glands DIRECTLY drain into the

submandibular lymph nodes. (Select all that apply.) a. Sublingual salivary gland b. Submandibular salivary gland c. Parotid salivary gland d. Thyroid gland e. Thymus gland ANS: A, B Feedback Correct Incorrect

The sublingual salivary gland and submandibular salivary gland both DIRECTLY drain into the submandibular lymph nodes. The parotid gland DIRECTLY drains into the deep parotid lymph nodes, and the thyroid gland DIRECTLY drains into the superior deep cervical lymph nodes. The thymus gland has lymphatics that arise within the

substance of the gland and terminate in the internal jugular vein. DIF: Recall REF: p. 159, Table 7-1 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, 1.1.1 Head and Neck Anatomy 5. From the following list of glands, select which glands DIRECTLY drain into the superior deep

cervical lymph nodes. (Select all that apply.) a. Sublingual salivary gland b. Submandibular salivary gland c. Parotid salivary gland d. Thyroid gland e. Thymus gland ANS: C, D Feedback Correct Incorrect

Both the thyroid gland and parathyroid glands DIRECTLY drain into the superior deep cervical lymph nodes. The sublingual salivary gland and submandibular salivary gland both DIRECTLY drain into the submandibular lymph nodes. The thymus gland has lymphatics that arise within the substance of the gland and terminate in the internal jugular vein.

DIF: Recall REF: p. 159, Table 7-1 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, 1.1.1 Head and Neck Anatomy 6. A patient of record recently on a new antidepressant states that their eyes are also drier than in

the past. Which of the following may also be present with this patient? (Select all that apply.) a. Less lacrimal fluid b. Dry eye syndrome c. Hyposalivation d. Xerostomia ANS: A, B, C, D

In contrast to the usual moisture level of the eyes or even crying, there can be persistent dryness, which is one of the signs of dry eye syndrome. With this syndrome, the lacrimal glands produce less lacrimal fluid, which mainly occurs with aging or certain medications such as antidepressants, especially when newly taken. Medications or diseases that cause dry eye syndrome can also cause hyposalivation with xerostomia or dry mouth. DIF: Application REF: p. 160 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, 1.1.1 Head and Neck Anatomy 7. Which of the following descriptive statements CORRECTLY concern the minor salivary

glands of the oral cavity? (Select all that apply.)

a. b. c. d. e.

Smaller in size than major salivary glands Secrete mainly a serous type of salivary product Less numerous than major salivary glands Found within soft palatal tissue Each has a single duct that secretes saliva

ANS: A, D, E Feedback Correct

Incorrect

The minor salivary glands are smaller than the larger major salivary glands. Most of the minor salivary glands are scattered in the tissue of the buccal, labial, and lingual mucosa, the soft palate, the lateral parts of the hard palate, and the floor of the mouth as well as associated with the circumvallate lingual papilla’s base. Each gland has a single duct that secretes saliva. The minor salivary glands are NOT less numerous than major salivary glands. Most minor salivary glands secrete a mainly mucous type of salivary product, with some serous secretion and NOT mainly a serous type of product. The exception is von Ebner glands, which secrete only a serous type of salivary product.

DIF: Comprehension REF: p. 163 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, 1.1.1 Head and Neck Anatomy 8. When palpating the right submandibular salivary gland, the clinician notes a stony, hard mass

during the extraoral examination and observes that the gland’s superficial lobe is slightly enlarged and tender. What information can be shared with the patient concerning this situation? (Select all that apply.) a. Can be uncomfortable but is not a dangerous situation b. Gland may be involved with salivary stone(s) c. Computed tomography can confirm diagnosis d. May only need manipulation of stone or minor surgery ANS: A, B, C, D

Salivary stones are uncomfortable but not dangerous and can involve one or more enlarged, tender salivary glands. The clinician may also be able to palpate the stony, hard salivary stone(s) during examination. Facial radiographs or computed tomography can confirm the diagnosis. Salivary stones are usually removed manually or with minor surgery. DIF: Application REF: p. 163 OBJ: 3 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, 1.1.1 Head and Neck 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

MATCHING

From the following list of exocrine glands, match those with their CORRECT associated location. a. Within fossa of frontal bone b. Posterior to mandibular ramus c. Superficial and posterior to mylohyoid muscle d. At floor of the mouth 1. 2. 3. 4.

Lacrimal gland Submandibular salivary gland Sublingual salivary gland Parotid salivary gland

1. ANS: A DIF: Recall REF: p. 159, Table 7-1 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, 1.1.1 Head and Neck Anatomy 2. ANS: C DIF: Recall REF: p. 159, Table 7-1 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, 1.1.1 Head and Neck Anatomy 3. ANS: D DIF: Recall REF: p. 159, Table 7-1 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, 1.1.1 Head and Neck Anatomy 4. ANS: B DIF: Recall REF: p. 159, Table 7-1 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, 1.1.1 Head and Neck Anatomy

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

C D

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

A B C D

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

B C D

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

B C

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

A B

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

B C D

Feedback 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. The hypoglossal nerve or twelfth cranial nerve provides efferent (motor) innervation for the extrinsic and intrinsic muscles of the tongue. The greater petrosal nerve, a branch of the facial nerve, provides afferent (sensory) nerve fibers for taste from the palate. 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 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. 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. 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. 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 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. The zygomatic branch of the facial nerve or seventh cranial nerve innervates the

orbicularis oculi and zygomatic muscles. 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. 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

A B C

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

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

A B C

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

16. Which of the following structures listed below is innervated by the vagus nerve? a. Parotid salivary gland b. Floor of the mouth c. Sternocleidomastoid muscle d. Soft palate muscles ANS: D

A B

C D

Feedback The parotid salivary gland receives motor innervation from the glossopharyngeal nerve or ninth cranial nerve. The floor of the mouth has sensory innervation provided by the lingual nerve and receives motor innervation from the mylohyoid nerve, both branches off the trigeminal nerve or fifth cranial nerve. The sternocleidomastoid muscle is innervated by the accessory nerve or eleventh cranial nerve. The soft palate, palatine tonsils, pharynx, and larynx are among the types of tissue that are innervated by the vagus nerve or tenth 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 17. Which of the following nerves is NOT part of the maxillary nerve or second division of the

trigeminal nerve? a. Anterior superior alveolar nerve b. Infraorbital nerve c. Buccal nerve d. Zygomaticotemporal nerve ANS: C

A B C

Feedback The anterior superior alveolar nerve is a branch of the maxillary nerve or second division of the trigeminal nerve or fifth cranial nerve. The infraorbital nerve is a branch of the maxillary nerve or second division of the trigeminal nerve or fifth cranial nerve. The buccal nerve is a branch off the mandibular nerve or third division of the trigeminal nerve or fifth cranial nerve and therefore is NOT part of the maxillary division. The zygomaticotemporal nerve is a branch off the zygomatic nerve that joins the maxillary nerve or second division of the trigeminal nerve or fifth cranial nerve.

DIF: Recall REF: pp. 188-189 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

18. Which of the following pairings of nerve to bony opening is INCORRECT? a. Mandibular nerve, foramen ovale b. Olfactory nerve, cribriform plate c. Oculomotor nerve, inferior orbital fissure d. Vagus nerve, jugular foramen ANS: C

A B C

Feedback The mandibular nerve or third division of the trigeminal nerve or fifth cranial nerve is associated with the foramen ovale. The olfactory nerve or first cranial nerve is associated with the cribriform plate of the ethmoid bone. There is NO association between the nerve and bony opening. The oculomotor nerve or third cranial nerve travels through the superior orbital fissure and NOT the cribriform plate. The vagus nerve or tenth cranial nerve is associated with the jugular foramen.

DIF: Recall 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 19. Where does the infraorbital nerve receive the posterior superior alveolar nerve in order to

form the maxillary nerve? a. Infratemporal fossa b. Inferior orbital fissure c. Maxillary tuberosity d. Pterygopalatine fossa ANS: D

B C

Feedback The infratemporal fossa is located posterior to the meeting place of these two nerves. Instead, both nerves are pterygopalatine fossa branches of the maxillary nerve or second division of the trigeminal nerve or fifth cranial nerve. The inferior orbital fissure is too anterior for the meeting of these two nerves. The posterior alveolar nerve enters the posterior superior alveolar foramina that are posterosuperior and medial to the maxillary tuberosity on the surface of the maxilla after it meets the infraorbital nerve. The infraorbital and posterior superior alveolar nerves do meet within the pterygopalatine fossa.

DIF: Recall REF: p. 185 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 20. Which of the following nerves carry pulpal sensations from the maxillary canine? a. Nasopalatine nerve

b. Anterior superior alveolar nerve c. Middle superior alveolar nerve d. Greater palatine nerve ANS: B

Feedback The nasopalatine nerve, a branch off the maxillary nerve or second division of the trigeminal nerve or fifth cranial nerve, provides sensory innervation to the anterior palate from the mesial of one maxillary premolar to the mesial of the maxillary premolar on the contralateral side. The anterior 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 pulp tissue of the maxillary canine as well as the maxillary incisors. The middle 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 pulp tissue of the maxillary premolars and the mesiobuccal root of the maxillary first molar, if present. The greater palatine nerve, a branch off the maxillary nerve or second division of the trigeminal nerve or fifth cranial nerve, provides sensory innervation to the posterior hard palate from the maxillary premolars and molars to the midline.

DIF: Recall REF: p. 185 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 21. Which of the following nerves provides motor innervation to the floor of the mouth? a. Inferior alveolar nerve b. Hypoglossal nerve c. Glossopharyngeal nerve d. Mylohyoid nerve ANS: D

B C

Feedback The inferior alveolar nerve, a branch of the mandibular nerve or third division of the trigeminal nerve or fifth cranial nerve, is an afferent nerve that provides sensory innervation to the mandibular teeth and associated periodontium. The hypoglossal nerve or twelfth cranial nerve provides efferent (motor) innervation to the tongue and NOT the floor of the mouth. The glossopharyngeal nerve or ninth cranial nerve provides efferent innervation to some pharyngeal muscles and the parotid salivary gland and NOT to the floor of the mouth. The mylohyoid nerve, a branch of the mandibular nerve or third division of the trigeminal nerve or fifth cranial nerve, provides efferent innervation to the floor of the mouth and the anterior belly of the digastric muscle.

DIF: Recall REF: p. 194 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 22. Which part of the brain is involved in the regulation of BOTH the heartbeat and breathing? a. Medulla b. Pons c. Cerebellum d. Midbrain ANS: A

A B C D

Feedback The medulla plays an important role in regulating heartbeat, breathing, blood pressure, and reflex centers. The pons serves as a connection between the medulla and other parts of the brain. The cerebellum is important for muscle coordination and tone, along with balance. The midbrain includes relay stations for hearing, vision, and motor pathways.

DIF: Recall REF: p. 174 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 23. Branches of the facial nerve traverse all of the following openings EXCEPT the a. foramen rotundum. b. internal auditory meatus. c. stylomastoid foramen. d. pterygoid canal. ANS: A

A B C D

Feedback The foramen rotundum allows the maxillary nerve or second division of the trigeminal nerve to traverse instead of the facial nerve. Branches of the facial nerve or seventh cranial nerve traverse the internal auditory meatus. Branches of the facial nerve or seventh cranial nerve traverse stylomastoid foramen. Branches of the facial nerve or seventh cranial nerve traverse pterygoid canal.

DIF: Recall 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 24. Which of the following nerves convey parasympathetic fibers to the lacrimal gland? a. Chorda tympani nerve b. Oculomotor nerve c. Glossopharyngeal nerve

d. Zygomatic nerve ANS: D

Feedback The chorda tympani nerve, a branch of the facial nerve or seventh cranial nerve, is a parasympathetic efferent nerve for the submandibular and sublingual salivary glands and also serves as an afferent nerve for taste sensation for the body of the tongue. The oculomotor nerve or third cranial nerve serves as an efferent nerve to some of the eye muscles that move the eyeball. The nerve also carries preganglionic parasympathetic fibers to the ciliary ganglion near the eyeball. The glossopharyngeal nerve or ninth cranial nerve carries an efferent component for the pharyngeal muscle, the stylopharyngeus muscle, and the preganglionic gland parasympathetic innervation for the parotid salivary gland (relaying the otic ganglion). The zygomatic nerve that joins the maxillary nerve or second division of the trigeminal nerve or fifth cranial nerve conveys the postganglionic parasympathetic fibers for the lacrimal gland to the lacrimal nerve.

DIF: Recall REF: p. 184 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 25. What structure when DIRECTLY damaged also results in the disruption of the nasopalatine

nerve? a. Nasal bones b. Nasal septum c. Frontal bone d. Bridge of nose ANS: B

Feedback The nasal bones are paired small oblong facial bones that lay side by side, fused to each other to form the bridge of the nose in the midline superior to the piriform aperture. Instead, the nasopalatine nerve travels along the nasal septum. Anteriorly, the nasal septum is formed by both the perpendicular plate of the ethmoid bone superiorly and the nasal septal cartilage inferiorly. The posterior parts of the nasal septum are formed by the vomer. The nasopalatine nerve originates in the mucosa of the anterior hard palate, palatal to the maxillary central incisors. The right and left nasopalatine nerves enter the incisive canal by way of the incisive foramen, deep to the incisive papilla, thus exiting the oral cavity. The nerve then travels along the nasal septum. The frontal bone is a single cranial bone that forms the anterior part of the skull superior to the eyes in the frontal region, and includes the forehead, the roof of the orbits, and part of the nasal cavity. Instead, the nasopalatine nerve travels along the nasal septum. The nasal bones are small, oblong, paired facial bones that lie side by side, fused

to each other to form the bridge of the nose in the midline superior to the piriform aperture. Instead, the nasopalatine nerve travels along the nasal septum. DIF: Comprehension REF: pp. 186-187 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 26. When periodontal scaling on the palatal gingival tissue of the maxillary right second molar

under block anesthesia administered ONLY to the maxillary right posterior sextant, the patient begins to gag without initiation by the clinician. What nerve was inadvertently anesthetized so as to cause this situation? a. Nasopalatine nerve b. Greater palatine nerve c. Lesser palatine nerve d. Middle superior alveolar nerve ANS: C

Feedback When administered anesthesia to greater palatine nerve by way of a block, some patients may become uncomfortable and may gag if the soft palate becomes inadvertently and harmlessly anesthetized even without clinician initiation, which is possible given the proximity of the lesser palatine nerve. Incorrect Greater palatine nerve is already anesthetized by a block and is NOT inadvertent anesthesia since the clinician is scaling the anesthetized palatal gingival tissue of the maxillary second molar. The anesthesia of the nasopalatine nerve by a block results in anesthesia of the anterior hard palate within the maxillary anterior sextant and NOT the posterior hard palate within the maxillary posterior sextant. The middle superior alveolar nerve may be anesthetized by a block due to its coverage of the mesiobuccal root of the maxillary first molar that is within the maxillary right posterior sextant, if the nerve is present, but this does NOT cause gagging as a result of soft palate anesthesia. Correct

DIF: Application REF: p. 186 OBJ: 8 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 | 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, Scientific Basis for Dental Hygiene Practice, 1.0 Assessing Patient Characteristics | NBDHE, Scientific Basis for Dental Hygiene Practice, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Scientific Basis for Dental Hygiene Practice, 4.0 Performing Periodontal Procedures MULTIPLE RESPONSE

1. From the following list of descriptions, select those that can be used to describe the middle

superior alveolar nerve. (Select all that apply.) a. Present in all patients b. Communicates with adjacent nerves c. May be absent in some patients d. Never communicates with adjacent nerves ANS: B, C Feedback Correct

Incorrect

The middle superior alveolar nerve may be absent in some patients. But if present, the nerve communicates with adjacent nerves within the maxillary arch, both the anterior and posterior superior alveolar nerves. The middle superior alveolar nerve may be absent in some patients, so it is NOT present in all patients. But if present, the nerve communicates with the adjacent nerves in the maxillary arch, the anterior and posterior superior alveolar nerves.

DIF: Comprehension REF: p. 185 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 2. From the following list of nerves, select those nerves that supply the parotid salivary gland.

(Select all that apply.) a. Glossopharyngeal nerve b. Hypoglossal nerve c. Auriculotemporal nerve d. Facial nerve e. Accessory nerve ANS: A, C Feedback Correct

Incorrect

The parotid salivary gland is supplied by both the glossopharyngeal nerve or ninth cranial nerve (efferent) and the auriculotemporal nerve, a branch off the mandibular nerve, which is the third division off the trigeminal nerve or fifth cranial nerve (afferent). The tongue muscles are supplied by the hypoglossal nerve or twelfth cranial nerve (efferent), and the facial nerve or seventh cranial nerve supplies the muscles of facial expression (efferent) and well as the submandibular and sublingual salivary glands (efferent). The accessory nerve or eleventh cranial nerve supplies the trapezius and sternocleidomastoid muscles (efferent).

DIF: Recall REF: pp. 181, 189 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

3. From the following list of terms, select those terms that can be used to describe the part of the

fifth cranial nerve that is formed by the merger of two trunks. (Select all that apply.) a. Second division b. Maxillary nerve c. Third division d. Mandibular nerve ANS: C, D Feedback Correct

Incorrect

The part of the fifth cranial nerve (or trigeminal nerve) that is formed by the merger of two trunks is the mandibular nerve or third division; a smaller anterior trunk and a larger posterior trunk form this nerve. The maxillary nerve is the second division of the fifth cranial nerve or trigeminal nerve and is NOT formed by two trunks but is instead one nerve trunk that is formed from the convergence of many nerves.

DIF: Recall 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 4. From the list of regions of the oral cavity, select the regions where crossover-innervation

occurs in the jaws of patients that may complicate local anesthesia procedures. (Select all that apply.) a. Maxillary anterior sextant b. Maxillary posterior sextants c. Mandibular anterior sextant d. Mandibular posterior sextants ANS: A, C Feedback Correct

Incorrect

Both the maxillary and mandibular anterior sextants may be involved in the crossover-innervation involving the anterior superior alveolar nerve and the incisive nerve, respectively. This presence of crossoverinnervation may complicate local anesthesia procedures in patients in these sextants. Both the maxillary and mandibular posterior sextants are NOT involved in the crossover-innervation.

