TEST BANK for Anatomy of Orofacial Structures 9th Edition by Brand, Isselhard & Smith

TEST BANK

TEST BANK

UNIT I: INTRODUCTION Chapter

1. Oral Cavity

UNIT II: DENTAL ANATOMY Chapter

2. The Tooth Functions and Terms

Chapter

3. Fundamental and Preventative Curvatures

Chapter

4. Dentition

Chapter

5. Development, Form, and Eruption

Chapter

6. Occlusion

Chapter

7. Dental Anomalies

Chapter

8. Supporting Structures

Chapter

9. Clinical Considerations

Chapter

10. Tooth Identification

Chapter

11. Root Morphology

Chapter

12. Incisors

Chapter

13. Canines

Chapter

14. Premolars

Chapter

15. Molars

Chapter

16. Deciduous Dentition

UNIT III: ORAL HISTOLOGY AND EMBRYOLOGY Chapter

17. Basic Tissues

Chapter

18. Development of Orofacial Complex

Chapter

19. Dental Lamina and Enamel Organ

Chapter

20. Enamel, Dentin, and Pulp

Chapter

21. Root Formation and Attachment Apparatus

Chapter

22. Eruption and Shedding of Teeth

Chapter

23. Oral Mucous Membrane

Chapter

24. The Tongue

Chapter

25. Histology of the Salivary Glands

UNIT IV: HEAD AND NECK ANATOMY Chapter

26. Osteology of the Skull

Chapter

27. Nose, Nasal Cavity, and Paranasal Sinuses

Chapter Muscles

28. Muscles of Mastication, Hyoid Muscles, and Sternocleidomastoid and Trapezius

Chapter

29. Temporomandibular Joint

Chapter

30. Muscles of Facial Expression

Chapter

31. Soft Palate and Pharynx

Chapter

32. Arterial Supply and Venous Drainage

Chapter

33. Salivary Glands

Chapter

34. Nervous System

Chapter

35. Lymphatics and Spread of Dental Infection

Chapter

36. Anatomical Considerations in Local Anesthesia Administration

Chapter 01: Oral Cavity Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. A diastema is a space between two teeth in the same arch. When this occurs between the

maxillary central incisors, it is often the result of a pronounced labial frenum. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

A space, or lack of contact area, between any two teeth in the same arch is called a diastema.

When a diastema occurs between the maxillary central incisors, it is often the result of a pronounced labial frenum extending to the crest of the alveolar ridge and possibly over the ridge. This band of firm connective tissue causes the erupting incisors to be pushed aside resulting in a diastema, or space. Correction of a diastema usually involves surgical removal, or cutting, of the frenal tissue between teeth.

REF: p. 3 OBJ: To describe the boundaries and sub-boundaries of the oral cavity and the structures in each area NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 2. Torus palatinus is seen on the a. soft palate. b. hard palate. c. alveolar ridge. d. oral pharynx.

ANS: B

Torus palatinus is excess bone growth and occurs in the midline of the hard palate. It may grow to varying sizes and is generally only a problem when the construction of a maxillary denture is necessary. In health, such bony protuberances, or excess bone growths, do not occur on the soft palate, alveolar ridge, or oral pharynx.

REF: p. 5 OBJ: To define the terms vestibule, oral cavity proper, mucobuccal fold, frenum, alveolar mucosa, gingiva, exostoses, torus palatinus, and torus mandibularis NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity, including but not limited to: 8. muscular/skeletal system.

TOP: BLOOM: Remembering 3. Contraction of which muscle raises the tongue upward? a. Mylohyoid b. Palatopharyngeal c. Palatoglossal d. Levator glossal ANS: A

Contraction of the mylohyoid muscle raises the tongue. The palatopharyngeal muscle and the palatoglossal muscle form the posterolateral borders of the oral cavity. There is not a muscle by the name of levator glossal.

REF: p. 7 OBJ: To define the landmarks in the floor of the mouth and the hard and soft palate and the structures that form them NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity, including but not limited to: 8. muscular/skeletal system.

TOP: BLOOM: Remembering 4. The oral vestibule is partially bordered by the lips and cheeks. The oral cavity proper extends

posteriorly to the soft palate. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The oral vestibule is the space or potential space that exists between the lips or cheeks and teeth. In an edentulous person, the vestibule would extend between the lips or cheeks and the alveolar ridges. The oral cavity proper is surrounded by teeth or alveolar ridges and extends all the way back to the palatine tonsils. This includes the region from the floor of the mouth upward to the hard and soft palates.

REF: p. 2 OBJ: To describe the boundaries and sub-boundaries of the oral cavity and the structures in each area NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 5. Each of the following is true of the uvula EXCEPT one. Which one is the EXCEPTION? a. It is located at the most posterior portion of the hard palate. b. It is located at the midline. c. It is a downwardly projecting muscle. d. It is necessary for swallowing.

ANS: D

The uvula is a downwardly projecting muscular tissue located at the midline of the most posterior portion of the hard palate. It is NOT necessary for swallowing.

REF: p. 6 OBJ: To define the landmarks in the floor of the mouth and the hard and soft palate and the structures that form them NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 6. The circumvallate papillae are located on the hard palate, buccal mucosa, and floor of the

mouth. The papillae found on the tongue are the filiform, fungiform, vallate, foliate, and incisive. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

All papillae listed in both statements are located on the tongue with the exception of the incisive papilla, which is located on the hard palate. Note that the incisive papilla is a singular structure, thus the different spelling. There are no papillae located on either the buccal mucosa or the floor of the mouth.

REF: p. 7 OBJ: To define the landmarks in the floor of the mouth and the hard and soft palate and the structures that form them NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 7. Each of the following structures can readily be viewed when examining the oral cavity

EXCEPT one. Which one is the EXCEPTION? a. Fovea palatinae b. Tonsillar pillars c. Laryngeal pharynx d. Sublingual fold ANS: C

The laryngeal pharynx is located below the oral pharynx and cannot be seen while examining the oral cavity. The fovea palatinae, the tonsillar pillars, and the sublingual fold can be seen when examining the oral cavity. Fovea palatinae are small depressions in mucosa on either side of the posterior nasal spine indicating the junction of the hard and soft palate. Tonsillar pillars are folds of tissue that partially surround the tonsils. The sublingual fold extends backward on either side of the floor of the mouth and is situated just superior to the submandibular gland.

REF: p. 2 | pp. 6-7 OBJ: To describe the boundaries and sub-boundaries of the oral cavity and the structures in each area NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 8. Each of the following structures is located within the hard palate EXCEPT one. Which one is

the EXCEPTION? a. Incisive papilla b. Rugae c. Greater palatine foramina d. The anterior and posterior pillars ANS: D

The anterior and posterior pillars are located posterior to the soft palate. The posterior pillar is also called the palatopharyngeal arch or fold. The anterior pillar is also called the palatoglossal arch or fold. The tonsils lie between the anterior and posterior pillars.

The incisive papilla and rugae are located on the anterior portion of the hard palate. The greater palatine foramina are located in the posterior portions of the hard palate lingual to the second and third maxillary molars.

REF: pp. 5-6 OBJ: To define the landmarks in the floor of the mouth and the hard and soft palate and the structures that form them NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity, including but not limited to: 8. muscular/skeletal system.

TOP: BLOOM: Remembering

9. The small bony growths that commonly occur on the buccal cortical plate of the maxillae and

the mandible are called a. torus palatinus. b. mandibular tori. c. exostoses. d. maxillary tuberosity.

ANS: C

Exostoses, small bony growths that occur on the buccal cortical plate on the mandible and the maxillae, are seen in a large portion of the population. They are normally inconsequential unless they become tender or a denture is needed. Exostoses occur more frequently on the mandible than on the maxillae.

Torus palatinus are excess bony growths that commonly occur in the midline of the palate.

Mandibular tori are bony swellings that frequently occur on the lingual surface of the mandible at the canine area. The maxillary tuberosity is a rounded bony protrusion in the area of the third molar.

REF: p. 4 OBJ: To define the terms vestibule, oral cavity proper, mucobuccal fold, frenum, alveolar mucosa, gingiva, exostoses, torus palatinus, and torus mandibularis NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity, including but not limited to: 8. muscular/skeletal system.

TOP: BLOOM: Remembering 10. Which structure is the MOST vascular in appearance? a. Mucogingival junction b. Alveolar mucosa c. Labial frenum d. Gingiva ANS: B

The alveolar mucosa, a thin layer of loosely attached and movable tissue, covers a highly vascular area. The presence of blood vessels immediately under this relatively thin mucosa is responsible for the general reddish color. By contrast, the mucogingival junction that divides the attached gingiva from the alveolar mucosa appears more pink in color. The gingiva and labial frenum also appear pink in color.

REF: p. 2 OBJ: To define the terms vestibule, oral cavity proper, mucobuccal fold, frenum, alveolar mucosa, gingiva, exostoses, torus palatinus, and torus mandibularis NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity, including but not limited to: 7. circulatory and lymphatic systems.

TOP: BLOOM: Remembering 11. Although a patient presenting with painful areas throughout the oral cavity or a child

presenting with gingival bleeding in the presence of excellent oral hygiene should be monitored carefully, referral to a dental specialist or physician is not indicated. A patient with a red and painful tongue does warrant such a referral as does a patient with moderate plaque on all teeth. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false, the second statement is true.

d. Both statements are false.

ANS: D

Of the four situations presented in this two-part question, only the patient with moderate plaque on all teeth does NOT warrant referral to a specialist. This patient should receive appropriate oral hygiene instructions, oral debridement, and be carefully monitored with short re-care appointments. The remaining three oral conditions described in the question describe conditions suggestive of systemic involvement and warrant further investigation, typically referral to a dental specialist or physician. In particular, gingival bleeding in the presence of excellent oral hygiene is a possible early sign of leukemia.

REF: p. 8 OBJ: To differentiate normal from abnormal anatomy in the oral cavity and to ensure a follow-up examination NAT: CDA: GC I. Evaluation, A. Preliminary examination. 4. Diagnostic data TOP: BLOOM: Analyzing 12. Which structure is most closely located to the lingual frenum? a. Sublingual caruncle b. Sublingual salivary gland c. Sublingual fold d. Lingual tonsils e. All of the above ANS: A

The sublingual caruncle, a small elevation on each side of the base of the lingual frenum, is the opening for the submandibular and sublingual salivary glands. Of the structures provided in the question, it is located most closely to the lingual frenum. The sublingual fold extends posteriorly from the sublingual caruncle. The lingual tonsils are located at the base of the tongue.

REF: p. 7 OBJ: To define the landmarks in the floor of the mouth and the hard and soft palate and the structures that form them NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 13. The term for misplaced sebaceous glands occurring in the oral cavity is rugae. These

harmless, yellowish granular structures occur in about 60% to 80% of the population. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Fordyce granules are misplaced sebaceous glands found in the oral cavity. These glands are normally associated with hair follicles, which are normally located in the skin. The most common locations for Fordyce granules are the lips, cheeks, and retromolar pads. Rugae are hard transverse ridges of epithelial and connective tissue located in the anterior portion of the hard palate.

REF: p. 5 OBJ: To differentiate normal from abnormal anatomy in the oral cavity and to ensure a follow-up examination NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity

TOP: BLOOM: Remembering 14. Of the following structures, which is the MOST susceptible to trauma? a. Hard palate b. Buccal mucosa c. Floor of the mouth d. Dorsal surface of the tongue e. Attached gingiva ANS: C

Although any oral tissue may be traumatized, the tissue in the floor of the mouth is one of the thinnest and thus very conducive to trauma. The hard palate and the attached gingiva have a more protective, fibrous nature. The dorsal (top) tongue and the buccal mucosa also have more protective features than does the mucosal lining on the floor of the mouth. Not listed as a selection, the ventral (lower) surface of the tongue is quite vulnerable to trauma.

REF: p. 7 OBJ: To define the landmarks in the floor of the mouth and the hard and soft palate and the structures that form them NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 15. A generally healthy man in his forties is curious about “little raised yellow spots” on his

buccal mucosa. He has noticed them in the past but they do not seem to cause problems or become larger, so has not previously asked about them. These areas are MOST likely a. vallate papillae. b. Kaposi’s spots. c. Fordyce granules. d. measles.

ANS: C

Fordyce granules are ectopic, or misplaced, sebaceous glands that occur on oral mucosal surfaces. They appear as small raised yellowish or whitish spots. Although alarming to patients, these formations are harmless. Vallate papillae, also called circumvallate papillae, are the large V-shaped row of taste buds located on the posterior dorsum of the tongue.

Kaposi’s spots, associated with immunodeficiency, are red and painful. Measles can appear anywhere on the body, including the oral cavity, and are red in color.

REF: p. 4 OBJ: To differentiate normal from abnormal anatomy in the oral cavity and to ensure a follow-up examination NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Understanding 16. Fordyce granules normally function as a. taste buds. b. a characteristic of a malignancy. c. sebaceous glands. d. an infectious viral illness.

ANS: C

Fordyce granules are misplaced sebaceous glands that appear as very small yellowish granular structures on oral mucosal surfaces in the oral cavity of 60% to 80% of the population.

Sebaceous glands normally occur in the skin; when they are present in the oral cavity they are considered misplaced, or ectopic. Although Fordyce granules may be alarming to patients, they are harmless. They most commonly occur in the mucosa of the lips, cheeks, retromolar pads, and gingival tissues.

REF: p. 4 OBJ: To differentiate normal from abnormal anatomy in the oral cavity and to ensure a follow-up examination NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 17. In the following illustration, structure “a” is the

a. b. c. d.

mucobuccal fold. maxillary labial frenum. mandibular labial frenum. mucogingival junction.

ANS: B

At the midline of the upper lip, a fold of connective tissue known as the maxillary labial frenum can be found. A corresponding structure, the mandibular labial frenum, is present at the midline of the lower lip. The upper frenum is usually more pronounced than the lower.

Both structures, as well as additional less well-defined frena, serve to attach the lips to the arch and contain only connective tissue. Structure “b” is the mandibular labial frenum.

Structure “c” is the mucogingival junction. Structure “d” is the mucobuccal fold.

REF: pp. 3-4 OBJ: To define the terms vestibule, oral cavity proper, mucobuccal fold, frenum, alveolar mucosa, gingiva, exostoses, torus palatinus, and torus mandibularis NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 18. In the following illustration, structure “b” is the

a. b. c. d.

mucobuccal fold. mucogingival junction. maxillary labial frenum. mandibular labial frenum.

ANS: D

At the midline of the lower lip, a fold of connective tissue known as the mandibular labial frenum can be found. A mandibular frenal attachment that extends too close to the gingiva may contribute to gingival recession. A corresponding structure, the maxillary labial frenum, is present at the midline of the upper lip. Both structures, as well as additional less welldefined frena, serve to attach the lips to the arch and contain only connective tissue. Structure “a” is the maxillary labial frenum. Structure “c” is the mucogingival junction. Structure “d” is the mucobuccal fold.

REF: pp. 3-4 OBJ: To define the terms vestibule, oral cavity proper, mucobuccal fold, frenum, alveolar mucosa, gingiva, exostoses, torus palatinus, and torus mandibularis NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 19. In the following illustration, structure “c” is the

a. b. c. d.

mucogingival junction. mandibular labial frenum. maxillary labial frenum. mucobuccal fold.

ANS: A

The mucogingival junction is the demarcation between the attached gingiva and the more loosely connected alveolar mucosa. A change in tissue color is evident at the mucogingival junction. The attached gingiva is pink in color whereas the alveolar mucosa is considerably more red. Structure “a” is the maxillary labial frenum. Structure “b” is the mandibular labial frenum. Structure “d” is the mucobuccal fold.

REF: pp. 3-4 OBJ: To describe the boundaries and sub-boundaries of the oral cavity and the structures in each area NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 20. In the following illustration, structure “d” is the

a. b. c. d.

mandibular labial frenum. mucogingival junction. mucobuccal fold. maxillary labial frenum.

ANS: C

The point at which the mucosa of the lips or cheeks joins the gingival tissue is known as the mucobuccal fold or mucolabial fold. These structures are generally located slightly distal to the canine teeth and are quite evident. Structure “a” is the maxillary labial frenum. Structure “b” is the mandibular labial frenum. Structure “c” is the mucogingival junction.

REF: pp. 3-4 OBJ: To define the terms vestibule, oral cavity proper, mucobuccal fold, frenum, alveolar mucosa, gingiva, exostoses, torus palatinus, and torus mandibularis NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 21. In the following illustration, structure “a” is the

a. sublingual fold. b. lingual frenum. c. sublingual caruncle.

ANS: B

The lingual frenum, also called the lingual frenulum, extends from an area near the tip of the ventral surface of the tongue to the floor of the mouth. If this frenum is attached close to the tip of the tongue and is rather short, the tongue movement will be limited resulting in a condition called ankyloglossia, or tongue tie. In the illustration, structure “b” is the sublingual fold; structure “c” is the sublingual caruncle.

REF: p. 7 OBJ: To define the terms vestibule, oral cavity proper, mucobuccal fold, frenum, alveolar mucosa, gingiva, exostoses, torus palatinus, and torus mandibularis NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 22. In the following illustration, structure “b” is the

a. sublingual fold. b. lingual frenum. c. sublingual caruncle.

ANS: A

The sublingual fold, a bilateral formation, extends from the sublingual caruncle and runs back along the floor of the mouth. In the illustration structure “a” is the lingual frenum; structure “c” is the sublingual caruncle.

REF: p. 7 OBJ: To define the landmarks in the floor of the mouth and the hard and soft palate and the structures that form them NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 23. In the following illustration, structure “c” is the

a. sublingual fold. b. sublingual caruncle. c. lingual frenum.

ANS: B

The sublingual caruncle is the opening for the ducts of the submandibular and sublingual salivary glands. It is a small elevation located at the base of each side of the lingual frenum.

Structure “a” is the lingual frenum. Structure “b” is the sublingual fold.

REF: p. 7 OBJ: To define the terms vestibule, oral cavity proper, mucobuccal fold, frenum, alveolar mucosa, gingiva, exostoses, torus palatinus, and torus mandibularis NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering TRUE/FALSE 1. The nasopalatine nerves and blood vessels travel through the incisive papilla.

ANS: F

The nasopalatine nerves and blood vessels travel through the incisive foramen as they innervate and deliver nutrients to the mucous membrane lingual to the maxillary incisor teeth.

The incisive papilla, a singular bulge of tissue at the midline immediately posterior to the central incisors, is located just above the incisive foramen. The incisive papilla is a point of injection for anesthetizing the anterior palate between the canines.

REF: p. 5 OBJ: To define the landmarks in the floor of the mouth and the hard and soft palate and the structures that form them NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity, including but not limited to: 7. circulatory and lymphatic systems. | CDA: GC I. Evaluation, B. Head, neck and oral cavity, including but not limited to: 9. nervous system.

TOP: BLOOM: Remembering 2. Beneath the incisive papilla is an injection site called the greater palatine foramen.

ANS: F

Beneath the incisive papilla is the incisive foramen, which carries the nasopalatine nerves and blood vessels to the mucous membrane lingual to the maxillary incisor teeth. The incisive foramen is a point of injection for anesthetizing the anterior palate area between the canines.

The greater palatine foramen, which serves as a landmark for local anesthesia, is located on the posterior portion of the hard palate adjacent to the maxillary second and third molars.

REF: p. 5 OBJ: To define the landmarks in the floor of the mouth and the hard and soft palate and the structures that form them NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity, including but not limited to: 8. muscular/skeletal system.

TOP: BLOOM: Remembering 3. The posterior portion of the soft palate is a part of the esophagus.

ANS: F

Most of the posterior portion of the soft palate is part of the oral pharynx. Food reaches the esophagus AFTER passing both the oral pharynx and laryngeal pharynx.

REF: p. 6 OBJ: To define the landmarks in the floor of the mouth and the hard and soft palate and the structures that form them NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 4. Projections on the cortical plate are exostoses of bone.

ANS: T

Exostoses are small, bony growths located on the cortical plate of the mandible and maxillae.

They generally occur more frequently on the mandible than on the maxilla. Exostoses are normally of no consequence unless they become tender from toothbrushing or if dentures are being constructed.

REF: p. 4 OBJ: To differentiate normal from abnormal anatomy in the oral cavity and to ensure a follow-up examination NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity, including but not limited to: 8. muscular/skeletal system.

TOP: BLOOM: Remembering 5. The indentation at the midline above the upper lip is called the philtrum.

ANS: T

The philtrum, derived from the embryonic nasal processes, is an indentation at the midline of the upper lip. It is at the lateral junction of the philtrum that a cleft lip might be formed.

REF: p. 2 OBJ: To describe the boundaries and sub-boundaries of the oral cavity and the structures in each area NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 6. Lymphoid tissues located at the base of the tongue are known as foliate papillae.

ANS: F

Enlargements of lymphoid tissue located at the base of the tongue are collectively known as lingual tonsils. Rudimentary foliate papillae are located on the lateral surfaces of the tongue.

Both lingual tonsils and foliate papillae should be carefully examined because their location makes them difficult to see and might hide early signs of oral cancer.

REF: p. 7

OBJ: To differentiate normal from abnormal anatomy in the oral cavity and to ensure a follow-up examination NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity TOP: BLOOM: Remembering 7. The ridge of bone that can be palpated in the upper posterior aspect of the vestibular space is

referred to as the vestibular zygomaticoalveolar crest.

ANS: T

The zygomaticoalveolar crest is a ridge of bone that marks the beginning of the anterior part of the zygomatic arch (cheek bone) and can be palpated by running the finger along the upper posterior vestibular space.

REF: p. 2 OBJ: To describe the boundaries and sub-boundaries of the oral cavity and the structures in each area NAT: CDA: GC I. Evaluation, B. Head, neck and oral cavity, including but not limited to: 8. muscular/skeletal system.

TOP: BLOOM: Remembering

Chapter 02: The Tooth: Functions and Terms Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The sensation of pain is felt in which part of the tooth? a. Enamel b. Dentin c. Cementum d. Pulp ANS: D

The dental pulp is the sensory and nourishing portion of the tooth. It is composed of blood vessels, lymph vessels, connective tissue, and nerve cells. The pulp also contains special dentin-reparative/formative cells called odontoblasts. Sensation of pain is not felt in enamel, cementum, or dentin.

REF: pp. 15-17 OBJ: To identify the different tissues that compose teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. Each of the following terms refers to an “in-between” surface EXCEPT one. Which one is the

EXCEPTION? a. Facial b. Mesial c. Distal d. Proximal

NURSINGTB.COM

ANS: A

Proximal, mesial, and distal are terms that describe surfaces of teeth that face a neighboring tooth; they also can be thought of as “in-between” surfaces. Proximal is the more general term for this type of surface. More specifically, a mesial surface is the proximal surface of a tooth closest to the midline; distal describes the proximal surface farthest from the midline. Facial surfaces are NOT proximal surfaces. Facial surfaces are more specifically known as labial (lip) surfaces on anterior teeth or buccal surfaces on posterior teeth.

REF: p. 19 OBJ: To define the terminology used in naming the landmarks of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth. | CDA: GC I.C.2. Identify the surfaces of the tooth.

TOP: BLOOM: Remembering 3. Which of the following is an example of a line angle? a. Mesiolabioincisal b. Buccolingual c. Mesiodistal d. Labioincisal e. Inciso-occlusal ANS: D

Only the labioincisal description qualifies as a line angle because line angles separate two adjacent surfaces of a tooth by forming a junction. The labioincisal line angle represents the junction of the labial surface of an anterior tooth with its incisal edge; note these are two adjacent surfaces on anterior teeth. Buccolingual, inciso-occlusal, and mesiodistal junctions are not adjacent surfaces. A mesiolabioincisal line angle is not a line angle because it represents the junction of three adjacent surfaces and is thus a point angle.

REF: pp. 17-19 OBJ: To name and identify the line angles of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. The hard yellow tissue that makes up the bulk of the tooth is called the a. enamel b. dentin c. cementum d. pulp ANS: B

Dentin is the hard, dense, calcified tissue that forms the greatest bulk of the tooth because it forms the largest portion of the crown and root. Softer than enamel, but harder than cementum or bone, the chemical composition of dentin is 70% inorganic and 30% organic matter and water. Unlike enamel, dentin is capable of adding to itself by producing reparative dentin.

REF: p. 14 OBJ: To identify the different tissues that compose teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. All of the following formatioN nsUaR reSdIepr esT siB on.sC EO XM CEPT one. Which one is the NG

EXCEPTION? a. Fossa b. Marginal ridge c. Developmental groove d. Lingual pit e. All of the above are depressions.

ANS: B

A ridge is an elevated portion of a tooth that runs in a line and is named for the specific location in which it occurs. Specifically, marginal ridges are the rounded borders of enamel that form the mesial and distal elevated shoulders of the occlusal surfaces of posterior teeth as well as the mesial and distal shoulders of the lingual surfaces of anterior teeth.

Fossae, grooves, and pits are depressed formations within the tooth. They are also described as concavities, indented areas, or simply concave structures. A fossa is broadly defined as a depression or concavity. Developmental grooves are shallow, depressed lines that separate primary parts of the crown or root. A pit is a pinhole evident within a fossa or anywhere on a tooth. A lingual pit occurs on the lingual surface of a tooth.

REF: pp. 21-24 OBJ: To name and identify the location of the various tooth surfaces NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

6. The function of both incisors and premolars is to cut food. The function of molars is to cut,

grind, and chew food. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Both statements contain incorrect information. While it is true that the function of incisors is to tear food, premolars are more like molars; their pointed buccal cusps hold food while the lingual cusps grind it. Regarding the second statement, the function of molars is to grind and chew food; tearing or incising is NOT a molar function.

REF: pp. 17-18 OBJ: To understand the individual functions and therefore the individual differences that exist among incisors, canines, premolars, and molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 7. The CEJ is where enamel meets the a. dentin b. junction c. cementum d. cervical third ANS: C

Enamel and cementum meet at the cementoenamel junction (CEJ). The demarcating line is called the cervical line, formN ed bR U y SthIe NjuGncti TBon.oCfOthMe cementum of the root and enamel of the crown.

REF: pp. 11-12 OBJ: To differentiate between clinical and anatomic crowns and roots NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 8. The dental tissue that most resembles bone is a. cementum b. dentin c. enamel d. none of the above ANS: A

Cementum, a bonelike substance, contains 45% to 50% inorganic and 50% to 55% organic matter. Not as dense or as hard as enamel or dentin, cementum is more dense than bone and physiologically resembles bone. Cementum covers the root and provides a medium for the attachment of the tooth to the alveolar bone.

