Chapter 06: Vascular System
Fehrenbach: Illustrated Anatomy of the Head and Neck, 5th Edition
MULTIPLE CHOICE
- 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
| Feedback |
| A | An arteriole is a smaller artery that branches off an artery and connects with a capillary. |
| B | An artery is a type of blood vessel that carries blood away from the heart. |
| C | A capillary is a smaller blood vessel that branches off an arteriole blood supply directly to the tissue. |
| D | 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
- 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
| Feedback |
| A | 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. |
| B | 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. |
| C | 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. |
| D | The statement is correct. The dental professional must be able to locate the larger blood vessels of the head and neck. |
| E | 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
- 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
| Feedback |
| A | The first statement is false. Blood vessels are less numerous than lymphatic vessels. |
| B | The second statement is true. The venous part mainly parallels the lymphatic vessels. |
| C | 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. |
| D | 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
- 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
| Feedback |
| A | Antibiotics are available to treat facial and dental infections effectively. |
| B | 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. |
| C | 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. |
| D | 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
- 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
| Feedback |
| A | Anastomosis is communication of blood vessels with another connecting channel. |
| B | A foreign material in the blood is an embolus. |
| C | A large network of blood vessels is a plexus. |
| D | 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
- 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 |
| A | 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. |
| B | 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. |
| C | 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. |
| D | 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
- 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
| Feedback |
| A | The common carotid artery travels in the carotid sheath superiorly along the neck to branch into the internal and external carotid arteries. |
| B | The external carotid artery arises from the common carotid artery and supplies the extracranial tissue of the head and neck, including the oral cavity. |
| C | The pterygoid artery is a branch of arteries from the maxillary artery that supplies the pterygoid muscles. |
| D | 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. |
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
- 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
| Feedback |
| A | The second statement is false. The common carotid artery travels in a sheath deep to the sternocleidomastoid muscle. |
| B | 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. |
| C | 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. |
| D | 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
- 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
| Feedback |
| A | The intracranial structures are supplied by the internal carotid artery. |
| B | The subclavian artery also supplies the upper extremity or arm, so that is its major destination. |
| C | The superior thyroid artery supplies tissue inferior to the hyoid bone. |
| D | 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
- 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
| Feedback |
| A | The lingual artery supplies the suprahyoid muscles. |
| B | The lingual artery supplies the floor of the mouth. |
| C | The lingual artery does NOT supply the mylohyoid muscle. The sublingual artery supplies the mylohyoid muscle. |
| D | 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
- 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
| Feedback |
| A | The middle meningeal artery is a branch of the maxillary artery, which supplies the meninges of the brain and bones of the skull. |
| B | The facial artery is part of the anterior branch of the external carotid artery. |
| C | The ascending pharyngeal artery is a medial branch of the external carotid artery. |
| D | 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
- 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
| Feedback |
| A | The middle temporal artery is small and supplies the temporalis muscle along with parts of the scalp in the frontal and parietal regions. |
| B | The transverse facial artery supplies the parotid salivary gland and nearby facial tissue. |
| C | The superficial temporalis artery branches off into several directions in the area of the temporalis bone. |
| D | 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
- 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
| Feedback |
| A | 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. |
| B | The inferior alveolar artery supplies the mandibular teeth, the floor of the mouth, and mental region. |
| C | The sphenopalatine artery supplies the nasal cavity and anterior hard palate. |
| D | 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
- 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 |
| A | 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. |
| B | 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. |
| C | 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. |
| D | 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
- 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
| Feedback |
| A | The facial vein drains the upper lip by way of the superior labial drainage vein. |
| B | The facial vein drains the lower lip by way of the inferior labial drainage vein. |
| C | The facial vein drains the submental space by way of the submental drainage vein. |
| D | 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
- 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. | Posterior superior alveolar veins |
| b. | Pterygoid plexus of veins |
| c. | Maxillary vein |
| d. | Middle meningeal vein |
ANS: B
| Feedback |
| A | 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. |
| B | 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. |
| C | 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. |
| D | 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
- 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
| Feedback |
| A | 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. |
| B | The external jugular vein moves inferiorly along the neck, terminating in the subclavian vein. |
| C | The inferior alveolar vein drains the periodontium of the mandibular teeth, including the gingival tissue. |
| D | 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
- 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
| Feedback |
| A | 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. |
| B | A thrombus is a clot that forms on the inner vessel wall. It is NOT a serious, life-threatening blood vessel lesion unless it breaks away and becomes an embolus. |
| C | 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. |
| D | 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
- 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
| Feedback |
| A | 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. |
| B | The superior thyroid artery is an anterior branch from the external carotid artery that has a sternocleidomastoid branch to supply the sternocleidomastoid muscle. |
| C | 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. |
| D | 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
- 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
| Feedback |
| A | 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. |
| B | 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. |
| C | The sphenopalatine artery is a branch of the maxillary artery that reaches the nasal cavity through the sphenopalatine foramen. |
| D | 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
- What is the relationship of the maxillary vein to the superficial temporal vein?