DIF: Application REF: p. 185 OBJ: 6 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 | 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.0 Performing Periodontal Procedures

5. From the following list of descriptions, select those that can be used to describe the chorda

tympani nerve. (Select all that apply.) a. Afferent taste sensation for base of the tongue b. Communicates with the lingual nerve via the pterygopalatine ganglion c. Parasympathetic efferent nerve for the salivary glands d. Exits the skull by way of the petrotympanic fissure ANS: C, D Feedback Correct

Incorrect

The chorda tympani nerve, a branch of the facial nerve or seventh cranial nerve, serves as a parasympathetic efferent nerve for salivary glands (submandibular and sublingual) and exits the skull by way of the petrotympanic fissure. The chorda tympani nerve, a branch of the facial nerve or seventh cranial nerve, serves the afferent taste sensation for the body of the tongue and NOT the base; the lingual nerve communicates with the chorda tympani nerve via the submandibular ganglion and NOT the pterygopalatine ganglion.

DIF: Recall REF: p. 194 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 6. Which of the following local anesthetic nerve blocks can be administered that will anesthetize

the inferior alveolar nerve? (Select all that apply.) a. Incisive nerve block b. Gow-Gates nerve block c. Inferior alveolar nerve block d. Vazirani-Akinosi mandibular block ANS: B, C, D Feedback Correct

Incorrect

The Gow-Gates nerve block and the Vazirani-Akinosi mandibular nerve block will anesthetize the inferior alveolar nerve as well as the inferior alveolar block. Incisive nerve block ONLY anesthetizes the incisive nerve, which is part of the inferior alveolar nerve, but NOT the entire inferior alveolar nerve will be blocked. With the incisive block, the facial tissue and pulpal tissue of the mandibular anteriors and premolars on one side will be anesthetized. The entire lingual tissue and pulpal tissue of the mandibular molars on one side will not be anesthetized.

DIF: Comprehension REF: p. 194 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

7. What should a clinician expect when working on a patient with a history of trigeminal

neuralgia? (Select all that apply.) a. Unilaterally involves the maxillary or mandibular branches b. Usually more involvement of the left side of the face c. Pattern of pain follows along the seventh cranial nerve branch involved d. Excruciating short-term pain when facial trigger zones are touched ANS: A, D Feedback Correct

Incorrect

It usually unilaterally involves either the maxillary or mandibular nerve branches but not the ophthalmic branch. The patient may feel excruciating short-term pain on one side of the face when facial trigger zones are touched. The right side of the face, with its regions and structures, is affected more commonly than the left side. The pattern of pain follows along the pathway of the trigeminal nerve or fifth cranial nerve branch involved and NOT the seventh cranial nerve or facial nerve.

DIF: Application REF: p. 194 OBJ: 8 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, 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 MATCHING

From the following list of terms related to the nervous system, match the more commonly used term with its alternative term. a. Motor nerve b. Sensory nervous system c. Sensory nerve d. Motor nervous system 1. 2. 3. 4.

Afferent nervous system Afferent nerve Efferent nervous system Efferent nerve

1. ANS: B DIF: Recall REF: p. 172 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 2. ANS: C DIF: Recall REF: p. 172 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. ANS: D DIF: Recall REF: p. 172 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 4. ANS: A DIF: Recall REF: p. 172 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 OTHER 1. Place the following in the CORRECT order of occurrence after rapid depolarization of the cell

membrane happens. a. Sodium gates suddenly open in the membrane to allow sodium ions to pour in. b. Rapid depolarization of the cell membrane results in an action potential. c. Resting potential is reestablished again. d. Propagation of the nerve impulse along the membrane occurs. e. Sodium gates close and potassium channels open to allow potassium ions to pass to the outside of the membrane. ANS:

B, D, A, E, C Correct Order

Feedback The rapid depolarization of the cell membrane results in an action potential, which then causes propagation of the nerve impulse along the membrane. An action potential is a temporary reversal of the electric potential along the membrane for a brief period. Sodium gates suddenly open in the membrane to allow sodium ions to pour in, bringing a positive charge. At the height of the membrane potential reversal, sodium gates close and potassium channels open to allow potassium ions to pass to the outside of the membrane, reestablishing the resting potential.

DIF: Comprehension REF: p. 173 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

Chapter 09: Anatomy of Local Anesthesia Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition MULTIPLE CHOICE 1. Which of the following local anesthesia nerve blocks can be used during cosmetic restorative procedures because, after procedures are completed, the clinician can immediately and accurately access the patient’s smile line? a. Anterior superior alveolar nerve block b. Posterior superior alveolar nerve block c. Anterior middle superior alveolar nerve block d. Middle superior alveolar nerve block ANS: C A B C

Feedback The anterior superior alveolar nerve block can cause anesthesia to the soft tissue of the patient’s lip and face. The posterior superior alveolar nerve block can cause anesthesia to the soft tissue of the patient’s lip and face. The anterior middle superior alveolar nerve block can anesthetize multiple maxillary teeth from the maxillary second premolar through the maxillary central incisor, ALL without causing the usual collateral anesthesia to the soft tissue of the patient’s lip and face as with most maxillary blocks near the alveolar process of the maxilla. The middle superior alveolar nerve block can cause anesthesia to the soft tissue of the patient’s lip and face.

DIF: Application REF: p. 216 OBJ: 2 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 2. Which of the following local anesthesia nerve blocks is usually NOT used bilaterally due to possible complications associated with swallowing and speech? a. Incisive nerve block b. Inferior alveolar nerve block c. Posterior superior alveolar nerve block d. Greater palatine nerve block ANS: B

Feedback The incisive nerve block anesthetizes teeth and tissue of the anterior and part of the most anterior part of the posterior mandible but does NOT affect speech and swallowing. A bilateral inferior alveolar nerve block can cause complete anesthesia of the body of the tongue and floor of the mouth, resulting in speech and swallowing difficulties. The posterior superior alveolar nerve block anesthetizes the teeth and periodontium, including buccal gingival tissue of the maxillary molars, but does NOT affect speech and swallowing. The greater palatine nerve block anesthetizes the hard palate. Gagging by the patient may sometimes be a problem as the nearby lesser palatine nerve is also anesthetized that serves the soft palate is also anesthetized, but the patient’s speech is NOT usually affected by this block.

DIF: Application REF: p. 224 OBJ: 2 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 3. As a result of a bicycle accident, a patient has suffered trauma to the right upper lip and maxillary right central incisor. Which of the following local anesthetic blocks may be used on the involved side when treating the injured tissue? a. Anterior superior alveolar, infraorbital, and incisive nerve blocks b. Infraorbital and nasopalatine nerve blocks c. Anterior superior alveolar, middle superior alveolar, and greater palatine nerve blocks d. Infraorbital, greater palatine, and Gow-Gates mandibular nerve blocks ANS: B A B

Feedback The incisive nerve block is used on the mandibular anterior teeth and premolars and does NOT provide any anesthesia to maxillary arch. The infraorbital nerve block provides anesthesia to the maxillary facial tissue for the maxillary anteriors and the maxillary labial mucosa as well as providing anterior superior alveolar and middle superior alveolar nerve anesthesia that would anesthetize the pulp tissue of the maxillary central incisor and associated periodontium as well as nearby maxillary anteriors on the involved side. The nasopalatine nerve block anesthetizes the anterior hard palate and associated palatal gingival tissue. The middle superior alveolar nerve block would NOT be the best choice for anesthetizing the maxillary anterior teeth since is associated mainly with

anesthesia of pulp of the maxillary premolars and associated structures; additionally, the greater palatine nerve block is used ONLY for the posterior hard palate and associated palatal gingival tissue on one side. The greater palatine nerve block is used for the posterior hard palate ONLY, and the Gow-Gates mandibular block is used to provide anesthesia to nerves that are part of the mandibular nerve or third division of the trigeminal nerve for the mandibular arch and NOT the maxillary arch.

DIF: Application REF: p. 211 OBJ: 2 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, 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 4. Orientation of the syringe for the anterior middle superior alveolar nerve block SHOULD be from the contralateral premolars. The angle of the needle SHOULD be placed at approximately 45 degrees to the injection site. 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: A A B C

Feedback The needle is placed at an approximately 45-degree angle to the injection site of the palate for the anterior middle superior alveolar nerve block. The injection site for the anterior middle superior alveolar nerve block is approached from the contralateral maxillary premolars on the palate. The anterior middle superior alveolar nerve block is achieved by approaching the site from the contralateral premolars and maintaining the needle at an approximately 45-degree angle to the injection site of the palate. The anterior middle superior alveolar nerve block is achieved by approaching the site from the contralateral premolars and maintaining the needle at an approximately 45-degree angle to the injection site of the palate.

DIF: Comprehension REF: p. 223 OBJ: 4 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 5. Which of the following local anesthetic nerve blocks uses the apex of the maxillary canine for a landmark during administration? a. Infraorbital nerve block b. Anterior superior alveolar nerve block c. Middle superior alveolar nerve block d. Posterior superior alveolar nerve block ANS: B A B C D

Feedback The height of the mucobuccal fold at the apex of the maxillary first premolar is used as the injection site for the infraorbital nerve block. The height of the mucobuccal fold at the apex of the maxillary canine is used as the injection site for the anterior superior alveolar nerve block. The injection site for the middle superior alveolar nerve block is at the height of the mucobuccal fold at the apex of the maxillary second premolar. The injection site for the posterior superior alveolar nerve block is at the height of the mucobuccal fold at the apex of the maxillary second molar.

DIF: Recall REF: p. 218 OBJ: 2 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 6. When administering a local anesthetic agent to a patient’s teeth and their related dental structures, which three bones of the head and neck have the landmarks essential for clinically effective injection technique? a. Maxillae, mandible, and temporal bones b. Maxillae, mandible, and zygomatic bones c. Maxillae, mandible, and palatine bones d. Maxillae, mandible, and sphenoid bones ANS: C A B C

Feedback The temporal bone is NOT involved in either maxillary or mandibular injections. The zygomatic bone is NOT involved in either maxillary or mandibular injections. The maxillae, mandible, and palatine bones contain the foramina or alveolar processes, through which sensory nerves from dental structures travel. These

bones also have external and internal landmarks that help the clinician identify target areas for needle placement. Sphenoid bone is NOT involved in either maxillary or mandibular injections.

DIF: Comprehension REF: p. 211 OBJ: 3 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 7. Only one injection is necessary when anesthetizing BOTH the right and left maxillary anterior palate and associated palatal gingival tissue. Pressure anesthesia during the nasopalatine local anesthetic nerve block is NOT helpful with patient comfort. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second statement is false. d. The first statement is false; the second statement is true. ANS: C A

Feedback The first statement is true. Both nasopalatine nerves are anesthetized with one injection. The second statement is false. Pressure anesthesia is helpful in decreasing patient discomfort. Both the right and left nasopalatine nerves are anesthetized by the nasopalatine nerve block. Pressure anesthesia is helpful to decrease patient discomfort in this sensitive area. Thus the first statement is true, and the second statement is false. The first statement is true. Both nasopalatine nerves are anesthetized with one injection. The second statement is false. Pressure anesthesia is helpful in decreasing patient discomfort. The first statement is true. Both nasopalatine nerves are anesthetized with one injection. The second statement is false. Pressure anesthesia is helpful in decreasing patient discomfort.

DIF: Application REF: p. 221 OBJ: 5 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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

8. Which of the following descriptions concerning the injection site for the anterior middle superior alveolar local anesthetic nerve block is CORRECT? a. Approximately midway between the median palatine raphe and the palatal gingival margin of the maxillary premolars b. Approximately10 mm medial and directly superior to the palatal gingival margin of the maxillary third molar, anterior to the depression of the greater palatine foramen c. At the height of the mucobuccal fold at the apex of the maxillary canine d. At the height of the mucobuccal fold at the apex of the maxillary first premolar ANS: A A

B C D

Feedback This injection site of approximately midway between the median palatine raphe and the palatal gingival margin of the maxillary premolars will allow penetration of the local anesthetic agent through the small pores of the maxilla of the hard palate, thus reaching the anterior to middle part of the superior dental nerve plexus. This is the injection site for the greater palatine nerve block. This is the injection site for the anterior superior alveolar nerve block. This is the injection site for the middle superior alveolar nerve block.

DIF: Comprehension REF: p. 223 OBJ: 3 | 4 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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. Which of the following local anesthetic nerve blocks when administered together would provide the GREATEST area of anesthesia to a maxillary quadrant? a. Anterior superior alveolar, posterior superior alveolar, and greater palatine nerve blocks b. Middle superior alveolar and greater palatine nerve blocks c. Middle superior alveolar, posterior superior alveolar, and greater palatine nerve blocks d. Anterior middle superior alveolar and posterior superior alveolar nerve blocks ANS: D A

Feedback The palatal tissue of the maxillary anteriors would NOT be anesthetized as well as the maxillary premolars if the middle superior alveolar nerve is present but is NOT being anesthetized.

B C D

The pulp tissue of the maxillary anterior and posterior teeth, along with their associated facial tissue, would NOT be anesthetized. The pulp tissue of the maxillary anterior teeth and associated palatal tissue would NOT be anesthetized. Both the anterior middle superior alveolar and posterior superior alveolar nerve blocks when administered together will anesthetize the pulp tissue of the teeth and associated facial tissue, as well as the relevant palatal tissue thus providing the greatest area of anesthesia to the maxillary quadrant. However, this protocol is NOT without its possible setbacks due to the need for large amount of agent, slow onset, and rapid removal of anesthesia with the anterior middle superior alveolar block. In addition, the block does not provide a high enough level of hemostatic control.

DIF: Application REF: pp. 211, 221 OBJ: 2 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 10. Before periodontal scaling near the periodontal tissue clefting present on the facial surface of ALL the mandibular incisors of a patient, which local anesthetic block(s) would be the BEST to have administered bilaterally? a. Infraorbital block b. Incisive block c. Mental block d. Inferior alveolar block ANS: B A

Feedback The infraorbital block provides anesthesia for the maxillary anteriors and premolars, both pulpal and for the associated facial periodontium, and can be used bilaterally without complications but does NOT provide anesthesia for the mandibular incisors. The incisive block provides anesthesia for the mandibular anteriors and premolars, both pulpal and for the associated facial periodontium that would involve the periodontal tissue clefting, and can be used bilaterally without complications. The mental block provides anesthesia for the mandibular anteriors and premolars but only for the associated facial periodontium, and it can be used bilaterally without complications. However, it does NOT provide pulpal anesthesia for the mandibular incisors that may be sensitive to periodontal scaling. The inferior alveolar block provides anesthesia for the pulp tissue of ALL the mandibular teeth as well as for the associated facial periodontium of the

mandibular anteriors and premolars, but it is NOT recommended to use bilaterally due to complications with swallowing. DIF: Application REF: p. 224 OBJ: 2 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, 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 11. Which local anesthetic nerve block would be necessary for a patient undergoing oral surgery on an edentulous left mandibular alveolar process in the area of the extracted molars? a. Left buccal nerve block b. Right buccal nerve block c. Left mental nerve block d. Right infraorbital nerve block ANS: A A B C

Feedback The left buccal nerve block anesthetizes the buccal gingival tissue of alveolar process in the area of the extracted mandibular molars. The right incisive nerve block anesthetizes ONLY the contralateral side of the alveolar process of the mandible. The left mental nerve block would anesthetize the facial gingival tissue of the alveolar process in the area of mandibular premolars and anterior teeth but NOT the edentulous area of the extracted mandibular molars. The infraorbital nerve block is used ONLY for maxillary arch anesthesia.

DIF: Application REF: pp. 230-231 OBJ: 2 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, 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 12. A restoration will be placed on the occlusal surface of the maxillary first premolar, but no rubber dam will be used. However, which of the following local anesthetic nerve blocks MUST be administered? a. Anterior superior alveolar nerve block b. Middle superior alveolar nerve block

c. Greater palatine nerve block d. Inferior alveolar nerve block ANS: B A B C D

Feedback The anterior superior alveolar nerve block will provide pulpal anesthesia to the maxillary canine and maxillary incisors but NOT the maxillary first premolar. The middle superior alveolar nerve block provides pulpal anesthesia to the maxillary premolars as well as the mesiobuccal root of the maxillary molar. The greater palatine nerve block does NOT provide pulpal anesthesia but ONLY palatal anesthesia to the maxillary first premolar. The inferior alveolar nerve block is used for mandibular arch, NOT maxillary arch.

DIF: Application REF: pp. 213-214 OBJ: 3 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, 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 13. Which of the following local anesthetic nerve blocks anesthetizes the buccal gingival tissue of the maxillary first molar? a. Infraorbital nerve block b. Anterior superior alveolar nerve block c. Buccal nerve block d. Posterior superior alveolar nerve block ANS: D A B C D

Feedback The infraorbital nerve block anesthetizes the maxillary incisors, canines, and premolars. The anterior superior alveolar nerve block anesthetizes maxillary anterior teeth. The buccal nerve block anesthetizes buccal gingival tissue of the mandibular molars. The buccal gingival tissue of maxillary molars is anesthetized by the posterior superior alveolar nerve block.

DIF: Recall REF: pp. 211-212 OBJ: 5 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 | CDA: General Chairside, V. A. Oral Health Information

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 14. Which of the following complications can result from a greater palatine local anesthetic nerve block? a. Cheek bite by patient b. Anesthesia of the upper lip c. Stimulation of the gag reflex d. Hematoma in the infratemporal fossa ANS: C A B C

Feedback The greater palatine nerve block is administered on the palate and does NOT anesthetize the cheeks. The greater palatine nerve block is administered on the palate and does NOT anesthetize the upper lip. Stimulation of the gag reflex is a distinct possibility because of the proximity of the greater palatine nerve block to the lesser palatine nerve that may inadvertently anesthetize the soft palate. The greater palatine nerve block is administered on the palate and does NOT anesthetize the infratemporal fossa to allow for trauma that would induce a hematoma.

DIF: Comprehension REF: p. 220 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 15. Which of the following angulations of the needle MUST be followed during the administration of the posterior superior local anesthetic nerve block? a. Superiorly at approximately 45 degrees and medially at approximately 90 degrees to the occlusal plane b. Superiorly at approximately 90 degrees and medially at approximately 45 degrees to the occlusal plane c. Superiorly at approximately 45 degrees and medially parallel to the occlusal plane d. Superiorly at approximately 45 degrees and medially at approximately 45 degrees to the occlusal plane ANS: D

A B C D

Feedback The needle should NOT be at a 90-degree angle medially to the occlusal plane. The needle should NOT be at an approximately 90-degree angle superiorly to the occlusal plane. The needle should NOT be parallel to the occlusal plane. Both the superior and medial angulation of the needle to the injection site will be at an angle of approximately 45 degrees to the occlusal plane.