REF: p. 16 OBJ: To identify the different tissues that compose teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 9. How many surfaces does a posterior tooth have? a. 2

b. c. d. e.

3 4 5 6

ANS: D

Posterior teeth have five surfaces whereas anterior teeth have four surfaces and a ridge.

Posterior surfaces are mesial, distal, buccal, lingual, and occlusal. Anterior tooth surfaces are mesial, distal, facial, lingual, and a biting surface is called an incisal ridge. Experts are in disagreement as to whether the incisal ridge of anterior teeth qualifies as a fifth surface.

REF: p. 19 OBJ: To name and identify the location of the various tooth surfaces NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth. | CDA: GC I.C.2. Identify the surfaces of the tooth.

TOP: BLOOM: Remembering 10. None of the following tissues have the ability to regenerate EXCEPT one. Which one is the

EXCEPTION? a. Enamel b. Dentin c. Pulp d. Periodontal ligament ANS: B

Dentin has the unique ability to regenerate, or stated differently, to add to itself. The resultant material, called secondary dentin, is formed throughout the pulp chamber after tooth eruption.

Over time, secondary dentin can completely fill the pulp chamber and become problematic. A specific type of secondary deN ntin URcal SIledNGrepa TBra.tiCveOdMentin is laid down in response to dental caries or trauma. Please note that while not a selection in this question, cellular cementum, which is confined to the apical third of the root, can reproduce to compensate for attrition of more coronal aspects of a tooth.

REF: p. 14 OBJ: To identify the different tissues that compose teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 11. Pulp canals a. are located in the crown portion b. have hornlike projections c. occupy the root portion d. occupy both the crown and root portion ANS: C

Anatomically the pulp is divided into two areas: the pulp chamber and the pulp canals. The pulp canals, also called root canals, are located within the roots of the tooth. The pulp chamber is located within the coronal portion of the tooth. Together the pulp chamber and pulp canals are referred to as the pulp cavity. Hornlike projections, appropriately called the pulp horns, are located at the most coronal aspect of the pulp cavity.

REF: p. 17 OBJ: To identify the different tissues that compose teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

12. The tooth surface facing the lip is called the mesial surface. The corresponding surface facing

the cheek is called the distal surface. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The key feature to this terminology is the position of a surface within the arch. Surfaces of anterior teeth that face the lip are called labial surfaces. Surfaces of posterior teeth that face the cheek are called buccal surfaces. A more broad term, encompassing both labial and buccal surfaces, is the facial surface. Mesial and distal surfaces are considered proximal surfaces and are adjacent, next to, or face neighboring teeth. Mesial proximal surfaces face to the midline while distal proximal surfaces face away from the midline.

REF: p. 19 OBJ: To name and identify the location of the various tooth surfaces NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth. | CDA: GC I.C.2. Identify the surfaces of the tooth.

TOP: BLOOM: Remembering 13. The prominence on the cervical third of the lingual aspect of anterior teeth is called the a. cervical line b. lingual ridge c. marginal ridge d. cingulum e. lingual cusp ANS: D

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The cingulum is the developmental lobe that makes up the bulk of the cervical third of anterior teeth. The lingually occurring cingulum is considered the fourth lobe of anterior teeth because anterior teeth are comprised of three other lobes, all positioned on the labial surface.

The cervical line is the line that demarcates the cementoenamel junction (CEJ). A lingual ridge is the triangular ridge of a mesiobuccal cusp that runs to the center of an occlusal surface. A marginal ridge is a rounded border of enamel that forms the mesial and distal shoulders of occlusal surfaces of posterior teeth and the mesial and distal shoulders of the lingual surfaces of anterior teeth. Cusps occur on canines, premolars, and molars. Lingual cusps are positioned at the lingual aspect of teeth and assist in chewing and grinding functions.

REF: p. 2 | p. 12 | p. 19 | p. 21 OBJ: To name and identify the location of the various tooth surfaces NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 14. Each of the following teeth is developed from four lobes EXCEPT one. Which one is the

EXCEPTION? a. Maxillary incisor b. Mandibular canine c. Maxillary first molar d. Mandibular second molar

ANS: C

Incisors, canines, and most premolars are developed from four lobes—three facial and one lingual. Second molars are developed from four lobes—two facial and two lingual. First molars develop from five lobes.

REF: p. 21 OBJ: To recognize how the functions of teeth determine their shape and size NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 15. In a partially erupted tooth, the visible portion is called the clinical crown. The anatomic

crown is not yet fully formed. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The clinical crown is the portion of the tooth that is actually visible in the mouth. In a partially erupted tooth only the visible portion, i.e., the portion coronal to the marginal gingiva, comprises the clinical crown. Conversely, in areas of gingival recession the entire portion of the tooth that is visible, i.e., coronal to the marginal gingiva, comprises the clinical crown. In cases of recession the visible portion of the root as well as the entire crown comprise the clinical crown. The second statement is false because in partially erupted teeth the crown is fully formed.

REF: p. 11 OBJ: To differentiate between clinical and anatomic crowns and roots NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, COOMOM: Remembering including but not limited to: teeN thU . RSINGTT OB P:.BL 16. Which dental tissue is composed of 70% inorganic and 30% organic matter? a. Dentin b. Enamel c. Cementum d. Bone ANS: A

The chemical composition of dentin is 70% inorganic and 30% organic matter and water.

Dentin is softer than enamel but harder than cementum or bone. Dentin, the tissue forming the greatest bulk of the tooth, is yellow in color and elastic in nature. It is wrapped in an envelope of enamel covering the crown and an envelope of cementum covering the tooth.

REF: p. 14 OBJ: To identify the different tissues that compose teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 17. Which structure separates primary parts of a crown or root? a. Marginal ridge b. Developmental groove c. Developmental pit d. Transverse ridge e. B and C

ANS: B

Shallow grooves or lines that separate primary parts of the crown or root are called developmental grooves. Marginal ridges are rounded borders of enamel that form mesial and distal shoulders of occlusal and incisal surfaces. Developmental pits are pinpoint holes evident within a fossa or anywhere on a tooth that are not associated with a disease process. A transverse ridge is the union of two triangular ridges, a buccal and a lingual, that cross the occlusal surface of a posterior tooth.

REF: p. 21 | pp. 25-26 OBJ: To differentiate between clinical and anatomic crowns and roots NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 18. In the illustration below, structure “a” represents the

a. b. c. d.

distal marginal ridge mesial marginal ridge lingual fossa lingual groove

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ANS: C

Structure “a” in the illustration is the lingual fossa. A fossa is a depression, concavity, or an area on the tooth that is indented. Fossae are named for their location; the fossa represented in the question is a lingual fossa. Structures b, c, and d are the mesial marginal ridge, the lingual groove, and the distal marginal ridge, respectively.

REF: p. 21 | p. 23 OBJ: To name and identify the location of the various tooth surfaces NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 19. In the illustration below, structure “b” is the

a. b. c. d.

distal marginal ridge mesial marginal ridge lingual fossa lingual groove

ANS: B

Structure “b” in the illustration is the mesial marginal ridge, which forms the mesial shoulder of the lingual surface of an anterior tooth. Structures a, c, and d are the lingual fossa, the lingual groove, and the distal marginal ridge, respectively.

REF: p. 21 | pp. 23-24 OBJ: To name and identify the location of the various tooth surfaces NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 20. In the illustration below, struN cturR e “cI ” isGtheB.C

U S N T

a. b. c. d.

M O

distal marginal ridge mesial marginal ridge lingual fossa lingual groove

ANS: D

Structure “c” in the illustration is the lingual groove, which is a developmental line that separates the fourth (labial) lobe from the three labial lobes of anterior tooth. Structures a, b, and d, are the lingual fossa, the mesial marginal ridge, and the distal marginal ridge, respectively.

REF: p. 25

OBJ: To name and identify the location of the various tooth surfaces

NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 21. In the illustration below, structure “d” is the

a. b. c. d.

distal marginal ridge mesial marginal ridge lingual fossa lingual groove

ANS: A

Structure “d” in the illustration is the distal marginal ridge, which forms the distal shoulder of the lingual surface of an anterior tooth. Structures a, b, and c are the lingual fossa, mesial marginal ridge, and the lingual groove, respectively.

REF: p. 21 | p. 23 OBJ: To name and identify the location of the various tooth surfaces NAT: CDA: GC I.A.7. IdentifyNbasR ic oI ral aG nd dBe. ntaCl anM atomy, physiology, and development, including but not limited to: teethU . S N TT OP: BLOOOM: Remembering 22. In the following illustration, structure “a” refers to a fossa, which is a convexity or bulge on a

tooth. Structure “b” refers to a ridge, which is a concavity or depression within a tooth.

a. b. c. d.

Both statements are true.

The first statement is true; the second statement is false.

The first statement is false; the second statement is true.

Both statement are false.

ANS: D

Although the structures are correctly identified, the descriptive comments are reversed so both statements are incorrect. A fossa is a concavity or depression within a tooth. A ridge is a convexity or bulge on a tooth. More specifically, “a” is the lingual fossa; “b” is the distal marginal ridge.

REF: p. 21 OBJ: To name and identify the location of the various tooth surfaces NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. The pulp is composed of which of the following tissues (Select all that apply.)? a. Lymph tissue b. Connective tissue c. Nerve tissue d. Odontoblasts e. Alveolus ANS: A, B, C, D

The pulp is composed of blood vessels, lymph vessels, connective tissue, nerve tissue, and special dentin-formative cells called odontoblasts. Alveolus, the term for the tooth socket within the alveolar process, is not contained within the pulp and is an incorrect response.

REF: p. 13 | p. 16 OBJ: To identify the different tissues that compose teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

N R I G B.C M

2. Which of the following structuU res S reprN esenTt a conO cavity or depression within the surface of a

tooth (Select all that apply.)? a. Pit b. Fossa c. Tubercle d. Cusp e. Groove ANS: A, B, E

A concavity is a carved-out section or area, like a cave. The smallest concavities found on teeth are called pits, which are pinpoint holes usually occurring along developmental grooves or fossa. Grooves and fossa are also concavities because they are depressed or carved-out areas. Conversely, tubercles and cusps represent the opposite of concavities, convexities. A convexity is defined as an area that bulges out.

REF: p. 21 | p. 25 OBJ: To name and identify the location of the various tooth surfaces NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering TRUE/FALSE 1. All anterior teeth have cusps.

ANS: F

All POSTERIOR teeth have cusps; however the only anterior teeth with cusps are canines. In earlier nomenclature, canines were called cuspids. The remaining anterior teeth, the central and lateral incisors, do NOT have cusps.

REF: p. 25 OBJ: To recognize how the functions of teeth determine their shape and size NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. Cellular cementum has the ability to reproduce itself.

ANS: T

The two types of cementum are cellular and acellular; only the cellular type is capable of reproducing itself. Cellular cementum is confined to the apical third of the root and is able to compensate for the attrition (wear) that occurs on the crown of the tooth throughout life. The cells that produce cementum are called cementocytes.

REF: p. 16 OBJ: To identify the different tissues that compose teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Roots of molars can be bifurcated or trifurcated.

ANS: T

While it is true that molars can be bifurcated or trifurcated, this characteristic is dependent on the arch. Maxillary molars are trifurcated, meaning they have three roots; their root is divided into three portions. Mandibular molars are bifurcated; their root is divided into two portions.

REF: p. 14 | p. 172 | p. 183 NURSINGOT BB J:.C ToOdM efine single, bifurcated, and trifurcated roots NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. Mesio-occlusodistal is a location of a point angle.

ANS: F

A mesio-occlusaldistal point angle does not exist. A point angle is the point at which three surfaces meet. The mesial and distal surfaces are separated by too much distance for them to meet at a point with any other surface.

REF: p. 19 OBJ: To name and identify the point angles of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. The part of the tooth that shows when someone opens their mouth is the anatomic crown.

ANS: F

The anatomic crown is the entire coronal portion of the tooth that is covered by enamel, regardless of whether it is visible in the mouth or not. Unerupted portions of the crown are considered part of the anatomic crown. By contrast, the clinical crown is only that portion visible above the gingiva, and hence the part visible when someone opens his or her mouth.

The clinical crown is also described as that portion of the crown that has erupted.

REF: p. 11

OBJ: To differentiate between clinical and anatomic crowns and roots

NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. Edentulous people may have problems speaking properly.

ANS: T

Teeth are necessary for proper speech and phonetics; therefore those without teeth (edentulous) may have significant problems in this area.

REF: p. 11 OBJ: To identify the different functions of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 7. The lower the root to crown ratio number the more resistance a tooth would have to

displacement.

ANS: F

The higher the root to crown ratio number the more resistance to displacement. The root to crown ratio is the length of the root divided by the length of the crown. The root is measured from its apical end to the cervical line. The crown is measured from the cervical line to its most occlusal or incisal part. Almost all anatomic teeth have longer roots than crowns; therefore, the root to crown ratio of anatomic teeth is nearly always at least 1 or more. This ratio affords us a way to compare the resistance to displacement of teeth based on the length of their roots compared with their crowns.

REF: pp. 11-12 OBJ: To understand the significance of the crown/root ratio NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, COOMOM: Understanding including but not limited to: teeN thU . RSINGTT OB P:.BL MATCHING

Teeth are comprised of the four tissue types listed below. While examining and treating teeth dental professionals must understand the composition and characteristics of each tissue type.

Match the tissue type with the appropriate description. a. Enamel b. Cementum c. Dentin d. Pulp 1.

2.

3.

4.

Has a sensory function Outer covering of root Hardest mineralized tissue Tissue next to pulp

1. ANS: D REF: pp. 13-17 OBJ: To identify the different tissues that compose teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The pulp has sensory and nourishing functions as well as dentin-reparative capability. Enamel is the most densely mineralized and hardest tissue in the human body. The cementum is a bonelike substance that covers the root and provides a medium for attachment of the tooth to the alveolar bone.

Dentin is the tissue that lies next to the pulp, forms the main body of the tooth, and comprises the

largest portion of both the crown and root.

2. ANS: B REF: pp. 13-17 OBJ: To identify the different tissues that compose teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The cementum is a bonelike substance that covers the root and provides a medium for attachment of the tooth to the alveolar bone. Enamel is the most densely mineralized and hardest tissue in the human body. Dentin is the tissue that lies next to the pulp, forms the main body of the tooth, and comprises the largest portion of both the crown and root. The pulp has sensory and nourishing functions as well as dentin-reparative capability.

3. ANS: A REF: pp. 13-17 OBJ: To identify the different tissues that compose teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: Enamel is the most densely mineralized and hardest tissue in the human body. The cementum is a bonelike substance that covers the root and provides a medium for attachment of the tooth to the alveolar bone. Dentin is the tissue that lies next to the pulp, forms the main body of the tooth, and comprises the largest portion of both the crown and root. The pulp has sensory and nourishing functions as well as dentin-reparative capability.

4. ANS: C REF: pp. 13-17 OBJ: To identify the different tissues that compose teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: Dentin is the tissue that lies next to the pulp, forms the main body of the tooth, and comprises the largest portion of both the crown and root. Enamel is the most densely mineralized and hardest tissue in the human body. The cementum is a bonelike substance that covers the root and provides a medium for attachment of the tooth to the alveolar bone. The pulp has sensory and nourishing functions as well as dentin-reparative capability.

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Chapter 03: Fundamental and Preventive Curvatures Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Embrasures are spillways between teeth that allow food to be shunted away from contact

areas. While effective embrasures are self-cleaning, poorly contoured embrasures lead to gingival irritation and breakdown. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

Both statements correctly describe features of embrasures. The terms embrasure and spillway are often used synonymously. In addition to shunting food and self-cleansing aspects, effective embrasures permit a slight amount of gingival stimulation by frictionally massaging food. Poorly contoured embrasures decrease the beneficial aspects of embrasures and lead to accumulation of plaque, debris, and food.

REF: pp. 29-30 OBJ: To identify the successful characteristics of tooth shape and alignment in protecting the periodontium NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 2. Each of the following statemN enU tsRisStI ruN eG ofTtB he.cC urO vM ature of the CEJ EXCEPT one. Which one

is the EXCEPTION? a. The curvature of the cervical line, or CEJ, depends on the height of the contact area. b. The curvature of the cervical line, or CEJ, depends on the diameter of the crown. c. The mandibular anterior teeth show the greatest amount of curvature of the cervical line. d. The more anterior the tooth, the greater is the curvature of the cervical line.

ANS: C

The maxillary anterior teeth show the greatest amount of curvature of the cervical line. The more anterior the tooth, then the greater is the curvature. The remaining statements are correctly stated.

REF: p. 32 OBJ: To identify the proximal contact areas NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Height of contour is the same as a. embrasure b. crest of curvature c. alignment d. proximal contact e. width of tooth

ANS: B

Height of contour is also called crest of curvature and relates to the curvature of the cervical line, or the CEJ. The height of the contour impacts periodontal attachment in that a higher contoured cervical line affords more cementum on which bone can attach itself. The periodontal attachment follows the cervical line and connects the gingiva to the cementum.

REF: p. 32 OBJ: To identify the successful characteristics of tooth shape and alignment in protecting the periodontium NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. Each of the following is a function of embrasures EXCEPT one. Which one is the

EXCEPTION? a. Provide self-cleansing from the contact area b. Reduce occlusal trauma c. Discourage food impaction d. Prevent gingival stimulation ANS: D

Embrasures, also called spillways, permit a slight amount of stimulation to the gingiva by frictional massage of food while at the same time protecting the gingiva from undue trauma.

Embrasures provide the remaining protective features, which promote periodontal health and preserve the dentition.

REF: pp. 29-30 OBJ: To identify contact points NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oraN l cav P:.B Rity.I GTOB CLOMOM: Remembering

U S N T

O

5. Posterior teeth have contact areas slightly buccal to the center of teeth. Lingual embrasures of

posterior teeth are wider than buccal embrasures. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

Posterior teeth have contact areas slightly buccal to the center of teeth. Consequently, buccolingually the lingual embrasures are wider than the facial embrasures. The reason is that from their contact point outward, teeth are narrower on the lingual side than on the facial side.

These relationships are apparent when viewed occlusally.

REF: p. 31 OBJ: To identify the successful characteristics of tooth shape and alignment in protecting the periodontium NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. Each of the following is a characteristic of contact areas EXCEPT one. Which one is the

EXCEPTION? a. Stabilize teeth b. Discourage food impaction

c. Are located in middle third of tooth d. Protect interdental papilla e. All are true.

ANS: C

Contact areas are located in different positions on the proximal surfaces depending on the location of teeth. A helpful rule: the more posterior the tooth, then the more cervical is the location of its contact area. From a facial view the contact areas of anterior teeth are located closer to the incisal surfaces of teeth whereas the posterior teeth have their contact areas nearer to the middle third of teeth. Viewed occlusally, the contact areas of anterior teeth are located in the center between the labial and lingual surfaces of the tooth. Also viewed occlusally, posterior teeth have contact areas slightly buccal to the center of teeth. Functional contact areas perform a multitude of protective functions including those listed in the question.

REF: pp. 27-28 OBJ: To identify contact points NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 7. A molar with little or no curvature on the buccal surface would result in a. open contact area b. overstimulation of gingiva c. inadequate stimulation of gingiva d. difficult oral hygiene access ANS: B

Curvature of the buccal and lingual surfaces provides the right amount of gingival stimulation by deflecting food. InadequaN teUcuRrva S Iture N Gres T Bul.tsCinO tMoo much deflection of food, which causes overstimulation of the gingival tissues. This action, combined with food being forced into the gingival crevice, contributes to gingival inflammation, periodontal disease, or tissue recession.

The shapes of teeth aid greatly in prevention of periodontal disease.

REF: p. 33 OBJ: To identify the successful characteristics of tooth shape and alignment in protecting the periodontium NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 8. Interproximal spaces lie between teeth and bone on one side and the proximal surfaces and

their contact area on the other side. Interproximal spaces are U-shaped in posterior regions and more rounded in anterior regions. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Interproximal spaces are triangular-shaped spaces in all regions of the mouth. The contact area forms the apex of the triangle, the proximal surfaces form the sides, and the alveolar bone makes up the base.

REF: p. 28

OBJ: To identify the proximal contact areas

NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 9. Each of the following can be damaged by an overhanging restoration EXCEPT one. Which

one is the EXCEPTION? a. Contact point b. Marginal gingiva c. Plaque retention d. Alveolar bone e. Contact area ANS: A

A contact point is where the occlusal cusp of one tooth touches the occlusal portion of the opposing arch. Although an overhanging restoration would not affect the contact point, the health and position of the marginal gingiva; plaque retention and accumulation; integrity of the alveolar bone; and the contact AREA would all be affected. Note that the contact point and the contact area differ significantly. Also note that with time and progressive periodontal damage, teeth may drift and ultimately may also affect the contact point!

REF: pp. 27-28 | p. 34 OBJ: To identify the proximal contact areas NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 10. Each of the following is part of the periodontium EXCEPT one. Which one is the

EXCEPTION? a. Enamel b. Cementum c. Free gingiva d. Alveolar mucosa e. Alveolar bone

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ANS: A

The periodontium consists of the free gingiva, attached gingiva, alveolar mucosa, cementum, periodontal ligament, and the alveolar bone. Enamel is not part of the periodontium; it forms the outer surface of the anatomic crown.

REF: p. 13 | p. 33 OBJ: To identify the successful characteristics of tooth shape and alignment in protecting the periodontium NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 11. Which illustration depicts an overcontoured restoration? a.

b.

c.

ANS: C

Illustration “C” depicts an overcontoured restoration. The arrows indicate that food is being deflected in such a way that the gingival tissue is neither stimulated nor cleaned by the frictional action of food. Also apparent are mesial and distal contours that do not replicate the natural shape of the tooth.

REF: p. 33 OBJ: To identify the successful characteristics of tooth shape and alignment in protecting the periodontium NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 12. What are the arrows pointing to in the illustration below?

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a. b. c. d. e.

Contact areas Height of curvature Buccal contour Excess curvature None of the above

ANS: B

The arrows are pointing to the buccal and lingual crests of the height of the curvature of the crown. The buccal height of curvature is at the cervical third; the lingual height of curvature is at the middle third on maxillary and mandibular premolars and molars.

REF: p. 32 OBJ: To identify the successful characteristics of tooth shape and alignment in protecting the periodontium NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

TRUE/FALSE 1. An overhanging restoration extends above the occlusal surface and prevents normal occlusal

contact between the arches.

ANS: F

An overhanging restoration extends into the interproximal area, promoting retention and buildup of plaque, bacteria, and food. Such a response is damaging to surrounding gingival and periodontal tissues.

REF: p. 34 OBJ: To identify the successful characteristics of tooth shape and alignment in protecting the periodontium NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. The facial crest of curvature for all teeth is located at the cervical third.

ANS: T

The facial height, or crest, of tooth contour allows for maximum cleaning of the lips and cheeks. In general the location of the facial (buccal and labial) height of contour of both anterior and posterior teeth is always at the cervical third of the tooth. The crest/height of curvature refers to the widest part of the crown of the tooth.

REF: p. 31 OBJ: To identify the successful characteristics of tooth shape and alignment in protecting the periodontium NAT: CDA: GC I.A.7. IdentifyNbas ntaCl an URicSoIralNaGnd TdBe. OMatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. The curvature of the CEJ is generally greater on the mesial surfaces.

ANS: T

The mesial curvature of a tooth is greater than the distal curvature of the same tooth. Also pertinent, the maxillary anterior teeth show the greatest amount of curvature of the cervical line. The cervical line is also called the cementoenamel junction or CEJ. REF: p. 32 OBJ: To understand that teeth are shaped to align next to each other to preserve the dentition NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. Contact point and contact area are synonymous terms; that is, they mean the same thing.

ANS: F

A contact point differs from a contact area. A contact point is where the occlusal cusp of one tooth touches the occlusal portion of another tooth in the opposing arch. By contrast, contact areas of teeth are the areas where the proximal surfaces touch one another. The contact area, more formally called the proximal contact area, prevents food from packing between two adjacent teeth.

REF: p. 28

OBJ: To identify the proximal contact areas | To identify contact points

NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 5. Alignment refers to the height or level of alveolar bone between teeth.

ANS: F

Alignment refers to the position of teeth in each arch.

REF: p. 27 OBJ: To understand that teeth are shaped to align next to each other to preserve the dentition NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. Deep pits and fissures on the occlusal surface make cleaning the tooth difficult.

ANS: F

While it may seem that deep pits, fissures, or holes in enamel make cleaning difficult, these structures have numerous beneficial aspects. By serving as spillways during mastication, pits and fissures enable food to pass around teeth. This action prevents food from being forced interproximally. Pits and fissures facilitate interdigitation of opposing cusps during grinding of food, which dissipates extreme occlusal forces. Along with these beneficial aspects, deep pits and fissures promote plaque retention.

REF: p. 33 OBJ: To identify the successful characteristics of tooth shape and alignment in protecting the periodontium NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeN th. R I GTOB P:.C BLOMOM: Understanding

U S N T

O

MATCHING

Characteristics of tooth shape and alignment protect the periodontium, preserve the dentition, and enhance self-cleaning mechanisms. Match each anatomic feature with its most closely related corresponding term. a. Interdental space b. Crest of curvature c. Cervical line d. Embrasure e. Occlusal contact 1.

2.

3.

4.

5.

Spillway CEJ Contact point Height of contour Interproximal space

1. ANS: D REF: pp. 28-29 | pp. 31-32 OBJ: To identify the successful characteristics of tooth shape and alignment in protecting the periodontium NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

2.

3.

4.

5.

NOT: Embrasures are spillways between teeth that are occlusal to the contact areas. They prevent food impaction. The CEJ, or more formally the cementoenamel junction, is demarcated by the cervical line. A contact point is where the occlusal cusp of one tooth touches the occlusal portion of a tooth in the opposing arch. The height of contour, also called the crest of contour, depends on the height of the contact area above the crown cervix as well as the diameter of the crown labiolingually or buccolingually. The interproximal spaces are triangular-shaped spaces between teeth that are normally filled with papillary gingiva-also called the interdental papilla. Not in the question but pertinent, interdental space is the space between teeth that provides a place for the bulk of bone and affords nutritive vascular support and a stronger bony base.

ANS: C REF: pp. 28-29 | pp. 31-32 OBJ: To understand that teeth are shaped to align next to each other to preserve the dentition NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The CEJ, or more formally the cementoenamel junction, is demarcated by the cervical line.