| a. | Shallower |
| b. | Deeper |
| c. | Superior |
| d. | Inferior |
ANS: B
| Feedback |
| A | 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. |
| B | 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. |
| C | 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. |
| D | 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
- 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 |
| A | The pterygoid plexus of veins is a collection of small anastomosing vessels located around the pterygoid muscles and directly surrounding the maxillary artery. |
| B | The pterygoid plexus of veins is a collection of small anastomosing vessels located around the pterygoid muscles and directly surrounding the maxillary artery. |
| C | The pterygoid plexus of veins is a collection of small anastomosing vessels located around the pterygoid muscles and directly surrounding the maxillary artery. |
| D | 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
- What is the relationship of the subclavian artery to the common carotid artery?
| a. | Anterior |
| b. | Posterior |
| c. | Medial |
| d. | Lateral |
ANS: D
| Feedback |
| A | The subclavian artery arises lateral to the common carotid artery. |
| B | The subclavian artery arises lateral to the common carotid artery. |
| C | 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. |
| D | 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
- What is the usual number of anterior branches that arise from the external carotid artery?
ANS: C
| Feedback |
| A | 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. |
| B | 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. |
| C | There are three anterior branches from the external carotid artery: superior thyroid, lingual, and facial. |
| D | 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
- 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
| Feedback |
| A | At its origin, the occipital artery is closely associated with the twelfth cranial or hypoglossal nerve. |
| B | At its origin, the occipital artery is closely associated with the twelfth cranial or hypoglossal nerve. |
| C | At its origin, the occipital artery is closely associated with the twelfth cranial or hypoglossal nerve. |
| D | 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
- 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 | 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. |
| Incorrect | 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
- 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 | The pterygoid plexus of veins anastomoses with both the facial vein and retromandibular vein. |
| Incorrect | 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
- 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 | The terms concerning compromised blood vessels that are DIRECTLY associated with clot formation are thrombus (plural, thrombi), embolus (plural, emboli), and hematoma. |
| Incorrect | 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
- 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 | 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. |
| Incorrect | 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
- 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 | The maxillary artery runs either superficial or deep to the lateral pterygoid muscle and through the infratemporal fossa superiorly. |
| Incorrect | 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
- 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
| Feedback |
| A | The nasal bones form the bridge of the nose and do NOT form part of the nasolacrimal duct. |
| B | 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. |
| C | The nasal bones do NOT form part of the nasolacrimal duct. |
| D | 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
- 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
| Feedback |
| A | The sublingual salivary gland produces approximately 10% of the total volume of saliva and is an exocrine gland. |
| B | The submandibular salivary gland produces approximately 60% to 65% of the total volume of saliva and is an exocrine gland. |
| C | The parotid salivary gland produces approximately 25% of the total volume of saliva and is an exocrine gland. |
| D | 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
- 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
| Feedback |
| A | 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. |
| B | The thyroid gland is palpated in the anterior neck region. |
| C | The parathyroid glands are located on the posterior surface or inside the posterior surface of the thyroid gland. They CANNOT be palpated. |
| D | 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
- Both the major and minor salivary glands are _______ glands.