DIF: Recall REF: p. 212 OBJ: 4 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 16. Which of the following locations is the BEST injection site for the inferior alveolar local anesthetic nerve block? a. Medial to the pterygomandibular fold b. Lateral to the pterygomandibular fold c. Superior to the pterygomandibular fold d. Inferior to the pterygomandibular fold ANS: B A

Feedback The needle will NOT be in the pterygomandibular space lateral to the sphenomandibular ligament for the injection site if inserted medial to the pterygomandibular fold. Finding the pterygomandibular fold helps determine the anteroposterior positioning for needle insertion, which will be in the most posterior part of the pterygomandibular space when lateral to the pterygomandibular fold. Positioning the needle too high from being superior to the pterygomandibular fold will NOT ensure deposition of the local anesthetic agent in the CORRECT needle insertion site to achieve anesthesia. Positioning the needle too low from being inferior to the pterygomandibular fold will NOT ensure deposition of the local anesthetic agent in the CORRECT needle insertion site to achieve anesthesia.

DIF: Application REF: pp. 225-227 OBJ: 2 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 17. When administering the inferior alveolar local anesthetic nerve block, it is important to contact bony medial surface of the mandibular ramus because this will decrease the risk of depositing a local anesthetic agent into the parotid salivary gland. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A A

Feedback It is important to contact bony medial surface of the mandibular ramus to prevent too posterior of a penetration, which might result in deposition of local anesthetic agent into the parotid salivary gland, causing complications such as transient facial paralysis. It is important to contact bony medial surface of the mandibular ramus to prevent too posterior of a penetration, which might result in deposition of local anesthetic agent into the parotid salivary gland, causing complications such as transient facial paralysis. It is important to contact bony medial surface of the mandibular ramus to prevent too posterior of a penetration, which might result in deposition of local anesthetic agent into the parotid salivary gland, causing complications such as transient facial paralysis. It is important to contact bony medial surface of the mandibular ramus to prevent too posterior of a penetration, which might result in deposition of local anesthetic agent into the parotid salivary gland, causing complications such as transient facial paralysis. It is important to contact bony medial surface of the mandibular ramus to prevent too posterior of a penetration, which might result in deposition of local anesthetic agent into the parotid salivary gland, causing complications such as transient facial paralysis.

DIF: Application REF: p. 227 OBJ: 3 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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

18. A 9-year-old child is having a restoration placed on the occlusal surface of the mandibular left first molar. Which of the following heights of the inferior alveolar local anesthetic nerve block injection sites should be followed during the pain control procedure? a. Approximately 6 to 10 mm superior to the occlusal plane of the mandibular molars b. Slightly inferior to the occlusal plane of the mandibular molars c. At the same height as the occlusal plane of the mandibular molars d. More than approximately 10 mm superior to the occlusal plane of the mandibular molars ANS: C A B

Feedback This is the height for the injection site for inferior alveolar nerve block when it is administered to adults. An injection site’s height being inferior to the occlusal plane would NOT deposit the local anesthetic agent superior enough to anesthetize the inferior alveolar nerve. The height of the injection site is NOT as superior in children and even small adults due to the length of the mandibular ramus. The injection site should be the same height as the occlusal plane of the mandibular molars. Using a placement of approximately10 mm superior to the occlusal plane for the height of the injection site would be too superior for children and even for most average-sized adults.

DIF: Application REF: p. 225 OBJ: 3 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, 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 19. Which of the following ligaments can act as a barrier to the inferior alveolar nerve block if mandibular bone is NOT contacted during the injection? a. Sphenomandibular ligament b. Temporomandibular ligament c. Stylomandibular ligament d. Anterior cruciate ligament ANS: A A

Feedback The sphenomandibular ligament can act as a barrier to the inferior alveolar nerve block if mandibular bone is NOT contacted during the injection since it runs from the angular spine of the sphenoid bone to the lingula of the mandibular foramen on the medial aspect of the mandible.

The temporomandibular ligament is the major ligament for the temporomandibular joint but does NOT act as a barrier during the inferior alveolar nerve block. The stylomandibular ligament runs from the styloid process of the temporal bone to the angle of the mandible and separates the parotid and submandibular salivary glands but does NOT act as a barrier during the inferior alveolar nerve block. The anterior cruciate ligament (ACL) is one of the most important of four strong ligaments connecting the bones of the knee joint and can become injured.

DIF: Comprehension REF: p. 230 OBJ: 2 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 20. Which of the following complications can occur during an incorrect administration of the inferior alveolar local anesthetic nerve block, resulting in inability to close the eyelid? a. Motor function of the abducens nerve b. Motor function of the facial nerve c. Motor function of the oculomotor nerve d. Sensory function of the facial nerve ANS: B A B

C D

Feedback The abducens nerve is NOT in the area of the inferior alveolar nerve block and affects movement of the eye, NOT the eyelid. The facial nerve provides motor innervation to the muscles of facial expression and can result in the inability to close the eyelid with an incorrect administration of the inferior alveolar nerve block. This can occur with a deeper injection into the parotid salivary gland that contains the facial nerve, causing temporary anesthesia of the nerve and its related structures. This is considered transient facial paralysis. To prevent this complication, the needle needs to contact the medial surface of the mandibular ramus. The oculomotor nerve affects movement of the eye, NOT the eyelid. The sensory part of the facial nerve does NOT move the eyelid.

B C

Feedback There is less risk of spread of infection to the cavernous sinus with the anterior superior alveolar nerve block than with the posterior superior alveolar nerve block. There is less risk of spread of infection to the cavernous sinus with the inferior alveolar nerve block than with the posterior superior alveolar nerve block. The posterior superior alveolar nerve block is administered close to the pterygoid plexus of veins, which communicate with the cavernous sinus. If the needle becomes contaminated, this increases the risk for infection in the area, which can then spread. There is less risk of spread of infection to the cavernous sinus with the infraorbital nerve block than with the posterior superior alveolar nerve block.

DIF: Comprehension REF: pp. 212-213 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 22. Which of the following local anesthetic nerve blocks MAINLY uses an extraoral landmark on the face when locating the injection site? a. Inferior alveolar nerve block b. Infraorbital nerve block c. Posterior superior alveolar nerve block d. Mental nerve block ANS: B A

Feedback The inferior alveolar nerve block is administered at the mandibular foramen on

C D

the medial surface of the mandibular ramus. The coronoid notch is used to help locate the injection site and can be palpated intraorally. Palpation of the infraorbital rim on the facial surface is used to help locate the infraorbital foramen for the infraorbital nerve block; thus, an extraoral landmark of the face is used when locating the injection site. In addition, extraoral pressure is applied to the infraorbital foramen during the injection. It is NOT necessary to palpate any extraoral structure to administer the posterior superior alveolar nerve block. It is NOT necessary to palpate any extraoral structure to administer the mental nerve block. Instead, the mental foramen is palpated intraorally.

DIF: Comprehension REF: p. 217 OBJ: 2 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, 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 23. There MUST never be an injection through an area with an abscess, cellulitis, or osteomyelitis so as to prevent the spread of dental infection. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A A

Feedback Both the statement and the reason are correct and related. There MUST never be an injection through an area with an abscess, cellulitis, or osteomyelitis so as to prevent the spread of dental infection; this is considered a needle tract infection. Both the statement and the reason are correct and related. There MUST never be an injection through an area with an abscess, cellulitis, or osteomyelitis so as to prevent the spread of dental infection; this is considered a needle tract infection. Both the statement and the reason are correct and related. There MUST never be an injection through an area with an abscess, cellulitis, or osteomyelitis so as to prevent the spread of dental infection; this is considered a needle tract infection. Both the statement and the reason are correct and related. There MUST never be an injection through an area with an abscess, cellulitis, or osteomyelitis so as to prevent the spread of dental infection; this is considered a needle tract infection. Both the statement and the reason are correct and related. There MUST never be an injection through an area with an abscess, cellulitis, or osteomyelitis so as to prevent the spread of dental infection; this is considered a needle tract infection.

DIF: Comprehension REF: p. 210 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 24. Less variation exists in the anatomy of the maxillae and palatine bones and associated nerves with respect to local anesthetic landmarks as compared with similar mandibular structures, making the maxillary injections less routine and usually with the need for any troubleshooting of failure cases. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: C A

Feedback The statement is NOT correct, but the reason is correct. Less variation exists in the anatomy of the maxillae and palatine bones and associated nerves with respect to local anesthetic landmarks as compared with similar mandibular structures, making the maxillary injections MORE routine and usually without the need for troubleshooting of failure cases. The statement is NOT correct, but the reason is correct. Less variation exists in the anatomy of the maxillae and palatine bones and associated nerves with respect to local anesthetic landmarks as compared with similar mandibular structures, making the maxillary injections MORE routine and usually without the need for troubleshooting of failure cases. The statement is NOT correct, but the reason is correct. Less variation exists in the anatomy of the maxillae and palatine bones and associated nerves with respect to local anesthetic landmarks as compared with similar mandibular structures, making the maxillary injections MORE routine and usually without the need for troubleshooting of failure cases. The statement is NOT correct, but the reason is correct. Less variation exists in the anatomy of the maxillae and palatine bones and associated nerves with respect to local anesthetic landmarks as compared with similar mandibular structures, making the maxillary injections MORE routine and usually without the need for troubleshooting of failure cases. The statement is NOT correct, but the reason is correct. Less variation exists in the anatomy of the maxillae and palatine bones and associated nerves with respect to local anesthetic landmarks as compared with similar mandibular structures, making the maxillary injections MORE routine and usually without the need for troubleshooting of failure cases.

DIF: Comprehension REF: p. 211 OBJ: 2 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 25. Palatal anesthesia usually involves anesthesia of the soft and hard tissue of the periodontium of the palatal area such as the gingival tissue, periodontal ligament, and alveolar process. Palatal anesthesia usually does NOT provide any pulpal anesthesia to the maxillary teeth or associated facial or buccal gingival tissue. 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: A A

Feedback Both statements are true. Palatal anesthesia usually involves anesthesia of the soft and hard tissue of the periodontium of the palatal area such as the gingival tissue, periodontal ligament, and alveolar process. Palatal anesthesia usually does NOT provide any pulpal anesthesia to the maxillary teeth or associated facial or buccal gingival tissue. Both statements are true. Palatal anesthesia usually involves anesthesia of the soft and hard tissue of the periodontium of the palatal area such as the gingival tissue, periodontal ligament, and alveolar process. Palatal anesthesia usually does NOT provide any pulpal anesthesia to the maxillary teeth or associated facial or buccal gingival tissue. Both statements are true. Palatal anesthesia usually involves anesthesia of the soft and hard tissue of the periodontium of the palatal area such as the gingival tissue, periodontal ligament, and alveolar process. Palatal anesthesia usually does NOT provide any pulpal anesthesia to the maxillary teeth or associated facial or buccal gingival tissue. Both statements are true. Palatal anesthesia usually involves anesthesia of the soft and hard tissue of the periodontium of the palatal area such as the gingival tissue, periodontal ligament, and alveolar process. Palatal anesthesia usually does NOT provide any pulpal anesthesia to the maxillary teeth or associated facial or buccal gingival tissue.

DIF: Recall REF: p. 211 OBJ: 5 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 | CDA: General Chairside, V. A. Oral Health

Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 26. The dental professional MUST know the location of certain adjacent soft tissue structures, such as major blood vessels and glandular tissue, so as to make sure to allow for injecting these structures. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: C A

Feedback The statement is correct, but the reason is NOT. The dental professional MUST know the location of certain adjacent soft tissue structures, such as major blood vessels and glandular tissue, so as to make sure to avoid inadvertently injecting these structures and causing complications. The statement is correct, but the reason is NOT. The dental professional MUST know the location of certain adjacent soft tissue structures, such as major blood vessels and glandular tissue, so as to make sure to avoid inadvertently injecting these structures and causing complications. The statement is correct, but the reason is NOT. The dental professional MUST know the location of certain adjacent soft tissue structures, such as major blood vessels and glandular tissue, so as to make sure to avoid inadvertently injecting these structures and causing complications. The statement is correct, but the reason is NOT. The dental professional MUST know the location of certain adjacent soft tissue structures, such as major blood vessels and glandular tissue, so as to make sure to avoid inadvertently injecting these structures and causing complications. The statement is correct, but the reason is NOT. The dental professional MUST know the location of certain adjacent soft tissue structures, such as major blood vessels and glandular tissue, so as to make sure to avoid inadvertently injecting these structures and causing complications.

DIF: Comprehension REF: p. 204 OBJ: 5 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 27. There is ONLY one type of local anesthetic injection used commonly in dentistry, the nerve block. The type of injection used for a given dental procedure is determined by the type and length of the procedure. 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: D A

Feedback The first statement is false; the second is true. There are two types of local anesthetic injections used commonly in dentistry: supraperiosteal injection and nerve block. The type of injection used for a given dental procedure is determined by the type and length of the procedure. The first statement is false; the second is true. There are two types of local anesthetic injections used commonly in dentistry: supraperiosteal injection and nerve block. The type of injection used for a given dental procedure is determined by the type and length of the procedure. The first statement is false; the second is true. There are two types of local anesthetic injections used commonly in dentistry: supraperiosteal injection and nerve block. The type of injection used for a given dental procedure is determined by the type and length of the procedure. The first statement is false; the second is true. There are two types of local anesthetic injections used commonly in dentistry: supraperiosteal injection and nerve block. The type of injection used for a given dental procedure is determined by the type and length of the procedure.

DIF: Comprehension REF: p. 204 OBJ: 2 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 28. Which of the following statements can be CORRECTLY used when discussing the “lingual shock” some patients may experience when administering an inferior alveolar local anesthetic block? a. Occurs when the needle passes by the mylohyoid nerve b. Patient may make involuntary movements c. Reactions only include a slight opening of the eyes d. Reactions made by the patient continue until anesthesia wears off

ANS: B Feedback A B

The “lingual shock” occurs when the needle passes by the lingual nerve and NOT the mylohyoid nerve during administration of the inferior alveolar block. The “lingual shock” occurs when the needle passes by the lingual nerve during administration of the inferior alveolar block. The patient may make an involuntary movement, varying from a slight opening of the eyes to jumping in the chair. This reaction is only momentary, and anesthesia will quickly occur. The patient may make an involuntary movement, such as a slight opening of the eyes, but also may involve jumping in the chair. However, this reaction is only momentary and will NOT continue, and anesthesia will quickly occur. The patient may make an involuntary movement, such as a slight opening of the eyes, but also may involve jumping in the chair. However, this reaction is only momentary and will NOT continue, and anesthesia will quickly occur.

DIF: Comprehension REF: p. 230 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 MULTIPLE RESPONSE 1. From the following list, select those that are anatomic factors involved in providing MORE clinically effective maxillary arch anesthesia than mandibular arch anesthesia. (Select all that apply.) a. Thinner facial cortical plate over teeth b. Less variation exists in anatomy c. More variation exists in anatomy d. Thicker facial cortical plate over teeth ANS: A, B Feedback Correct

Incorrect

MORE clinically effective maxillary arch anesthesia involves thinner facial cortical plate over teeth, and less variation exists in anatomy making it MORE clinically effective than mandibular arch anesthesia. MORE clinically effective maxillary arch anesthesia involves thinner facial cortical plate over teeth, and less variation exists in anatomy making it MORE clinically effective than mandibular arch anesthesia.

DIF: Comprehension REF: pp. 210-211 OBJ: 2 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 2. From the following list of complications involving the eyelid, nose, and upper lip, select the MOST common ones associated with the infraorbital nerve block. (Select all that apply.) a. Hematoma b. Stimulation of the gag reflex c. Tingling d. Numbness ANS: C, D Feedback Correct

Incorrect

The most common complications noted with the infraorbital block are tingling and numbness of the eyelid, nose, and upper lip; there is rarely hematoma of the eyelid, nose, and upper lip. The most common complications noted with the infraorbital block are tingling and numbness of the eyelid, nose, and upper lip; there is rarely hematoma of the eyelid, nose, and upper lip.

DIF: Comprehension REF: p. 218 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 3. From the following list, select those statements that can be used CORRECTLY when discussing paresthesia from the administration of local anesthesia and its progression over time. (Select all that apply.) a. Possibly abnormal area sensation b. Possible burning or prickling c. Usually occurs with infections d. Usually occurs with nonsurgical procedures ANS: A, B, C Feedback Correct

The following can be used to describe paresthesia and its progression: possible abnormal area sensation, burning or prickling; it usually occurs

Incorrect

with infections as well as oral surgical procedures. Paresthesia does NOT usually occur with nonsurgical oral procedures such as periodontal scaling but with oral surgical procedures such as the removal of impacted mandibular third molars.

DIF: Recall REF: p. 230 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 4. From the following list of oral cavity landmarks, select those that need to be noted before administering a clinically effective inferior alveolar nerve block. (Select all that apply.) a. Occlusal plane b. Maxillary tuberosity c. Pterygomandibular fold d. Coronoid notch e. Mandibular notch ANS: A, C, D Feedback Correct Incorrect

The occlusal plane, pterygomandibular fold, and coronoid notch are ALL landmarks for the administration of the inferior alveolar nerve block. The maxillary tuberosity is a landmark for the administration of the posterior superior alveolar nerve block and NOT the inferior alveolar nerve block. The mandibular notch is NOT a landmark for the administration of the inferior alveolar nerve block.

DIF: Recall REF: p. 225 OBJ: 3 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 5. From the following list of oral cavity landmarks, select those that need to be noted before administering a clinically effective posterior superior alveolar nerve block. (Select all that apply.) a. Mucobuccal fold

b. Coronoid notch c. Maxillary first molar d. Maxillary tuberosity ANS: A, D Feedback Correct

Incorrect

The height of the mucobuccal fold and the maxillary tuberosity are landmarks for the administration of the posterior superior alveolar nerve block. The coronoid notch is a landmark for the administration of the inferior alveolar nerve block. The maxillary first molar is usually NOT a landmark for any maxillary nerve anesthesia, but the maxillary second molar is a landmark for the administration of the posterior superior alveolar nerve block.