Embrasures are spillways between teeth that are occlusal to the contact areas. They prevent food impaction. A contact point is where the occlusal cusp of one tooth touches the occlusal portion of a tooth in the opposing arch. The height of contour, also called the crest of contour, depends on the height of the contact area above the crown cervix as well as the diameter of the crown labiolingually or buccolingually. The interproximal spaces are triangular-shaped spaces between teeth that are normally filled with papillary gingiva-also called the interdental papilla. Not in the question but pertinent, interdental space is the space between teeth that provides a place for the bulk of bone and affords nutritive vascular support and a stronger bony base.

ANS: E REF: pp. 28-29 | pp. 31-32 OBJ: To identify contact points NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: A contact point is where the occlusal cusp of one tooth touches the occlusal portion of a tooth in the opposing arch. Embrasures are spillways between teeth that are occlusal to the contact areas.

They prevent food impaction. The CEJ, or more formally the cementoenamel junction, is demarcated by the cervical line. The height N ofUcR onS toI urN , aG lsT oB ca. lleCdO thM e crest of contour, depends on the height of the contact area above the crown cervix as well as the diameter of the crown labiolingually or buccolingually. The interproximal spaces are triangular-shaped spaces between teeth that are normally filled with papillary gingiva-also called the interdental papilla. Not in the question but pertinent, interdental space is the space between teeth that provides a place for the bulk of bone and affords nutritive vascular support and a stronger bony base.

ANS: B REF: pp. 28-29 | pp. 31-32 OBJ: To identify the successful characteristics of tooth shape and alignment in protecting the periodontium NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The height of contour, also called the crest of contour, depends on the height of the contact area above the crown cervix as well as the diameter of the crown labiolingually or buccolingually.

Embrasures are spillways between teeth that are occlusal to the contact areas. They prevent food impaction. The CEJ, or more formally the cementoenamel junction, is demarcated by the cervical line.

A contact point is where the occlusal cusp of one tooth touches the occlusal portion of a tooth in the opposing arch. The interproximal spaces are triangular-shaped spaces between teeth that are normally filled with papillary gingiva-also called the interdental papilla. Not in the question but pertinent, interdental space is the space between teeth that provides a place for the bulk of bone and affords nutritive vascular support and a stronger bony base.

ANS: A REF: pp. 28-29 | pp. 31-32 OBJ: To understand that teeth are shaped to align next to each other to preserve the dentition NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The interproximal spaces are triangular-shaped spaces between teeth that are normally filled

with papillary gingiva which-also called the interdental papilla. Embrasures are spillways between teeth that are occlusal to the contact areas. They prevent food impaction. The CEJ, or more formally the cementoenamel junction, is demarcated by the cervical line. A contact point is where the occlusal cusp of one tooth touches the occlusal portion of a tooth in the opposing arch. The height of contour, also called the crest of contour, depends on the height of the contact area above the crown cervix as well as the diameter of the crown labiolingually or buccolingually. Not in the question but pertinent, interdental space is the space between teeth that provides a place for the bulk of bone and affords nutritive vascular support and a stronger bony base.

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Chapter 04: Dentition Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. A tooth numbering system that always uses two numbers for each tooth is the a. Palmer b. Federation Dentaire Internationale (FDI) c. universal d. double digit ANS: B

The Federation Dentaire Internationale (FDI) tooth identification system assigns each tooth, deciduous or permanent, a two-digit number. No letters or duplicate numbers are used. The first digit indicates the quadrant and whether the tooth is permanent or deciduous. The second digit identifies the tooth’s position relative to the midline. Lowest numbers are closest to the midline.

REF: pp. 36-41 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 2. In the Palmer System, permanent central incisors are assigned the number a. 1 b. 5 c. 8 d. 24

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ANS: A

In the Palmer tooth identification system the permanent teeth closest to the midline have the lowest number. Permanent central incisors are assigned the number 1. Note that the Palmer system utilizes letters to identify the deciduous dentition. Deciduous teeth closest to the midline are assigned letters closer to the beginning of the alphabet. Deciduous central incisors are assigned the letter A. REF: pp. 37-39 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 3. In the deciduous dentition, tooth “K” refers to a. maxillary left second molar b. mandibular left second molar c. mandibular right first molar d. mandibular right canine e. none of the above ANS: B

The letter K refers to the deciduous mandibular left second molar. This represents the Universal system of deciduous teeth. Letters A–J are assigned to the 10 maxillary deciduous teeth; letters K–T are assigned to the 10 mandibular deciduous teeth.

REF: p. 39 OBJ: To understand the difference between primary dentition, secondary dentition, and mixed dentition NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 4. In the Universal System, #9 refers to the permanent maxillary left central incisor. In the

Universal System, #29 refers to the permanent mandibular first right molar. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

In the Universal System the maxillary left central incisor is identified as tooth #9. Tooth #29 refers to the permanent right second premolar. The Universal system utilizes numbers 1–32 to identify the permanent teeth. This system begins with the maxillary right third molar as tooth number 1 and proceeds across the arch to the maxillary left third molar, which is tooth number 16. The system then identifies the mandibular left third molar as tooth number 17 and proceeds across the arch to mandibular right third molar, tooth number 32.

REF: pp. 36-37 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NURSINGTB.COM NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 5. In the deciduous dentition, tooth “C” in the Universal System refers to the maxillary right

lateral incisor. Tooth “K” refers to the mandibular left second molar. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

In the Universal System tooth “C” refers to the deciduous maxillary right canine. The question correctly identifies “K” as the mandibular left second molar. For the deciduous dentition the Universal System utilizes letters A through T. The letter A is assigned to the deciduous maxillary right second molar, and the letter T to the deciduous mandibular right second molar.

Note that the deciduous dentition is also called the primary dentition.

REF: pp. 36-37 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 6. In the Universal System, #19 refers to

a. b. c. d.

permanent mandibular left first molar permanent mandibular left second molar permanent mandibular right first molar permanent mandibular left second premolar

ANS: A

In the Universal System the permanent mandibular left first molar is identified as tooth #19.

The Universal system utilizes numbers 1–32 to identify the permanent teeth. This system begins with the maxillary right third molar as tooth number 1 and proceeds across the arch to the maxillary left third molar, tooth number 16. The system then identifies the mandibular left third molar as tooth number 17 and proceeds across the arch to mandibular right third molar, tooth number 32.

REF: pp. 36-37 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 7. Tooth number 3, the permanent maxillary right first molar, is succedaneous because it

replaces a primary (deciduous) molar. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

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Permanent molars are not succedaneous because they do not replace deciduous teeth. Primary molars are replaced by permanent premolars (there are no deciduous premolars).

Succedaneous applies to only teeth that succeed or take the place of the deciduous teeth after they have been shed. Succedaneous teeth are the permanent incisors, canines, and premolars.

Note that while the term deciduous is technically correct, the term primary is often used interchangeably.

REF: p. 36 OBJ: To understand the difference between primary dentition, secondary dentition, and mixed dentition NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 8. Tooth #65 is the code for the a. permanent mandibular right second premolar b. deciduous mandibular left second molar c. deciduous maxillary left first molar d. deciduous maxillary right second molar e. none of the above ANS: E

In the Federation Dentaire Internationale (FDI) system tooth #65 is the deciduous maxillary LEFT second molar. Note that selection “d” is incorrect because it is on the wrong side of the mouth. All identification systems view teeth as if the practitioner is looking at the face from the outside.

REF: pp. 39-41 OBJ: To identify a tooth when given a code from one of the three systems NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 9. A patient has porcelain crowns on #3 and #14. These are the permanent a. maxillary right first molar and maxillary left second molar b. maxillary right canine and maxillary left first molar c. maxillary first molars d. maxillary right first molar and mandibular left first molar e. none of the above ANS: C

Permanent maxillary first molars are teeth numbers 3 and 14. Permanent mandibular molars are teeth numbers 19 and 30. Memorizing key teeth such as first molars provides students with a means of relating to other teeth.

REF: pp. 36-37 OBJ: To identify a tooth when given a code from one of the three systems NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 10. Decay on the occlusal surface of tooth S refers to which deciduous tooth? a. Maxillary left second molar b. Mandibular left second mNoU laR r SINGTB.COM c. Mandibular right first molar d. Mandibular right second molar ANS: C

For the deciduous dentition the Universal System utilizes letters A through T. The mandibular right first molar is assigned the letter “S.” Regarding the incorrect selections, the maxillary left second molar is assigned the letter “J.” The mandibular left second molar is assigned the letter “K.” The mandibular right second molar is assigned the letter “T.” REF: pp. 36-37 OBJ: To identify a tooth when given a code from one of the three systems NAT: CDA: GC I.C.2. Identify surfaces of the tooth.

TOP: BLOOM: Remembering TRUE/FALSE 1. The right quadrant refers to the patient’s right side.

ANS: F

The dentition contains two arches, maxillary and mandibular. Each arch is further divided into a right and a left half, making four quadrants. The right quadrant is an incorrect term as there are two quadrants on the patient’s right side – the maxillary right quadrant and the mandibular right quadrant.

REF: p. 36

OBJ: To understand the arrangement of teeth into dentitions, arches, and quadrants NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. Permanent first molars are succedaneous teeth.

ANS: F

Permanent teeth that replace or succeed the deciduous teeth are called succedaneous teeth.

Because permanent molars do NOT have predecessors, and they do NOT succeed or replace deciduous teeth, they are considered nonsuccedaneous teeth.

REF: p. 36 OBJ: To understand the difference between primary dentition, secondary dentition, and mixed dentition NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. A 30-year-old can have a retained deciduous premolar.

ANS: F

There are no deciduous (primary) premolars. The deciduous dentition consists of incisors, canines, and molars. The permanent premolars replace the deciduous molars.

REF: p. 36 OBJ: To understand the difference between primary dentition, secondary dentition, and mixed dentition NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeN th. R I GTOB P:.BL C OMOM: Remembering

U S N T

O

4. Only the Palmer and Universal System use letters to represent deciduous teeth.

ANS: T

Both the Palmer and Universal System use letters to represent deciduous teeth; however the Federation Dentaire Internationale (FDI) does NOT use letters.

REF: p. 36 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 5. A missing tooth is given a symbol in any of the classification systems.

ANS: T

All teeth are given a symbol. Whether the tooth is present or not, it retains that symbol for reference. Whether a tooth remains missing or if it is replaced with an implant or a bridge, the symbol continues to represent that tooth.

REF: pp. 36-38 OBJ: To name and code any individual tooth NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering

COMPLETION 1. In the Universal System number 3 represents the

.

ANS:

permanent maxillary right first molar The Universal System uses the Arabic numerals 1 through 32 for permanent teeth and the letters A through T for the primary teeth. When identifying a specific tooth, list the dentition, arch, quadrant, and tooth name in that order.

REF: pp. 36-37 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 2. In the Federation Dentaire Internationale (FDI) the symbol 36 represents the

.

ANS:

permanent mandibular left first molar The Federation Dentaire Internationale (FDI) system assigns a two-digit number to each deciduous or permanent tooth. No letters or duplicate numbers are used. The first digit indicates the quadrant and whether the tooth is permanent or deciduous. Each quadrant is symbolized by a specific first digit. The second digit depends on the position the tooth occupies relative to the midline. The lowest number is assigned to the tooth closest to the NURSINGTB.COM midline.

REF: p. 39 | p. 41 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 3. In the Universal System the letter D represents the

.

ANS:

deciduous maxillary right lateral incisor The Universal system uses letters A through T for the primary teeth and Arabic numerals 1 through 32 for permanent teeth. When identifying a specific tooth, list the dentition, arch, quadrant, and tooth name in that order.

REF: pp. 37-38 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 4. In the Universal system the number 31 represents the

.

ANS:

permanent mandibular right second molar The Universal system uses the Arabic numerals 1 through 32 for permanent teeth and the letters A through T for the primary teeth. When identifying a specific tooth, list the dentition, arch, quadrant, and tooth name in that order.

REF: pp. 37-38 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 5. In the Universal System the letter L represents the

.

ANS:

deciduous mandibular left first molar The Universal system uses the Arabic numerals 1 through 32 for permanent teeth and the letters A through T for the primary teeth. When identifying a specific tooth, list the dentition, arch, quadrant, and tooth name in that order.

REF: pp. 36-37 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering

NURSINGTB.COM

6. The Universal system code for the deciduous maxillary right second molar is

.

ANS:

A The Universal system uses the Arabic numerals 1 through 32 for permanent teeth and the letters A through T for the primary teeth. When identifying a specific tooth, list the dentition, arch, quadrant, and tooth name in that order.

REF: pp. 36-37 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 7. The Universal system code for the permanent mandibular left canine is

.

ANS:

22 The Universal system uses the Arabic numerals 1 through 32 for permanent teeth and the letters A through T for the primary teeth. When identifying a specific tooth, list the dentition, arch, quadrant, and tooth name in that order.

REF: pp. 36-37 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 8. The Universal system code for the permanent maxillary right first premolar is

.

ANS:

5 The Universal system uses the Arabic numerals 1 through 32 for permanent teeth and the letters A through T for the primary teeth. When identifying a specific tooth, list the dentition, arch, quadrant, and tooth name in that order.

REF: pp. 36-37 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 9. The Universal system code for the deciduous maxillary right central incisor is

.

ANS:

E The Universal system uses leN tter sA he primary teeth and Arabic numerals 1 UR SIthro NGugh TBT.fCorOtM through 32 for permanent teeth. When identifying a specific tooth, list the dentition, arch, quadrant, and tooth name in that order.

REF: pp. 36-37 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering 10. In the FDI system the code for the deciduous mandibular left canine is

.

ANS:

73 The Federation Dentaire Internationale (FDI) system assigns a two-digit number to each deciduous or permanent tooth. No letters or duplicate numbers are used. The first digit indicates the quadrant and whether the tooth is permanent or deciduous. Each quadrant is symbolized by a specific first digit. The second digit depends on the position the tooth occupies relative to the midline. The lowest number is assigned to the tooth closest to the midline.

REF: pp. 39-41 OBJ: To code teeth using the Universal system, the Palmer notation system, and the Federation Dentaire Internationale system

NAT: CDA: GC I.C.1. Identify permanent and primary teeth using the Universal numbering system.

TOP: BLOOM: Remembering

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Chapter 05: Development, Form, and Eruption Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Permanent mandibular central incisors are the first succedaneous teeth to erupt. The earliest

visible portion of an anterior tooth is the cusp of Carabelli, the name for the lingual lobe of mandibular central incisors. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Although the mandibular first molars are the first permanent teeth to erupt, they are NOT succedaneous because they do NOT replace primary teeth. It is important to remember that primary molars are replaced by permanent premolars. Therefore, the first succedaneous teeth to erupt are the permanent mandibular central incisors, which replace the primary mandibular central incisors. The cusp of Carabelli is a cusp like elevation located on the maxillary first molar and occasionally on the maxillary second molar.

REF: p. 46 | p. 49 OBJ: To understand the eruption schedule of the deciduous and permanent teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

mU ajR orSbI ucNcG alT cuBs. psCbO ecMause the third buccal cusp develops from 2. Maxillary molars have three N the lobe of Carabelli. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Maxillary molars have two major buccal cusps. The lobe, or cusp, of Carabelli is a small cusp-like elevation that develops into a tubercle. Most often seen on maxillary first molars, the cusp of Carabelli is considered a rudimentary lobe and is located on the lingual surface of the mesiolingual cusp.

REF: p. 46 OBJ: To know how many lobes form each type of tooth and where the lobes are located NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Roots of primary teeth resorb and dissolve because odontoblasts destroy the surrounding

bone. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct.

d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The initial statement accurately describes steps in the exfoliation of primary teeth. The reasoning provided is incorrect because odontoblasts are cells that form dentin. The cells that destroy surrounding bone during exfoliation of primary teeth are osteoclasts. Note that “blasts” are formative cells whereas “clasts” are destructive cells.

REF: p. 50 OBJ: To understand general rules about the eruption of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 4. Another name for wearing away of the tooth through contact with an opposing tooth is a. exfoliation b. attrition c. impaction d. resorption ANS: B

Attrition is the wearing away of a tooth through contact of its functioning surfaces with an opposing tooth. Exfoliation is the process by which the roots of primary teeth are dissolved and resorbed. Impaction is a term descriptive of teeth that do not completely erupt but remain embedded in bone or soft tissue. Resorption, as it applies to exfoliation of teeth, is a phenomenon caused by osteoclastic cells, which destroy the roots of deciduous teeth. Note that “clasts” are destructive cells whereas “blasts” are formative cells.

REF: p. 51 NURSINGTB.COM OBJ: To understand the implications of the terms impacted teeth, congenitally missing teeth, attrition, occlusal plane, and curve of Spee NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. Small clumps of cells that will later form teeth are called a. tooth germs b. ameloblasts c. lobes d. tubercles ANS: A

Tooth germs, which later form teeth, initially develop into growth centers and become developmental lobes. Ameloblasts are cells responsible for formation of enamel. Tubercles are cusp like elevations.

REF: pp. 44-45 OBJ: To understand how the tooth germs develop within the crypts NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. Bicuspid is not an accurate name for premolars. Premolars can have two, three, or four cusps. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true.

d. Both statements are false.

ANS: B

The term bicuspid is reserved for teeth that actually have two cusps. Premolars can have two or three cusps. Although patterns vary, in general the maxillary first and second premolars as well as the mandibular first premolars have two cusps. The mandibular second premolars can have two or three cusps.

REF: p. 45 OBJ: To understand that this fusion can take a variety of forms, which result in different types of teeth such as incisors, premolars, and molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 7. Which choice best indicates the years of eruption for all of the premolars? a. 8 to 10 b. 9 to 11 c. 10 to 12 d. 11 to 13 ANS: C

The first premolars erupt at 10 to 11 years of age. The second premolars erupt at 10 to 12 years of age with eruption of the maxillary teeth preceding the mandibular. This unique pattern is the most common exception to the rule that mandibular teeth erupt prior to their maxillary counterparts.

REF: p. 51 OBJ: To understand the eruption schedule of the deciduous and permanent teeth N asic RSora IN G B.Canatomy, M NAT: CDA: GC I.A.7. Identify bU l andTdental O physiology and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 8. Exfoliation is the process by which the roots of a deciduous tooth are pushed together by the

calcification process. Resorption is the phenomenon where osteoblasts destroy the roots of primary teeth. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Exfoliation is the process by which the roots of a primary (deciduous) tooth are resorbed and dissolved until so little root remains that the primary tooth falls out. As a permanent tooth erupts, bone-destructive osteoclasts destroy the root of the deciduous tooth. This process is called resorption. Note that “clasts” are destructive cells whereas “blasts” are formative cells.

REF: p. 50 OBJ: To understand the phenomena of mesial drift, root resorption, and exfoliation NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 9. An impacted tooth is one that has a. not erupted fully

b. c. d. e.

no tooth germs less cusps or roots to be extracted A and C

ANS: A

Impacted teeth are those that do not completely erupt but remain embedded in bone or soft tissue. There are varying degrees of impaction.

REF: p. 51 OBJ: To understand the implications of the terms impacted teeth, congenitally missing teeth, attrition, occlusal plane, and curve of Spee NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 10. Formation of teeth can be affected by nutritional deficiencies, fever, or childhood illnesses.

While trauma to the dentition may delay eruption, it does not negatively impact formation of teeth. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Formation of teeth can be affected by many factors including nutritional deficiencies, fever, childhood illness, and trauma to the dentition. Not only may tooth formation be altered by these factors, formation or mineralization may also be stopped completely.

N R I G B.C M

U S N general T rules O about the eruption of teeth REF: p. 47 OBJ: To understand NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 11. A 6-year-old has a space maintainer on the area of the deciduous mandibular left first molar.

Which permanent tooth will erupt in the space? a. First premolar b. Second premolar c. First molar d. Second molar ANS: A

Deciduous molars are replaced by permanent premolars. The deciduous mandibular left first molar will be replaced by the permanent mandibular left first premolar. A space maintainer is an excellent device for preserving space in the event of premature loss of a deciduous tooth.

REF: p. 50 OBJ: To understand general rules about the eruption of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 12. Which is the last permanent incisor to erupt? a. Maxillary central b. Maxillary lateral c. Mandibular central

d. Mandibular lateral ANS: B

The first general rule concerning eruption is that individual mandibular teeth precede their maxillary counterparts. Eruption of central incisors precedes eruption of lateral incisors. Thus, the maxillary lateral incisor is the last permanent incisor to erupt.

REF: pp. 47-78 OBJ: To understand the eruption schedule of the deciduous and permanent teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 13. Edentulous refers to a. the final dentition period b. a space maintainer c. absence of teeth d. unerupted third molars ANS: C

Edentulous means that all teeth are missing. A space maintainer is an appliance utilized to preserve space for either premature loss of a deciduous tooth or loss of any tooth. Unerupted third molars are considered impacted if they remain embedded in bone or soft tissue and fail to erupt.

REF: pp. 50-52 OBJ: To understand the periods of primary, mixed, and permanent dentition NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

N R I G B.C M

UtheSruN 14. The most common exception to le ofTeruptioOn that mandibular teeth precede eruption of maxillary teeth is the maxillary first premolar because this tooth often precedes eruption of its mandibular counterpart. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Eruption of the maxillary first premolar often precedes eruption of the mandibular first premolar. This is in direct contradiction to the first general rule of tooth eruption, which states that mandibular teeth usually precede the maxillary teeth.

REF: p. 50 OBJ: To understand the eruption schedule of the deciduous and permanent teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 15. The rounded protuberances on the incisal edge of a newly erupted incisor are called a. mamelons b. developmental grooves c. cusp tips d. tooth buds

e. attrition ANS: A

Mamelons, rounded protuberances on the incisal edge of a newly erupted incisor, are incisal ridges of the three labial developmental lobes. Regarding the incorrect selections, developmental grooves separate tooth lobes and are visible on erupted teeth as grooves separating cusps. Cusp tips are the most coronal and pointed aspect of a cusp. Tooth buds, also called tooth germs, are early cellular precursors to teeth. Attrition is the wearing away of tooth surface by contact with opposing tooth surfaces.

REF: pp. 44-45 OBJ: To understand that this fusion can take a variety of forms, which result in different types of teeth such as incisors, premolars, and molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 16. The first deciduous teeth, the mandibular central incisors, erupt at approximately 6.5 to 7

months. The first permanent teeth, the maxillary premolars, erupt at approximately 6 years of age. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false ANS: B

The first deciduous teeth are the mandibular central incisors, which erupt at approximately 6.5 to 7 months. Approximately 1 month later, the maxillary central incisors become visible. The first permanent teeth to eruptNareRtheImaG laC r firM U S Nndib TBu. Ost molars, followed by the maxillary first molars within a few weeks. These teeth are often called the 6-year molars because they erupt at approximately 6 years of age. The maxillary premolars do not erupt until approximately 10 to 11 years of age.

REF: p. 47 | p. 49 OBJ: To understand the eruption schedule of the deciduous and permanent teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 17. It is unusual for a 3-year-old child to have all 20 primary teeth because second molars do not

typically erupt until 4 years of age. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Both the initial statement and the reason provided are incorrect because all 20 deciduous teeth typically erupt by the time a child is 2.5 years of age. The second molars, often the last teeth to erupt, are called the 2-year-old molars. Their eruption is considered a factor in the somewhat cantankerous attitude of 2-year-olds.

REF: p. 50

OBJ: To understand the eruption schedule of the deciduous and permanent teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. Which of the following selections include teeth that should be present in the dentition of a

3-year-old child (Select all that apply.)? a. Primary maxillary and mandibular canines b. Primary maxillary and mandibular central incisors c. Primary maxillary molars, but NOT primary mandibular molars d. Primary mandibular central and lateral incisors, but NOT primary mandibular incisors e. Primary mandibular and maxillary premolars ANS: A, B

In a 3-year-old child all primary teeth should be present. Selections C and D are incorrect because they exclude primary teeth. Selection E is incorrect because the primary dentition does NOT have premolars. The primary dentition consists of 20 teeth comprised of incisors, canines, and molars.

REF: pp. 47-48 | pp. 50-52 OBJ: To understand the eruption schedule of the deciduous and permanent teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. Which of the following selections include teeth that should have erupted or may be in the

N R I G B.C M

process of eruption in the dentiU tionSof N an 8T -year-oO ld child? (Select all that apply.) a. All deciduous teeth b. Permanent maxillary central and lateral incisors c. Permanent maxillary and mandibular first molars d. Permanent canines ANS: B, C

The mixed dentition begins at about 6 years of age. The deciduous maxillary and mandibular central and lateral incisors will have been exfoliated in an 8-year-old child. At this age the central incisors of both arches should be present; the corresponding lateral incisors should be in the process of eruption. Permanent maxillary and mandibular first molars, appropriately called the 6-year molars, erupt at approximately 6 years of age. Permanent canines do not erupt until ages 9 to 12, with the mandibular canines preceding the maxillary.

REF: p. 47 | pp. 49-50 OBJ: To understand the eruption schedule of the deciduous and permanent teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. A 15-month-old toddler would generally have (Select all that apply.) a. central incisors b. lateral incisors c. canines d. first molars

e. second molars ANS: A, B, D

Deciduous central and lateral incisors typically erupt between 6.5 and 8 months. First molars typically erupt between 12 and 16 months. Regarding the incorrect selections, canines do not erupt until 16 to 21 months; they are followed by the second molars between the 21st and 13th months. Deciduous second molars are often called the 2-year-old molars.

REF: p. 47 OBJ: To understand the eruption schedule of the deciduous and permanent teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. A 10-year-old will generally have the following permanent teeth (Select all that apply.): a. Maxillary lateral incisors b. Maxillary canines c. Mandibular canines d. Mandibular second premolars e. Mandibular first molars ANS: A, C, E

Maxillary lateral incisors erupt at 7 to 9 years of age. The mandibular canines erupt at 9 to 10 years of age. The mandibular first molars erupt at 6 to 7 years of age. Regarding the incorrect selections, the maxillary canines do not erupt until 11 to 12 years of age. The mandibular second premolars do not erupt until 10 to 12 years of age.

REF: pp. 50-52 OBJ: To understand the eruption schedule of the deciduous and permanent teeth N asic RSora IN G B.Canatomy, M NAT: CDA: GC I.A.7. Identify bU l andTdental O physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering TRUE/FALSE 1. A tooth with two cusps, such as a maxillary premolar, was formed from two lobes.

ANS: F

Premolars are formed from four lobes: three facial lobes and one lingual lobe.

REF: p. 45 OBJ: To understand that this fusion can take a variety of forms, which result in different types of teeth such as incisors, premolars, and molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. The crypt will become the tooth socket.