| a. | endocrine |
| b. | exocrine |
| c. | large |
| d. | small |
ANS: B
| Feedback |
| A | 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. |
| B | All of the salivary glands are exocrine, so this answer is correct. They do NOT secrete saliva into the vascular system like exocrine glands. |
| C | Major glands are large glands, and minor glands are small glands. |
| D | 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
- 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
| Feedback |
| A | The fifth cranial nerve does NOT innervate the minor salivary glands. It innervates the parotid salivary gland. |
| B | The seventh cranial nerve innervates the minor salivary glands. |
| C | The ninth cranial nerve does NOT innervate the minor salivary glands. It innervates the parotid salivary gland. |
| D | 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
- 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
| Feedback |
| A | 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. |
| B | The parathyroid glands are endocrine glands. |
| C | The thyroid gland is an endocrine gland. |
| D | 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
- 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 |
| A | 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 palpated in the floor of the mouth. |
| B | 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. |
| C | 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. |
| D | 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
- 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
| Feedback |
| A | The parotid salivary gland is NOT located in the floor of the mouth and does NOT wrap around the mylohyoid muscle. |
| B | The minor salivary glands, von Ebner glands, are associated with the circumvallate papillae located on the dorsum of the tongue. |
| C | 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. |
| D | 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
- 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 | The submental lymph nodes are NOT the primary nodes for the submandibular salivary gland. |
| B | The submandibular lymph nodes are the primary nodes for the submandibular salivary gland. |
| C | The superior deep cervical lymph nodes are NOT the primary nodes for the submandibular salivary gland. |
| D | 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
- 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 |
| A | 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. |
| B | 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. |
| C | 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. |
| D | 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. |
| E | 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
- 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
| Feedback |
| A | The parotid salivary glands produce a serous type of saliva but the submandibular salivary glands produce a mixed type of saliva. |
| B | The submandibular salivary glands produce a mixed type of saliva, and the sublingual salivary glands produce a mixed, mostly mucous type of saliva. |
| C | Both von Ebner glands and the parotid salivary glands produce a serous type of saliva. |
| D | 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
- 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
| Feedback |
| A | Most of the minor salivary glands produce a mainly mucous type of saliva. |
| B | Most of the minor salivary glands produce a mainly mucous type of saliva. |
| C | The minor salivary glands produce a mainly mucous type of saliva. |
| D | 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
- 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 |
| A | The superior deep cervical lymph nodes are NOT the primary nodes for the parotid salivary gland that becomes involved with mumps. |
| B | The primary nodes for the parotid gland that becomes involved with mumps are the deep parotid lymph nodes. |
| C | The superficial parotid lymph nodes are NOT the primary nodes for the parotid salivary gland that becomes involved with mumps. |
| D | 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
- 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
| Feedback |
| A | The parathyroid glands are NOT located on the anterior surface of the thyroid gland. |
| B | The parathyroid glands are NOT located superficial and lateral to the trachea. |
| C | The parathyroid glands are located on or within the posterior surface of the thyroid gland. |
| D | 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
- 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
| Feedback |
| A | The minor salivary glands, von Ebner glands, are associated with the circumvallate papillae. |
| B | The filiform papillae are NOT associated with any salivary gland. |
| C | The foliate papillae are NOT associated with any salivary gland. |
| D | 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
- Which of the following glands is associated with Wharton duct?