DIF: Recall REF: p. 212 OBJ: 2 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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 6. Which of the following local anesthesia nerve blocks would benefit from using a topical anesthetic-laced long cotton tip applicator to palpate the injection site as if it were the needle and syringe? (Select all that apply.) a. Posterior superior alveolar block b. Inferior superior alveolar block c. Greater palatine block d. Nasopalatine block ANS: A, B, C, D The sometimes-complex orientation for ALL local anesthetic nerve blocks can be practiced using a topical anesthetic-laced long cotton tip applicator to palpate the injection site as if it were the needle and syringe. DIF: Application REF: pp. 212, 223-224, 229 OBJ: 2 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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

7. When troubleshooting incomplete anesthesia following an inferior alveolar local anesthetic nerve block on a patient, the clinician notes a doubled mandibular canal on an intraoral radiograph. What is present with this patient, and how can clinically effective anesthesia be achieved? (Select all that apply.) a. More superiorly placed second mandibular foramen exists. b. More inferiorly placed second mandibular foramen exists. c. The local anesthetic agent needs to be deposited more inferiorly to the usual anatomic landmarks. d. The local anesthetic agent needs to be deposited more superiorly to the usual anatomic landmarks. ANS: B, C Feedback Correct

Incorrect

Incomplete anesthesia following an inferior alveolar block may be due to a bifid inferior alveolar nerve, which can be detected by noting a doubled mandibular canal on an intraoral radiograph. In many such cases a second mandibular foramen, MORE inferiorly placed, exists. To correct this, the local anesthetic agent is deposited MORE inferiorly to the usual anatomic landmarks for the target area of the inferior alveolar block. Incomplete anesthesia following an inferior alveolar block may be due to a bifid inferior alveolar nerve, which can be detected by noting a doubled mandibular canal on an intraoral radiograph. In many such cases a second mandibular foramen, more inferiorly placed and NOT superiorly placed, exists. To correct this, the local anesthetic agent is deposited more inferiorly and NOT superiorly to the usual anatomic landmarks for the target area of the inferior alveolar block.

DIF: Application REF: p. 230 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Provision of Clinical Dental Hygiene Services, 1.0 Assessing Patient Characteristics | NBDHE, Provision of Clinical Dental Hygiene Services, 2.0 Obtaining and Interpreting Radiographs | 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 8. Which of the following procedures may allow for LESS discomfort when anesthetizing the palate of a patient with the anterior middle superior alveolar block? (Select all that apply.) a. Topical anesthetic b. Pressure anesthesia c. Computer-controlled local anesthetic delivery device d. Bidirectional rotation needle insertion technique e. Prepuncture technique with needle bevel ANS: A, B, C, D, E

To allow for less discomfort when anesthetizing the palate of a patient anterior middle superior alveolar block, topical anesthetic, pressure anesthesia, computer-controlled local anesthetic delivery device may be used. In addition, the techniques of bidirectional rotation needle insertion and prepuncture with the needle may be also used. DIF: Comprehension REF: pp. 223-224 OBJ: 2 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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. Which of the following are included in the linear relationship noted on the face that can assist with the CORRECT administration of the infraorbital block? (Select all that apply.) a. Ipsilateral supraorbital notch b. Pupil of the eye looking forward c. Midpoint of the infraorbital notch d. Posterior superior alveolar foramina e. Philtrum near the upper lip ANS: A, B, C Feedback Correct

Incorrect

There is also a linear relationship noted on the face that can assist with the infraorbital block between the ipsilateral supraorbital notch, pupil of the eye looking forward, midpoint of the infraorbital rim with its zygomaticomaxillary suture, infraorbital foramen, and labial commissure. There is also a linear relationship noted on the face that can assist with the infraorbital block between the ipsilateral supraorbital notch, pupil of the eye looking forward, midpoint of the infraorbital rim with its zygomaticomaxillary suture and NOT midline median palatine suture, infraorbital foramen and NOT the posterior superior alveolar foramina, and labial commissure and NOT the midline philtrum near the upper lip.

DIF: Recall REF: p. 217 OBJ: 2 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 | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | 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

Chapter 10: Lymphatic System Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition MULTIPLE CHOICE 1. Which of the following structures allows lymph to flow DIRECTLY into the surrounding lymph nodes? a. Afferent vessel b. Efferent vessel c. Lymphatic duct d. Capillary e. Venule ANS: A A B C D E

Feedback The afferent vessels are a type of lymphatic vessel in which lymph flows into the lymph node. The efferent vessel is a type of lymphatic vessel in which lymph flows out of the lymph node in the area of the node’s hilus. The lymphatic duct allows the lymph to converge before emptying into the venous system. The capillary serves as blood supply for the tissue surrounding the lymphatic system. The venule serves to drain the blood supply for the tissue surrounding the lymphatic system. However, the lymphatics do drain into larger vessels of the venous system of the blood in the chest area.

DIF: Recall REF: p. 244 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 2. The lymphatics are a part of the immune system, and they help fight disease processes. Another component of the lymphatic system is the thymus gland because it works within the immune 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 A B

Feedback The second statement is false. The thymus gland is NOT a component of the lymphatic system even though it works within the immune system. The first statement is true. The lymphatics are a part of the immune system, and they help fight disease processes.

The first statement is true. The lymphatics are a part of the immune system, and they help fight disease processes. The second statement is false because the thymus gland is NOT a component of the lymphatic system even though it works within the immune system. The first statement is true. The lymphatics are a part of the immune system, and they help fight disease processes. The second statement is false because the thymus gland is NOT a component of the lymphatic system even though it works within the immune system.

DIF: Comprehension REF: p. 243 OBJ: 2 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care 3. Which of the following is considered the MAIN role of the lymph nodes in relationship to the lymph within lymphatic vessels? a. Filtration b. Liquefaction c. Disassociation d. Oxygenation ANS: A A B C D

Feedback The lymph nodes are positioned along the lymphatic vessels to filter toxic products from the lymph to prevent their entry into the vascular system. The lymph nodes do NOT liquefy toxic products. The lymph nodes do NOT disassociate themselves from toxic products. Lymph nodes do NOT oxygenate toxic products.

DIF: Recall REF: pp. 243-244 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 4. The lymphatics of the right side of the head and the neck converge by way of the right jugular trunk. These lymphatics then join the lymphatics from the right arm and thorax to form the thoracic duct. 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

B C

The second statement is false. The lymphatics on the right side of the head and neck converge by way of the right jugular trunk to join the lymphatics from the right arm and thorax to form the right lymphatic duct, which drains into the venous system at the junction of the right subclavian and right internal jugular veins. The lymphatic vessels of the left side of the head and neck converge into the left jugular trunk, actually a short vessel, and then into the thoracic duct. The first statement is true. The lymphatics of the right side of the head and neck converge by way of the right jugular trunk. The first statement is true. The lymphatics of the right side of the head and neck converge by way of the right jugular trunk. The second statement is false. The lymphatics on the right side of the head and neck converge by way of the right jugular trunk to join the lymphatics from the right arm and thorax to form the right lymphatic duct, which drains into the venous system at the junction of the right subclavian and right internal jugular veins. The lymphatic vessels of the left side of the head and neck converge into the left jugular trunk, actually a short vessel, and then into the thoracic duct. The first statement is true. The lymphatics of the right side of the head and neck converge by way of the right jugular trunk. The second statement is false. The lymphatics on the right side of the head and neck converge by way of the right jugular trunk to join the lymphatics from the right arm and thorax to form the right lymphatic duct, which drains into the venous system at the junction of the right subclavian and right internal jugular veins. The lymphatic vessels of the left side of the head and neck converge into the left jugular trunk, actually a short vessel, and then into the thoracic duct.

DIF: Recall REF: p. 246 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, 1.1.1 Head and Neck Anatomy 5. A dental professional needs to check carefully for any palpable nodes of the head and neck during an extraoral examination BECAUSE the palpable lymph nodes may help determine where a disease process is active. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A A

Feedback The statement and the reason are correct and related. A dental professional MUST examine any palpable nodes of the head and neck during an extraoral examination. Palpable lymph nodes may help determine where a disease process is active. The statement and reason are also related because they both focus on palpable lymph nodes that can pinpoint disease and infection through signs and symptoms.

C D E

The statement and the reason are correct, but they are also related. They both focus on palpable lymph nodes that can help to pinpoint the progression of both disease and infection. The reason is correct. Palpable lymph nodes may help determine where a disease process is active. The statement is correct. A dental professional MUST examine any palpable nodes of the head and neck during an extraoral examination. Both the statement and reason are correct. A dental professional MUST examine any palpable nodes of the head and neck during an extraoral examination. Palpable lymph nodes may help determine where a disease process is active.

DIF: Application REF: pp. 255-256 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 MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology 6. Which of the teeth listed below, when infected, do NOT initially drain into the submandibular lymph nodes but into another group of lymph nodes? a. Maxillary anterior teeth b. Maxillary first and second molars c. Maxillary premolars d. Maxillary third molars ANS: D A B C D

Feedback The maxillary anterior teeth initially drain into the submandibular lymph nodes and then into the superior deep cervical lymph nodes. The maxillary first and second molars initially drain into the submandibular lymph nodes and then into the superior deep cervical lymph nodes. The maxillary premolars initially drain into the submandibular lymph nodes and then into the superior deep cervical lymph nodes. The maxillary third molars initially drain into the superior deep cervical lymph nodes and then into inferior deep cervical lymph nodes and do NOT drain into the submandibular lymph nodes at any time.

DIF: Comprehension REF: pp. 250, 254 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, 1.1.2 Dental Anatomy 7. Which of the following lymph nodes are NOT considered to be superficial lymph nodes located in the head? a. Occipital lymph nodes b. Retropharyngeal lymph nodes c. Retroauricular lymph nodes d. Facial lymph nodes

ANS: B A

Feedback The occipital lymph nodes are superficial lymph nodes located bilaterally on the posterior base of the head in the occipital region, which drains this part of the scalp. The retropharyngeal lymph nodes are NOT considered superficial lymph nodes but instead deep lymph nodes of the head. These nodes are located near the deep parotid nodes and at the level of the atlas and the first cervical vertebra. The retroauricular lymph nodes are superficial lymph nodes located posteriorly to each ear, where the sternocleidomastoid muscle inserts on the mastoid process. The facial lymph nodes are superficial lymph nodes located along the length of the facial vein.

DIF: Recall REF: pp. 246, 248 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, 1.1.1 Head and Neck Anatomy 8. The occipital lymph nodes can be palpated during the extraoral examination by asking the patient to tilt his or her head to the left and then to the right with the chin upward BECAUSE the occipital lymph nodes empty into the inferior deep cervical nodes of the neck. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: D A

C D

Feedback The statement is NOT correct. The occipital lymph nodes can be palpated when the patient leans his or her head forward because the occipital lymph nodes are located bilaterally at the posterior base of the head. The statement is NOT correct. The occipital lymph nodes can be palpated when the patient leans his or her head forward because the occipital lymph nodes are located bilaterally at the posterior base of the head. In addition, the statement and the reason are related. Both deal with location of the occipital lymph nodes. The reason is correct. The occipital lymph nodes empty into the inferior deep cervical nodes of the neck. The statement is NOT correct. The occipital lymph nodes can be palpated when the patient leans his or her head forward because the occipital lymph nodes are located bilaterally at the posterior base of the head. The reason is correct. The occipital lymph nodes empty into the inferior deep cervical nodes of the neck.

DIF: Application REF: p. 247 OBJ: 3 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 MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Provision of Clinical Dental Hygiene Services, 1.2 Head and Neck Examination 9. The retroauricular lymph nodes are also known by which of the following terms? a. Mastoid lymph nodes b. Facial lymph nodes c. Deep parotid lymph nodes d. Retropharyngeal lymph nodes ANS: A A

C D

Feedback The retroauricular lymph nodes are also known as the mastoid lymph nodes. They are located where the sternocleidomastoid muscle inserts on the mastoid process, draining the tissue posterior to the ear. The facial lymph nodes are positioned along the length of the facial vein, with each facial node subgroup draining the skin and mucous membranes where the nodes are specifically located. The deep parotid lymph nodes are located deep in the parotid salivary gland and drain the middle ear. The retropharyngeal lymph nodes are located near the deep parotid nodes and at the level of the atlas at the first cervical vertebra, draining the pharynx, palate, paranasal sinuses, and nasal cavity.

DIF: Recall REF: p. 247 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, 1.1.1 Head and Neck Anatomy 10. The submandibular lymph nodes are located at the inferior border of the mandibular ramus, just superficial to the submandibular salivary gland and within the submandibular fascial space. These nodes drain the cheeks, upper lip, body of the tongue, and anterior hard palate, as well as the mandibular incisors and maxillary third molars. 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 A

Feedback The second statement is false. The submandibular lymph nodes drain the cheeks,

upper lip, body of the tongue, anterior hard palate, and associated teeth, except for the mandibular incisors and maxillary third molars. The first statement is true. The submandibular lymph nodes are located at the inferior border of the mandibular ramus, just superficial to the submandibular salivary gland and within the submandibular fascial space. The first statement is true. The submandibular lymph nodes are located at the inferior border of the mandibular ramus, just superficial to the submandibular salivary gland and within the submandibular fascial space. The second statement is false. The submandibular lymph nodes drain the cheeks, upper lip, body of the tongue, anterior hard palate, and associated teeth, except for the mandibular incisors and maxillary third molars. The first statement is true. The submandibular lymph nodes are located at the inferior border of the mandibular ramus, just superficial to the submandibular salivary gland and within the submandibular fascial space. The second statement is false. The submandibular lymph nodes drain the cheeks, upper lip, body of the tongue, anterior hard palate, and associated teeth, except for the mandibular incisors and maxillary third molars.

DIF: Recall REF: p. 250 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, 1.1.1 Head and Neck Anatomy 11. Which of the following lymph nodes can be effectively palpated during an extraoral examination by having the patient turn his or her head to the side? a. Superficial cervical lymph nodes b. Anterior jugular lymph nodes c. Inferior cervical lymph nodes d. Occipital lymph nodes ANS: B A

B C

Feedback The superficial cervical lymph nodes can be effectively palpated by having the patient lower his or her chin. Then tissue in the area is pushed over the bony edge of the mandible on each side, where it is grasped and rolled. The anterior jugular lymph nodes can be effectively palpated by having the patient turn his or her head to the side. The inferior cervical lymph nodes can be effectively palpated by having the patient turn his or her head to the side along with raising the shoulders upward and forward. The occipital lymph nodes can be effectively palpated by having the patient tilt his or her head forward.

DIF: Application REF: pp. 251-252 OBJ: 3 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

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Provision of Clinical Dental Hygiene Services, 1.2 Head and Neck Examination | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care 12. Tonsils are masses of lymphoid tissue located in the oral cavity and pharynx. Like lymph nodes, tonsils are located along lymphatic vessels. 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 A B C

Feedback The second statement is false. Unlike lymph nodes, tonsils are NOT located along lymphatic vessels. The first statement is true. Tonsils are masses of lymphoid tissue located in the oral cavity and pharynx. The first statement is true. Tonsils are masses of lymphoid tissue located in the oral cavity and pharynx. The second statement is false. Unlike lymph nodes, tonsils are NOT located along lymphatic vessels. The first statement is true. Tonsils are masses of lymphoid tissue located in the oral cavity and pharynx. The second statement is false. Unlike lymph nodes, tonsils are NOT located along lymphatic vessels.

DIF: Recall REF: pp. 254-255 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, 1.1.1 Head and Neck Anatomy 13. The palatine tonsil is located in the oral cavity between the posterior faucial pillar and which of the following structures? a. Posterior wall of the nasopharynx b. Anterior faucial pillar c. Uvula d. Soft palate e. Pterygomandibular fold ANS: B A

B C

Feedback The palatine tonsil is located between the anterior faucial pillar and the posterior faucial pillar or vice versa on each side of the fauces. In contrast, the pharyngeal tonsil is located on the posterior wall of the nasopharynx. The palatine tonsil is located between the posterior faucial pillar and the anterior faucial pillar or vice versa on each side of the fauces. The uvula is a muscular structure that hangs from the posterior margin of the soft

D E

palate. The soft palate is the posterior nonbony part of the palate. The pterygomandibular fold is a fold of tissue that extends from the junction of hard and soft palates down to the mandible, just posterior to the most distal mandibular molar.

DIF: Recall REF: p. 255 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, 1.1.1 Head and Neck Anatomy 14. Which of the following terms BEST describes the process in lymph nodes when a patient has a disease process active in a region, such as cancer or infection, by increasing in size and changing the consistency of the lymphoid tissue? a. Lymphosarcoma b. Lymphangitis c. Lymphedema d. Lymphadenopathy ANS: D A B C D

Feedback Lymphosarcoma is a term used to describe a malignant tumor of the lymphatic tissue. Lymphangitis is a term used to describe inflammation of the lymphatic vessels that connect the lymph nodes. Lymphedema is a term used to describe when lymphatic fluid builds up in the soft tissue of the body, usually in an arm or leg. Lymphadenopathy is a term that describes the process in lymph nodes when a patient has a disease process active in a region, such as cancer or infection, by increasing in size and changing the consistency of the lymphoid tissue.

DIF: Comprehension REF: p. 255 OBJ: 6 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. A. 1. Identify medical conditions that can cause medical emergencies in patients MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care 15. What is the term used to denote the spread of cancer from the original or primary site of the tumor to another secondary site? a. Miosis b. Metastasis c. Mitosis d. Mydriasis

ANS: B A B C D

Feedback The term miosis denotes the contraction of the pupil of the eye. The term metastasis denotes the spread of cancer from the original or primary site of the tumor to another secondary site. The term mitosis denotes cell division. The term mydriasis denotes prolonged abnormal dilation of the pupil.

DIF: Recall REF: p. 256 OBJ: 6 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. A. 1. Identify medical conditions that can cause medical emergencies in patients MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care 16. Which of the following signs or symptoms listed below CANNOT be used to describe a lymph node involved in cancer? a. Bony hard b. Nonmotile c. NOT tender d. Mobile ANS: D A B

Feedback Nodes involved in cancer can be bony hard, unlike those nodes involved with acute infections, which are only firm. Nodes involved in cancer can become fixed to surrounding tissue and structures, making them nonmotile, unlike those nodes involved with acute infections, which are mobile. Nodes involved in cancer are usually NOT tender, unlike those nodes involved with acute infections, which become tender due to enlargement and pressure placed on surrounding nerves. However, they may be painful with perineural infiltration such as that which can occur with parotid salivary gland cancer in some cases. Nodes involved in cancer are NOT mobile; they can become fixed to surrounding tissue and structures, unlike those nodes involved with acute infections that are mobile.

DIF: Comprehension REF: p. 256 OBJ: 6 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. A. 1. Identify medical conditions that can cause medical emergencies in patients

MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care 17. MOST lymph from the head and neck ultimately drains through which group of lymph nodes? a. Superior deep cervical nodes b. External jugular nodes c. Inferior deep cervical nodes d. Anterior cervical nodes ANS: C A B

C D

Feedback The superior deep cervical nodes may be secondary nodes for all other nodes of the head and neck, except inferior deep cervical nodes. The external jugular nodes or superficial cervical nodes may be secondary nodes for the occipital, retroauricular, anterior auricular, and superficial parotid nodes. These nodes then empty into the deep cervical nodes. The inferior deep cervical nodes may be secondary nodes for the superficial lymph nodes of the head and superior deep cervical nodes. The anterior jugular nodes or anterior cervical nodes empty into the deep cervical nodes.