ANS: T

Primary and secondary teeth develop from tooth germs, which form in small holes within bone. Crypts later become tooth sockets, which house the root of the tooth.

REF: p. 45 OBJ: To understand how the tooth germs develop within the crypts NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development,

including but not limited to: teeth.

TOP: BLOOM: Remembering

3. Third molars are the most unpredictable of all teeth.

ANS: T

Development of third molars is the most unpredictable of all teeth. It is highly possible for mandibular third molars to be extremely well developed, better proportioned, and larger than the first molars in the same mouth. However, they are more likely to be poorly formed and can vary from three to eight cusps. The third molars are also the most common teeth to be congenitally missing.

REF: p. 47 OBJ: To know how many lobes form each type of tooth and where the lobes are located NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 4. Calcification of all deciduous teeth begins near the end of the sixth month in utero.

ANS: F

Calcification of the primary teeth begins by about the fourth or fifth month of fetal life. This process continues until about the third or fourth year after birth, when the deciduous roots become fully formed.

REF: p. 47 OBJ: To understand how the tooth germs develop within the crypts NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

arU atR esSoI neNcG usTpBfr. oC mOaM nother.

5. A developmental groove sepN ANS: T

Developmental grooves separate developmental lobes from each other. Cusps, which originate from lobes, are visibly separated after eruption by developmental grooves.

REF: p. 44 OBJ: To understand how the growth centers or lobes fuse and form a tooth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. Third molar roots continue to calcify until about 25 years of age.

ANS: T

Calcification of permanent teeth begins soon after birth and continues until about the 25th year, when roots of the third molars become calcified. The last area of any tooth to become calcified is the apex of the root.

REF: p. 44 OBJ: To understand how the growth centers or lobes fuse and form a tooth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

Chapter 06: Occlusion Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Class II occlusion is called distoclusion because the distal surface of the mandibular canine is

distal to the mesial surface of the maxillary canine. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Class II occlusion is called distoclusion. This question addresses the canine relationship; however the dental classification, described by E. H. Angle, more frequently relies on the relationship between maxillary and mandibular first molars. Note that for both Class II and Class III occlusion, the discrepancy must be by at least the width of a premolar.

REF: p. 62 OBJ: To identify the three occlusal classifications NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. Classification of occlusion by the Angle system primarily relies on the relationship between

maxillary and mandibular canines because the anatomical features of molars are more difficult to interpret.

N R I G B.C M a. Both the statement and the U reasSon N are T correct O and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Classification of occlusion by Dr. Angle’s system, the most commonly utilized dental classification system, primarily relies on molar relationship. The anatomical features of molars provide optimal means of assessing occlusal patterns. The canine relationship is utilized when one or more first molars are missing or there is another reason that makes analysis of molar relationship not possible.

REF: p. 62 | p. 64 OBJ: To identify the three occlusal classifications NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 3. Class III occlusion is also known as mesioclusion because the mesiobuccal cusp of the

mandibular first molar is mesial to the buccal groove of the maxillary first molar. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

As stated correctly in the question, Class III occlusion is also known as mesioclusion.

However the reason provided is incorrect. In Class III occlusion the buccal groove of the mandibular first molar is more anterior than normal to the mesiobuccal cusp of the maxillary first molar. Note that in the question the landmarks for the maxillary and mandibular first molars are reversed. The landmarks that are analyzed in classification of molar relationship are the buccal groove of the first mandibular molar as it relates to the mesiobuccal cusp of the maxillary first molar.

REF: p. 63 OBJ: To identify the three occlusal classifications NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 4. An open bite refers to a. a diastema b. open contact between the arches c. an overjet d. premature contact e. a crossbite ANS: B

An open bite refers to open contact between the arches. While open bite can occur in the posterior areas, it is most common in anterior regions. A diastema is a space between two adjacent teeth; a contact area is lacking. Overjet is the amount of facial horizontal overlap of the maxillary teeth to the mandibular teeth. A premature contact is an occlusal interference where one tooth hits ever so slightly before the others. A crossbite occurs when one or more of the mandibular teeth are loNcateRd fI aciaG l to B th. eC maxMillary counterparts.

U S N T

O

REF: p. 54 | pp. 60-61 | p. 64 OBJ: To define overjet, overbite, crossbite, and open bite and to understand how they occur NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. A crossbite occurs between only one maxillary tooth and one mandibular tooth because when

more teeth are involved the condition is called overbite. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

A crossbite can exist between any number of teeth. The most common cause of crossbite is failure of the maxillae bones to grow in proportion to the mandible. Note that overbite is the extension of the incisal edges of the maxillary anterior teeth below the incisal edges of the mandibular teeth. Overbite is classified in degrees as slight, moderate, or excessive.

REF: pp. 60-61 OBJ: To define overjet, overbite, crossbite, and open bite and to understand how they occur NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding

6. In Class II Division II, one would expect to see a. overjet b. retruded maxillary laterals c. retruded maxillary centrals d. edge to edge bite ANS: C

Class II, division II occurs when the permanent first molars are in Class II relationship and the permanent maxillary central incisors are retruded and inclined lingually.

REF: p. 63 OBJ: To identify the three occlusal classifications NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 7. Each of the following may be present in Class III occlusion EXCEPT one. Which one is the

EXCEPTION? a. Prognathic facial profile may be present. b. The mandible may be retruded. c. The mandible has a mesial relationship with the maxilla. d. The incisal margins of the mandibular incisors may lie in front of the maxillary incisors.

ANS: B

In Class III occlusion the mandible is rarely retruded; most often it is protruded. The remaining selections correctly describe potential features of Class III occlusion. Note that Class III is often described as mesioclusion, which is in conflict with retrusion of the mandible. Further note that dN escr ons h. asCme URipti SI NGsuc TB OMsioclusion or distoclusion refer to the position of the mandible in relation to the maxilla.

REF: p. 63 | p. 65 OBJ: To identify the three occlusal classifications NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 8. The transverse occlusal curve seen from a posterior view is called the curve of Spee. The

curve of Wilson refers to the fairly even curve of the buccal cusp tips of posterior teeth when viewed laterally. a. Both statements are true. b. The first statement is true, the second statement is false. c. The first statement is false, the second statement is true. d. Both statements are false.

ANS: D

Both statements are false because the descriptions are reversed. The curve of Spee, viewed from a lateral aspect, is the fairly even curve of the buccal cusp tips of posterior teeth. The curve of Wilson, from a posterior aspect, is a transverse occlusal curve viewed from right to left.

REF: p. 57 OBJ: To understand the maxillary to mandibular vertical and horizontal alignment of teeth and which molars play a key part in this NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development,

including but not limited to: teeth.

TOP: BLOOM: Understanding

9. Occlusion must be evaluated bilaterally. An individual might have a Class I on one side and a

Class III on the other side. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

It is possible for both sides of the mandible to be in different occlusal classes. Remember, when evaluating dental occlusion, the position of the mandibular landmark is studied as it relates to the maxillary landmark. This applies whether a molar or canine relationship is being evaluated.

REF: p. 63 OBJ: To understand how the eruption schedule, growth, and ultimate alignment of teeth are related NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 10. A premature contact can be associated with each of the following EXCEPT one. Which one is

the EXCEPTION? a. Tender protagonist muscles b. Teeth that are sensitive to percussion c. Abnormal stress on the TMJ d. Tooth mobility e. Fractured teeth ANS: A

NURSINGTB.COM

When the jaw closes, all of the posterior teeth should come into contact at the same time.

When one tooth hits prematurely, abnormal stress is created and muscles that act as antagonists to muscles of mastication become tired, sore, and tender. The remaining selections all accurately describe manifestations of prematurely contacting teeth.

REF: p. 64 OBJ: To understand the maxillary to mandibular vertical and horizontal alignment of teeth and which molars play a key part in this NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 11. When a maxillary canine contacts its opposing antagonist before any other teeth occlude, it is

described as anterior coupling. When one tooth hits ever so slightly more than the others, premature contact is occurring. a. Both statements are true. b. The first statement is true, the second statement is false. c. The first statement is false, the second statement is true. d. Both statements are false.

ANS: C

During jaw closing, premature contact occurs when one tooth hits ever so slightly more than the others. This differs from normal occlusion, where all posterior teeth should come into contact at the same time. Premature contact results in an interference, which places more force on the involved teeth. During anterior coupling the anterior teeth hit in centric occlusion.

REF: p. 64 OBJ: To understand the maxillary to mandibular vertical and horizontal alignment of teeth and which molars play a key part in this NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 12. Retruded teeth are lingually inclined. Retruded permanent central incisors are associated with

Class III occlusion. a. Both statements are true. b. The first statement is true, the second statement is false. c. The first statement is false, the second statement is true. d. Both statements are false.

ANS: B

By definition retruded teeth are lingually inclined. Retruded and lingually inclined permanent maxillary incisors are associated with Class II, division II occlusion.

REF: p. 63 OBJ: To identify the three occlusal classifications NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 13. In ideal occlusion the mandibular first molar is stolarized because neither its mesial nor distal

contact areas are open.

NURSINGTB.COM a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

In ideal occlusion the maxillary first molar is stolarized, which means that it is tipped mesially and touches both the mandibular first and second molars. Although it is true that in ideal occlusion the surrounding contact areas would not be open, this is not a definitive feature of a stolarized first molar. Note that very few individuals have ideal occlusion.

REF: p. 64 OBJ: To understand the maxillary to mandibular vertical and horizontal alignment of teeth and which molars play a key part in this NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 14. Each of the following is true of centric occlusion EXCEPT one. Which one is the

EXCEPTION? a. It is determined by the way teeth fit together. b. It is the jaw position that affords greatest interdigitation of teeth. c. It is related to occlusion. d. It is determined by both muscle and bone.

ANS: D

Centric occlusion is NOT determined by muscle or bone. Very different from centric relation, centric occlusion is the jaw position that affords the greatest interdigitation of teeth. Thus, it is determined by the way teeth fit together and is related to occlusion.

REF: pp. 58-59 OBJ: To define centric occlusion, centric relation, primate space, and leeway space NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 15. A comparison of 800 Australian aboriginal skulls shows that Class III occlusions were more

successfully passed on through genetics than other occlusal patterns. Such analysis revealed that the prognathic profile and mesially protruded Class III mandible provided superior strength in incising and grinding food. a. Both statements are true. b. The first statement is true, the second statement is false. c. The first statement is false, the second statement is true. d. Both statements are false.

ANS: D

In the 1930s Dr. P. R. Begg determined that Class I occlusions were more successfully passed on through genetics than other occlusal patterns. Begg documented that Class II and III malocclusions caused serious physical afflictions through interference with proper masticatory function and increased dental disease.

REF: pp. 64-65 OBJ: To identify the three occlusal classifications NAT: CDA: GC I.A.7. IdentifyNbasR ic oI ral aG nd dBe. ntaCl anM atomy, physiology, and development, including but not limited to: teethU .

S N TTOP: BLOOOM: Understanding

16. A deep bite could result from hyperactive masticatory muscles because such muscular activity

could prevent full eruption of posterior teeth. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Hyperactive masticatory muscles, primarily the masseter, can prevent full eruption of posterior teeth. The resulting “shorter” teeth cause extensive malocclusion including posterior bite collapse. Such conditions frequently result in a moderate to deep overbite.

REF: p. 55 OBJ: To understand how muscle forces affect the alignment of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 17. A position that allows the greatest interdigitation of teeth is referred to in each of the

following EXCEPT one. Which one is the EXCEPTION? a. Acquired centric occlusion b. Centric relation c. Habitual occlusion

d. Intercuspal position e. Convenience occlusion ANS: B

Centric occlusion, the position that allows the greatest interdigitation of teeth, is also referred to as acquired centric occlusion, habitual occlusion, convenience occlusion, and intercuspal position (ICP). Centric relation is an entirely different position that does NOT have anything to do with interdigitation of teeth.

REF: p. 59 OBJ: To define centric occlusion, centric relation, primate space, and leeway space NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 18. From a lateral view, most teeth show a slight inclination in which direction? a. Mesial b. Distal c. Vertical d. Lingual ANS: A

Teeth are often thought to be vertically straight, but this is not true. From a lateral view, all teeth—maxillary and mandibular, anterior and posterior—show a slight mesial inclination.

The maxillary third molars are a possible exception to this trend.

REF: p. 57 OBJ: To understand the maxillary to mandibular vertical and horizontal alignment of teeth and which molars play a key part in this N R I G B.C M U S N T O NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 19. Each structure acts as an internal force in determining tooth alignment EXCEPT one. Which

one is the EXCEPTION? a. Tongue b. Lips c. Palate d. Cheeks ANS: C

The palate does NOT act as an internal force in determining tooth alignment. A balance in forces exists among the tongue and the facial muscles, which form the lips and cheeks. The palate does not exert muscular force.

REF: p. 56 OBJ: To understand how muscle forces affect the alignment of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 20. Each of the following is a possible manifestation of a Class III occlusion EXCEPT one.

Which one is the EXCEPTION? a. Mandibular teeth are positioned facial to maxillary teeth. b. Incisal margins of mandibular incisors lie in front of the middle third of the lingual surface of the maxillary incisors.

c. The mandible is retruded. d. The distal surface of the mandibular canine is mesial to the mesial surface of a

maxillary canine by at least the width of a premolar.

ANS: C

In Class III occlusion, also called mesioclusion, the mandible is often protruded and the maxilla is often retruded. The remaining selections accurately describe potential manifestations of a Class III occlusion.

REF: pp. 62-63 OBJ: To identify the three occlusal classifications NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 21. An 11-year-old child presents with wide spaces between mandibular second premolars and

permanent first molars. These spaces are typical of a. mesial step b. distal step c. leeway space d. flush terminal plane ANS: C

Leeway spaces literally provide leeway, or additional space, between the deciduous canines and the first molars. In an arch that is not fully grown, leeway spaces allow an extra margin of space for the eruption of the permanent canine and the premolars. It is typical to see leeway spaces in an 11-year-old child. Note that leeway spaces also exist between the first and second molars.

Mesial step, closely related to leeway spaces, is the chain reaction that occurs as the permanent molars close spacN esUbR yS puIshi ngTaB g. ainCstOdMeciduous molars. In mesial step the NG mandibular molars are situated more mesially than their maxillary counterparts, thereby forming a mesial step. In a distal step the mandibular molars are situated more distally than their maxillary counterparts. In flush terminal plane the distal surfaces of the deciduous molars are even with each other.

REF: pp. 54-55 OBJ: To understand how the mesial step, flush terminal plane, and distal step affect occlusal classifications NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 22. Protrusion of the maxillary anterior teeth can be caused by tongue-thrusting because improper

tongue placement during swallowing exerts powerful pressure against lingual surfaces of anterior teeth. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Tongue-thrusting exerts a powerful force against the lingual surface of anterior teeth. The result is a protrusion of maxillary teeth with disruption of normal eruption. In normally developed swallowing patterns protrusion of anterior teeth is prevented because the tongue is placed against the roof of the mouth, not against teeth.

REF: p. 61 OBJ: To understand the relationship that exists between teeth during protrusive and lateral excursive movements NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding TRUE/FALSE 1. The average overjet of primary teeth is 2.0 mm.

ANS: F

The average overjet of primary teeth is 3.0 mm. The average overbite is 2.5 mm. Overjet is defined as the amount of facial horizontal overlap of the maxillary teeth. Overbite is the extension of the incisal edges of the maxillary anterior teeth below the incisal edges of the mandibular anterior teeth in a vertical direction.

REF: p. 54 OBJ: To define overjet, overbite, crossbite, and open bite and to understand how they occur NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. When the maxilla outgrows the mandible, a Class II occlusion often results.

N R I G B.C M U S N T O

ANS: T

As the permanent molars erupt, the formation of a mesial step between the deciduous maxillary and mandibular second molars ensures that in most instances a Class I occlusion (permanent first molar relationship) is formed. However, Class II occlusion often results when the maxilla outgrows the mandible or if the mandible does not continue to grow.

REF: p. 55 OBJ: To identify the three occlusal classifications NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Centric relation refers to the position of the retruded mandible to the maxilla.

ANS: T

Centric relation, a relationship of the structural features of the temporal mandibular joint (TMJ), is defined as the most retruded relationship of the mandible to the maxillae when the condyles of the TMJ are in their most upward, backward, and unstrained position in the glenoid fossae.

REF: pp. 57-58 OBJ: To define centric occlusion, centric relation, primate space, and leeway space NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

4. The curve of Spee deepens with age.

ANS: T

The curve of Spee, a fairly even curve in an anterior to posterior direction of the buccal cusp tips of posterior teeth, deepens with age.

REF: p. 64 OBJ: To understand the maxillary to mandibular vertical and horizontal alignment of teeth and which molars play a key part in this NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. Dr. P. R. Begg described a dental classification system based on the relationship of the

permanent first molars.

ANS: F

E. H. Angle described a dental classification system based primarily on the relationship of the permanent first molars to each other. To a lesser extent this system is based on the relationship of the permanent canines to each other. Dr. Angle’s system is called the dental classification system because it is concerned with teeth. There is another system, the skeletal classification, which relates to bones. Dr. P.R. Begg studied Australian aboriginal skulls in the 1930s.

According to Begg, the survival of our ancestors was affected by the class of dental occlusion they possessed. More Class I occlusions successfully passed to future generations through genetics.

REF: p. 62 | p. 64 OBJ: To identify the three occlusal classifications NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development,

COOMOM: Remembering including but not limited to: teeN thU . RSINGTT OB P:.BL

6. In Class I occlusion the mesiobuccal cusp of the maxillary first molar occludes with the

buccal groove of the mandibular first molar.

ANS: T

In a Class I molar relationship the mesiobuccal cusp of the maxillary first molar is directly in line with the buccal groove of the mandibular first molar. The full name of this relationship is called Class I occlusal relationship, or neutroclusion.

REF: pp. 62-63 OBJ: To identify the three occlusal classifications NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 7. Class II occlusion is the most common classification of occlusion.

ANS: F

P.R. Begg, who studied prehistoric skulls, determined that Class I occlusion is the most common human occlusal pattern. He further postulated that the survival of our ancestors was affected by the class of dental occlusion they possessed and that Class I occlusion more successfully passed to future generations.

REF: p. 65 OBJ: To identify the three occlusal classifications NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development,

including but not limited to: teeth.

TOP: BLOOM: Remembering

8. Tongue-thrusting can cause an overbite.

ANS: F

Tongue-thrusting or thumb-sucking can cause an open bite, manifested by maxillary and mandibular anterior teeth that are widely separated in centric occlusion. (The anterior teeth are “open” when the posterior teeth are in occlusion.) This condition is also described as lack of overlap of the maxillary anterior teeth with the mandibular teeth in a vertical direction. An OVERBITE has the opposite effect; the incisal edges of the maxillary teeth overextend the incisal edges of the mandibular teeth in a vertical direction.

REF: pp. 60-61 OBJ: To define overjet, overbite, crossbite, and open bite and to understand how they occur NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

NURSINGTB.COM

Chapter 07: Dental Anomalies Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Supernumerary maxillary teeth are more common than supernumerary mandibular teeth

because metabolic intrinsic factors within the palate produce more hyperdontia. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

Hyperdontia, an anomaly resulting in formation of too many teeth (called supernumerary teeth), occurs more commonly in the midline and molar regions of the maxillae. Maxillary supernumerary teeth outnumber mandibular nine to one. Extra teeth are less commonly formed in the premolar region of the mandible. Other sites are rarely involved. The reason provided is entirely false.

REF: p. 67 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. A distomolar is attached to the distal surface of a maxillary molar. Maxillary distomolars are

B.C M the most common supernumerary teeth.

N R I G a. Both statements are true. U S N T O b. The first statement is true, the second statement is false. c. The first statement is false, the second statement is true. d. Both statements are false.

ANS: B

More specifically, distomolars are located distal to maxillary third molars. They are called fourth molars. Mandibular distomolars do occur, but with much less frequency than in the maxillae.

REF: p. 67 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 3. Fusion involves the joining of two adjacent teeth at the cementum because this process is

associated with excessive production of cementum. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

This question incorrectly combines aspects of tooth fusion with hypercementosis. Very importantly, fusion involves the joining of two adjacent teeth at dentin. If teeth are only connected at the cementum, concrescence has occurred. Further, cementoma is a form of hypercementosis associated with localized destruction of bone.

REF: pp. 69-72 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 4. The canines are LEAST likely of all permanent teeth to be congenitally missing because

unlike other permanent teeth, canines begin to calcify by about the fourth of fifth month of fetal life. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

Canines are the least likely of all permanent teeth to be congenitally missing. However, the calcification timeline provided in the question applies to primary teeth. Calcification of all permanent teeth begins soon after birth.

REF: p. 44 | p. 67 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 5. The MOST commonly missiN ngUpR erSmIaN neG ntTtB ee. thCaO reMthe maxillary premolars. The next teeth

MOST likely to be missing are the permanent maxillary lateral incisors. a. Both statements are true. b. The first statement is true, the second statement is false. c. The first statement is false, the second statement is true. d. Both statements are false.

ANS: C

The most commonly missing permanent teeth are the third molars, with maxillary thirds the most frequently absent. Teeth next most likely to be missing are the permanent maxillary lateral incisors. Between 1% and 2% of the population are missing at least one permanent maxillary lateral incisor.

REF: p. 67 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. Dens in dente, or dwarfed roots, is a developmental variation that occurs because the outer

surface of the tooth crown invaginates by turning itself inward prior to mineralization. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

The initial statement is incorrect because dens in dente and dwarfed roots are two separate anomalies. The reason provided correctly describes the cause of dens in dente. Dwarfed roots is a condition in which the roots are extremely short in comparison with their crowns.

REF: p. 69 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 7. Tetracycline staining is an enamel dysplasia that occurs because an expectant mother or young

child with tooth crowns still developing takes the antibiotic tetracycline. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Tetracycline staining is a developmental disturbance of dentin. Because dentin forms the body of the tooth, the discoloration is typically visible through enamel. Tetracycline staining occurs when tetracycline is taken by an expectant mother or a young child with developing tooth crowns. Staining ranges from yellow to brown or grayish blue.

REF: p. 74 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding

ofUdR ent inog s iC mp erfecta EXCEPT one. Which one is the 8. Each of the following is true N SI NGene TBsi. OM EXCEPTION? a. The pulp is filled with dentin. b. The tooth appears translucent. c. Enamel cannot develop over defective dentin. d. It is a hereditary developmental anomaly. e. All of the above are true.

ANS: C

Although enamel formation occurs in the presence of dentinogenesis imperfecta, it often chips away. The poorly developed underlying dentin does not adequately support enamel. The remaining statements correctly describe aspects of dentinogenesis imperfecta.

REF: p. 74 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 9. Enamel dysplasia is associated with each of the following EXCEPT one. Which one is the

EXCEPTION? a. Fluorosis b. Amelogenesis imperfecta c. Turner’s tooth d. Enamel hypocalcification e. Dilaceration

ANS: E

Enamel dysplasia is a broad term that includes both enamel hypoplasia and enamel hypocalcification. Dilaceration, a sharp bend or curve of more than 40 degrees in the root or crown, is NOT an enamel anomaly. Regarding the remaining selections, fluorosis is one of the most common types of hypocalcification. Turner’s tooth, a hypocalcification of a single tooth, can occur in a permanent tooth that is affected by infection or trauma.

REF: pp. 73-74 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 10. Which permanent tooth is the LEAST likely to be congenitally missing? a. Maxillary lateral incisor b. Mandibular second premolar c. Maxillary third molar d. Mandibular third molar ANS: B

Of the listed teeth the mandibular second premolar is the least likely to be congenitally missing. The most commonly missing permanent teeth are third molars, with maxillary absent more than mandibular. The second most likely are the permanent maxillary lateral incisors.

REF: p. 67 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 11. Each of the following is an example of microdontia EXCEPT one. Which one is the

EXCEPTION? a. Mesiodens b. Paramolar c. Distomolar d. Tubercle e. Enamel pearl

NURSINGTB.COM

ANS: E

Enamel pearls are small masses of excess enamel on the surface of teeth located apically to the cementoenamel junction (CEJ). Enamel pearls are formed by a small, misplaced group of ameloblasts. The remaining selections are all variations of microdontia, which is an anomaly associated with teeth that are too small.

REF: pp. 67-68 | p. 72 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 12. Gemination occurs most frequently in the permanent dentition. It is the splitting of the tooth

into two crowns and separate roots. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Gemination, an anomaly that arises when a tooth attempts to divide itself by splitting its tooth germ, occurs most often in the permanent dentition. While gemination can result in formation of two crowns and separate roots, the second statement is incorrect because numerous variations can occur. For example, a tooth split into two crowns with one root would be termed a bifid tooth or bifurcated crown. The type of gemination described in the question is called twinning.

REF: p. 69 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 13. A dilacerated root is one that exhibits a. bifurcated roots b. twisted roots c. a sharp bend in the root d. short, fused roots ANS: C

A dilacerated root is one that exhibits a sharp bend or curve of more than 40 degrees in the root. Although curved roots commonly occur, the term dilaceration is reserved for teeth with very sharp bends. Dilaceration can also occur in the crown. Another term, flexion, is often used to describe a sharp curvature or twist of a tooth root only.

REF: p. 69 | p. 76 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

NURSINGTB.COM

14. Intrinsic factors that can contribute to dental anomalies include all of the following EXCEPT a. mutations b. heredity c. metabolic dysfunction d. nutritional deficiencies ANS: D

Mutations, heredity, and metabolic dysfunction originate from inside the body, and are therefore examples of intrinsic factors. Nutritional deficiency is an extrinsic factor, as it originates from outside of the body.

REF: p. 67 OBJ: To discuss intrinsic factors NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 15. An anomaly common to mandibular second premolars is a. dwarfed roots b. buccal tubercles c. accessory roots d. large lingual cusps ANS: C

The maxillary second premolars often have two bifurcated roots, although more frequently only one is present. It is not uncommon for these teeth to have accessory, or additional, roots.

When present, accessory roots sometimes bifurcate at the apical third only.

REF: pp. 75-76 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 16. Fusion of roots of adjacent teeth at the cementum is called concrescence and is primarily

caused by dilaceration. Gemination is the deposition of excessive secondary cementum. a. Both statements are true. b. The first statement is true, the second statement is false. c. The first statement is false, the second statement is true. d. Both statements are false.

ANS: D

Concrescence, fusion of the roots of adjacent teeth at the cementum, is thought to occur sometimes as a result of trauma. It is NOT caused by dilaceration. Gemination is an anomaly arising when a tooth attempts to divide itself or partially twin itself by splitting its tooth germ.