| a. | Lacrimal gland |
| b. | Parotid gland |
| c. | Sublingual gland |
| d. | Submandibular gland |
ANS: D
| Feedback |
| A | The lacrimal gland is associated with the nasolacrimal duct, NOT Wharton duct or the submandibular duct. |
| B | The parotid salivary gland is associated with Stensen or the parotid duct. |
| C | The sublingual salivary gland is associated with Bartholin or the sublingual duct. |
| D | 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
- 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
| Feedback |
| A | The cervical nerves are associated with the neck or deeper structures. |
| B | 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. |
| C | 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. |
| D | 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
- 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
| Feedback |
| A | 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. |
| B | The greater petrosal nerve innervates the lacrimal gland, which is NOT a salivary gland. |
| C | The seventh cranial nerve innervates the minor salivary glands, which produce a mostly mucous type of saliva. |
| D | 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
- 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
| Feedback |
| A | 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. |
| B | The nasolacrimal duct is NOT located within the oral cavity. |
| C | The Stensen duct, also called the parotid duct, is NOT located in the floor of the oral cavity. |
| D | 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
- 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
| Feedback |
| A | The preganglionic and postganglionic parasympathetic fibers of the greater petrosal nerve synapse in the pterygopalatine ganglion as they provide innervation to the lacrimal gland. |
| B | Nerves that innervate the parotid salivary gland are NOT associated with the pterygopalatine ganglion. |
| C | Innervation of the sublingual salivary gland is NOT associated with the pterygopalatine ganglion. |
| D | 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
- 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
| Feedback |
| A | The inferior thyroid artery does NOT provide blood supply to the sublingual salivary gland. |
| B | The sublingual salivary glands are innervated by the sublingual (and submental) arteries. |
| C | 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. |
| D | 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
- 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
| Feedback |
| A | The lingual nerve in relationship to the submandibular duct is first superior and lateral and then inferior and medial. |
| B | The lingual nerve in relationship to the submandibular duct is first superior and lateral and then inferior and medial. |
| C | The lingual nerve in relationship to the submandibular duct is first superior and lateral and then inferior and medial. |
| D | 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
- 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 |
| A | 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. |
| B | 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. |
| C | 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. |
| D | 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
- 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 |
| A | 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. |
| B | 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. |
| C | 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. |
| D | 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. |
| E | 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
- 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 |
| A | 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. |
| B | 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. |
| C | 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. |
| D | 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
- 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. |
| B | 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, 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. |
| C | 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. |
| D | The parotid salivary gland also becomes enlarged and tender when a patient has mumps but NOT bony hard or constantly painful. |
| E | 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
- 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 | The lacrimal gland is innervated by parasympathetic fibers, drains into the superficial parotid lymph nodes, and lubricates the inside of the eyelids. |
| Incorrect | 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
- 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 | The thyroid gland produces and secretes thyroxine. The thyroid gland is both visible and palpable, if present. |
| Incorrect | 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
- 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 | The thymus gland matures T-cell lymphocytes, shrinks as an adult to undergo involution, and is innervated by branches of vagus nerve. |
| Incorrect | 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
- 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 | The sublingual salivary gland and submandibular salivary gland both DIRECTLY drain into the submandibular lymph nodes. |
| Incorrect | 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
- 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 | Both the thyroid gland and parathyroid glands DIRECTLY drain into the superior deep cervical lymph nodes. |
| Incorrect | 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
- 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
- Which of the following descriptive statements CORRECTLY concern the minor salivary glands of the oral cavity? (Select all that apply.)
| a. | Smaller in size than major salivary glands |
| b. | Secrete mainly a serous type of salivary product |
| c. | Less numerous than major salivary glands |
| d. | Found within soft palatal tissue |
| e. | Each has a single duct that secretes saliva |
ANS: A, D, E
| Feedback |
| Correct | 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. |
| Incorrect | 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
- 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 |
- Lacrimal gland
- Submandibular salivary gland
- Sublingual salivary gland
- Parotid salivary gland
- 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
- 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
- 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
- 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