DIF: Recall REF: p. 254 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, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care 18. What is another term for external jugular lymph nodes? a. Superficial cervical nodes b. Suprahyoid lymph nodes c. Anterior cervical nodes d. Mastoid glands e. Occipital glands ANS: A A B C D E

Feedback The external jugular lymph nodes are also known as the superficial cervical nodes. The suprahyoid lymph nodes are also known as the submental lymph nodes. The anterior cervical nodes are also known as the anterior jugular nodes. The mastoid glands are also known as the retroauricular lymph nodes. The occipital lymph nodes are located on the posterior base of the head in the

occipital region and drain this part of the scalp. DIF: Recall REF: p. 251 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, 1.1.1 Head and Neck Anatomy 19. Unlike capillaries, lymphatic vessels have valves similar to many veins. These valves ensure a one-way flow of lymph through the lymphatic vessel. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A A

Feedback Both the statement and the reason are correct and related. Unlike capillaries, lymphatic vessels have valves similar to many veins. These valves ensure a oneway flow of lymph through the lymphatic vessel. Both the statement and the reason are correct and related. Unlike capillaries, lymphatic vessels have valves similar to many veins. These valves ensure a oneway flow of lymph through the lymphatic vessel. Both the statement and the reason are correct and related. Unlike capillaries, lymphatic vessels have valves similar to many veins. These valves ensure a oneway flow of lymph through the lymphatic vessel. Both the statement and the reason are correct and related. Unlike capillaries, lymphatic vessels have valves similar to many veins. These valves ensure a oneway flow of lymph through the lymphatic vessel. Both the statement and the reason are correct and related. Unlike capillaries, lymphatic vessels have valves similar to many veins. These valves ensure a oneway flow of lymph through the lymphatic vessel.

DIF: Comprehension REF: p. 243 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 20. In healthy patients, lymph nodes are usually small, soft, and free or mobile in the surrounding tissue. Therefore lymph nodes can be easily visualized or palpable during an extraoral examination of a healthy patient. 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 The first statement is true; the second is false. In healthy patients, lymph nodes are usually small, soft, and free or mobile in the surrounding tissue. Therefore lymph nodes CANNOT be visualized or palpable during an extraoral examination of a healthy patient. The first statement is true; the second is false. In healthy patients, lymph nodes are usually small, soft, and free or mobile in the surrounding tissue. Therefore lymph nodes CANNOT be visualized or palpable during an extraoral examination of a healthy patient. The first statement is true; the second is false. In healthy patients, lymph nodes are usually small, soft, and free or mobile in the surrounding tissue. Therefore lymph nodes CANNOT be visualized or palpable during an extraoral examination of a healthy patient. The first statement is true; the second is false. In healthy patients, lymph nodes are usually small, soft, and free or mobile in the surrounding tissue. Therefore lymph nodes CANNOT be visualized or palpable during an extraoral examination of a healthy patient.

DIF: Application REF: p. 244 OBJ: 3 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. 1. Identify medical conditions that can cause medical emergencies in patients MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.2 Head and Neck Examination 21. Lymph from a particular tissue region drains into a secondary node, regional node, or master node. Secondary nodes, in turn, drain into a primary node or central node. 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: B A

Feedback Both statements are false. Lymph from a particular tissue region drains into a primary node, regional node, or master node. Primary nodes, in turn, drain into a secondary node or central node. Both statements are false. Lymph from a particular tissue region drains into a primary node, regional node, or master node. Primary nodes, in turn, drain into a secondary node or central node. Both statements are false. Lymph from a particular tissue region drains into a primary node, regional node, or master node. Primary nodes, in turn, drain into a secondary node or central node. Both statements are false. Lymph from a particular tissue region drains into a

primary node, regional node, or master node. Primary nodes, in turn, drain into a secondary node or central node. DIF: Recall REF: p. 244 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, 1.1.1 Head and Neck Anatomy 22. The thoracic duct is MUCH smaller than the right lymphatic duct BECAUSE it drains the lymph from the entire lower half of the body, both the right and left sides. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: D A

Feedback The statement is NOT correct, but the reason is correct. The thoracic duct is much larger than the right lymphatic duct because it drains the lymph from the entire lower half of the body, both the right and left sides. The statement is NOT correct, but the reason is correct. The thoracic duct is much larger than the right lymphatic duct because it drains the lymph from the entire lower half of the body, both the right and left sides. The statement is NOT correct, but the reason is correct. The thoracic duct is much larger than the right lymphatic duct because it drains the lymph from the entire lower half of the body, both the right and left sides. The statement is NOT correct, but the reason is correct. The thoracic duct is much larger than the right lymphatic duct because it drains the lymph from the entire lower half of the body, both the right and left sides. The statement is NOT correct, but the reason is correct. The thoracic duct is much larger than the right lymphatic duct because it drains the lymph from the entire lower half of the body, both the right and left sides.

DIF: Comprehension REF: p. 246 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 23. The dental professional needs to remember that the lymph nodes NEVER drain other structures of the head and neck but only the teeth and associated structures. A patient may need a referral when lymph nodes are palpable due to a disease process. 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: D A

Feedback The first statement is false; the second is true. The dental professional needs to remember that the lymph nodes drain NOT only intraoral dental structures such as the teeth but also other structures of the head and neck. A patient may need a referral when lymph nodes are palpable due to a disease process in these other structures. The first statement is false; the second is true. The dental professional needs to remember that the lymph nodes drain NOT only intraoral dental structures such as the teeth but also other structures of the head and neck. A patient may need a referral when lymph nodes are palpable due to a disease process in these other structures. The first statement is false; the second is true. The dental professional needs to remember that the lymph nodes drain NOT only intraoral dental structures such as the teeth but also other structures of the head and neck. A patient may need a referral when lymph nodes are palpable due to a disease process in these other structures. The first statement is false; the second is true. The dental professional needs to remember that the lymph nodes drain NOT only intraoral dental structures such as the teeth but also other structures of the head and neck. A patient may need a referral when lymph nodes are palpable due to a disease process in these other structures.

DIF: Application REF: p. 256 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 | CDA: General Chairside, VI. A. 1. Identify medical conditions that can cause medical emergencies in patients MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.2 Dental 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, 3.0 Planning and Managing Dental Hygiene Care 24. The lymph nodes of the head are located in either a superficial or a deep position relative to the surrounding tissue. All nodes of the head drain either the right or left tissue, structures, or organs in each region. 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: A A

Feedback Both statements are true. The lymph nodes of the head are located in either a

superficial or a deep position relative to the surrounding tissue. All nodes of the head drain either the right or left tissue, structures, or organs in each region. Both statements are true. The lymph nodes of the head are located in either a superficial or a deep position relative to the surrounding tissue. All nodes of the head drain either the right or left tissue, structures, or organs in each region. Both statements are true. The lymph nodes of the head are located in either a superficial or a deep position relative to the surrounding tissue. All nodes of the head drain either the right or left tissue, structures, or organs in each region. Both statements are true. The lymph nodes of the head are located in either a superficial or a deep position relative to the surrounding tissue. All nodes of the head drain either the right or left tissue, structures, or organs in each region.

DIF: Recall REF: p. 246 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, 1.1.1 Head and Neck Anatomy 25. The retroauricular, anterior auricular, and superficial parotid nodes drain the external ear, lacrimal gland, and adjacent regions of the scalp and face. All of these nodes empty into the submandibular lymph nodes. 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 A

Feedback The first statement is true; the second is false. The retroauricular, anterior auricular, and superficial parotid nodes drain the external ear, lacrimal gland, and adjacent regions of the scalp and face. All of these nodes empty into the deep cervical lymph nodes. The submandibular nodes may be secondary nodes for the submental nodes and facial regions. The lymphatic system from both the sublingual and submandibular salivary glands also drains into these nodes. The submandibular nodes then empty into the deep cervical nodes. The first statement is true; the second is false. The retroauricular, anterior auricular, and superficial parotid nodes drain the external ear, lacrimal gland, and adjacent regions of the scalp and face. All of these nodes empty into the deep cervical lymph nodes. The submandibular nodes may be secondary nodes for the submental nodes and facial regions. The lymphatic system from both the sublingual and submandibular salivary glands also drains into these nodes. The submandibular nodes then empty into the deep cervical nodes. The first statement is true; the second is false. The retroauricular, anterior auricular, and superficial parotid nodes drain the external ear, lacrimal gland, and adjacent regions of the scalp and face. All of these nodes empty into the deep cervical lymph nodes. The submandibular nodes may be secondary nodes for the submental nodes and facial regions. The lymphatic system from both the sublingual and submandibular salivary glands also drains into these nodes. The

submandibular nodes then empty into the deep cervical nodes. The first statement is true; the second is false. The retroauricular, anterior auricular, and superficial parotid nodes drain the external ear, lacrimal gland, and adjacent regions of the scalp and face. All of these nodes empty into the deep cervical lymph nodes. The submandibular nodes may be secondary nodes for the submental nodes and facial regions. The lymphatic system from both the sublingual and submandibular salivary glands also drains into these nodes. The submandibular nodes then empty into the deep cervical nodes.

DIF: Recall REF: p. 247 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, 1.1.1 Head and Neck Anatomy MULTIPLE RESPONSE 1. From the following list of descriptions, select those that can CORRECTLY be used to describe the lymphatic system or its components, including the vessels and the nodes. (Select all that apply.) a. Mainly parallels nervous system b. Only superficial in location c. No part visualized in healthy patients d. Has valves for one-way flow ANS: C, D Feedback Correct

Incorrect

NO part of the lymphatic system, either lymph vessels or nodes, can be visualized in healthy patients, and the lymphatic vessels do have valves for one-way flow of lymph. Within the lymphatic system, the lymphatic vessels mainly parallel the venous blood vessels and NOT the nervous system but are more numerous. Its lymph nodes can be either superficial or deep in location and NOT only superficial.

DIF: Recall REF: pp. 243-244 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 2. From the following list of lymph nodes, select those that are categorized as facial lymph nodes. (Select all that apply.) a. Malar lymph nodes b. Buccal lymph nodes c. Anterior auricular lymph nodes d. Retroauricular lymph nodes ANS: A, B

Feedback Correct Incorrect

Both malar and buccal lymph nodes are considered facial lymph nodes since they are located along the length of the facial vein. Both the anterior auricular and retroauricular lymph nodes are NOT considered facial lymph nodes since they are NOT located along the length of the facial vein.

DIF: Recall REF: p. 247 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, 1.1.1 Head and Neck Anatomy 3. From the following list of lymph nodes, select those that are categorized as superficial cervical lymph nodes. (Select all that apply.) a. Retropharyngeal lymph nodes b. Jugulodigastric lymph node c. External jugular lymph nodes d. Anterior jugular lymph nodes ANS: C, D Feedback Correct Incorrect

Both the external and anterior jugular lymph nodes are considered superficial cervical lymph nodes. Retropharyngeal lymph nodes are NOT considered superficial cervical lymph nodes. The jugulodigastric lymph node is a superior deep cervical lymph node.

DIF: Recall REF: p. 250 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, 1.1.1 Head and Neck Anatomy 4. From the following list of descriptions, select those that can be used to CORRECTLY describe the jugulo-omohyoid lymph node. (Select all that apply.) a. Superior deep cervical lymph node b. Drains parts of tongue c. Drains submental region d. Inferior deep cervical lymph node ANS: B, C, D Feedback Correct

Incorrect

The jugulo-omohyoid lymph node drains parts of the tongue and submental region and also is considered an inferior deep cervical lymph node. The jugulo-omohyoid lymph node is considered an inferior deep cervical

lymph node and is NOT considered a superior deep cervical lymph node. DIF: Recall REF: p. 254 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, 1.1.1 Head and Neck Anatomy 5. From the following list of descriptions, select those that can be used to CORRECTLY describe tonsillar tissue. (Select all that apply.) a. Located in pharynx b. Drains into superior deep cervical lymph nodes c. Masses of tissue in oral cavity d. Found along lymphatic vessels e. Drains into the jugulodigastric lymph node ANS: A, B, C, E Feedback Correct

Incorrect

Tonsils are masses of lymphoid tissue located in the pharynx as well as the oral cavity. Tonsils drain into the superior deep cervical lymph nodes, including draining DIRECTLY into the jugulodigastric lymph node. Tonsillar tissue is NOT found along lymphatic vessels, unlike lymph nodes.

DIF: Recall REF: pp. 254-255 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, 1.1.1 Head and Neck Anatomy 6. Which of the following statements are CORRECT when applied to the cervical lymph node levels used by the medical community? (Select all that apply.) a. Designated by Roman numerals for each area b. Decrease in numbers as they become located nearer the chest c. Classification based on imaging d. Associated sublevels are included ANS: A, C, D Feedback Correct

Incorrect

An imaging-based classification used by the medical community divides the deep cervical lymph nodes into six areas or cervical lymph node levels. These levels, as well as associated sublevels, are designated by Roman numerals for each area, increasing in numbers as they become located nearer to the chest. The classification of cervical lymph node levels used by the medical community would increase in numbers and would NOT decrease in numbers as the levels become located nearer to the chest.

DIF: Comprehension REF: p. 248 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, 1.1.1 Head and Neck Anatomy 7. From the following list of descriptions, select those that can be used to CORRECTLY describe cancer and its involvement with the lymph nodes. (Select all that apply.) a. Nodes mainly aid in the spread of sarcomas b. Spread of a cancer from primary site is considered metastasis c. Nodes involved with cancer are softer than usual d. Nodes involved with cancer may be fixed to their surroundings e. Usually nodes with cancer are not as tender to palpation ANS: B, D, E Feedback Correct

Incorrect

The spread of a cancer from the original or primary site of the neoplasm to another or secondary site is considered metastasis. When they are involved with cancer, the lymph nodes can become possibly fixed to surrounding tissue, structures, and organs. The cancerous nodes are usually NOT as tender to palpation as those involved with infection. Nodes mainly aid in the spread of certain cancers, called carcinomas, from epithelial tissue in the region they filter and NOT sarcomas, which are involved instead with connective tissue. When they are involved with cancer, the lymph nodes can become bony hard and NOT softer than usual.

DIF: Comprehension REF: pp. 255-256 OBJ: 6 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. A. 1. Identify medical conditions that can cause medical emergencies in patients MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.2 Head and Neck Examination 8. Which of the following need to be present for any lymph nodes to be considered palpable on your patient with a history of hepatitis B? (Select all that apply.) a. May have undergone fibrosis from the past infection b. May be actively undergoing lymphadenopathy c. Must each be approximately larger than 5 mm in diameter d. Have increased number of lymphocytes e. Have increased size of each lymphocyte ANS: A, B, E Feedback Correct

Changes in size and consistency with an active response to an infection result in lymphadenopathy and allow the node to be palpated during the

Incorrect

extraoral examination along the even firmer backdrop of underlying bones and muscles or the clinician’s hands. Lymphadenopathy results from an increase in both the size of each individual lymphocyte and the overall cell count in the lymphoid tissue. The lymph nodes may stay enlarged as a result of scar tissue after lymphadenopathy and thus are still palpable, having a slightly firmer texture from the fibrosis process. In general, the lymph nodes must be larger than approximately 10 mm and NOT larger than approximately 5 mm in diameter to be palpable or even visualized.

DIF: Application REF: pp. 255-256 OBJ: 6 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, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Provision of Clinical Dental Hygiene Services, 1.2 Head and Neck Examination MATCHING Match the following cervical lymph nodes to their CORRECT cervical lymph node level as used by the medical community. a. Level I, Sublevel A b. Level II, Sublevel B c. Level II d. Levels II to V 1. 2. 3. 4.

Jugulodigastric lymph node Submandibular lymph nodes Submental lymph nodes Deep cervical lymph nodes

1. ANS: C DIF: Comprehension REF: p. 252 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, 1.1.1 Head and Neck Anatomy 2. ANS: B DIF: Comprehension REF: p. 250 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, 1.1.1 Head and Neck Anatomy 3. ANS: A DIF: Comprehension REF: p. 250 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, 1.1.1 Head and Neck Anatomy 4. ANS: D DIF: Comprehension REF: p. 252 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, 1.1.1 Head and Neck Anatomy OTHER 1. Place the following steps in the CORRECT order suggested that should be included in a clinically effective extraoral examination of the facial lymph nodes. a. Bilaterally palpate the angle of the mandible b. Bilaterally palpate the infraorbital region c. Bilaterally palpate the labial commissure d. Bilaterally palpate the submandibular region ANS: B, C, A, D Feedback Correct During an extraoral examination, bilaterally palpate the facial nodes on Order each side of the face, moving from the infraorbital region to the labial commissure, and then to the surface of the angle of the mandible. Note that the each facial node subgroup drains the skin and mucous membranes where the nodes are located. The facial nodes also drain from one to the other in a superior to inferior fashion and then finally drain together into the deep cervical nodes by way of submandibular nodes. Incorrect The submandibular region does NOT contain the facial lymph nodes. However, the facial nodes do finally drain together into the deep cervical nodes by way of submandibular nodes. DIF: Application REF: p. 248 OBJ: 3 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 MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1.1 Head and Neck Anatomy | NBDHE, Scientific Basis for Dental Hygiene Practice, 5.0 Pathology | NBDHE, Scientific Basis for Dental Hygiene Practice, 1.2 Head and Neck Examination

Chapter 11: Fasciae and Spaces Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition MULTIPLE CHOICE 1. The fascia consists of layers of epithelial tissue. The fascia lies underneath the skin and also surrounds the muscles, bones, vessels, nerves, organs, and other structures of the body. 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: D A B

C D

Feedback The first statement is false. The fascia consists of layers of fibrous connective tissue. The second statement is true. The fascia lies underneath the skin and also surrounds the muscles, bones, vessels, nerves, organs, and other structures of the body. The first statement is false. The fascia consists of layers of fibrous connective tissue. The first statement is false. The fascia consists of layers of fibrous connective tissue. The second statement is true. The fascia lies underneath the skin and also surrounds the muscles, bones, vessels, nerves, organs, and other structures of the body.