Deposition of excess cementum is an anomaly called hypercementosis.

REF: pp. 69-71 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 17. An unusually large tooth is an example of a. hyperdontia b. fusion NURSINGTB.COM c. gemination d. macrodontia ANS: D

Macrodontia is a developmental anomaly resulting in teeth that are too large. Hyperdontia results in an increase in the number of teeth. Fusion occurs when two adjacent tooth germs unite. Gemination is an anomaly arising when a tooth attempts to divide itself or partially twin itself by splitting its tooth germ.

REF: pp. 67-69 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 18. An odontoma is composed of each of the following EXCEPT one. Which one is the

EXCEPTION? a. Dentin b. Pulp c. Enamel d. Cementum ANS: B

An odontoma, a tumorous anomaly, does not contain pulpal tissue. There are two types of odontoma: complex and compound. A complex odontoma consists of a single mass of dentin, cementum, and enamel. It appears as a large blob or unspecified shape. Conversely, a compound odontoma consists of several small masses that resemble rudimentary teeth.

REF: p. 67 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 19. Turner’s tooth results in notched incisors and mulberry molars because prenatal syphilis

disturbs normal tooth formative processes. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Turner’s tooth is a hypocalcification of a single tooth, usually a maxillary incisor. It is caused by local infection or trauma that disturbs the ameloblastic layer, resulting in hypoplastic enamel. The initial statement correctly describes another anomaly, Hutchinson’s incisors, which are caused by prenatal syphilis. Such incisors appear notched and screwdriver shaped.

Also characteristic of congenital syphilis are mulberry molars, which are irregularly shaped and have poorly formed cusps.

REF: pp. 73-74 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development,

COOMOM: Understanding including but not limited to: teeN thU . RSINGTT OB P:.BL

20. A fourth molar may be described by each of the following EXCEPT one. Which one is the

EXCEPTION? a. Macrodont b. Distomolar c. Supernumerary tooth d. Supplemental tooth e. Hyperdont ANS: A

While there are many terms to describe a fourth molar, macrodont is not applicable.

Macrodontia refers to formation of teeth that are too large. A fourth molar is technically a supernumerary tooth. Other applicable terms include distomolar because of the location distal to the third molars. Hyperdont and supplemental tooth are also applicable terms. Hyperdontia refers to formation of excess teeth while supplemental, in a general sense, means additional.

REF: p. 67 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering TRUE/FALSE 1. Anomalies are caused by intrinsic factors only.

ANS: F

Anomalies are caused by intrinsic as well as extrinsic factors.

REF: p. 67 OBJ: To define dental anomaly NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. A child who has congenitally missing maxillary canines will have congenitally missing

permanent canines.

ANS: T

Anodontia is the formation of too few teeth. If primary teeth are congenitally missing, their permanent replacements will also be absent. True anodontia is the term for congenitally missing teeth. The extent of true anodontia ranges from one tooth to the full dentition. This may involve the permanent dentition, the primary dentition, or both.

REF: p. 67 OBJ: To define the various anomalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. A patient who has had four teeth extracted for orthodontia has true partial anodontia.

ANS: F

True anodontia applies only to congenitally missing teeth. This term does not apply to teeth that have been extracted. Such teeth are considered “missing due to extraction.”

REF: p. 67 OBJ: ToNdef the s aC nom URineSI NvGario TBu. OMalies listed in this chapter NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

Chapter 08: Supporting Structures Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Inflammation of the gingival papilla is easily recognized because the area takes on a color that

is more red than normal. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

In addition to the color change from pink to a more reddish hue, inflamed gingival papillae exhibit a puffy appearance with some blunting of the apex.

REF: p. 77 OBJ: To understand how the gingival unit functions NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 2. Each of the following structures is a component of the gingival unit EXCEPT one. Which one

is the EXCEPTION? a. Attached gingiva b. Free gingiva c. Alveolar mucosa d. Periodontal ligament

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ANS: D

The periodontal ligament is not a component of the gingival unit. It is a component of the attachment unit. The attachment unit is also called the attachment apparatus and is composed of the cementum, the periodontal ligament, and the alveolar bone.

REF: p. 77 OBJ: To understand how the attachment apparatus is related to the gingival unit NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 3. Which is a gingival fiber? a. Horizontal b. Oblique c. Circular d. Apical ANS: C

Circular fibers are one component of the gingival fibers that connect the gingiva to the tooth.

This meshwork of collagenous fibers travels in multiple directions and includes transseptal fibers, which attach to adjacent teeth. The remaining selections are a portion of the periodontal fibers, another unit of fibers that attach to the alveolar bone and cementum.

REF: p. 79

OBJ: To understand the terminology of the gingival unit and to identify its various parts NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 4. Sharpey’s fibers can be found in all of the following EXCEPT one. Which one is the

EXCEPTION? a. Alveolar bone b. Dentin c. Cementum d. Periodontal ligament e. They are in all of the above.

ANS: B

Sharpey’s fibers do not embed in dentin. All fibers embedded in the cementum are known as Sharpey’s fibers. These collagenous fibers extend from the cementum to the papillary area of the gingiva in small bundles. Groups of Sharpey’s fibers travel in multiple directions: some curve toward the mucosa of the free gingiva; others pass directly across the cementum to the gingiva; others pass from the cementum over the alveolar crest.

REF: pp. 81-82 OBJ: To identify the components of the alveolar process NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 5. When teeth are subjected to relatively constant forces tooth mobility is likely to result because

forces cause pressure on the root, periodontal ligament, and bone. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, N buUt R thS eI reN asG onTiB s.

NC OO TM correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Numerous types of forces act on teeth and the periodontium. Two broad categories include constant forces/consistent forces and those that are intermittent. Tooth mobility results from intermittent forces associated with occlusal trauma that tears the periodontal ligament. Often visible radiographically, the periodontal ligament space is enlarged and widened. The result is that the lamina dura is compressed and a tooth subject to occlusal trauma becomes loose and mobile within the socket. By contrast, teeth exposed to constant/consistent forces can tip, rotate, or move but do not exhibit mobility.

REF: p. 84 OBJ: To understand the relationship of cementum, periodontal ligament, and alveolar bone NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 6. Alveolar bone is composed of all of the following EXCEPT one. Which one is the

EXCEPTION? a. Collagen b. Intercellular substance c. Apatite crystals d. Lamina dura

ANS: D

A fine distinction, the lamina dura is a location within bone, not a component of bone. The lamina dura is defined as the edge of the alveolar bone, which appears radiographically as a thin radiopaque (white) border of the interdental septum situated adjacent to the periodontal ligament and alveolar crest. Bone has many components, including the remaining selections in the question. Other vital components of bone include calcium, phosphate, and carbonates.

REF: p. 81 OBJ: To understand the relationship of cementum, periodontal ligament, and alveolar bone NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 7. With regard to apposition and resorption, on which tissue are these activities MOST active? a. Dentin b. Bone c. Cementum d. Periodontal ligament ANS: B

Bone tissue is constantly undergoing change. Bone apposition and resorption are related to the functional demands placed on bone. While the terms apposition (growth) and resorption apply to most tissues, these activities are most active in bone.

REF: p. 81 OBJ: To understand the relationship of cementum, periodontal ligament, and alveolar bone NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering

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8. The physical arrangement of bone is permanently fixed. Only externally originated pressure or

tension from orthodontic forces cause bone apposition and resorption. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Bone tissue is continually undergoing change. The evolving architectural arrangement of the trabeculae, the interlacing meshwork that makes up the cancellous bone framework, is directly related to the demands of function. Bone apposition (growth) and resorption are related to functional demands. Orthodontic corrective forces involve placement of pressure-causing appliances to correct malocclusion.

REF: pp. 81-82 OBJ: To understand the relationship of cementum, periodontal ligament, and alveolar bone NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 9. The gingival transseptal fibers extend from the cementum of one tooth to the alveolar process

of adjacent teeth. The oblique gingival fibers are circular bands of connective tissue that surround teeth. a. Both statements are true. b. The first statement is true; the second statement is false.

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

ANS: D

The gingival transseptal fibers extend from the cementum of one tooth to the cementum of an adjacent tooth. Oblique fibers, not gingival in nature but periodontal, run obliquely from the cementum to bone. Note that gingival fibers attach the gingiva to the tooth while periodontal fibers attach the alveolar bone to the cementum. The circular bands of connective tissue referred to in the question are gingival fibers often called the circular fibers.

REF: p. 79 | p. 83 OBJ: To understand how the fibers of the periodontal ligament function in tooth movement and shock absorption NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 10. The thin, soft, smooth alveolar mucosa is highly keratinized. The thicker, stippled attached

gingiva is keratinized, contains rete pegs, and is covered with stratified squamous epithelium. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The alveolar mucosa, which joins the attached gingiva at the mucogingival junction, is thin, soft, and smooth as correctly stated in the first statement. However, the alveolar mucosa is not keratinized. By contrast, the attached gingiva is highly keratinized. Its stippled, or dimpled, effect is caused by rete peg foNrmR ns. T se.aC re irM Uatio SI NGhe TB O regular bindings of epithelium to bone by collagen fibers.

REF: pp. 79-80 OBJ: To understand the relationship of cementum, periodontal ligament, and alveolar bone NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 11. Each of the following fibers extend from the cementum to the alveolar bone EXCEPT one.

Which one is the EXCEPTION? a. Oblique b. Horizontal c. Alveolar d. Apical e. Transseptal ANS: E

Transseptal fibers do NOT extend from the cementum to the alveolar bone because they are gingival fibers. Gingival fibers, as opposed to periodontal fibers, extend from the tooth to the gingiva. The remaining selections are periodontal fibers, which extend from the cementum to the alveolar bone.

REF: pp. 79-81 OBJ: To understand how the fibers of the periodontal ligament function in tooth movement and shock absorption

NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 12. The mucogingival junction joins the free and attached gingiva. There is a raised line on the

surface of the mucogingival junction. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The mucogingival junction is the demarcation between the attached gingiva and the alveolar mucosa. There is not a raised line at the mucogingival junction. Note that a gingival groove is often visible on the outside of the free gingiva and corresponds to the base of the sulcus.

REF: p. 78 | p. 80 OBJ: To understand the relationships within the gingival unit, a supporting structure of teeth NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity. TOP: BLOOM: Understanding 13. Periodontal ligament fibers that extend from the tooth to the alveolar crest are called a. horizontal b. oblique c. apical d. interradicular e. alveolar crest fibers ANS: E

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There are five basic periodontal fiber groups. Alveolar crest fibers extend from the cervical area of the tooth to the alveolar crest. Horizontal fibers run horizontally from the tooth to the alveolar bone. Oblique fibers run obliquely from the cementum to bone. Apical fibers radiate apically from the tooth to bone. Interradicular periodontal fibers run between roots of multirooted teeth.

REF: p. 80 | p. 83 OBJ: To understand how the fibers of the periodontal ligament function in tooth movement and shock absorption NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 14. Bundle bone is the collection of numerous layers of bone added to the socket wall through

apposition. Because it is relatively new bone, it has no attachment with the periodontal ligament. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The term bundle bone applies when numerous layers of bone are added to the socket wall.

An immediate attachment is formed between bundle bone and cells of the periodontal ligament. This newly formed bone results from functional demands where alveolar bone is deposited next to the periodontal ligament and is supported by a more compact bone. Such deposition of newly formed bone is referred to as apposition. The opposite of apposition is resorption.

REF: p. 81 OBJ: To understand the relationship of cementum, periodontal ligament, and alveolar bone NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 15. The periodontal ligament provides a hammock of tissue bundles that support the tooth within

bone. Each of the following is true regarding the periodontal ligament EXCEPT one. Which one is the EXCEPTION? a. Periodontal ligament fibers tie the tooth to bone. b. Periodontal ligament fibers prevent the tooth from being pushed into the bone. c. The periodontal ligament contains small blood and lymph vessel and nerves. d. The main portion of the periodontal ligament is composed of osseous trabeculae. e. Fluids within the periodontal ligament act as a hydraulic pressure system on the alveolar walls.

ANS: D

The main portion of the periodontal ligament is composed of bundles of white collagenous connective tissue fibers, which are bundled together like the many strands of a rope. Osseous trabeculae are NOT part of the periodontal ligament but are an integral part of the architectural arrangement of bone. Osseous is a term descriptive of bone.

NURSINGTB.COM REF: p. 80 | p. 82 OBJ: To understand how the fibers of the periodontal ligament function in tooth movement and shock absorption NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 16. The periodontal ligament is constantly undergoing functional change because the fibers are

constantly subjected to a variety of pressures exerted on the tooth. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Because a variety of pressures continually exert pressure on teeth, the fibers of the periodontal ligament are constantly undergoing functional changes. The tooth itself is actually suspended by the ligament in such a way that some degree of movement within the bony cavity is possible. To a degree this provides a protective feature. For example, pressure exerted on the mesial surface will compress periodontal fibers of the distal surface, allowing more space between the tooth and bone.

REF: p. 83 OBJ: To understand how the fibers of the periodontal ligament function in tooth movement and

shock absorption NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding MULTIPLE RESPONSE 1. When assessing the health of the gingival unit, which of the following provide guidance to the

dental professional (Select all that apply.)? a. Free gingiva extends from the gingival margin to the base of the gingival sulcus. b. The attached gingiva is located apical to the mucogingival junction. c. The alveolar mucosa is contiguous with the mucous membrane of the cheeks, lips, and floor of the mouth. d. Free gingiva has a thick epithelial covering. e. Cells of the free gingiva are nonkeratinized.

ANS: A, C, D

The free gingiva, a component of the gingival unit, extends from the gingival margin to the base of the gingival sulcus. It is the attached gingiva that extends from the base of the sulcus to the mucogingival junction; the question incorrectly identified this as the alveolar mucosa.

The mucogingival junction divides the very dense masticatory mucosa of both the free and attached gingiva from the alveolar mucosa. While cells of the gingiva, both free and attached, have a thick epithelial covering and keratinized cells, the rest of the mouth is lined with thin and nonkeratinized lining mucosa.

REF: p. 77 OBJ: To understand the relationships within the gingival unit, a supporting structure of teeth NAT: CDA: GC I.A.6. IdentifyNbasR ic oI ral aG nd dBe. ntaCl anM atomy, physiology and development, including but not limited to: oral cUavitS y. N TT OP: BLOOOM: Applying

2. Important features to consider while evaluating gingival conditions include (Select all that

apply.): a. The attached gingiva begins at the base of the gingival sulcus. b. Cells of the alveolar mucosa are nonkeratinized. c. Both the free and attached gingiva are lined with freely movable lining mucosa. d. The free gingiva is usually light pink in color.

ANS: A, B, D

The underlying mucosa of both free and attached gingiva is composed of dense collagen fibers. This same masticatory mucosa is found on the hard palate. The attached gingiva extends from the base of the gingival sulcus to the mucogingival junction. The thick epithelial cellular covering of both the attached and free gingiva is keratinized and not movable.

Conversely, the more fragile alveolar mucosa is thin and nonkeratinized as well as freely movable and vulnerable to injury.

REF: pp. 77-78 | p. 80 OBJ: To understand the relationships within the gingival unit, a supporting structure of teeth NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity. TOP: BLOOM: Evaluating 3. The periodontium, composed of tissues that support teeth, includes which of the following

structures (Select all that apply.)?

a. b. c. d. e.

Attached gingiva Cementum Dentin Alveolar bone All of the above are part of the periodontium.

ANS: A, B, D

The periodontium consists of those tissues that support teeth and include the following individual parts: gingiva, free gingiva, attached gingiva, alveolar mucosa, attachment unit, cementum, alveolar bone, and periodontal ligament. These structures are grouped into two more general categories: the gingival unit and an attachment unit. The attachment unit is also called the attachment apparatus. Dentin, which makes up the body of the tooth, is NOT a component of the periodontium.

REF: p. 77 | p. 79 OBJ: To understand how the attachment apparatus is related to the gingival unit NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 4. Which of the following are functions of the attachment apparatus (Select all that apply.)? a. Nutritive b. Supportive c. Formative d. Sensory ANS: A, B, C, D

The function of the attachment apparatus is frequently described as supportive of teeth within bone. However, other functioN nal ects utC ritiv URasp SI NGare TBn. OMe, formative, and sensory. Nutritive and sensory functions are fulfilled by blood vessels and nerves. The formative function replaces cementum, periodontal ligament, and alveolar bone and is accomplished by cementoblasts, fibroblasts, and osteoblasts.

REF: p. 80 OBJ: To understand how the attachment apparatus is related to the gingival unit NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. Orthodontic movement is possible due to which of the following (Select all that apply.)? a. Bone resorption b. Bone apposition c. Periodontal ligament stretching d. Hydraulic function of periodontal fluids ANS: A, B, C, D

Orthodontic corrective therapies apply pressure-causing forces on teeth to correct malocclusion. All selections are involved in these forces. They are considered consistent or constant forces, which move teeth because bone-remodeling system exerts pressure on the root, periodontal ligament, and bone. The result is movement of teeth through bone, with osteoclastic bone destruction (resorption) on one side of a tooth and osteoblastic bone formation (apposition) on the other side. Note that these mechanisms differ from the forces that create pathologic tooth mobility. Such forces are intermittent (not constant) and are typically associated with traumatic occlusion.

REF: p. 84 OBJ: To understand how the fibers of the periodontal ligament function in tooth movement and shock absorption NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering TRUE/FALSE 1. Interdental papilla is classified as attached gingiva.

ANS: F

The interdental papilla is the free gingiva located in the triangular interdental spaces.

REF: p. 77 OBJ: To understand the terminology of the gingival unit and to identify its various parts NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 2. Cementum that is free of embedded cementoblasts is clear and without structure.

ANS: T

The two types of cementum, cellular and acellular, are composed of cementoblasts. The acellular type is free of embedded cementoblasts and is clear and without structure. In the cellular type the cementoblasts become embedded in the cementum.

REF: p. 80 OBJ: To understand how the aN ttU acR hm ppT arB at. usC isOreMlated to the gingival unit SeIntNaG NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 3. On a radiograph, the alveolar bone that surrounds the tooth is called supraperiosteal bone.

ANS: F

On a radiograph, the alveolar bone that surrounds the tooth is called the lamina dura. The lamina dura is defined as the edge of the alveolar bone, which appears radiographically as a thin radiopaque (white) border of the interdental septum situated adjacent to the periodontal ligament and alveolar crest.

REF: pp. 80-81 OBJ: To understand the relationship of cementum, periodontal ligament, and alveolar bone NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering MATCHING

Evaluation, diagnosis, and treatment of gingival and periodontal conditions require a sound understanding of the structure of the gingival unit and periodontal attachment apparatus.

Match the gingival structure with its corresponding description. a. Free gingiva located in triangular interdental spaces b. Located apical to the mucogingival junction

c. d. e. f. g.

1.

2.

3.

4.

5.

6.

7.

Extends from base of gingival sulcus to mucogingival junction Surface covering of attached gingiva Extends from free gingival margin to base of gingival sulcus Responsible for darker-colored gingiva Composition of underlying mucosa of gingiva

Stratified squamous epithelium Gingival papilla Melanin Free gingiva Dense collagen fibers Attached gingiva Alveolar mucosa

1. ANS: D REF: pp. 77-80 OBJ: To understand the terminology of the gingival unit and to identify its various parts NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering NOT: The surface of the attached gingiva is covered with stratified squamous epithelium whereas alveolar mucosa is covered with lining mucosa. The free gingiva extends from the gingival margin to the base of the gingival sulcus. The attached gingiva extends from the base of the gingival sulcus to the mucogingival junction, which is the line of demarcation between the attached gingiva and the more apically located alveolar mucosa. The gingival papilla is the free gingiva located in the triangular interdental spaces. It has a more pointed apex in anterior teeth than in posterior teeth. Underlying gingival mucosa is composed of dense collagenous fibers. Melanin is responsible for darker-colored gingival tissues; the darker a person's skin the more likely the gingiva is darker in color.

G B.C M 2. ANS: A REF: pp. 77-80 N R I OBJ: To understand the terminoU logySof tN he gT ingival O unit and to identify its various parts NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering NOT: The gingival papilla is the free gingiva located in the triangular interdental spaces. It has a more pointed apex in anterior teeth than in posterior teeth. The free gingiva extends from the gingival margin to the base of the gingival sulcus. The attached gingiva extends from the base of the gingival sulcus to the mucogingival junction, which is the line of demarcation between the attached gingiva and the more apically located alveolar mucosa. The surface of the attached gingiva is covered with stratified squamous epithelium whereas alveolar mucosa is covered with lining mucosa. Underlying gingival mucosa is composed of dense collagenous fibers. Melanin is responsible for darker-colored gingival tissues; the darker a person's skin the more likely the gingiva is darker in color.

3. ANS: F REF: pp. 77-80 OBJ: To understand the terminology of the gingival unit and to identify its various parts NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering NOT: Melanin is responsible for darker-colored gingival tissues; the darker a person's skin the more likely the gingiva is darker in color. The free gingiva extends from the gingival margin to the base of the gingival sulcus. The attached gingiva extends from the base of the gingival sulcus to the mucogingival junction, which is the line of demarcation between the attached gingiva and the more apically located alveolar mucosa. The gingival papilla is the free gingiva located in the triangular interdental spaces. It has a more pointed apex in anterior teeth than in posterior teeth. The surface of the attached gingiva is covered with stratified squamous epithelium whereas alveolar mucosa is covered with lining mucosa. Underlying gingival mucosa is composed of dense collagenous fibers.

4. ANS: E REF: pp. 77-80 OBJ: To understand the terminology of the gingival unit and to identify its various parts

NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering NOT: The free gingiva extends from the gingival margin to the base of the gingival sulcus. The attached gingiva extends from the base of the gingival sulcus to the mucogingival junction, which is the line of demarcation between the attached gingiva and the more apically located alveolar mucosa.

The gingival papilla is the free gingiva located in the triangular interdental spaces. It has a more pointed apex in anterior teeth than in posterior teeth. The surface of the attached gingiva is covered with stratified squamous epithelium whereas alveolar mucosa is covered with lining mucosa.

Underlying gingival mucosa is composed of dense collagenous fibers. Melanin is responsible for darker-colored gingival tissues; the darker a person's skin the more likely the gingiva is darker in color.

5. ANS: G REF: pp. 77-80 OBJ: To understand the terminology of the gingival unit and to identify its various parts NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering NOT: Underlying gingival mucosa is composed of dense collagenous fibers. The free gingiva extends from the gingival margin to the base of the gingival sulcus. The attached gingiva extends from the base of the gingival sulcus to the mucogingival junction, which is the line of demarcation between the attached gingiva and the more apically located alveolar mucosa. The gingival papilla is the free gingiva located in the triangular interdental spaces. It has a more pointed apex in anterior teeth than in posterior teeth. The surface of the attached gingiva is covered with stratified squamous epithelium whereas alveolar mucosa is covered with lining mucosa. Melanin is responsible for darker-colored gingival tissues; the darker a person's skin the more likely the gingiva is darker in color.

6. ANS: C REF: pp. 77-80 OBJ: To understand the terminology of the gingival unit and to identify its various parts NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering NOT: The attached gingiva extends from the base of the gingival sulcus to the mucogingival junction, which is the line of demarcation between the attached gingiva and the more apically located alveolar mucosa. The free gingiva extenN dsUfrR om thN eG ginTgB iv. al C mO arM gin to the base of the gingival sulcus. The SI gingival papilla is the free gingiva located in the triangular interdental spaces. It has a more pointed apex in anterior teeth than in posterior teeth. The surface of the attached gingiva is covered with stratified squamous epithelium whereas alveolar mucosa is covered with lining mucosa. Underlying gingival mucosa is composed of dense collagenous fibers. Melanin is responsible for darker-colored gingival tissues; the darker a person's skin the more likely the gingiva is darker in color.

7. ANS: B REF: pp. 77-80 OBJ: To understand the terminology of the gingival unit and to identify its various parts NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering NOT: Alveolar mucosa is located apical to the mucogingival junction and is contiguous with the rest of the oral mucous membranes. The free gingiva extends from the gingival margin to the base of the gingival sulcus. The attached gingiva extends from the base of the gingival sulcus to the mucogingival junction, which is the line of demarcation between the attached gingiva and the more apically located alveolar mucosa. The gingival papilla, located in the triangular interdental spaces, has a more pointed apex in anterior teeth than in posterior teeth. The surface of the attached gingiva is covered with stratified squamous epithelium whereas alveolar mucosa is covered with lining mucosa. Underlying gingival mucosa is composed of dense collagenous fibers. Melanin is responsible for darker-colored gingival tissues; the darker a person's skin the more likely the gingiva is darker in color.

Chapter 09: Clinical Considerations Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Dentinal surfaces are rarely exposed during root planing because the envelope of cementum

covering the root is quite thick. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Although regular root cleaning can prevent disease by destroying plaque-trapping areas, the dental professional must always remember how thin the envelope of cementum is that wraps around the root. Unfortunately, exposure of dentin due to inadvertent removal of cementum can readily occur.

REF: p. 87 OBJ: To understand how preventive clinical situations are related to tooth form and supportive dental structures NAT: CDA: GC II.B.2.w. Demonstrate understanding of how to select and prepare armamentarium for chairside and emergency procedures, including: root planing and curettage.

TOP: BLOOM: Understanding 2. Pain can occur around a nonvNitU alRtoSoI thNbG ecTaB us. eC thO eM nerve cells in the pulp frequently

regenerate. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

In a nonvital tooth the nerves do not regenerate; however pain may persist because the nerve tissues in the periodontal ligament and surrounding bone tissue are still alive. This applies to a tooth whose pulp has been severely damaged through disease as well as an endodontically treated tooth whose pulp cavity has been completely debrided of all traces of nerve tissue and filled with root canal filling material.

REF: p. 89 OBJ: To evaluate the reliability of dental pain as a diagnostic aid NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves and 7. teeth.

TOP: BLOOM: Understanding 3. To some degree, prevention of periodontal disease is attributable to the smoothness of

cementum because bacteria that initiate gingival and periodontal diseases are prevented from accumulating on smooth surfaces. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related.

c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

To a degree, periodontal disease is prevented by the smoothness of enamel. Retention of food debris and plaque biofilm is diminished by the smooth nature of enamel. However, the root surface covering known as cementum does NOT have this attribute. Once the destructive influences of plaque and bacteria access the cementum, the likelihood of disease increases dramatically.

REF: p. 87 OBJ: To understand how occlusal trauma and the natural shape and contour of teeth can contribute to dental disease NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 4. Occlusal trauma results in mobility of the affected teeth as well as migration and tipping of

affected teeth. Although migrated teeth cause restorative dental problems, damage to the periodontium rarely occurs. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Occlusal trauma causes tooth mobility and predisposes affected teeth to migration and tipping.

A result of such occlusal dishNarmRonyIis G f tC he cMontact area between adjacent teeth. An U S Nloss TBo. O open contact, virtually impossible for patients to adequately clean, can cause a periodontal pocket with loss of fibrous attachment and formation of intraosseous periodontal pockets.

REF: p. 87 OBJ: To understand how occlusal trauma and the natural shape and contour of teeth can contribute to dental disease NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 5. When a tooth has no antagonist in the opposing arch, the tooth can a. over-erupt b. develop periodontal disease c. develop dental caries d. develop occlusal trauma e. All of the above ANS: E

Without an opposing tooth, called an antagonist, a tooth is likely to over-erupt in an attempt to “find” its antagonist. This same action typically occurs within 24 hours of a tooth becoming fractured. This action is referred to a tooth migration. Over-eruption beyond the occlusal plane in an attempt to meet an antagonist is called supraeruption.

REF: p. 89 OBJ: To understand how clinical experience is related to the theory and lecture portion of dental

anatomy NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. Each of the following is a common result of occlusal trauma EXCEPT for one. Which one is

the EXCEPTION? a. Muscle pain b. Tighter contact areas c. Nerve trauma d. Periodontal pocketing ANS: B

Occlusal trauma causes muscle pain, nerve trauma, and periodontal pocketing but does NOT cause tighter contact areas. Conversely, occlusal trauma can cause mobility, migration, and tipping of teeth, which lead to LOSS of contact area between adjacent teeth. This condition, referred to as open contact, typically causes retention of oral debris and bacterial plaque— major precursors to gingival and periodontal diseases as well as dental caries.

REF: p. 87 OBJ: To understand how occlusal trauma and the natural shape and contour of teeth can contribute to dental disease NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 7. Tooth migration can begin with 24 hours of an extraction. Tooth migration, otherwise known

as mesial drift, of teeth is a natural phenomenon. a. Both statements are true. b. The first statement is trueN , tU hR e sSec IoNndGstTaBte.mCent Mis false.

O c. The first statement is false, the second statement is true. d. Both statements are false.

ANS: B

Tooth migration, the tendency of a tooth to over-erupt in an attempt to “find” its opposing tooth, can begin in as little as 24 hours after extraction of an opposing tooth. The second statement incorrectly equates tooth migration with mesial drift. These are two separate phenomena. Mesial drift is defined as the natural phenomenon of permanent molars to continue to move mesially after eruption.

REF: p. 89 OBJ: To understand how tooth migration can affect the success of treatment or necessitate different treatment NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 8. Pulpal tissue cannot expand because the pulp is encased in hard dentinal tissue that makes

expansion virtually impossible. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Pulpal walls are lined, or encased, with dentin, which is a hard tooth structure. Unlike other parts of the body, pulpal tissue is not able to expand when injury initiates the body’s protective inflammatory response. The result is increased pressure, which causes pain.

REF: p. 88 OBJ: To understand how clinical experience is related to the theory and lecture portion of dental anatomy NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 9. During pulpal inflammation, arterial walls collapse and the venous walls remain intact

because arterial walls are thicker than the walls of veins. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

During pulpal inflammation, as with inflammation in any tissue, delivery of blood is increased. The walls of the arteries, which deliver blood, are stronger and therefore more likely to survive. Conversely, the veins, which remove blood, are quite thin and readily collapse. This results in retention of excess blood leading to increased pressure and pain.

Increased pressure causes obstruction of the apical foramen, which stops blood flow and results in death of pulpal tissues.

NURSINGTB.COM REF: p. 88 OBJ: To understand how occlusal trauma and the natural shape and contour of teeth can contribute to dental disease NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 10. Which is the most common initial response to gingival recession? a. Gingival inflammation b. Plaque formation c. Tooth sensitivity d. Stain formation ANS: C

Root surface exposed by gingival recession often leaves areas of exposed dentin, which elicits pain when exposed to air, sweets, hot, or cold. In this sense dentin can be nature’s warning sign of gum disease. Each of the remaining selections very commonly occurs in areas of longer-standing recession. Plaque retention and stain formation occur far more frequently on root surface than on the smooth enamel of anatomic crowns. Gingival inflammation is directly related to retained plaque and debris.

REF: p. 89 OBJ: To evaluate the reliability of dental pain as a diagnostic aid NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 11. Sealants are most effective in preventing decay in

a. b. c. d.

interproximal areas uneven enamel buccal and lingual grooves occlusal pits

ANS: D

Prevention of decay is most effective in occlusal pits because anatomic features increase sealant retention. Although more difficult and less predictable in other areas, various authors have suggested techniques to improve retention rates in areas not typically sealed. It is possible to place sealants interproximally only when adjacent space exists; this occasionally happens during the mixed dentition.

REF: p. 87 OBJ: To understand how preventive clinical situations are related to tooth form and supportive dental structures NAT: CDA: GC II.B.2.y. Demonstrate understanding of how to select and prepare armamentarium for chairside and emergency procedures, including: sealant application.

TOP: BLOOM: Remembering 12. When restoring the anatomy of a decayed tooth each of the following should be recreated

EXCEPT one. Which one is the EXCEPTION? a. Buccal and lingual contour b. Deep occlusal pits and grooves c. Interproximal contact area d. Occlusal contact point ANS: B

Recreating the anatomic formNofR a toI oth is eB ssentialMto restorative dentistry. However, deep U not S beNG T .CObecause occlusal pits and grooves should recreated these structures are plaque traps.

The buccal and lingual contours as well as the interproximal contact area should be restored in a manner to protect the gingiva. Occlusal contact points should be restored with the goal of creating occlusal harmony. Note the difference between a contact area and a contact point.

REF: pp. 88-89 OBJ: To understand how preventive clinical situations are related to tooth form and supportive dental structures NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 13. If a mandibular first molar is lost, the mandibular second molar will a. develop decay b. supra-erupt c. drift mesially d. drift distally e. None of the above ANS: C

Collapse of dental tissues is initiated by the loss of a single tooth, a mandibular first molar.

Numerous events occur, eventually resulting in mesial drift of the mandibular second molar.

This movement is accompanied by occlusal trauma and tipping in a mesial direction of the same tooth. Open contacts between the second and third molar result as well as between the second premolar and the second molar. Consider the periodontal, occlusal, and carious potential of these events.

REF: pp. 89-90 OBJ: To understand how tooth migration can affect the success of treatment or necessitate different treatment NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 14. After placing a restoration, the dentist and auxiliary should check a patient’s bite by having

the patient chew a thin piece of sugarless gum because checking the bite ensures that no part of the restoration is hitting prematurely. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Articulating paper is the material of choice for checking the patient’s occlusion after placement of a restoration. Articulating paper literally “articulates” occlusal patterns, which enable the dental professional to ensure that no part of the restoration is hitting prematurely.

This critical step should not be skipped as premature contact results in occlusal trauma and

.CevOeM leads to eventual fracture of tN heUrR esStoIraNtiG onTaBnd n the tooth itself.

REF: p. 89 OBJ: To understand how the placement of a restoration can contribute to disease of the supporting tissues NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 15. An ideal situation is to have all teeth occlude equally on closure of the jaw because this

pattern allows dissipation of occlusal forces over all of teeth. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

If dissipation of occlusal forces is not achieved during restorative procedures a tooth will prematurely contact another. This results in only two teeth bearing the initial brunt of occlusal forces. Trauma from excess force, known as occlusal trauma, results in periodontal disease, cracking of enamel, and possible tooth fracture.

REF: p. 87 OBJ: To understand how occlusal trauma and the natural shape and contour of teeth can contribute to dental disease

NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding MULTIPLE RESPONSE 1. Which of the following accurately describe preventive clinical considerations of existing

dental conditions (Select all that apply.)? a. Polishing restorations b. Root planing c. Using amalgam to fill a tooth d. Removing plaque and calculus ANS: A, B, D

Preventive procedures include polishing restorations to provide a smooth surface and assure that the tooth can resume normal function. Also preventive in nature are root planing as well as removal of plaque and calculus. Placing an amalgam restoration is considered a restorative procedure and is technically not a preventive procedure. It could be argued that placement of the amalgam prevents more serious dental consequences; however, the direct answer remains restorative.

REF: pp. 87-88 OBJ: To understand how preventive clinical situations are related to tooth form and supportive dental structures NAT: CDA: GC II.B. Demonstrate understanding of how to select and prepare armamentarium: chairside and dental emergency procedures, including: s. oral prophylaxis and w. root plating and curettage | GC II.C.14.b. Demonstrate understanding of intraoral procedures, including: assist with general dentistry and dental emergency procedures, including: cavity preparation and restoration | GC NUgRoS INque GTcontrol B.CO M IV.C.5. Demonstrate understandin f pla techniques, including: oral hygiene devices.

TOP: BLOOM: Applying 2. Which of the following contribute to dental caries and periodontal disease (Select all that

apply.)? a. Rough pits and grooves b. The consistent presence of bacterial plaque on teeth c. Inferior restorative dentistry d. Intact enamel surfaces e. Neglecting to replace missing teeth ANS: A, B, C, E

Dental caries and periodontal disease are primarily caused by retention of bacterial plaque.

Retentive factors include rough surfaces and projections, whether created by inferior restorative dentistry or naturally occurring pits, fissures, ridges, etc. Incomplete removal of calculus, stain, and biofilm during professional treatment are included in this list of causative factors. Note that selection “d” is not a correct answer because enamel provides a strong, resistant barrier.

REF: pp. 87-88 OBJ: To understand how occlusal trauma and the natural shape and contour of teeth can contribute to dental disease | To understand how the placement of a restoration can contribute to disease of the supporting tissues NAT: CDA: GC IV.C.5. Demonstrate understanding of plaque control techniques, including: oral

hygiene devices.

TOP: BLOOM: Remembering

TRUE/FALSE 1. The walls of the pulp chamber are formed by dentin and enamel.

ANS: F

The walls of the pulp chamber are formed from dentin. Dentin makes up the body of the tooth.

Enamel is the hard, smooth, outer covering that encases the anatomical crown of a tooth.

REF: p. 88 OBJ: To understand how clinical experience is related to the theory and lecture portion of dental anatomy NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. In protrusive occlusion, only the anterior teeth occlude.

ANS: T

As the mandible initiates protrusive movement, the distal area of the maxillary first molar hits the mesial area of the mandibular second molar. Once in protrusive occlusion, the posterior teeth should disengage; only the anterior teeth should occlude.

REF: p. 89 OBJ: To understand how clinical experience is related to the theory and lecture portion of dental anatomy NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development,

COOMOM: Remembering including but not limited to: teeN thU . RSINGTT OB P:.BL 3. A temporary crown can prevent mesial drift.

ANS: T

Mesial drift, the phenomenon of molars continuing to move mesially after eruption, can be prevented by a well-placed temporary crown.

REF: p. 89 OBJ: To understand how preventive clinical situations are related to tooth form and supportive dental structures NAT: CDA: GC II.C.14.c. Demonstrate understanding of intraoral procedures, including but not limited to: assist with general dentistry and general dental procedures, including but not limited to: crown and bridge restoration, preparation, temporization and cementation.

TOP: BLOOM: Remembering 4. Adjusting occlusion to discourage premature contact is considered a preventive therapeutic

procedure.

ANS: T

Adjusting occlusion prevents occlusal trauma. Serious dental/orofacial problems including pain, fractured teeth, periodontal diseases, and tooth loss result from occlusal trauma.

REF: p. 87 OBJ: To understand how preventive clinical situations are related to tooth form and supportive dental

structures NAT: CDA: GC II.C.14.i. Demonstrate understanding of intraoral procedures, including but not limited to: assist with general dentistry and general dental procedures, including but not limited to: occlusal equilibration/adjustment.

TOP: BLOOM: Applying MATCHING

Evaluation of existing conditions requires that the dental professional understand preventive and restorative clinical considerations. Match the dental condition with the appropriate description. a. Phenomenon of permanent molars moving mesially after eruption b. Causes tooth mobility c. Lined with dentin d. Tooth over-erupts in an attempt to “find” its antagonist e. Small opening into pulp cavity at tip of root 1.

2.

3.

4.

5.

Migration Mesial drift Apical foramen Pulpal walls Occlusal trauma

1. ANS: D REF: pp. 87-89 OBJ: To understand how tooth migration can affect the success of treatment or necessitate different treatment NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeN th. R I GTOB Remembering U S N TPit:.noBLClonger OOMOM: NOT: If a tooth is extracted or fractured so that occludes with its antagonist in the opposite arch, within 24 hours it will begin to supra-erupt in an attempt to "find" its antagonist. This is referred to as migration. Although mesial drift, a phenomenon of permanent molars continuing to move mesially after eruption, differs from migration, both processes change occlusal patterns. The apical foramen is the small opening at the apex of the root that enables delivery of oxygenated blood.

Pulpal walls, encased in hard tooth structures, are lined with dentin. This is significant because during inflammation pulpal tissues are unable to expand. Increased internal pressure, severe pain, and obliteration of the apical foramen result. Occlusal trauma, associated with all of the above conditions, causes tooth mobility.

2. ANS: A REF: pp. 87-89 OBJ: To understand how occlusal trauma and the natural shape and contour of teeth can contribute to dental disease NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: Although mesial drift, a phenomenon of permanent molars continuing to move mesially after eruption, differs from migration, both processes change occlusal patterns. If a tooth is extracted or fractured so that it no long occludes with its antagonist in the opposite arch, within 24 hours it will begin to supra-erupt in an attempt to "find" its antagonist. This is referred to as migration. The apical foramen is the small opening at the apex of the root that enables delivery of oxygenated blood. Pulpal walls, encased in hard tooth structures, are lined with dentin. This is significant because during inflammation pulpal tissues are unable to expand. Increased internal pressure, severe pain, and obliteration of the apical foramen result. Occlusal trauma, associated with all of the above conditions, causes tooth mobility.

3. ANS: E REF: pp. 87-89 OBJ: To understand how occlusal trauma and the natural shape and contour of teeth can contribute to

dental disease NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The apical foramen is the small opening at the apex of the root that enables delivery of oxygenated blood. If a tooth is extracted or fractured so that it no long occludes with its antagonist in the opposite arch, within 24 hours it will begin to supra-erupt in an attempt to "find" its antagonist.

This is referred to as migration. Although mesial drift, a phenomenon of permanent molars continuing to move mesially after eruption, differs from migration, both processes change occlusal patterns.

Pulpal walls, encased in hard tooth structures, are lined with dentin. This is significant because during inflammation pulpal tissues are unable to expand. Increased internal pressure, severe pain, and obliteration of the apical foramen result. Occlusal trauma, associated with all of the above conditions, causes tooth mobility.

4. ANS: C REF: pp. 87-89 OBJ: To understand how occlusal trauma and the natural shape and contour of teeth can contribute to dental disease NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: Pulpal walls, encased in hard tooth structures, are lined with dentin. This is significant because during inflammation pulpal tissues are unable to expand. Increased internal pressure, severe pain, and obliteration of the apical foramen result. Occlusal trauma, associated with all of the above conditions, causes tooth mobility. If a tooth is extracted or fractured so that it no longer occludes with its antagonist in the opposite arch, within 24 hours it will begin to supra-erupt in an attempt to "find" its antagonist. This is referred to as migration. Although mesial drift, a phenomenon of permanent molars continuing to move mesially after eruption, differs from migration, both processes change occlusal patterns. The apical foramen is the small opening at the apex of the root that enables delivery of oxygenated blood.

5. ANS: B REF: pp. 87-89 OBJ: To understand how occlusal trauma and the natural shape and contour of teeth can contribute to NURSINGTB.COM dental disease NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: Occlusal trauma causes tooth mobility. If a tooth is extracted or fractured so that it no longer occludes with its antagonist in the opposite arch, within 24 hours it will begin to supra-erupt in an attempt to "find" its antagonist. This is referred to as migration. Although mesial drift, a phenomenon of permanent molars continuing to move mesially after eruption, differs from migration, both processes change occlusal patterns. The apical foramen is the small opening at the apex of the root that enables delivery of oxygenated blood. Pulpal walls, encased in hard tooth structures, are lined with dentin. This is significant because during inflammation pulpal tissues are unable to expand. Increased internal pressure, severe pain, and obliteration of the apical foramen result.

Chapter 10: Tooth Identification Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Tooth roots do not always curve. If roots do curve, they typically curve distally. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

Teeth exhibit extreme amounts of anatomical variation; however a general rule of identification is that tooth roots do not always curve, which implies that root curvature certainly exists. The rule further states that root curvature usually is in a distal direction.

However, the rule further states that it is not uncommon for roots to curve mesially.

REF: p. 93 OBJ: To understand how to use landmarks to identify the incisors | To understand how to use landmarks to identify the canines | To understand how to use landmarks to identify the premolars | To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. Third molars are generally larger than first molars because a general rule of tooth

identification states that permanent molars are generally taller in height and have more cusps the more posteriorly they areNpU laR ceS d.INGTB.COM a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

The general rule of tooth identification applicable to molars states that permanent molars are typically smaller in height and have fewer cusps the more posteriorly they are positioned. For example, the permanent first molar usually has five cusps and is larger than either a second or third molar.

REF: p. 93 OBJ: To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 3. Secondary anatomy refers to anatomical features of second molars and premolars. Tertiary

anatomy refers to unique anatomical features of third molars. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Secondary anatomy refers to extra grooves and pits in addition, or secondarily, to the main primary developmental anatomy in any tooth. Tertiary anatomy refers specifically to the extremely shallow and more numerous grooves, pits, and lines present in third molars.

Tertiary features give third molars a more wrinkled appearance than first or second molars.

REF: p. 93 OBJ: To understand how to use landmarks to identify the premolars | To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 4. The crowns of the maxillary incisors are wider mesiodistally than labiolingually. The roots of

maxillary incisors are oval in cross section. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The crowns of maxillary incisors are wider in mesiodistal dimension than in faciolingual dimension. The second statement is false because the roots of maxillary incisors are triangular in cross section. The roots of the mandibular incisors, however, are oval in cross section.

These facts apply to both central and lateral incisors.

REF: p. 93 OBJ: To understand how to use landmarks to identify the incisors NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding

NURSINGTB.COM 5. Which incisor exhibits a slight distolingual rotation? a. b. c. d.

Maxillary central Maxillary lateral Mandibular central Mandibular lateral

ANS: D

The distal half of the incisal edge of the mandibular lateral incisor is rotated toward the lingual side. This can also be described as a slight distolingual rotation. This rotation is most apparent from the incisal view.

REF: p. 96 OBJ: To understand how to use landmarks to identify the incisors NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. The lingual cusp of the maxillary first premolar is longer than the facial cusp. This tooth often

has two roots, one mesial and one distal. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The lingual cusp of the maxillary first premolar is shorter than the facial cusp. While it is true that this tooth often has two roots, they are the buccal and lingual roots. For comparison, mandibular molars have a mesial and distal root.

REF: p. 99 OBJ: To understand how to use landmarks to identify the premolars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 7. Which premolar has a small lingual cusp and no central pit? a. Maxillary first b. Maxillary second c. Mandibular first d. Mandibular second ANS: C

The mandibular first premolar has no central pit whereas the mandibular second premolar does have a central pit. Important to note, both the mandibular first and second premolars have a small lingual cusp. A distinction is that the mandibular second premolar frequently has two lingual cusps whereas the first typically has only one cusp.

REF: p. 100 OBJ: To understand how to use landmarks to identify the premolars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 8. Maxillary molars have three roots, a facial and two lingual. Mandibular molars have two

roots, a facial and a lingual. a. Both statements are true. b. The first statement is trueN ;U thR eS seI coN nG dT staBte.mCeO ntMis false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

While it is true that maxillary molars have three roots, there are two facial roots and one lingual root. Mandibular molars have two roots, one buccal and one lingual.

REF: pp. 102-103 OBJ: To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 9. Root bifurcations may be present on maxillary premolars but not on mandibular premolars

because maxillary premolars have two roots whereas mandibular premolars have only one root. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Both the statement and the reason are incorrect because only maxillary first premolars have two roots. The remaining premolars have only one root. This fact illustrates the importance of strong command of tooth anatomy as it applies to periodontal assessment.

REF: pp. 99-100 OBJ: To understand how to use landmarks to identify the premolars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 10. Which molars have five (major and minor) cusps? a. Maxillary first and second b. Maxillary first and mandibular first c. Mandibular first and second d. Maxillary third and mandibular third ANS: B

The maxillary first and mandibular first molars have five cusps. This count includes major as well as minor cusps. The fifth cusp of the maxillary first molar is located on the mesiolingual cusp and is called the cusp of Carabelli. The fifth cusp of the mandibular first molar is the distal cusp.

REF: pp. 101-102 OBJ: To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 11. The cusp of Carabelli is located on the a. mandibular first molar b. mandibular second molar c. maxillary first molar d. maxillary second molar ANS: C

NURSINGTB.COM

The cusp of Carabelli is located on the maxillary first molar. It is considered the fifth lobe of this tooth and is situated at the tip of the mesiolingual cusp.

REF: p. 101 OBJ: To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 12. Roots of third molars are most often dilacerated because the more posterior the molars are

positioned, the more variation of anatomy is evident. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Roots of third molars are often fused. In general, the roots of molars tend to be shorter and closer together the more posterior the molars are positioned. Often third molar roots fuse into one. Conversely, first molars have the widest and longest roots of all molars. A dilacerated root is one that has a sharp bend or curve.

REF: p. 93 | pp. 101-103 OBJ: To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development,

including but not limited to: teeth.

13.

TOP: BLOOM: Understanding

Which are the smallest teeth? a. Maxillary lateral incisors b. Maxillary third molars c. Mandibular central incisors d. Mandibular lateral incisors ANS: C

Mandibular central incisors are the smallest teeth. The crown and root of the mandibular lateral incisor are slightly larger than those of the central incisor. Both the maxillary central and lateral incisors are larger than their mandibular counterparts.

REF: pp. 94-98 OBJ: To understand how to use landmarks to identify the incisors NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 14. Which molar has two buccal grooves? a. Maxillary first b. Maxillary second c. Mandibular first d. Mandibular second ANS: C

The mandibular first molar has two buccal/facial grooves. This tooth is also distinguished by its widely separate and relatively vertical roots. It also has a distal cusp, which is generally the smallest cusp.

N R I G B.C M

U S N how T to useOlandmarks to identify the molars REF: p. 102 OBJ: To understand NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 15. The mandibular second molar has a. four almost equal cusps b. one small distal cusp, two buccal cusps, and two lingual cusps c. three buccal cusps and two lingual cusps d. three major cusps and one minor cusp ANS: A

The mandibular second molar has four almost equal cusps. It is the mandibular first molar that has an additional smaller distal cusp.

REF: p. 103 OBJ: To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 16. Which premolar most frequently has three cusps? a. Maxillary first b. Maxillary second c. Mandibular first d. Mandibular second

ANS: D

The second mandibular premolar most frequently has three cusps. Both the first and second mandibular premolars always have at least two cusps, one a single facial cusp, with one or two lingual cusps. The second is more likely to have two lingual cusps.

REF: pp. 99-101 OBJ: To understand how to use landmarks to identify the premolars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. Which has an oblique ridge (Select all that apply.)? a. Maxillary first premolars b. Maxillary second premolars c. Maxillary first molars d. Maxillary second molars e. Maxillary third molars ANS: C, D

The maxillary first molar has a strong oblique ridge and the maxillary second molar has a smaller oblique ridge that is usually interrupted by a groove. The maxillary third molar does not have an oblique ridge. Note that the maxillary first and second premolars do not have an oblique ridge; instead the maxillary first premolar has a well-developed central groove and the maxillary second has a short central groove.

REF: pp. 99-103 OBJ: To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, N RSI NG TB.C OM including but not limited to: teethU .

TOP: BLOOM: Remembering 2. Which of the following accurately describe mandibular molars (Select all that apply.)? a. Crowns are wider mesiodistally than faciolingually. b. Three roots are present: two facial and one lingual. c. The mandibular second molar has a cusp of Carabelli. d. The occlusal groove on the second molar is well established. e. A strong oblique ridge is present on the first molar.

ANS: A, D

Crowns of mandibular molars are wider mesiodistally than faciolingually. Note that the opposite is true of maxillary molars. Mandibular molars have two roots: one buccal and one lingual. The cusp of Carabelli is not located on a mandibular molar; it is found on the maxillary first molar. It is true that the occlusal groove on the second molar is well established. Running in a mesial to distal direction, this groove forms a cross (+) with facial and lingual grooves. Finally, a strong oblique ridge is present on the maxillary first molar, not the mandibular.

REF: pp. 99-103 OBJ: To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Crowns of which teeth are wider faciolingually than mesiodistally (Select all that apply.)? a. Maxillary premolars

b. Mandibular premolars c. Maxillary molars d. Mandibular molars ANS: A, C

Crowns of maxillary premolars and molars are wider faciolingually than mesiodistally. This difference is more prominent in maxillary premolars. Mandibular molars are wider in the mesiodistal dimension. Mandibular premolars are nearly equal in their mesiodistal vs. faciolingual dimension.

REF: pp. 99-103 OBJ: To understand how to use landmarks to identify the premolars | To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering TRUE/FALSE 1. On anterior teeth, the curvature of the CEJ is the same on mesial and distal surfaces.

ANS: F

A general rule of tooth identification is that the curvature of the cementoenamel junction (CEJ) is usually about 1 mm less on the distal surface of the tooth than on the mesial. This rule applies to anterior as well as posterior teeth.

REF: p. 93 OBJ: To understand how to use landmarks to identify the incisors | To understand how to use IdNerGstaTnBd . landmarks to identify the canineNs U | TRoSun hoC wOtoMuse landmarks to identify the premolars | To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. The distal incisal edges of anterior teeth are more rounded than the mesial incisal edges.

ANS: T

A general rule of tooth identification is that the distal incisal edges of anterior teeth are more rounded than the mesial incisal edges.

REF: p. 93 OBJ: To understand how to use landmarks to identify the incisors | To understand how to use landmarks to identify the canines | To understand how to use landmarks to identify the premolars | To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Canines have a single cusp.

ANS: T

Canines, also called cuspids, have a single cusp with a well-developed mesiofacial lobe.