DIF: Recall REF: p. 264 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 2. Superficial fasciae of the body, as well as superficial fasciae of the head and neck, contain vessels, nerves, and muscles BECAUSE the superficial fasciae are located just deep to and attached to skin. a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: D A

Feedback The statement is NOT correct. The superficial fasciae of the body do NOT usually enclose muscles, except for the superficial fasciae of the head and neck. The superficial fasciae contain muscles of facial expression. The statement is NOT correct. The superficial fasciae of the body do NOT

usually enclose muscles, except for the superficial fasciae of the head and neck. The superficial fasciae contain muscles of facial expression. Also, the statement and the reason are related. The statement is NOT correct. The superficial fasciae of the body do NOT usually enclose muscles, except for the superficial fasciae of the head and neck. The superficial fasciae contain muscles of facial expression. The reason is correct. Superficial fasciae are located just deep to and attached to the skin. The statement is NOT correct. The superficial fasciae of the body do NOT usually enclose muscles, except for the superficial fasciae of the head and neck. The superficial fasciae contain muscles of facial expression. The reason is correct. Superficial fasciae are located just deep to and attached to the skin.

DIF: Comprehension REF: p. 264 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 3. Which fascia is NOT included in the layers of the deep fasciae of the face and jaws? a. Brachial fascia b. Temporal fascia c. Masseteric-parotid fascia d. Pterygoid fascia ANS: A A B C

Feedback Brachial fascia is investing fascia in the arm and NOT in the face and jaws. Temporal fascia is a layer of the deep fasciae of the face and jaws. It covers the temporal muscle down to the zygomatic arch. Masseteric-parotid fascia is a layer of the deep fasciae of the face and jaws. The masseteric-parotid fascia is located inferior to the zygomatic arch and covers the masseter muscle. It surrounds the parotid salivary gland. The pterygoid fascia is a layer of the deep fasciae of the face and jaws. The pterygoid fascia is located on the medial surface of the medial pterygoid muscle.

DIF: Recall REF: pp. 264-266 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 4. Which of the following statements is the BEST description of investing fascia? a. It is a tube of deep cervical fasciae, deep to the sternocleidomastoid muscle, running inferiorly along each side of the neck from the base of the skull to the thorax. b. It is the most external layer of deep cervical fasciae that surrounds the neck, continuing onto the masseteric-parotid fascia. c. It is a single midline tube of deep cervical fasciae running inferiorly along the neck, surrounding the airway and food way, including the trachea, esophagus, and

thyroid gland. d. It is the deepest layer of the deep cervical fasciae, which covers the vertebrae, spinal column, and associated muscles. ANS: B A

B C

Feedback This is the description of the carotid sheath. It is a tube of deep cervical fasciae, deep to the sternocleidomastoid muscle, running inferiorly along each side of the neck from the base of the skull to the thorax. Investing fascia is the most external layer of deep cervical fasciae that surrounds the neck, continuing on to the masseteric-parotid fascia. This is the description of visceral fascia. It is a single midline tube of deep cervical fasciae running inferiorly along the neck, surrounding the airway and food way including the trachea, esophagus, and thyroid gland. This is the description of vertebral fascia. It is the deepest layer of the deep cervical fasciae, which covers the vertebrae, spinal column, and associated muscles.

DIF: Recall REF: p. 266 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 5. Which of the following structures listed below is NOT found within the carotid sheath? a. Internal carotid artery b. Common carotid artery c. Eleventh cranial nerve or accessory nerve d. Internal jugular vein ANS: C A B C

Feedback The internal carotid artery is within the carotid sheath. The common carotid artery is within the carotid sheath. The tenth cranial nerve or the vagus nerve is within the carotid sheath but NOT the eleventh cranial nerve or accessory nerve. The eleventh cranial nerve or the accessory nerve exits the skull through the jugular foramen, which is between the occipital and temporal bones. The internal jugular vein is within the carotid sheath.

b. Visceral fascia c. Buccopharyngeal fascia d. Prevertebral fascia ANS: B A B C D

Feedback The vertebral fascia covers the vertebrae, spinal column, and associated muscles. The visceral fascia surrounds the airway and food way, including the trachea, esophagus, and thyroid gland. The buccopharyngeal fascia encloses the entire superior part of the alimentary canal and is continuous with the fascia on the surface of the buccinator muscle. The prevertebral fascia is also known as the vertebral fascia, which covers the vertebrae, spinal column, and associated muscles.

DIF: Recall REF: p. 266 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 7. Which of the following fasciae is also known as pretracheal fascia? a. Visceral fascia b. Prevertebral fascia c. Buccopharyngeal fascia d. Investing fascia ANS: A A B C D

Feedback The visceral fascia is also known as pretracheal fascia. Prevertebral fascia is also known as vertebral fascia and NOT visceral fascia. Buccopharyngeal fascia is NOT known as visceral fascia. Investing fascia is NOT known as visceral fascia.

DIF: Recall REF: p. 266 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 8. A dental professional MUST have knowledge of the anatomic aspects of the spaces of the head and neck when examining a patient BECAUSE these spaces can be involved in infections arising in dental tissue. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A

Feedback The statement is correct. Dental professionals MUST know the anatomic aspects of the spaces because this allows the dental professional to form a threedimensional view of the head and neck anatomy, and it also will permit the dental professional to identify and understand possible infections occurring within the head and neck. The reason is also correct because these spaces communicate with each other directly, as well as through their blood and lymph vessels. In addition, the statement and the reason are related. Both relate to the spaces, the role of the spaces, and the importance of considering these spaces during the patient examination. The statement and the reason are correct and they are related. Dental professionals MUST know the anatomic aspects of the spaces because this allows them to form a three-dimensional view of the head and neck anatomy and permits them to identify and understand possible infections occurring within the head and neck. Also, these spaces communicate with each other directly, as well as through their blood and lymph vessels. Both relate to the spaces, the role of the spaces, and the importance of considering these spaces during the patient examination. The statement is correct. Dental professionals MUST know the anatomic aspects of the spaces because this allows the dental professional to form a threedimensional view of the head and neck anatomy, and it also will permit the dental professional to identify and understand possible infections occurring within the head and neck. The reason is also correct. These spaces communicate with each other directly, as well as through their blood and lymph vessels. The statement is correct. Dental professionals MUST know the anatomic aspects of the spaces because this allows them to form a three-dimensional view of the head and neck anatomy, and it also will permit the dental professional to identify and understand possible infections occurring within the head and neck. The statement and the reason are correct. Dental professionals MUST know the anatomic aspects of the spaces because this allows the dental professional to form a three-dimensional view of the head and neck anatomy, and it also permits the dental professional to identify and understand possible infections occurring within the head and neck. Also, these spaces communicate with each other directly, as well as through their blood and lymph vessels.

DIF: Comprehension REF: p. 277 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, II. C. Describe how to perform and/or assist with intraoral procedures | CDA: General Chairside, II. D. Patient Management | 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, 5.0 Pathology | 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

9. Where is the vestibular space of the mandible located? a. Envelopes parotid salivary gland b. Superior to upper lip c. Between buccinator muscle and oral mucosa d. Lateral to buccinator muscle ANS: C A B C D

Feedback The parotid space envelopes the parotid salivary gland. The canine space is located superior to the upper lip. The vestibular space of the mandible is located between the buccinator muscle and the oral mucosa. The buccal space is located lateral to the buccinator muscle.

DIF: Recall REF: p. 267 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 10. Which space contains BOTH part of the mandible and the inferior alveolar nerve and vessels? a. Pterygomandibular space b. Space within body of mandible c. Submental space d. Submandibular space ANS: B A B C D

Feedback The pterygomandibular space contains ONLY a part of the inferior alveolar nerve and vessels and NOT the mandible. The space within the body of the mandible contains both part of the mandible and the inferior alveolar nerve and vessels. The submental space contains both the submental lymph nodes and anterior jugular vein. The submandibular space contains submandibular lymph nodes, most of the submandibular salivary gland, and parts of the facial artery.

DIF: Recall REF: p. 268, Table 11-2 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 11. The vestibular space of the maxilla is located medial to the buccinator muscle and inferior to the attachment of this muscle along the alveolar process of the maxilla. This space communicates with the maxillary anterior teeth and associated periodontium. 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 A

Feedback The second statement is false. This space communicates with the maxillary molar teeth and periodontium, NOT the maxillary anterior teeth and associated periodontium. The first statement is true. The vestibular space of the maxilla is located medial to the buccinator muscle and inferior to the attachment of this muscle along the alveolar process of the maxilla. The first statement is true. The vestibular space of the maxilla is located medial to the buccinator muscle and inferior to the attachment of this muscle along the alveolar process of the maxilla. The second statement is false. This space communicates with the maxillary molar teeth and associated periodontium, NOT the maxillary anterior teeth and associated periodontium. The first statement is true. The vestibular space of the maxilla is located medial to the buccinator muscle and inferior to the attachment of this muscle along the alveolar process of the maxilla. The second statement is false. This space communicates with the maxillary molar teeth and associated periodontium.

DIF: Recall REF: p. 267 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 12. Which of the following spaces communicates with the canine space? a. Buccal space b. Temporal space c. Masticator space d. Vestibular space of the maxilla ANS: A A B C D

Feedback The canine space communicates with the buccal space. The temporal space communicates with the infratemporal and submasseteric spaces. All parts of the masticator space communicate with each other, as well as with the submandibular space and a cervical fascial space, the parapharyngeal space. The vestibular space of the maxilla communicates with the maxillary teeth and periodontium.

DIF: Recall REF: p. 269 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

13. Which of the following structures is/are NOT included within the masticator space? a. Temporal and infratemporal space b. Masseter muscle and ramus c. Body of the mandible d. Buccinator muscle ANS: D A B C D

Feedback Both the temporal and infratemporal spaces are included within the masticator space. The masseter muscle and the ramus of the mandible are included within the masticator space. The body of the mandible is included within the masticator space. The buccinator muscle is a muscle of facial expression and NOT a muscle of mastication and is NOT included within the masticator space.

DIF: Recall REF: pp. 270-271 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 14. What is the significance of pterygomandibular space to local anesthesia in the oral cavity? a. Contains a part of the posterior superior alveolar nerve b. Contains a part of inferior alveolar nerve c. Contains part of both the anterior superior alveolar and middle superior alveolar nerves d. Contains a part of the greater palatine nerve ANS: B A B C D

Feedback The pterygomandibular space does NOT contain a part of the superior alveolar nerve. The pterygomandibular space contains a part of the inferior alveolar nerve. The pterygomandibular space does NOT contain a part of either the anterior superior alveolar or middle superior alveolar nerves. The pterygomandibular space does NOT contain a part of the greater palatine nerve.

DIF: Comprehension REF: p. 271 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 15. The submandibular space contains the submandibular lymph nodes, most of the submandibular salivary gland, and parts of the facial artery. This space is usually involved if an odontogenic infection spreads. 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: A A

C D

Feedback The first statement is true. The submandibular space contains the submandibular lymph nodes, most of the submandibular salivary gland, and parts of the facial artery. The second statement is also true. This space is usually involved if an odontogenic infection spreads. The first statement is true. The submandibular space contains the submandibular lymph nodes, most of the submandibular salivary gland, and parts of the facial artery. The second statement is also true. This space is usually involved if an odontogenic infection spreads. The second statement is true. This space is usually involved if an odontogenic infection spreads. The first statement is true. The submandibular space contains the submandibular lymph nodes, most of the submandibular salivary gland, and parts of the facial artery. The second statement is also true. This space is usually involved if an odontogenic infection spreads.

DIF: Comprehension REF: pp. 274-275 OBJ: 3 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, II. D. Patient Management | 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, 5.0 Pathology | 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 16. To which cranial nerve, besides the eleventh and twelfth cranial nerves, is the parapharyngeal space adjacent in the skull? a. Third cranial nerve b. Sixth cranial nerve c. Seventh cranial nerve d. Ninth cranial nerve ANS: D A

Feedback The third cranial nerve or oculomotor nerve lies in the lateral wall of the cavernous sinus and exits the skull through the superior orbital fissure of the sphenoid bone on its way to the orbit. The sixth cranial nerve or abducens nerve exits the skull through the superior

orbital fissure of the sphenoid bone on its way to the orbit. This nerve runs through the cavernous sinus close to the internal artery. The seventh cranial nerve or facial nerve leaves the cranial cavity by passing through the internal acoustic meatus, which leads to the facial canal inside the temporal bone. It exits the skull by way of the stylomastoid foramen of the temporal bone. The ninth cranial nerve or glossopharyngeal nerve passes through the skull by way of the jugular foramen between the occipital and temporal bones, which is lateral to the visceral fascia around the pharynx.

DIF: Recall REF: p. 276 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 17. What is the potential space between the buccopharyngeal fascia and the alar fascia that extends posteriorly to the superior mediastinum termed? a. Lateral pharyngeal space b. Retrovisceral space c. Parapharyngeal space d. Previsceral space ANS: B A

Feedback The parapharyngeal space or lateral pharyngeal space is a fascial space lateral to the pharynx and medial to the medial pterygoid muscle, paralleling the carotid sheath. The parapharyngeal space in its posterior part is adjacent to the carotid sheath, which contains the internal and common carotid arteries and the internal jugular vein, as well as the tenth cranial or vagus nerve. The retropharyngeal space or retrovisceral space is a fascial space located immediately posterior to the pharynx, between the vertebral and visceral fasciae. It extends from the base of the skull, where it is posterior to the superior pharyngeal constrictor muscle, inferiorly to the thorax. Some anatomists distinguish a separate layer of the vertebral fascia, called the alar fascia, which runs from the skull base to connect with the visceral fascia inferiorly in the neck. The parapharyngeal space or lateral pharyngeal space is a fascial space lateral to the pharynx and medial to the medial pterygoid muscle, paralleling the carotid sheath. The parapharyngeal space in its posterior part is adjacent to the carotid sheath, which contains the internal and common carotid arteries and the internal jugular vein, as well as the tenth cranial or vagus nerve. The previsceral space is located between the visceral and investing fasciae, anterior to the trachea.

DIF: Recall REF: p. 277 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

18. The buccal space is the fascial space formed between the buccinator muscle and masseter muscle. Therefore the buccal space is superior to the zygomatic arch. 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 A

Feedback The first statement is true; the second is false. The buccal space is the fascial space formed between the buccinator muscle and masseter muscle. Therefore the buccal space is superior to the zygomatic arch. The first statement is true; the second is false. The buccal space is the fascial space formed between the buccinator muscle and masseter muscle. Therefore the buccal space is superior to the zygomatic arch. The first statement is true; the second is false. The buccal space is the fascial space formed between the buccinator muscle and masseter muscle. Therefore the buccal space is superior to the zygomatic arch. The first statement is true; the second is false. The buccal space is the fascial space formed between the buccinator muscle and masseter muscle. Therefore the buccal space is superior to the zygomatic arch.

DIF: Recall REF: pp. 269-270 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 19. Which of the following muscles creates a division between the submandibular and sublingual spaces? a. Mylohyoid muscle b. Intrinsic muscles of the tongue c. Sternocleidomastoid muscle d. Platysma muscle ANS: A A B C D

Feedback The mylohyoid muscle creates a division between the submandibular and sublingual space. The tongue and its intrinsic muscles form the medial border of the sublingual space. The carotid sheath is a tube of deep cervical fasciae deep to both the investing fascia and sternocleidomastoid muscle on both sides of the neck. The superficial cervical fasciae of the neck do contain the platysma muscle, which covers most of the anterior cervical triangle.

DIF: Recall REF: p. 275 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 20. What is a general term for a fascial space located in the face and jaws? a. Parapharyngeal space b. Fascial plane c. Median plane d. Vestibular space ANS: B A B

C D

Feedback The parapharyngeal space is a cervical fascial space lateral to the pharynx and medial to the medial pterygoid muscle. A potential space is created between the layers of fasciae of the body because of the sheetlike nature of the fasciae. They are termed a fascial space or fascial plane. The median plane is created by an imaginary line dividing the body into equal right and left halves. The space of the upper jaw, the vestibular space of the maxilla, is located medial to the buccinator muscle and inferior to the attachment of this muscle along the alveolar process of the maxilla. The vestibular space of the mandible is located between the buccinator muscle and overlying oral mucosa.

DIF: Recall REF: p. 264 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 21. Which of the following structures is NOT contained even in part within the parotid space? a. Seventh cranial nerve b. External carotid artery c. Retromandibular vein d. Internal carotid artery ANS: D A B C D

Feedback The seventh cranial nerve or facial nerve is contained in part within the parotid space. The external carotid artery is contained in part within the parotid space. The retromandibular vein is contained in part within the parotid space. The internal carotid artery is NOT contained within the parotid space but instead within the carotid sheath.

DIF: Recall REF: p. 270 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

22. The buccopharyngeal fascia is continuous with the fascia covering the buccinator muscle, where that muscle and the superior pharyngeal constrictor muscle come together at the a. lateral pterygoid plate. b. mandibular symphysis. c. pterygomandibular raphe. d. hyoid bone. ANS: C A B C

Feedback The infratemporal space is bordered anteriorly by the lateral pterygoid plate. The submental space is located in the midline between the mandibular symphysis and hyoid bone. The buccopharyngeal fascia is continuous with the fascia covering the buccinator muscle, where that muscle and the superior pharyngeal constrictor muscle come together at the pterygomandibular raphe. The hyoid bone creates the medial apex of the submandibular space.

DIF: Recall REF: pp. 266-267 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 23. Which of the following spaces is NOT part of the masticator space? a. Infratemporal space b. Temporal space c. Pterygomandibular space d. Space of the body of the mandible ANS: D A B C D

Feedback The infratemporal space is part of the masticator space. The temporal space is part of the masticator space. The pterygomandibular space is a part of the infratemporal space, which is part of the masticator space. The space of the body of the mandible is NOT part of the masticator space but formed instead by the periosteum, anterior to the body of the mandible from its symphysis to the anterior borders of the masseter and medial pterygoid muscles.

DIF: Recall REF: pp. 270-272 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 24. Which space of the face and jaws has NO border inferiorly and posteriorly and is continuous with the cervical fascial space and the parapharyngeal space? a. Submental space

b. Infratemporal space c. Submandibular space d. Retropharyngeal space ANS: B A

Feedback The floor of the submental space is the superficial cervical fascia covering the suprahyoid muscles. The roof is the mylohyoid muscle, covered by the investing fascia. Forming the lateral boundaries of this space of the face and jaws are the diverging anterior bellies of the digastric muscles. The infratemporal space is a space of the face and jaws that has NO border inferiorly and posteriorly. The space is continuous with the cervical fascial space and the parapharyngeal space. The mylohyoid line of the mandible is the superior border of the submandibular space, a space of the face and jaws. The mylohyoid muscle forms the medial border of the space, and the hyoid bone creates its medial apex. The retropharyngeal space is a cervical space that is located immediately posterior to the pharynx, between the vertebral and visceral fasciae and extends from the base of the skull, where it is posterior to the superior pharyngeal constrictor muscle and inferior to the thorax.