REF: p. 96 OBJ: To understand how to use landmarks to identify the canines NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development,

including but not limited to: teeth.

TOP: BLOOM: Remembering

MATCHING

Identification of teeth involves mastery of tooth anatomy. Match the anatomical descriptions with the appropriate teeth. a. Two roots, one mesial and one distal b. Two facial roots and one lingual root c. Lingual surface almost smooth d. Incisal edge angled toward lingual e. Prominent facial cusp with one or two smaller lingual cusps f. Mesioincisal angle is relatively sharp g. Single cusp tip directly over midcenter of root h. Buccal and lingual cusps approximately equal in height 1.

2.

3.

4.

5.

6.

7.

8.

Maxillary incisors Mandibular incisors Maxillary canine Mandibular canine Maxillary premolars Mandibular premolars Maxillary molars Mandibular molars

1. ANS: F REF: pp. 93-103 OBJ: To understand how to use landmarks to identify the incisors N asic RSora IN G B.Canatomy, M NAT: CDA: GC I.A.7. Identify bU l andTdental O physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The mesioincisal angle of maxillary incisors is relatively sharp, typically close to 90 degrees.

Although the incisal edge of mandibular incisors is angled toward the lingual side, note that the incisal edge wears on the labial surface. The maxillary canine has a single cusp with its tip centered directly over the midcenter of the root. The mandibular canine has an almost smooth surface with poorly developed ridges, cingulum, and fossa. This differs significantly from the lingual surface of the maxillary canine, which has well-developed ridges and fossa as well as a prominent cingulum. The maxillary premolars have two major cusps, one buccal and one lingual, approximately equal in size.

Mandibular premolars differ in that they have one prominent facial cusp with one or two much smaller lingual cusps. Maxillary molars have three roots, two facial and one lingual. Mandibular molars have two roots, one mesial and one distal.

2. ANS: D REF: pp. 93-103 OBJ: To understand how to use landmarks to identify the incisors NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: Although the incisal edge of mandibular incisors is angled toward the lingual side, note that the incisal edge wears on the labial surface. The mesioincisal angle of maxillary incisors is relatively sharp, typically close to 90 degrees. The maxillary canine has a single cusp with its tip centered directly over the midcenter of the root. The mandibular canine has an almost smooth surface with poorly developed ridges, cingulum, and fossa. This differs significantly from the lingual surface of the maxillary canine, which has well-developed ridges and fossa as well as a prominent cingulum. The maxillary premolars have two major cusps, one buccal and one lingual, approximately equal in size.

Mandibular premolars differ in that they have one prominent facial cusp with one or two much smaller lingual cusps. Maxillary molars have three roots, two facial and one lingual. Mandibular molars have

two roots, one mesial and one distal.

3. ANS: G REF: pp. 93-103 OBJ: To understand how to use landmarks to identify the canines NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The maxillary canine has a single cusp with its tip centered directly over the midcenter of the root. The mandibular canine has an almost smooth surface with poorly developed ridges, cingulum, and fossa. This differs significantly from the lingual surface of the maxillary canine, which has well-developed ridges and fossa as well as a prominent cingulum. The mesioincisal angle of maxillary incisors is relatively sharp, typically close to 90 degrees. Although the incisal edge of mandibular incisors is angled toward the lingual side, note that the incisal edge wears on the labial surface. The maxillary premolars have two major cusps, one buccal and one lingual, approximately equal in size.

Mandibular premolars differ in that they have one prominent facial cusp with one or two much smaller lingual cusps. Maxillary molars have three roots, two facial and one lingual. Mandibular molars have two roots, one mesial and one distal.

4. ANS: C REF: pp. 93-103 OBJ: To understand how to use landmarks to identify the canines NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The mandibular canine has an almost smooth surface with poorly developed ridges, cingulum, and fossa. This differs significantly from the lingual surface of the maxillary canine, which has well-developed ridges and fossa as well as a prominent cingulum. Also note, the maxillary canine has a single cusp with its tip centered directly over the midcenter of the root. The maxillary premolars have two major cusps, one buccal and one lingual, approximately equal in size. Mandibular premolars differ in that they have one prominent facial cusp with one or two much smaller lingual cusps.

Maxillary molars have three roots, two facial and one lingual. Mandibular molars have two roots, one mesial and one distal. The mesioincisal angle of maxillary incisors is relatively sharp, typically close to 90 degrees. Although the incisal edge of mandibular incisors is angled toward the lingual side, note that the incisal edge wears on thN eU laR biS al I suN rfG acT e.B.COM 5. ANS: H REF: pp. 93-103 OBJ: To understand how to use landmarks to identify the premolars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The maxillary premolars have two major cusps, one buccal and one lingual, approximately equal in size. Mandibular premolars differ in that they have one prominent facial cusp with one or two much smaller lingual cusps. Maxillary molars have three roots, two facial and one lingual. Mandibular molars have two roots, one mesial and one distal. The mesioincisal angle of maxillary incisors is relatively sharp, typically close to 90 degrees. Although the incisal edge of mandibular incisors is angled toward the lingual side, note that the incisal edge wears on the labial surface. The maxillary canine has a single cusp with its tip centered directly over the midcenter of the root. The mandibular canine has an almost smooth surface with poorly developed ridges, cingulum, and fossa. This differs significantly from the lingual surface of the maxillary canine, which has well-developed ridges and fossa as well as a prominent cingulum.

6. ANS: E REF: pp. 93-103 OBJ: To understand how to use landmarks to identify the premolars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: Mandibular premolars have one prominent facial cusp with one or two much smaller lingual cusps. This differs from the maxillary premolars which have two major cusps, one buccal and one lingual, approximately equal in size. Maxillary molars have three roots, two facial and one lingual.

Mandibular molars have two roots, one mesial and one distal. The mesioincisal angle of maxillary incisors is relatively sharp, typically close to 90 degrees. Although the incisal edge of mandibular incisors is angled toward the lingual side, note that the incisal edge wears on the labial surface. The

maxillary canine has a single cusp with its tip centered directly over the midcenter of the root. The mandibular canine has an almost smooth surface with poorly developed ridges, cingulum, and fossa.

This differs significantly from the lingual surface of the maxillary canine, which has well-developed ridges and fossa as well as a prominent cingulum.

7. ANS: B REF: pp. 93-103 OBJ: To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: Maxillary molars have three roots, two facial and one lingual. Mandibular molars have two roots, one mesial and one distal. The maxillary premolars have two major cusps, one buccal and one lingual, approximately equal in size. Mandibular premolars differ in that they have one prominent facial cusp with one or two much smaller lingual cusps. The mesioincisal angle of maxillary incisors is relatively sharp, typically close to 90 degrees. Although the incisal edge of mandibular incisors is angled toward the lingual side, note that the incisal edge wears on the labial surface. The maxillary canine has a single cusp with its tip centered directly over the midcenter of the root. The mandibular canine has an almost smooth surface with poorly developed ridges, cingulum, and fossa. This differs significantly from the lingual surface of the maxillary canine which has well-developed ridges and fossa as well as a prominent cingulum.

8. ANS: A REF: pp. 93-103 OBJ: To understand how to use landmarks to identify the molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: Mandibular molars have two roots, one mesial and one distal. Maxillary molars have three roots, two facial and one lingual. The mesioincisal angle of maxillary incisors is relatively sharp, typically close to 90 degrees. Although the incisal edge of mandibular incisors is angled toward the lingual side, note that the incisal edge wears on the labial surface. The maxillary canine has a single cusp with its tip centered directly over the midcenter of the root. The mandibular canine has an almost smooth surface with poorly developed ridges, cingulum, and fossa. This differs significantly from the lingual surface of the maxillaryN caUnR inS e, I wN hiG chThB as. wC elO l-dMeveloped ridges and fossa as well as a prominent cingulum. The maxillary premolars have two major cusps, one buccal and one lingual, approximately equal in size. Mandibular premolars differ in that they have one prominent facial cusp with one or two much smaller lingual cusps.

Chapter 11: Root Morphology Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Root pain due to exposed dentin is caused by gingival recession. Exposed spots of dentin can

stimulate pulpal nerves through the cementoenamel junction (CEJ). a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Gingival recession exposes the tooth root and causes pain because the thin, fragile cementum has bare areas of exposed dentin. Pulpal nerves are stimulated through dentinal tubules in exposed spots of dentin.

REF: p. 105 OBJ: To understand how root shape affects the periodontal tissue health and hygiene NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. Pressure and temperature responses are elicited by all of the following EXCEPT one. Which

one is the EXCEPTION? a. Bone b. Periodontal ligament c. Gingiva d. Pulp tissue

NURSINGTB.COM

ANS: D

Pressure and temperature responses are not elicited by pulp tissue. Instead the nerve tissue within bone, periodontal ligament, and gingiva elicits these responses. Root canals can only respond to pain.

REF: p. 105 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development, including but not limited to: 5. nerves and 7. teeth.

TOP: BLOOM: Remembering 3. Blood vessels traveling through the apical foramen support nerves and odontoblasts because

blood supply enables delivery of essential nutrients as well as removal of harmful products. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Blood vessels comprised of arteries, veins, and lymph tissues nourish and replenish the nerves and odontoblasts. As these vessels enter and exit the apical foramen they enable circulation of nutrients and oxygen throughout the pulp chamber. Critically important, they also provide a system to remove harmful products such as carbon dioxide.

REF: p. 105 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development, including but not limited to: 1. blood vessels and 7. teeth.

TOP: BLOOM: Understanding 4. Each of the following teeth frequently has two roots EXCEPT one. Which one is the

EXCEPTION? a. Maxillary first premolar b. Maxillary second premolar c. Mandibular first molar d. Mandibular second molar ANS: B

While maxillary premolars can have one or two roots, the maxillary second premolar most frequently has only one root. The maxillary first premolar often has two roots. All mandibular molars usually have two root roots, a mesial and a distal.

REF: p. 108 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. Maxillary molar root trifurcations are located on each of the following surfaces EXCEPT one.

Which one is the EXCEPTION? a. Mesial b. Distal c. Lingual d. Buccal ANS: C

NURSINGTB.COM

Maxillary molars have a trifurcation between their three roots. Because there is a large lingual (palatal) root, there is not a trifurcation on the lingual surface. The three different furcation areas for maxillary molars are located between: the two buccal roots; the distobuccal and lingual roots; and the mesiobuccal and lingual roots.

REF: p. 107 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. Orthodontics requires a sustained pressure to move teeth to a new location. Osteoblasts

respond to the new location by forming new bone. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

Orthodontics, the gradual movement of teeth to a new location, is accomplished by exerting a sustained pressure for a prolonged time period. While osteoblastic (bone formative) activity is essential to formation of new bone in the new location, osteoclastic (bone destructive) activity is also necessary to dissolve bone so that teeth will move.

REF: p. 106

OBJ: To understand how orthodontic tooth movement is possible

NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 7. Teeth with curved roots afford resistance to apical and distal forces but are vulnerable to

occlusal forces. Roots with triangular cross section are particularly vulnerable to lateral displacement. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Teeth with curved roots afford resistance to occlusal, apical, and distal forces. Roots with triangular cross sections (canines) offer resistance to lateral displacement.

REF: p. 106 OBJ: To understand how the shape of the root affects the support of the tooth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 8. Root canal therapy in third molars is considered very unpredictable because the tooth is

located so far distally in the mouth. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

NURSINGTB.COM

Root canal therapy is considered very unpredictable in third molars because the roots are usually curved. An additional obstacle, the roots tend to be fused. Gaining access to the apex of roots with such challenging anatomy poses great difficulty. While it is true that the distal location of third molars poses great challenge, this feature is less daunting than anatomical considerations.

REF: p. 108 OBJ: To understand the anatomical differences between root canals NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 9. Mandibular premolars typically have two pulp canals. Maxillary first premolars are more

likely than maxillary second premolars to have two pulp canals. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Mandibular premolars usually have only one canal. Maxillary premolars often have two canals; the first is more likely to have two canals than the second.

REF: p. 108 OBJ: To understand the anatomical differences between root canals NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding

10. During hypercementosis, excess cementum is deposited a. along the CEJ b. irregularly, throughout the root surface c. at the dentinocemental junction d. at the apex of the root ANS: D

During hypercementosis, a process of extreme excess cementum production, a formation called a cementoma is deposited at the apex of the root. This process is usually associated with bone destruction and/or trauma. The newly formed excess cementum is different from the rest that lines the root.

REF: p. 105 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 11. Cementum formed during hypercementosis is different from the cementum lining the root

because this newly formed product can continue to grow and add on to itself. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Hypercementosis is a process of extreme overproduction of cementum. Occurring at the apical third of the root, this new proNduc diB ff. erC ent from the more typical cementum lining the URt isSIquit NGe T OM surface of the root. The primary difference is that cementum formed during hypercementoma can continue to grow. Also pertinent, it is called cellular cementum because it traps cementoblasts, the cells that form cementum.

REF: p. 105 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 12. Each of the following root characteristics provides significant resistance to displacement from

traumatic forces EXCEPT one. Which one is the EXCEPTION? a. Root grooves b. Root concavities c. A short, smooth root d. Multiple roots ANS: C

A short, smooth root has very little resistance to traumatic forces because it has less surface area for attachment of periodontal fibers. Root grooves and root concavities enhance resistance to trauma because they offer more surface area for attachment of fibers. Such root irregularities also enable fibers to attach from multiple directions, further strengthening the attachment mechanism. Multiple roots offer the same mechanisms for enhanced resistance to trauma.

REF: pp. 105-106

OBJ: To understand the functions of the roots of teeth

NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 13. A slight amount of mobility is not considered normal. Orthodontics can help with bone

remodeling that can prevent even slight tooth mobility. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Slight mobility is a normal, healthy, and desirable feature. Slight mobility exists because the collagenous periodontal ligament that fills the thin space between bone and the root provides a cushioning effect against mild pressure. Orthodontic therapy is intended to move teeth to a more desirable location.

REF: p. 106 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 14. Each of the following is a characteristic of the periodontal ligament EXCEPT one. Which one

is the EXCEPTION? a. Capable of regeneration b. Capable of compression c. Provides tension d. Provides support ANS: A

NURSINGTB.COM

The periodontal ligament, the supportive collagenous structure that fills the thin area of space between the tooth and bone, cannot regenerate itself. Although it is capable of remodeling, which involves lengthening, compressing, and relaxing as it responds to tension and pressure, this vital supportive structure is not able to regenerate. Extensive research is being conducted to establish regenerative potential.

REF: p. 105 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 15. A patient who has sensitivity in the mandibular anterior area due to abrasion is interested in

having her teeth bleached. Which factor could contribute to her sensitivity? a. Discolored teeth b. Thin, uneven cementum c. Root canal treatment on mandibular central incisors d. Slight mobility ANS: B

Thin, uneven cementum exposes spots of dentin, which can stimulate the pulpal nerves via dentinal tubules. Discolored teeth, while a cosmetic concern, are not predisposed to sensitivity. Root canal therapy is an unlikely culprit since it is performed to alleviate tooth pain. Slight mobility is considered normal and healthy and not contributive to tooth sensitivity.

REF: p. 105 | p. 107 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Applying 16. The figure below shows a mesial view (A) and a distal view (B) of a linguobuccal section.

Identify the tooth.

a. b. c. d.

Mandibular first premolar Mandibular second premolar Mandibular first molar Mandibular second molar

ANS: C

Identifying features include the two separate root canals in the mesial root. Although mandibular molars usually have a total of two root canals, a mesial and a distal, this tooth is the most likely to have two canals located in its mesial root in addition to a canal in the distal N s,RthSeImNesia GTl B.C M root. Note that when this occurU root hO as a buccal and a lingual canal, both of which are considerably smaller than the distal canal in the same tooth. The distal root has only one canal.

From the mesial aspect only the mesiolingual and mesiobuccal cusps can be seen (there are five total cusps). The mesiolingual is the higher and more conical of the two visible cusps.

REF: p. 107 | p. 185 OBJ: To understand the anatomical differences between root canals NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 17. Which of the following best describes the root canal opening(s) in the figure “A” below?

a. Accessory root canals b. One main and one accessory root canal c. Two apical root canals ANS: C

The mesial view of the mandibular first molar, featured in the figure above, has two apical root canals. The two root canal openings, also called orifices or foramens, are located at the apex of the root. If the openings are lateral rather than apical, they are referred to as accessory canals. It is possible for many variations to occur.

REF: p. 107 OBJ: To understand the anatomical differences between root canals NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. Pain within the root (root pain) can be elicited by which of the following (Select all that

apply.)? a. Root decay b. Root resorption c. Secondary dentin d. Dehydration e. Reparative dentin ANS: A, B, D

Root pain is not caused by formation of either secondary or reparative dentin. Secondary and reparative dentin, protective in nature, are formed by the odontoblasts in response to trauma.

NUd RdeShyd INrati GTonB.C Root decay, root resorption, an causO eM root pain. Other causes include air, sweets, and chemicals such as bleaching agents.

REF: p. 17 | p. 105 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Applying 2. Which of the following travel through the apical foramen (Select all that apply.)? a. Nerves b. Enamel pearls c. Blood vessels d. Nutrients e. Lymphatic vessels ANS: A, C, D, E

Nerves, blood vessels, nutrients, and lymphatic vessels travel through the apical foramen.

They provide innervation, nourishment, and replenishment of the pulpal tissues. Blood vessels, including arteries and veins, deliver oxygen and nutrients. Lymphatic vessels, part of the circulatory system, remove toxins such as carbon dioxide. Enamel pearls, small elevations of enamel located within root furcations, do not travel through the apical foramen.

REF: p. 105 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

TRUE/FALSE 1. Dentin tubules can carry a stimulus from the root surface to the nerves in the pulp canal.

ANS: T

Nerves within the pulp canal can be stimulated in various manners. The most common way is for dentin tubules to carry a stimulus from the root surface through dentin tubules to the nerve tissue lining the root canal.

REF: p. 105 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. The cementum covering the root is thick and smooth when first formed.

ANS: F

When initially formed, the layer of cementum covering the root is imperfect, thin, and unevenly distributed. By comparison, enamel is thin but very hard and perfectly distributed.

Dentin is a thick tissue, forming the body of the tooth.

REF: p. 105 | p. 107 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Root pain always means that dental caries is present.

ANS: F

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Root pain has numerous causes not related to dental caries. Such causes include gingival recession, root resorption, and abrasion as well as exposure to stimuli such as air, sweets, and cold. Chemicals such as bleaching agents cause dehydration of dentinal tubules, which can be extremely painful but not carious.

REF: p. 105 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Applying 4. If there are two pulp canals in a root, there could be one or two openings in the root.

ANS: T

There are many variations of numbers of pulp canals and foramen (openings) in roots. As described in the question, it is possible for a tooth to have two canals that fuse into one apical opening. More frequently a tooth with two canals will have two openings. To illustrate possible variations, anterior teeth usually have one large root canal per tooth with one apical foramen. However, the mandibular canine sometimes has two canals with a foramen in each.

REF: pp. 107-109 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 5. Mandibular second molars often have two canals in each root.

ANS: F

Typically each root has one canal. While mandibular second molars frequently have two canals in the larger and wider mesial root, the distal root almost always has one canal.

REF: p. 108 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering MATCHING

Knowledge of anatomic features unique to root morphology is essential to assessment of periodontal and dental health. Match each anatomic feature with its corresponding description. a. Rough cementum b. Opening at apex c. Cementum meets enamel d. Cementoma e. Enamel pearl f. Accessory canal(s) g. Secondary dentin CEJ Apex Root surface Lateral foramen 5. Pulp chamber 6. Furcation 7. Apical foramen 1.

2.

3.

4.

1. ANS: C REF: pp. 105-107 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The junction between enamel and cementum is called the cementoenamel junction, commonly referred to as the CEJ. Root surface is rough in nature due to the characteristics of cementum. A cementoma, produced by hypercementosis, is formed by deposition of excess cementum at the apex of the root. Cementoma formation is associated with bone destruction and/or trauma. An apical foramen is an opening at the apex of the root. Conversely, an accessory canal is a lateral foramen (orifice/opening), located on the side of the root. Secondary and reparative dentin forms in response to trauma throughout the tooth, including the entire pulp chamber. Enamel pearls, small elevations of enamel most frequently found in furcations, pose significant challenge to maintenance of oral hygiene.

2. ANS: D REF: pp. 105-107 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: A cementoma, produced by hypercementosis, is formed by deposition of excess cementum at the apex of the root. Cementoma formation is associated with bone destruction and/or trauma. The junction between enamel and cementum is called the cementoenamel junction, commonly referred to as the CEJ. Root surface is rough in nature due to the characteristics of cementum. An apical foramen is an opening at the apex of the root. Conversely, an accessory canal is a lateral foramen (orifice/opening), located on the side of the root. Secondary and reparative dentin forms in response to trauma throughout the tooth, including the entire pulp chamber. Enamel pearls, small elevations of

enamel most frequently found in furcations, pose significant challenge to maintenance of oral hygiene.

3. ANS: A REF: pp. 105-107 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: Root surface is rough in nature due to the characteristics of cementum. A cementoma, produced by hypercementosis, is formed by deposition of excess cementum at the apex of the root. Cementoma formation is associated with bone destruction and/or trauma. The junction between enamel and cementum is called the cementoenamel junction, commonly referred to as the CEJ. An apical foramen is an opening at the apex of the root. Conversely, an accessory canal is a lateral foramen (orifice/opening), located on the side of the root. Secondary and reparative dentin forms in response to trauma throughout the tooth, including the entire pulp chamber. Enamel pearls, small elevations of enamel most frequently found in furcations, pose significant challenge to maintenance of oral hygiene.

4. ANS: F REF: pp. 105-107 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: An accessory canal is a lateral foramen (orifice/opening), located on the side of the root.

Conversely, an apical foramen is an opening at the apex of the root. Secondary and reparative dentin forms in response to trauma throughout the tooth, including the entire pulp chamber. Root surface is rough in nature due to the characteristics of cementum. A cementoma, produced by hypercementosis, is formed by deposition of excess cementum at the apex of the root. Cementoma formation is associated with bone destruction and/or trauma. The junction between enamel and cementum is called the cementoenamel junction, commonly referred to as the CEJ. Enamel pearls, small elevations of enamel most frequently found in furcations, pose significant challenge to maintenance of oral hygiene.

5. ANS: G REF: pp. 105-107 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: Secondary and reparative dentin forms in response to trauma throughout the tooth, including the entire pulp chamber. The junction between enamel and cementum is called the cementoenamel junction, commonly referred toN asUthReS CI EN J. G RoToB t s. urC faO ceMis rough in nature due to the characteristics of cementum. A cementoma, produced by hypercementosis, is formed by deposition of excess cementum at the apex third of the root. Cementoma formation is associated with bone destruction and/or trauma.

An apical foramen is an opening at the apex of the root. Conversely, an accessory canal is a lateral foramen (orifice/opening), located on the side of the root. Enamel pearls, small elevations of enamel most frequently found in furcations, pose significant challenge to maintenance of oral hygiene.

6. ANS: E REF: pp. 105-107 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: Enamel pearls, small elevations of enamel most frequently found in furcations, pose significant challenge to maintenance of oral hygiene. The junction between enamel and cementum is called the cementoenamel junction, commonly referred to as the CEJ. Root surface is rough in nature due to the characteristics of cementum. A cementoma, produced by hypercementosis, is formed by deposition of excess cementum at the apex of the root. Cementoma formation is associated with bone destruction and/or trauma. An apical foramen is an opening at the apex of the root. Conversely, an accessory canal is a lateral foramen (orifice/opening), located on the side of the root. Secondary and reparative dentin forms in response to trauma throughout the tooth, including the entire pulp chamber.

7. ANS: B REF: pp. 105-107 OBJ: To understand the functions of the roots of teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: An apical foramen is an opening at the apex of the root. Conversely, an accessory canal is a lateral foramen (orifice/opening), located on the side of the root. The junction between enamel and cementum is called the cementoenamel junction, commonly referred to as the CEJ. Root surface is rough in nature due to the characteristics of cementum. A cementoma, produced by hypercementosis, is formed by deposition of excess cementum at the apex of the root. Cementoma formation is

associated with bone destruction and/or trauma. Secondary and reparative dentin forms in response to trauma throughout the tooth, including the entire pulp chamber. Enamel pearls, small elevations of enamel most frequently found in furcations, pose significant challenge to maintenance of oral hygiene.

Chapter 12: Incisors Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Each mamelon forms the incisal edge of one of the primary labial lobes of the incisors. With

wear, the rounded incisal edge becomes flat and is then referred to the incisal ridge. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The terms incisal edge and incisal ridge are reversed in the question. Each mamelon initially forms the incisal ridge of one of the three primary labial lobes. However, normal use eventually wears down the rounded ridge into a flat edge. At this point the term incisal edge is more appropriate than ridge.

REF: p. 119 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. Mandibular lateral incisors are generally smaller than mandibular central incisors. Mandibular

lateral incisors have greater facial curvature than the central incisors. a. Both statements are true. b. The first statement is true; the second statement is false.

NUthe RSsec IN G B.C M c. The first statement is false; ondTstatemeOnt is true. d. Both statements are false.

ANS: C

Mandibular lateral incisors are larger, wider, and longer than the mandibular central incisors.

They are wider both mesiodistally and longer gingivoincisally. The second statement is true because the endpoints of the mesiofacial line angle are farther apart than those of the distofacial line angle.

REF: p. 131 OBJ: To compare maxillary central incisors with maxillary lateral incisors NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 3. Extracted mandibular central incisors are the easiest to identify as either right or left because

they are located anteriorly and near the midline. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Mandibular central incisors are the most difficult to identify as either right or left because they are bilaterally symmetrical and difficult to differentiate. Their anterior location does not assist in right/left identification. An occasionally helpful feature is that the distofacial line angle is more rounded than the mesiofacial.

REF: p. 129 OBJ: To identify an extracted incisor NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 4. The maxillary lateral incisor usually has a straight, thick, cylindrically shaped root. The root

length of the maxillary lateral incisor is about 1.5 times the length of the crown. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

It is the root of the maxillary central incisor that usually is straight, thick, and cylindrically shaped. Conversely, the root of the maxillary lateral appears thinner and often curves distally.

As a rule the root of the maxillary lateral incisor is about 1.5 times the length of the crown.

REF: p. 121 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 5. Which incisor is not derived from four primary lobes? a. Maxillary central b. Maxillary lateral NURSINGTB.COM c. Mandibular central d. Mandibular lateral e. All of the above are derived from four lobes.

ANS: E

All incisor teeth are derived from four primary lobes, three facial and one lingual.