DIF: Recall REF: pp. 270-271 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 25. Which of the following fasciae is considered deep cervical fasciae? a. Pterygoid fasciae b. Anterior cervical triangle c. Muscles of facial expression d. Investing fasciae ANS: D A B C D

Feedback The pterygoid fasciae are a part of the deep fasciae of the face and jaws and are located on the medial surface of the medial pterygoid muscle. The superficial cervical fasciae of the neck contain the platysma muscle, which covers most of the anterior cervical triangle. The superficial fasciae of the face enclose the muscles of facial expression. The deep cervical fasciae are composed of layers that include investing fasciae, carotid sheath, visceral fasciae, and vertebral fasciae.

26. Which of the following spaces has important landmarks for administering either the inferior alveolar block or Vazirani-Akinosi mandibular block? a. Submasseteric space b. Submandibular space c. Pterygomandibular space d. Parapharyngeal space ANS: C Feedback The pterygomandibular space is important to dental professionals because it contains the inferior alveolar and lingual nerves and associated blood vessels. Thus the space in itself is a landmark for the inferior alveolar block as well as the Vazirani-Akinosi mandibular block, since it contains the target for both of these blocks. Incorrect The submasseteric space, submandibular space, and parapharyngeal space do NOT contain landmarks for the either the inferior alveolar block or Vazirani-Akinosi mandibular block NOR are they each a landmark in themselves like the pterygomandibular space. Note that even though the submasseteric space is part of the masticator space that includes the pterygomandibular space as well, it is the submasseteric space located between the masseter muscle and the external surface of the vertical mandibular ramus and NOT the medial surface of the mandibular ramus that is important for both injections. Correct

DIF: Comprehension REF: p. 271 OBJ: 3 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. D. Patient Management MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy MULTIPLE RESPONSE 1. From the following list of descriptions, select those that CORRECTLY describe the location of the sublingual space. (Select all that apply.) a. Oral mucosa is the roof b. Palatal tonsils form medial border c. Mandible forms lateral wall d. Floor is hard palate ANS: A, C Feedback Correct Incorrect

The oral mucosa is the roof, and the mandible forms the lateral wall for the sublingual space. The tongue (NOT the tonsils) forms the medial border; the floor is the mylohyoid muscle for the sublingual space and NOT the hard palate.

DIF: Recall REF: p. 275 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 2. From the list of fascial spaces, select those that are considered spaces of the face and jaws. (Select all that apply.) a. Canine space b. Parotid space c. Carotid sheath d. Parapharyngeal space e. Previsceral space ANS: A, B Feedback Correct Incorrect

The canine space and parotid space are considered fascial spaces of the face and jaws. The carotid sheath is a tube of deep fascia along the side of neck. The parapharyngeal and previsceral spaces are considered cervical fascial spaces and NOT spaces of the face and jaws.

DIF: Recall REF: p. 268, Table 11-2 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. From the following list of structures, select which are contained within the sublingual space. (Select all that apply.) a. Submandibular duct b. Facial artery and hypoglossal nerve c. Submental lymph nodes d. Lingual nerve and lingual artery e. Mandible ANS: A, D Feedback Correct Incorrect

The contents of the sublingual space include the submandibular duct and also the lingual nerve and lingual artery, as well as the hypoglossal nerve. The facial artery is located within the submandibular space, and the submental lymph nodes are located within the submental space. The mandible is located within the space of the body of the mandible.

DIF: Recall REF: p. 275 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 4. From the following list of fascial spaces, select those that communicate with the submandibular space. (Select all that apply.) a. Space of the body of the mandible

b. c. d. e.

Infratemporal space Submental space Sublingual space Buccal space

ANS: A, B, C, D Feedback Correct

Incorrect

The submandibular space communicates with the space of the body of the mandible, infratemporal space, submental space, and sublingual space, as well as the parapharyngeal space. The buccal space communicates with the canine space, pterygomandibular space, and the space of the body of the mandible and NOT the submandibular space.

DIF: Recall REF: p. 268, Table 11-2 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 5. From the following list of structures, select those located within the carotid sheath. (Select all that apply.) a. Hypoglossal nerve b. Internal carotid artery c. Internal jugular vein d. Common carotid artery e. Vagus nerve ANS: B, C, D, E Feedback Correct Incorrect

The internal jugular vein and both the common and internal carotid arteries, as well as the vagus nerve, are located within the carotid sheath. The hypoglossal nerve is NOT located within the carotid sheath.

DIF: Recall REF: p. 266 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 6. Which of the following descriptions are CORRECT when discussing the cervical compartments of the neck? (Select all that apply.) a. Neck is divided into three major cervical compartments b. Useful when deciding on the anatomic borders of the cancer c. Neck is divided into four major cervical compartments d. Useful when defining the anatomic borders of cancer treatment ANS: B, C, D Feedback

Correct

Incorrect

The neck can be divided into four major cervical compartments. The defining of these cervical compartments is useful when deciding on the anatomic borders of the cancer and subsequent cancer treatment. The neck can be divided into four major cervical compartments and NOT three cervical compartments.

DIF: Comprehension REF: pp. 277-278 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 7. A patient (when updating their medical history) states that they had thyroid gland cancer but that it was contained within the visceral compartment of the neck. Which of the following is CORRECT when discussing this compartment of the neck? (Select all that apply.) a. Also considered the posterior compartment of the neck b. Contains the spinal cord and cervical vertebrae, as well as associated muscles c. Within the surrounding vertebral fascia d. Continuation of the gastrointestinal and respiratory systems e. More movable in comparison to other compartments ANS: D, E Feedback Correct

Incorrect

The visceral compartment is a continuation of the gastrointestinal and respiratory systems. This compartment is more movable in comparison to the other compartments. The visceral compartment is the anterior compartment and NOT the posterior compartment. The compartment contains the thyroid, thymus, and parathyroid glands, as well as the hyoid bone, larynx, trachea, esophagus and pharynx, but does NOT contain the spinal cord or cervical vertebrae, as well as associated muscles. The visceral compartment is within the surrounding visceral fascia and NOT the vertebral fascia.

DIF: Application REF: pp. 277-278 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, II. D. Patient Management 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, 1.1 Medical and Dental History | NBDHE, Provision of Clinical Dental Hygiene Services, 3.0 Planning and Managing Dental Hygiene Care 8. When discussing odontogenic infections, what can be noted about what is known by dental professionals as the “danger space” of the neck? (Select all that apply.) a. Located immediately anterior to the pharynx b. Located between the vertebral and visceral fasciae c. Communicates directly with the submental space d. Communicates directly with the parapharyngeal spaces ANS: B, D

Feedback Correct

Incorrect

The retropharyngeal space or “danger space” of the neck as known by dental professionals is located between the vertebral and visceral fasciae and communicates directly with the parapharyngeal spaces. The retropharyngeal space or “danger space” of the neck as known by dental professionals is located immediately posterior and NOT immediately anterior to the pharynx. The retropharyngeal space does NOT communicate with the submental space but directly with the parapharyngeal spaces.

DIF: Comprehension REF: p. 277 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, II. C. Describe how to perform and/or assist with intraoral procedures | CDA: General Chairside, II. D. Patient Management 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, 3.0 Planning and Managing Dental Hygiene Care 9. What are the CORRECT borders of the triangular-shaped submandibular space? (Select all that apply.) a. Mylohyoid line of mandible is its superior border b. Masseter muscle forms its medial border c. Mandible forms its medial border d. Alveolar process of mandible is its superior border ANS: B, D Feedback Correct Incorrect

The mylohyoid line of the mandible is the superior border of the submandibular space. The mylohyoid line of the mandible is the superior border of the submandibular space and NOT the alveolar process of the mandible. The mylohyoid muscle then forms its medial border and NOT the masseter muscle or mandible; the hyoid bone also creates its medial apex.

DIF: Recall REF: pp. 274-275 OBJ: 3 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. D. Patient Management MSC: NBDHE, Scientific Basis for Dental Hygiene Practice, 1.1 Anatomy

Chapter 12: Spread of Infection Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition MULTIPLE CHOICE 1. Which of the following terms is BEST used to describe an infection with suppuration resulting from the entrapment of pathogens in a contained space? a. Cellulitis b. Abscess c. Fistula d. Embolus ANS: B A B C D

Feedback Cellulitis is a diffuse inflammation of soft tissue. An abscess is an infection with suppuration resulting from the entrapment of pathogens in a contained space. A fistula is a passageway in the skin, mucosa, or even bone that allows drainage of an abscess at the surface. An embolus is foreign material or a thrombus traveling in the blood that can block the vessel.

DIF: Recall REF: p. 290 OBJ: 2 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 2. Which of the following terms BEST describes the infectious process created by indigenous regional microorganisms because the body’s defenses are compromised? a. Resident microbiota b. Suppuration c. Opportunistic infection d. Perforation ANS: C A B

Feedback Resident microbiota is defined as indigenous regional microorganisms that usually do NOT cause infections. Suppuration is pus containing pathogenic bacteria, white blood cells, tissue fluid, and debris.

C D

An opportunistic infection is an infectious process created by resident microbiota when the body’s defenses are compromised. A perforation is an abnormal hole in a hollow organ such as in the wall of a sinus.

DIF: Recall REF: p. 293 OBJ: 2 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care 3. Which of the following infections initially and DIRECTLY involves teeth and associated tissue? a. Odontogenic infection b. Lymphadenitis c. Endophthalmitis d. Otitis media ANS: A A B C D

Feedback An odontogenic infection is a dental infection involving the teeth and associated tissue. Lymphadenitis is an infection of the lymph nodes. Endophthalmitis is an infection within the ocular cavity usually involving the internal structures of the eye. Otitis media is an infection of the middle ear, usually involving the eardrum.

DIF: Recall REF: pp. 289-290 OBJ: 2 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 4. A dental professional SHOULD understand the infectious process that allows microorganisms to create disease. Certain nonresident microorganisms can invade and initiate an infection. 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: A A

C D

Feedback Both the first and second statements are true. A dental professional SHOULD understand the infectious process that allows microorganisms to create disease. Certain nonresident microorganisms can invade and initiate an infection. Both the first and second statements are true. A dental professional SHOULD understand the infectious process that allows microorganisms to create disease. Certain nonresident microorganisms can invade and initiate an infection. The second statement is true. Certain nonresident microorganisms can invade and initiate an infection. The first statement is true. A dental professional SHOULD understand the infectious process that allows microorganisms to create disease.

DIF: Comprehension REF: p. 289 OBJ: 2 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. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 5. Upon intraoral examination of a patient’s palate, you notice the presence of an abscess. Which teeth can be involved with the clinical presentation of this abscess? a. Maxillary molars: buccal surface and buccal roots b. Maxillary lateral incisors: lingual surfaces and roots; maxillary premolars: lingual surfaces and roots; and maxillary molars: lingual surfaces and roots c. Maxillary anterior teeth: all surfaces and roots; maxillary posterior teeth: buccal surfaces and roots d. Maxillary molars: buccal surfaces and buccal roots; mandibular first and second molars: buccal surfaces and buccal roots ANS: B A B

Feedback The maxillary molars, buccal surface and buccal roots, are involved when an abscess or fistula perforates into the maxillary sinuses. The maxillary lateral incisors: lingual surfaces and roots; maxillary premolars: lingual surfaces and roots; and maxillary molars: lingual surfaces and roots are involved when an abscess or fistula is clinically present on the palate. The maxillary anterior teeth (all surfaces and roots) and maxillary posterior teeth (buccal surfaces and roots) are involved when an abscess or fistula is clinically present in the maxillary vestibule.

The maxillary molars (buccal surfaces and buccal roots) and mandibular first and second molars (buccal surfaces and buccal roots) are involved when an abscess or fistula is clinically present on the buccal skin surface.

DIF: Application REF: p. 292, Table 12-1 OBJ: 4 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 | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 6. Which of the following disease states can DIRECTLY cause a periapical abscess? a. Periodontal disease b. Chronic gingivitis c. Progressive caries d. Dentigerous cyst formation ANS: C A B C

Feedback Acute periodontal disease can cause a periodontal abscess to occur along with apical migration of the gingival tissue and alveolar bone. Chronic gingivitis can cause the marginal and interdental gingival tissue to become enlarged and inflamed. A periapical abscess can result from progressive caries. This occurs from an infection of the pulp causing the pulp to become necrotic due to invasion of microorganisms into the sterile pulp from the progressive caries. The infection will usually spread apically. A dentigerous cyst is a developmental odontogenic cyst that forms around the crown of a developing impacted tooth.

DIF: Comprehension REF: p. 290 OBJ: 4 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases

7. Early detection of an abscess is imperative in order to avoid destruction of dental tissue. Early detection of an abscess is BEST accomplished with the use of dental radiographs. 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 A

B C

Feedback The second statement is false. Abscess formation may NOT be detectable on radiographs during the early stages. This is because the infection process may NOT have destroyed alveolar bone, thereby decreasing the density of the bone that can be seen radiographically as a radiolucent image. The first statement is true. Early detection of abscess is imperative in order to avoid destruction of dental tissue. The first statement is true. Early detection of abscess is imperative in order to avoid destruction of dental tissue. The second statement is false. Abscess formation may NOT be detectable on radiographs during the early stages. This is because the infection process may NOT have destroyed alveolar bone, thereby decreasing the density of the bone that can be seen radiographically as a radiolucent image. The first statement is true. Early detection of abscess is imperative in order to avoid destruction of dental tissue. The second statement is false. Abscess formation may NOT be detectable on radiographs during the early stages. This is because the infection process may NOT have destroyed alveolar bone, thereby decreasing the density of the bone that can be seen on radiographs as a radiolucent image.

DIF: Application REF: p. 290 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 | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 8. Which of the following signs OR symptoms CANNOT be used to describe cellulitis of the face and neck? a. Pain b. Tenderness c. Redness d. Systemic infection ANS: D

A B

C D

Feedback Pain is often associated with infection and inflammation such as that which occurs with cellulitis, a diffuse inflammation of soft tissue spaces. Tenderness is often associated with infection due to the swelling and pressure placed on surrounding nerves such as that which occurs with cellulitis, a diffuse inflammation of soft tissue spaces. Redness or inflammation is often associated with infection such as that which occurs with cellulitis, a diffuse inflammation of soft tissue spaces. Even though infection is associated with cellulitis, a diffuse inflammation of soft tissue spaces, the infection usually remains localized and is NOT systemic.

DIF: Comprehension REF: p. 292 OBJ: 2 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. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 9. Which of the following disease states may be involved in an odontogenic infection that has an inflammation of the bone marrow? a. Osteomyelitis b. Paresthesia c. Cellulitis d. Meningitis ANS: A A B C D

Feedback Osteomyelitis is an inflammation of the bone marrow. Paresthesia is an abnormal sensation in an area such as burning or prickling. Cellulitis is a diffuse inflammation of soft tissue spaces. Meningitis is an inflammation of the meninges of the brain or spinal cord.

DIF: Recall REF: p. 292 OBJ: 2 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases

10. Osteomyelitis MOST often occurs in the mandible BECAUSE of the mandible’s thicker cortical plates and reduced vascularization. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A A

C D E

Feedback Both the statement and the reason are correct and related. Osteomyelitis MOST often occurs in the mandible due to the mandible’s thicker cortical plates and reduced vascularization. They are also related because the statement refers to osteomyelitis, which is an inflammation within the bone, and the reason discusses why this inflammation occurs in a bone such as the mandible. Both the statement and the reason are correct and related. Osteomyelitis MOST often occurs in the mandible due to the mandible’s thicker cortical plates and reduced vascularization. The statement and reason are also related because the statement refers to osteomyelitis, which is an inflammation within the bone, and the reason discusses why this inflammation occurs in a bone such as the mandible. The reason is correct. The fact that the mandible has thicker cortical plates and reduced vascularization allows osteomyelitis to occur MORE readily. The statement is correct. Osteomyelitis MOST often occurs in the mandible. The statement and the reason are correct. Osteomyelitis MOST often occurs in the mandible due to the mandible’s thicker cortical plates and reduced vascularization.

DIF: Comprehension REF: p. 292 OBJ: 2 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 11. When a patient complains of burning and prickling in the mandible, more than likely he or she has a condition known as Ludwig angina BECAUSE an infection from the entrapment of pathogens or resident microbiota with suppuration has become encased in that area. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E A

Feedback The statement is NOT correct. When a patient complains of burning and prickling in the mandible, more than likely he or she has a condition known as paresthesia, NOT Ludwig angina. The reason is NOT correct. An infection from the entrapment of pathogens with suppuration describes an abscess, and resident microbiota are indigenous regional microorganisms that usually do NOT cause an infection. The statement and the reason are NOT related. The statement is NOT correct. When a patient complains of burning and prickling in the mandible, more than likely he or she has a condition known as paresthesia, NOT Ludwig angina. The reason is NOT correct. An infection from the entrapment of pathogens with suppuration describes an abscess, and resident microbiota are indigenous regional microorganisms that usually do NOT cause an infection. The statement is NOT correct. When a patient complains of burning and prickling in the mandible, more than likely he or she has a condition known as paresthesia, NOT Ludwig angina. The reason is NOT correct. An infection from the entrapment of pathogens with suppuration describes an abscess, and resident microbiota are indigenous regional microorganisms that usually do NOT cause an infection. The statement is NOT correct. When a patient complains of burning and prickling in the mandible, more than likely he or she has a condition known as paresthesia, NOT Ludwig angina. The reason is NOT correct. An infection from the entrapment of pathogens with suppuration describes an abscess, and resident microbiota are indigenous regional microorganisms that usually do NOT cause an infection.

DIF: Application REF: p. 293 OBJ: 2 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. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 12. Which of the following symptoms is NOT related to an infection of the paranasal sinuses that resulted from a direct spread of infection from the teeth and associated oral tissue? a. Headache b. Pharyngeal discharge c. Hypothermia d. Tenderness ANS: C

A B

C D

Feedback Sinus pressure from enlarged, inflamed sinus tissue will often result in a headache in the area of the maxillary sinuses. A pharyngeal discharge occurs due to infectious, puslike fluids building up in the sinus cavity due to paranasal sinus infections. It can be foul smelling and can also involve nasal discharge. Fever or increased body temperature is often associated with infection. However, hypothermia is a decrease in body temperature. Tenderness due to tissue enlargement in the area of the infection presses on nerves in the surrounding area, causing tenderness that can occur with paranasal sinus infections.

DIF: Comprehension REF: p. 294 OBJ: 4 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 13. Which of the following disease states can DIRECTLY cause the spread of odontogenic infections by way of the vascular system? a. Fistula b. Bacteremia c. Pustule d. Abscess ANS: B A B C D

Feedback A fistula is a passageway in the skin, mucosa, or even bone that allows drainage of an abscess at the surface. Bacteremia is bacteria traveling within the blood system, thus allowing a spread of odontogenic infection by way of the vascular system. A pustule is a small, elevated, circumscribed suppuration-containing lesion of either the skin or oral mucosa. An abscess is a type of infection from an entrapment of pathogens with suppuration in a contained space.

DIF: Comprehension REF: p. 294 OBJ: 2 | 3 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 14. An infected thrombus can dislodge from the inner blood vessel wall and travel as an embolus. Emboli can travel in the veins, draining the oral cavity into areas such as the dural venous sinuses within the oral cavity. 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: A A

C D

Feedback Both statements are true. An infected intravascular clot or thrombus can dislodge from the inner blood vessel wall and travel as an embolus. Emboli can travel in the veins, draining the oral cavity into areas such as the dural venous sinuses within the oral cavity. Both statements are true. An infected intravascular clot or thrombus can dislodge from the inner blood vessel wall and travel as an embolus. Emboli can travel in the veins, draining the oral cavity into areas such as the dural venous sinuses within the oral cavity. The second statement is true. Emboli can travel in the veins, draining the oral cavity into areas such as the dural venous sinuses within the oral cavity. The first statement is true. An infected intravascular clot or thrombus can dislodge from the inner blood vessel wall and travel as an embolus.

DIF: Recall REF: p. 294 OBJ: 3 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. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 15. Which of the following signs and symptoms CANNOT be used to describe cavernous sinus thrombosis? a. Fever b. Drowsiness c. Bradycardia d. Rapid pulse ANS: C

A B C

Feedback Fever is a common symptom of an infection such as cavernous sinus thrombosis. Drowsiness is a common symptom of cavernous sinus thrombosis. Bradycardia is a decreased heart rate or pulse rate. However, an increase in the pulse rate or rapid pulse is a common sign or symptom of cavernous sinus thrombosis. A rapid pulse is a sign or symptom of cavernous sinus thrombosis.

DIF: Recall REF: p. 295 OBJ: 4 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care 16. The loss of which of the following is noted during an examination of a patient with abducens nerve paralysis? a. Hearing b. Smelling sensation c. Eyeball movement d. Tongue movement ANS: C A B C D

Feedback Abducens nerve paralysis does NOT affect the seventh cranial nerve, which serves as an afferent nerve for hearing and balance. Abducens nerve paralysis does NOT affect the first cranial nerve, which transmits smell from the nasal mucosa to the brain. Abducens nerve paralysis does affect the sixth cranial nerve, which is an efferent nerve to one of the muscles that moves the eyeball. Abducens nerve paralysis does NOT affect the twelfth cranial nerve XII, which is an efferent nerve for the intrinsic and extrinsic muscles of the tongue.

DIF: Application REF: p. 295 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 | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care

17. From what case histories do MOST odontogenic infections in patients result from? a. Dermatologic infections b. Upper respiratory infection c. Dental biofilm (dental plaque) d. Sinusitis ANS: C A

C D

Feedback Only some odontogenic infections are secondary infections incited by an infection from the tissue surrounding the oral cavity such as the skin, tonsils, ears, or sinuses. Only some odontogenic infections are secondary infections incited by an infection from the tissue surrounding the oral cavity such as the skin, tonsils, ears, or sinuses. MOST odontogenic infections result initially from the formation of dental biofilm (dental plaque) from the surrounding area. Only some odontogenic infections are secondary infections incited by an infection from the tissue surrounding the oral cavity such as the skin, tonsils, ears, or sinuses.

DIF: Comprehension REF: p. 290 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 | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 18. Which of the following complications can result from untreated cellulitis? a. Bell palsy b. Ludwig angina c. Trigeminal neuralgia d. Transient facial paralysis ANS: B A B

Feedback Bell palsy involves unilateral facial paralysis with NO known cause, except that there is a loss of excitability of the involved facial nerve. Cellulitis can possibly spread due to perforation of the surrounding bone, causing serious complications such as Ludwig angina, which is cellulitis of the submandibular space. Trigeminal neuralgia or tic douloureux has NO known etiology but involves the

afferent nerves of the fifth cranial or trigeminal nerve. Transient facial paralysis can occur due to injection into the gland during an incorrectly administered inferior alveolar block.

DIF: Comprehension REF: p. 292 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 | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 19. Which of the following is KEY to preventing complications with odontogenic infections in patients? a. Sterilizing instruments b. Covering hard operatory surfaces c. Using mouthwashes d. Early diagnosis and treatment ANS: D A B C D

Feedback Early diagnosis and treatment of odontogenic infections MUST occur in all patients. Early diagnosis and treatment of odontogenic infections MUST occur in all patients. Early diagnosis and treatment of odontogenic infections MUST occur in all patients. Early diagnosis and treatment of odontogenic infections MUST occur in all patients.

DIF: Application REF: p. 297 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 | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases

20. Evaluation of lymph node involvement can BEST determine which of the following? a. Healing level of patient b. Etiology of infection c. Age of the patient d. Regional involvement ANS: D A

Feedback Evaluation of the involved nodes can determine the degree of regional involvement in the infection process, which is instrumental in the diagnosis and management of the infection. Evaluation of the involved nodes can determine the degree of regional involvement in the infection process, which is instrumental in the diagnosis and management of the infection. Evaluation of the involved nodes can determine the degree of regional involvement in the infection process, which is instrumental in the diagnosis and management of the infection. Evaluation of the involved nodes can determine the degree of regional involvement in the infection process, which is instrumental in the diagnosis and management of the infection.

DIF: Comprehension REF: p. 295 OBJ: 2 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. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 21. Which of the following factors is important in the spread of odontogenic infections from their involvement with gram-negative anaerobic bacteria? a. Adaption to wet environment b. Increased metabolism c. Beta-lactamase enzyme d. Thicker cell walls ANS: C A

Feedback More than half of the gram-negative anaerobic bacteria are capable of producing the beta-lactamase enzyme, which is responsible for the initial etiology of head and neck infections, as well as treatment failures in odontogenic infections. More than half of the gram-negative anaerobic bacteria are capable of producing

the beta-lactamase enzyme, which is responsible for the initial etiology of head and neck infections, as well as treatment failures in odontogenic infections. More than half of the gram-negative anaerobic bacteria are capable of producing the beta-lactamase enzyme, which is responsible for the initial etiology of head and neck infections, as well as treatment failures in odontogenic infections. The pathogenic capability of gram-negative bacteria is often associated with certain components of gram-negative cell walls, in particular, the lipopolysaccharide, also known as LPS or endotoxin layer.

DIF: Comprehension REF: p. 290 OBJ: 3 TOP: CDA: General Chairside, I. A. Demonstrate understanding of basic oral and dental anatomy, physiology, and development | CDA: General Chairside, V. A. Oral Health Information | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 22. What recent procedure performed in the community has increased the cases of Ludwig angina? a. Tongue piercing b. Tooth jewelry c. Ear piercing d. Laser hair removal ANS: A A

Feedback With the recent popularity of the piercing of oral sites such as the tongue, there has been an increase in infections of these sites that can become more serious such as with Ludwig angina. With the advent of earlier care of abscessed teeth and more routine antibiotic treatment, Ludwig angina has become an uncommon dental emergency in healthy patients. With the advent of earlier care of abscessed teeth and more routine antibiotic treatment, Ludwig angina has become an uncommon dental emergency in healthy patients. With the advent of earlier care of abscessed teeth and more routine antibiotic treatment, Ludwig angina has become an uncommon dental emergency in healthy patients.

emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 23. A thorough medical history with periodic updates will allow the dental professional to perform effective treatment of medically compromised patients and avoid serious complications due to dental diseases. These patients may require antibiotic premedication before dental treatment or other changes in the dental treatment plan so as to prevent serious sequelae. 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: A A

Feedback Both statements are true: a thorough medical history with periodic updates will allow the dental professional to perform safe treatment of medically compromised patients and avoid serious complications due to dental diseases. These patients may require antibiotic premedication before dental treatment or other changes in the dental treatment plan so as to prevent serious sequelae. Both statements are true: a thorough medical history with periodic updates will allow the dental professional to perform safe treatment of medically compromised patients and avoid serious complications due to dental diseases. These patients may require antibiotic premedication before dental treatment or other changes in the dental treatment plan so as to prevent serious sequelae. Both statements are true: a thorough medical history with periodic updates will allow the dental professional to perform safe treatment of medically compromised patients and avoid serious complications due to dental diseases. These patients may require antibiotic premedication before dental treatment or other changes in the dental treatment plan so as to prevent serious sequelae. Both statements are true: a thorough medical history with periodic updates will allow the dental professional to perform safe treatment of medically compromised patients and avoid serious complications due to dental diseases. These patients may require antibiotic premedication before dental treatment or other changes in the dental treatment plan so as to prevent serious sequelae.

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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 24. Using an antiseptic oral rinse before treatment, a rubber dam, or an antimicrobial-laced external water supply during treatment when ultrasonics or irrigators are used may be of help in preventing the spread of infection. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: A A

Feedback Both the statement and the reason are correct and related. MOST odontogenic infections result initially from the formation of dental biofilm (dental plaque) from the surrounding area. There must also be strict adherence to standard precautions of infection control during other types of dental treatment so as to prevent the spread of infection. Both the statement and the reason are correct and related. MOST odontogenic infections result initially from the formation of dental biofilm (dental plaque) from the surrounding area. There must also be strict adherence to standard precautions of infection control during other types of dental treatment so as to prevent the spread of infection. Both the statement and the reason are correct and related. MOST odontogenic infections result initially from the formation of dental biofilm (dental plaque) from the surrounding area. There must also be strict adherence to standard precautions of infection control during other types of dental treatment so as to prevent the spread of infection. Both the statement and the reason are correct and related. MOST odontogenic infections result initially from the formation of dental biofilm (dental plaque) from the surrounding area. There must also be strict adherence to standard precautions of infection control during other types of dental treatment so as to prevent the spread of infection. Both the statement and the reason are correct and related. MOST odontogenic infections result initially from the formation of dental biofilm (dental plaque) from the surrounding area. There must also be strict adherence to standard precautions of infection control during other types of dental treatment so as to prevent the spread of infection.

emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 25. Since the apices of the mandibular second and third molars are inferior to the mylohyoid muscle, an infection here will MOST likely spread directly to the sublingual space. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is correct, but the reason is NOT. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct. ANS: D A

Feedback The statement is NOT correct, but the reason is correct. Since the apices of the mandibular second and third molars are inferior to the mylohyoid muscle, an infection here will directly spread to the submandibular space. The statement is NOT correct, but the reason is correct. Since the apices of the mandibular second and third molars are inferior to the mylohyoid muscle, an infection here will directly spread to the submandibular space. The statement is NOT correct, but the reason is correct. Since the apices of the mandibular second and third molars are inferior to the mylohyoid muscle, an infection here will directly spread to the submandibular space. The statement is NOT correct, but the reason is correct. The apex of the mandibular first molar is superior to the mylohyoid muscle, so involvement of this tooth or teeth anterior to this will first involve the sublingual space. Since the apices of the mandibular second and third molars are inferior to the mylohyoid muscle, an infection here will directly spread to the submandibular space. The statement is NOT correct, but the reason is correct. Since the apices of the mandibular second and third molars are inferior to the mylohyoid muscle, an infection here will directly spread to the submandibular space.

DIF: Comprehension REF: p. 295 OBJ: 3 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. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of

periodontal diseases 26. From the following list, select those that describe components that may be involved as infection resistance factors in the oral cavity. a. Gram-positive aerobic bacteria b. Beta-lactamase enzyme production c. Penicillin-susceptible pathogens d. Lipase enzyme production ANS: B Feedback Correct Beta-lactamase enzyme production can be involved as an infection resistance factor, as well as gram-negative anaerobic bacteria and penicillin-resistance pathogens, in the oral cavity. Incorrect Gram-positive aerobic bacteria, penicillin-susceptible pathogens, and lipase enzyme production are NOT infection resistance factors noted in the oral cavity. DIF: Comprehension REF: p. 290 OBJ: 2 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. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 27. From the following list, select which are the imaging modalities of choice in the evaluation of the patient with a deep tissue cervical infection. a. Ultrasound imaging b. Full mouth radiographs c. Panoramic radiograph d. Contrast-enhanced computed tomography scan ANS: D Feedback A

Ultrasound imaging, full mouth radiographs, or panoramic radiograph are NOT the imaging modalities of choice in the evaluation of the patient with a deep tissue cervical infection. Ultrasound imaging, full mouth radiographs, or panoramic radiograph are NOT the imaging modalities of choice in the evaluation of the patient with a deep tissue cervical infection. Ultrasound imaging, full mouth radiographs, or panoramic radiograph are NOT the imaging modalities of choice in the evaluation of the patient with a deep

tissue cervical infection. Contrast-enhanced computed tomography scan has become the imaging modality of choice in the evaluation of the patient with a deep tissue cervical infection.

DIF: Comprehension REF: p. 297 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 | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 28. Why does abducens nerve paralysis possibly become fatal in a dental patient? a. Damage only to the sixth cranial nerve b. Edema of the larynx occurs c. May lead to meningitis d. Only because diplopia occurs ANS: C Feedback A

B C

There may also be damage to the other cranial nerves with abducens nerve paralysis, with cavernous sinus thrombosis involving abducens nerve paralysis such as the oculomotor nerve (third) and trochlear nerve (fourth), as well as to the ophthalmic and maxillary divisions of the trigeminal nerve (fifth). Only Ludwig angina can involve edema of the larynx. Abducens nerve paralysis can be fatal because it may lead to meningitis, inflammation of the meninges in the brain or spinal cord, which requires immediate hospitalization with intravenous antibiotics and anticoagulants. The patient with abducens nerve paralysis usually has double vision (diplopia) due to restricted movement of one eye, as well as edema of the eyelids and conjunctivae, tearing (lacrimation), and extruded eyeballs (exophthalmus), depending on the course of the infection.

DIF: Comprehension REF: p. 295 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 | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases MULTIPLE RESPONSE 1. From the following list of fascial spaces, select those that can be DIRECTLY involved in the spread of infection concerning Ludwig angina. (Select all that apply.) a. Infratemporal space b. Retropharyngeal space c. Parapharyngeal space d. Submandibular space ANS: A, B, C, D The infratemporal space, retropharyngeal space, and parapharyngeal space can ALL be directly involved in Ludwig angina since they ALL communicate with the submandibular space and, most importantly, infection in any of these spaces can spread in this manner from space to space. DIF: Comprehension REF: p. 297 OBJ: 2 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. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 2. From the following list of case histories of dental patients, select those that have a high risk of opportunistic infections. (Select all that apply.) a. Human immunodeficiency virus infection b. Uncontrolled diabetes c. Cancer therapy d. Transplant therapy ANS: A, B, C, D Case histories involving human immunodeficiency virus infection and uncontrolled diabetes, as well as cancer and transplant therapy, ALL have a high risk of opportunistic infections. DIF: Application REF: pp. 293-294 OBJ: 2 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. B. 1. Recognize the signs and symptoms related to specific dental conditions/

emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 3. From the following list of factors, select those that involve bacteremia and its complications. (Select all that apply.) a. Lodging of bacteria in compromised tissue b. Need for psychologic premedication c. Low risk of infective endocarditis d. High risk of serious heart infection ANS: A, D Feedback Correct Incorrect

Bacteremia and its complications can involve lodging of bacteria in compromised tissue as well as a high risk for serious heart infection. Bacteremia and its complications can involve a high risk of infective endocarditis and thus the possible need for antibiotic premedication.

DIF: Comprehension REF: p. 294 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 | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 4. From the following list, select those that can be involved in the spread of odontogenic infections. (Select all that apply.) a. Vascular system b. Paranasal sinuses c. Fascial spaces d. Lymphatics ANS: A, B, C, D Odontogenic infections can spread by the vascular system, paranasal sinuses, fascial spaces, and lymphatics. DIF: Comprehension REF: p. 294 OBJ: 3 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. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 5. From the following list of dental setting procedures, select those that might serve as precautions when undertaken to prevent the spread of an odontogenic infection in a patient. (Select all that apply.) a. Adhering to standard infection control measures b. Removing heavy dental biofilm (dental plaque) c. Avoiding contamination of oral surgery sites d. Using antimicrobial rinse or rubber dam ANS: A, B, C, D Odontogenic infections can be prevented from spreading by adhering to standard infection control measures, removing heavy dental biofilm (dental plaque), avoiding contamination of oral surgery sites, and using antimicrobial rinse or rubber dam. DIF: Application REF: p. 297 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 | CDA: General Chairside, VI. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases 6. From the following list, select which treatments are usually administered with the acute medical emergency of Ludwig angina. (Select all that apply.) a. Removal of tonsils b. Cricothyrotomy c. Puncture of tympanic membrane d. Immediate hospitalization ANS: B, D Feedback Correct

Ludwig angina is an acute medical emergency requiring immediate hospitalization and may necessitate an emergency cricothyrotomy. During this emergency airway puncture, an incision is made through the skin and cricothyroid membrane (the larger part of the laryngeal membrane) to

Incorrect

quickly create a patent airway due to it being compromised. Both the removal of tonsils and puncture of tympanic membrane do NOT usually occur with the acute medical emergency of Ludwig angina.

DIF: Comprehension REF: p. 297 OBJ: 2 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. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases OTHER 1. Place the following in the CORRECT order of occurrence when untreated Ludwig angina becomes involved with edema of the larynx. a. Asphyxiation c. Complete respiratory obstruction d. Death ANS: C, A, D Feedback When Ludwig angina becomes involved with edema of the larynx there can be (in this order) complete respiratory obstruction, asphyxiation, and death. Incorrect Ludwig angina is an acute medical emergency requiring immediate hospitalization and may necessitate the treatment of an emergency cricothyrotomy. During this emergency airway puncture, an incision is made through the skin and cricothyroid membrane (the larger part of the laryngeal membrane) to quickly create a patent airway due to it being compromised. Correct Order

DIF: Recall REF: p. 297 OBJ: 3 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. B. 1. Recognize the signs and symptoms related to specific dental conditions/ emergencies likely to occur in the office 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, 3.0 Planning and Managing Dental Hygiene Care | NBDHE, Provision of Clinical Dental Hygiene Services, 4.1 Etiology and pathogenesis of periodontal diseases