Developmental lines on the labial aspect divide the surface into three parts, each developmental line separating a primary lobe.

REF: p. 129 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. Maxillary central incisors usually develop normally. Two anomalies that sometimes occur are

a longer root or a shorter crown. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

While the central incisors usually develop normally, two anomalies that sometimes occur are a shorter root and a longer crown. A third anomaly is germination, where the tooth shows evidence of attempting to divide itself. An additional note, the maxillary central incisors are the largest and most prominent incisors.

REF: p. 119 OBJ: To recognize the normal and deviated anatomic forms of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 7. All incisors have two marginal ridges, a cingulum, and a lingual fossa. The mandibular central

incisor has the least distinct lingual anatomy. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

Marginal ridges, a cingulum, and a lingual fossa are standard anatomic features of incisors.

The cingulum is a smooth convexity on the lingual surface immediately below the cervical line. The lingual fossa is mesially and distally confluent with the cingulum. Marginal ridges are rounded convexities that border the lingual fossa. Of the four incisors, the mandibular central has the least distinct anatomy as evidenced by a shallow surface with no prominent features.

REF: p. 128 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding

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8. When incisors first erupt the incisal ridge is smooth. After teeth have been in function for

several months, mamelons, which aid in mastication, develop on the incisal ridge. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

When incisors first erupt, mamelons can be seen on the incisal ridge (later called the incisal edge). Mamelons are rounded portions of the incisal ridge of newly erupted incisors and form the incisal ridge portion of one of the labial primary lobes. Normal use eventually wears down the mamelons into a flat edge. At this point the incisal ridge is more appropriately called the incisal edge. Mamelons have no special function in mastication.

REF: pp. 119-120 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 9. Each of the following statements correctly describes maxillary lateral incisors EXCEPT one.

Which one is the EXCEPTION? a. The incisal aspect can resemble that of a central incisor or a canine. b. Incisally, they exhibit more convexity both labially and lingually than maxillary centrals.

c. Of all incisors, the maxillary laterals vary the least in form. d. The mesial aspect of a maxillary lateral incisor is similar to that of a small central

incisor. e. Frequently maxillary lateral incisors are peg-shaped.

ANS: C

Maxillary lateral incisors vary in form more than any other teeth in the mouth except the third molars. If the variation is too great, it is considered a developmental anomaly. By contrast, the maxillary central incisors are much more likely to develop normally. The incisal aspect of the maxillary lateral incisors sometimes resembles that of the central incisors or a small canine because of developmental variation.

REF: p. 119 | p. 121 | p. 124 OBJ: To compare maxillary central incisors with maxillary lateral incisors NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 10. Teeth most likely to be peg-shaped are the mandibular lateral incisors because the distal

developmental lobe is large and located more lingually than its mesial lobe. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Teeth most likely to be peg-shaped are the maxillary lateral incisors, which vary greatly in form. The reasoning providedNin n. acC cur ately describes the mandibular lateral URthe SIque NGstio TB OM incisors. Note that the lingual location of the large developmental lobe is the reason the mandibular lateral incisors curve distally to fit into the mandibular arch.

REF: p. 121 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 11. The mandibular lateral incisors are wider mesiodistally than the mandibular central incisors

because the mesial developmental lobe of the laterals is larger than that of the centrals. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The mandibular lateral incisors, nearly identical in form to the mandibular central incisors, are wider mesiodistally and longer gingivoincisally than the central incisors. This distinction occurs because the distal developmental lobe of the mandibular lateral incisors is larger than that of the centrals.

REF: p. 131 OBJ: To compare maxillary central incisors with maxillary lateral incisors NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding

12. The mandibular central incisor occludes with both the maxillary central incisor and the

maxillary lateral incisor. Similar to other anterior teeth, a mandibular incisor is derived from five lobes, three facial lobes and two lingual lobes. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The mandibular central incisor, the smallest tooth in the mouth, occludes with only one opposing tooth, a maxillary central incisor. All anterior teeth are derived from four lobes, three facial and one lingual. Also pertinent, mandibular central incisors are the most difficult to identify as either right or left because they are bilaterally symmetrical.

REF: p. 129 OBJ: To identify the particular anatomic features of incisor teeth | To compare maxillary central incisors with maxillary lateral incisors NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 13. Which incisor has a lingual pit? a. Maxillary central b. Maxillary lateral c. Mandibular central d. Mandibular lateral ANS: B

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The lingual anatomic features of the maxillary lateral incisor are similar to those of the central incisors but are more highly developed and have more prominent marginal ridges and deeper lingual fossae. More than any other incisor, laterals are more likely to have a lingual pit.

Interestingly, the cingulum may be smaller or even almost absent.

REF: p. 121 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 14. Which anatomical landmark could make an incisor more prone to dental caries? a. Cingulum b. Lingual pit c. Mamelons d. Prominent marginal ridges ANS: B

Of the four selections, only the lingual pit is concave in nature; the remaining selections are primarily convex. Concavities provide ideal nurturing locale for plaque biofilms, primary etiologic factors of dental caries.

REF: p. 121 | p. 129 | p. 131 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Applying

15. In an anterior crossbite, the maxillary central incisors would exhibit wear in which location? a. Labioincisal edge b. Linguloincisal edge c. Cervical region d. Apex ANS: A

In anterior crossbite, the smooth enamel of the slightly convex labial surface of maxillary central incisors would exhibit wear. While technically such wear would appear at the incisal edge of the labial surface, with extensive occlusal disharmony evidence of wear can involve more of the labial surface than the labioincisal edge.

REF: p. 120 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 16. Each of the following is true of the permanent central incisor EXCEPT one. Which one is the

EXCEPTION? a. Evidence of calcification occurs at three months. b. This is the widest mesiodistally of any of the anterior teeth. c. Root formation is completed by six years of age. d. Gemination is an anomaly that sometimes occurs. e. Development is usually normal.

ANS: C

Root formation of the permanent central incisors is not complete until ten years of age. The remaining selections accurateNlyUdResc s t. ooCth. SIribe NGthi TB OMWhile development is usually normal, gemination, an infrequent anomaly, is a process where the tooth shows evidence of attempting to divide itself. Other anomalies include a short root or an unusually long crown.

REF: p. 119 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 17. The eruption time for both the maxillary central incisor and mandibular lateral incisor is a. 6 to 7 years b. 7 to 8 years c. 8 to 9 years d. None of the above ANS: B

Both maxillary central and mandibular lateral incisors erupt at approximately 7 to 8 years of age. Maxillary lateral incisors erupt at approximately 8 to 9 years of age. Mandibular central incisors erupt at approximately 6 to 7 years of age.

REF: p. 119 | p. 122 | pp. 128-129 OBJ: To compare maxillary incisors with their mandibular incisor counterparts NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 18. Which of the following are commonly found on roots of maxillary incisors?

a. b. c. d. e.

Proximal grooves Evidence of division Bifurcation Indentation None of the above

ANS: E

Neither maxillary central nor lateral incisor roots show evidence of division, bifurcation, indentation, or proximal grooves.

REF: p. 119 | p. 124 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. Which of the following are characteristic of one or both maxillary incisors (Select all that

apply.)? a. Slender roots b. Linguoincisal attrition c. Greater labiolingual than mesiodistal crown dimension d. Most prominent teeth in the mouth ANS: B, C

Linguoincisal attrition is characteristic of maxillary incisors because this surface contacts the mandibular teeth during normal function. The maxillary central incisors are the most GaTnB .uClaOr M prominent teeth in the mouthN .R fm dib incisors are thinner than those of the UoRots SIoN maxillary incisors. The contours of the mandibular teeth are such that the labiolingual crown dimension is wider than is the mesiodistal.

REF: p. 121 | p. 124 | p. 132 OBJ: To recognize the normal and deviated anatomic forms of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. Which of the following are characteristic of one or both mandibular incisors (Select all that

apply.)? a. All contact areas are in incisal third. b. Rounded distoincisal angle c. Smooth, shallow lingual surface d. Slender roots ANS: A, C, D

Mesial and distal contact areas for both the central and lateral incisors are located at the incisal third. Lingual surfaces of mandibular central incisors are smooth and shallow with no prominent features. Lingual surfaces of mandibular lateral incisors have slightly more definition. By contrast, lingual surfaces of maxillary incisors have much more pronounced anatomy. Slender roots are associated with mandibular incisors.

REF: pp. 129-134

OBJ: To recognize the normal and deviated anatomic forms of incisor teeth

NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering TRUE/FALSE 1. Gemination is an anomaly that most commonly occurs in mandibular incisors.

ANS: F

Gemination, an anomaly where a tooth shows evidence of attempting to divide itself, occurs in maxillary central incisors more frequently than other incisors. Other anomalies occurring in this tooth are a short root or an unusually long crown. It must be emphasized that the maxillary central incisors usually develop normally and these are unusual occurrences.

REF: p. 119 OBJ: To recognize the normal and deviated anatomic forms of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. Proximal grooves are commonly found on the roots of the maxillary incisors.

ANS: F

Proximal grooves are not commonly found on the roots of maxillary incisors nor is there evidence of division, bifurcation, or indentation.

REF: p. 124 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. All incisors can erupt with mN am UeRloSnI s.NGTB.COM ANS: T

Both maxillary and mandibular central and lateral incisors can erupt with mamelons on their incisal ridge. Mamelons are rounded portions of the incisal ridge of newly erupted teeth.

REF: p. 120 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. Mandibular incisors do not have marginal ridges.

ANS: F

All incisors have marginal ridges.

REF: pp. 128-129 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. Maxillary lateral incisors vary in form more than any other teeth in the mouth.

ANS: F

While third molars vary in form more than any other teeth in the mouth, maxillary lateral incisors are a close second. By contrast, the maxillary central incisors have very little developmental variation. If the variation in the laterals is too great, it is considered a developmental anomaly.

REF: p. 121 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. Mandibular lateral incisors are distolingually inclined when viewed incisally.

ANS: T

When viewed incisally, mandibular lateral incisors appear rotated on their root axis. Because the distal developmental lobe is larger and located more lingually than the mesial lobe, these teeth must curve distally to fit into the mandibular arch.

REF: p. 131 OBJ: To identify the particular anatomic features of incisor teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

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Chapter 13: Canines Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Although the labiolingual and mesiodistal widths of the maxillary canine are about equal, the

crown is usually wider mesiodistally. Viewed from the incisal aspect, the cusp tip of the maxillary canine is labial and mesial to the center of the crown. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Viewed from the incisal aspect, the maxillary canine is slightly wider labiolingually. Also viewed incisally, the cusp tip of the maxillary canine is labial to the center of the crown in a labiolingual direction and mesial to the center mesiodistally.

REF: p. 139 OBJ: To compare maxillary and mandibular canines and identify each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. The canine fossa is a depression in the maxillae below the infraorbital foramen. The canine

eminence, located on the lingual surface of maxillary canines, separates the mesial and distal lingual fossae. a. Both statements are true.

R I G B.C M N b. The first statement is true; U the S secoN nd T statemeO nt is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The canine fossa, correctly described in the question, is not visible in the oral cavity. The canine eminence is a bony projection in the maxillae that provides additional support and strength for the root of the maxillary canine. The structure located on the lingual surface of maxillary canines that separates the mesial and distal lingual fossae is the lingual ridge. When the lingual ridge is missing there is only one lingual fossa on the maxillary canine.

REF: pp. 139-140 OBJ: To recognize and identify the anatomic structure and landmarks of the canine teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 3. Maxillary and mandibular canines have the same time sequence for their a. calcification b. enamel completion c. eruption d. root completion ANS: A

Calcification time sequences for maxillary and mandibular canines are both 4 months. Time sequences for enamel completion are 6 to 7 years for maxillary and 7 years for mandibular.

Time sequences for eruption are 11 to 12 years maxillary and 9 to 10 years mandibular. Time sequences for root completion are 13 to 15 years maxillary and 13 years mandibular.

REF: p. 137 | p. 140 OBJ: To understand the calcification and root completion schedules in relation to the eruption dates of the canines NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. From the labial aspect the mesial surface of the mandibular canine is more convex than the

distal surface because the mesial outline is more straight. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Because the mesial outline of the mandibular canine is more straight than the distal, it is considered less convex. By comparison, the distal appears more outwardly curved, which is the definition of convex. The opposite of convex is concave. Concave surfaces “dip” or slant inwardly.

REF: p. 141 OBJ: To recognize and identify the anatomic structure and landmarks of the canine teeth NAT: CDA: GC I.A.7. IdentifyNbas ntaCl an URicSoIralNaGnd TdBe. OMatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 5. The root of the mandibular canine is sometimes bifurcated like the a. maxillary lateral b. maxillary canine c. mandibular lateral d. None of the above ANS: D

Although the root of the mandibular canine occasionally bifurcates, this occurs far more frequently than on other anterior teeth. Thus, none of the selections are accurate. Bifurcated mandibular canines have one labial and one lingual branch.

REF: p. 141 OBJ: To compare maxillary and mandibular canines and identify each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. Maxillary canines erupt about two years after the mandibular canines. Root formation of

maxillary canines is considered complete between 13 and 15 years of age. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

Maxillary canines erupt between 11 and 12 years of age whereas mandibular canines erupt between 9 and 10 years of age. Root formation of maxillary canines is considered complete between 13 and 15 years of age. By contrast, root formation of mandibular canines is considered complete at 13 years of age.

REF: p. 137 | p. 140 OBJ: To compare maxillary and mandibular canines and identify each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 7. Both maxillary and mandibular canines are more rounded on the distal surface. Their distal

contact area is in the incisal third. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Given their cornerstone position in the arches, both the mandibular and maxillary canines are more rounded on the distal surface. The contact area for the maxillary canine is at the junction of the incisal and middle thirds.

REF: p. 137 | p. 140 OBJ: To compare maxillary and mandibular canines and identify each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding

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8. Each of the following incorrectly describes the canine eminence EXCEPT one. Which one is

the EXCEPTION? a. Large cingulum b. Projection of bone c. Sharp cusp tip d. Prominent labial ridge ANS: B

The canine eminence is accurately described as a projection of bone. More specifically it is defined as extra bulk of bone on the labial aspect of the maxillae which overlies the roots of the canine teeth. The canine eminence provides additional anchorage for the fibers and support for the very long roots of the maxillary canines.

REF: p. 137 OBJ: To recognize and identify the anatomic structure and landmarks of the canine teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 9. The canines are especially efficient at pulverizing food because their double-cuspal

arrangement provides assistance to the molars. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct.

e. NEITHER the statement NOR the reason is correct.

ANS: E

The canines act as holding and tearing tools and assist both the incisors and premolars. It should be emphasized that the canines have only one cusp.

REF: p. 137 OBJ: To understand the function of a canine tooth in relation to its shape NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 10. A basic difference between canines and incisors is that canines develop from four

developmental lobes whereas incisors develop from three. The canines are the most stable teeth in the mouth. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

All anterior teeth, canines and incisors, develop from four developmental lobes. There are three labial developmental lobes and one lingual. The canines are the most stable teeth in the mouth due to their thick crowns, strong anchorage, and smooth, pointed shape.

REF: p. 137 | p. 140 OBJ: To understand how the canines are different from other anterior teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding

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11. Compared to maxillary caninesU , mS andN ibulT ar caninO es have all of the following EXCEPT one.

Which one is the EXCEPTION? a. Narrower mesiodistal width b. Smoother lingual surface c. Flatter cingulum d. Wider labiolingual width ANS: D

The maxillary canine has the widest labiolingual width of any anterior tooth. Mandibular canines are more narrow mesiodistally than maxillary canines. A noteworthy feature of the maxillary canine is the extremely well-developed, sometimes described as huge, cingulum.

Both the cingulum and lingual surface of mandibular canines are less well developed than in the maxillary.

REF: p. 138 | p. 140 OBJ: To compare maxillary and mandibular canines and identify each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 12. Compared to their maxillary counterparts, each of the following descriptions of mandibular

canines is accurate EXCEPT one. Which one is the EXCEPTION? a. Mandibular canines resemble maxillary canines in their wedge-shaped outline. b. A mandibular canine crown length is as long as that of a maxillary canine and sometimes longer.

c. The root of a mandibular canine is often longer than that of a maxillary canine. d. The lingual surface of a mandibular canine is smoother than that of a maxillary

canine.

ANS: B

The root of a mandibular canine may be as long as that of a maxillary canine, but often it is shorter. Note that the root of the maxillary canine is usually the longest of any tooth in the mouth. The remaining statements accurately describe mandibular canines in respect to their maxillary counterparts. Also note that the lingual surface of a mandibular canine is smoother, the cingulum is less developed, and the marginal ridges are less prominent than are those in the maxillary canine.

REF: p. 137 | pp. 139-140 OBJ: To compare maxillary and mandibular canines and identify each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 13. Although similar in appearance, maxillary and mandibular canines have numerous different

landmarks. Both maxillary and mandibular canines have prominent marginal ridges. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Maxillary and mandibular canines have many of the same general landmarks. Prominent marginal ridges occur on maxillary canines but not on mandibular canines.

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U S N T O REF: p. 139 OBJ: To compare maxillary and mandibular canines and identify each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 14. The canines’ stability can be attributed to all of the following factors EXCEPT one. Which

one is the EXCEPTION? a. Root length b. Large cingulum c. Canine eminence d. Location in the dentition ANS: B

The long canine roots, anchored firmly in the special projection of bone called the canine eminence, coupled with their cornerstone location are factors that make the canines the most stable teeth in the mouth. Other stabilizing factors include their smooth, pointed shape; the thickness of their crowns; and their self-cleaning qualities. Although a landmark, the large cingulum does not contribute to stability of the canine.

REF: p. 137 OBJ: To understand the function of a canine tooth in relation to its shape NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 15. Each of the following is true of the cusp tip EXCEPT one. Which one is the EXCEPTION? a. When a canine is newly erupted, the cusp tip is shaped like a mamelon.

b. The maxillary cusp tip is labially inclined. c. The mandibular cusp tip is lingually inclined. d. Cusps tips can become abraded with wear.

ANS: A

Mamelons, small elevations on the incisal edge of incisors, are not present on canines. From the incisal aspect the cusp tip of a maxillary canine is labial to the center of the crown labiolingually and mesial to the center mesiodistally. Conversely, from the incisal aspect the mandibular cusp tip is located more lingually. Like all teeth, cusp tips can become abraded with wear and occlusal trauma.

REF: p. 119 | p. 137 | p. 143 OBJ: To recognize and identify the anatomic structure and landmarks of the canine teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 16. Which anterior teeth are widest mesiodistally? a. Maxillary central incisors b. Maxillary canines c. Mandibular lateral incisors d. Mandibular canines ANS: A

The crown and root of maxillary central incisors have the widest mesiodistal dimension of teeth listed. Note that maxillary canines are only wider in this dimension than mandibular canines by 0.5 mm.

REF: p. 137 OBJ: ToNunR dersI tandGhowBt. he canM ines are different from other anterior teeth.

U Soral NandTdentalCanatomy, O NAT: CDA: GC I.A.7. Identify basic physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 17. In the illustration below, figure “A” is a

a. maxillary central incisor b. maxillary lateral incisor c. mandibular canine

d. maxillary canine ANS: C

Figure “A” is a canine because unlike incisors, canines have a cusp. Although maxillary and mandibular canines have the same wedge-shaped outline, long crown and root, and well-developed cingulum, there are numerous subtle differences. Figure “A” is a mandibular canine because it has a slightly shorter root and less developed cusp tip as compared to a maxillary canine. Also note that the crown of the mandibular canine is narrower mesiodistally than the maxillary by about 0.5 mm.

REF: p. 137 OBJ: To compare maxillary and mandibular canines and identify each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 18. In the illustration below, Figure “B” is a

NURSINGTB.COM a. b. c. d.

maxillary central incisor maxillary lateral incisor mandibular canine maxillary canine

ANS: D

Figure “B” is not an incisor because incisors do not have a cusp tip. Compared to the mandibular canine, this tooth has a longer root and a more well-developed cusp tip, a defining feature of the maxillary canine. Also note that the crown of a maxillary canine is about 0.5 mm wider mesiodistally than the crown of a mandibular canine.

REF: p. 137 OBJ: To understand how the canines are different from other anterior teeth.

NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. Which of the following accurately describe canines (Select all that apply.)? a. They are the most stable teeth in the dentition. b. Their location can only accommodate a short root.

c. The canine eminence is located on the lingual surface coronal to the cingulum. d. Canines function as holding and tearing tools. e. Their “V” shape at the corner of the mouth helps dissipate occlusal pressure.

ANS: A, D, E

Canines are the most stable teeth in the dentition, with extremely long roots. Canines function as holding and tearing tools that assist both the incisors and premolars. Additionally, their “V” shape at the corner of the mouth enables dissipation of pressures that could otherwise force the premolars to protrude or the incisors to retrude. Note that the canine eminence is not located on the crown of the tooth. However, it is a special projection of bone that provides extra anchorage.

REF: p. 137 OBJ: To understand the function of a canine tooth in relation to its shape | To recognize how canines are similar to some premolar teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. Which of the following are true of the root of the maxillary canine (Select all that apply.)? a. It is usually the longest root in the mouth. b. In a cross-sectional view it appears to taper from the lingual toward the labial. c. The apical portion often points mesially but seldom distally. d. It is very strong and firmly embedded in the maxilla.

ANS: A, D

The root of the maxillary canine, the longest in the mouth, is very strong and firmly embedded in the maxilla. The length and shape of this root enhances its strength and anchorage in bone.

Regarding incorrect selectionNs, thRis rI taper from the labial to the lingual in cross U SootNGapp TBea.rsCtoOM section. Also, the apical portion often points distally but seldom mesially.

REF: p. 140 | p. 145 OBJ: To recognize and identify the anatomic structure and landmarks of the canine teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Which statements correctly describe features of canines (Select all that apply.)? a. The three facial lobes of the maxillary canine resemble the facial lobes of the

incisors. b. Maxillary canines frequently have one pulp horn and one root. c. Mandibular canines have one pulp horn and can have one or two roots. d. The cingulum is equally developed on maxillary and mandibular canines.

ANS: A, B, C

The three facial lobes of the maxillary canine resemble those of the incisors except that the middle facial lobe of the canine extends farther incisally. Both maxillary and mandibular canines usually have one pulp horn. Note that mandibular canines can have one or two roots.

When two roots are present, the original has bifurcated into a facial and a lingual root. The cingulum is less developed on mandibular canines and more developed on maxillary canines.

REF: p. 137 | p. 140 OBJ: To recognize and identify the anatomic structure and landmarks of the canine teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development,

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including but not limited to: teeth.

TOP: BLOOM: Remembering

TRUE/FALSE 1. The cusp tip of the maxillary canine is formed by the junction of four ridges.

ANS: T

The cusp tip of the canine is formed by the junction of four ridges, one of which extends along the middle lobe of the tooth on its most facial part; another extends along the lingual part. The two other ridges run from the mesioincisal and distoincisal corners. All four ridges converge to form the cusp tip.

REF: p. 137 OBJ: To recognize and identify the anatomic structure and landmarks of the canine teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. The contact areas for the maxillary canine are located in the incisal third.

ANS: F

The distal contact area is located in the middle third. The mesial contact area is at the junction of the incisal and middle thirds.

REF: p. 137 | p. 140 OBJ: To compare maxillary and mandibular canines and identify each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BL OOM: Remembering

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3. If a lingual ridge is present, there will be two lingual fossae.

ANS: T

The area typically occupied by a lingual fossa on other anterior teeth is occupied by a lingual ridge on maxillary canines. This ridge creates two separate lingual fossae, one on the mesial and one on the distal side of the lingual ridge. When present these fossae are called the mesial and distal lingual fossae. Important caveat, sometimes the lingual surface of a canine crown is so smooth that no concavities or fossae are present.

REF: p. 139 OBJ: To recognize and identify the anatomic structure and landmarks of the canine teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. The cusp tip of the mandibular canine is located more labially than the cusp tip of the

maxillary canine.

ANS: F

The cusp tip of the mandibular canine is located more lingually than the cusp tip of the maxillary canine. Note that the opposite is true of the maxillary canine.

REF: pp. 139-140

OBJ: To compare maxillary and mandibular canines and identify each

NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development,

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including but not limited to: teeth.

TOP: BLOOM: Remembering

5. Mandibular canine roots have proximal root grooves, but maxillary canines do not.

ANS: F

Both maxillary and mandibular canine roots have proximal root grooves.

REF: p. 140 | p. 145 OBJ: To compare maxillary and mandibular canines and identify each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. The mesial marginal ridge of the maxillary canine is more developed than the distal marginal

ridge.

ANS: F

The opposite is true. Not only is the distal marginal ridge more developed, it is heavier in outline than the mesial marginal ridge.

REF: p. 139 OBJ: To compare maxillary and mandibular canines and identify each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 7. Mandibular canines usually have a bifurcation in the apical third.

ANS: F

Although the root of the mandibular canine occasionally is bifurcated, the single-rooted form is much more common. WheN n thR e roI ot isGbifB ur.caCtedM , one branch is labial and the other lingual.

U S N T

O

REF: p. 143 OBJ: To compare maxillary and mandibular canines and identify each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

Chapter 14: Premolars Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The mandibular second premolar shows evidence of calcification at 2.5 years. Completion of

enamel formation does not occur, until 11 to 12 years. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

While the mandibular second premolar shows evidence of calcification at 2.5 years of age, completion of enamel formation occurs at 6 to 7 years of age. Eruption, however, occurs between 11 and 12 years.

REF: p. 157 OBJ: To understand how development occurs through the formation and fusion of the lobes NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. Any ridge that runs from the cusp tip to the central groove of the occlusal surface is called a

triangular ridge. Triangular ridges are located near the mesial marginal ridge of premolars but not near the distal marginal ridge. a. Both statements are true.

R I G B.C M N b. The first statement is true; U the S secoN nd T statemeO nt is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Triangular ridges, found near both the mesial and distal marginal ridges of premolars, run from the cusp tip to a central groove on the occlusal surface. Note that triangular ridge is a broad term and can apply to any posterior tooth.

REF: p. 149 OBJ: To recognize and name the pertinent dental anatomic form of each tooth such as cusps, ridges, developmental grooves, triangular grooves, pits, and developmental depressions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 3. The overall height of the premolars is longer than that of the canines because the root of the

premolars is considerably longer than those of the canines. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Both the crowns and roots of the premolars are shorter than those of the canines. Note that the roots of the canines are the longest of the entire dentition, with the maxillary canine roots the longest.

REF: p. 137 | p. 147 OBJ: To recognize and name the pertinent dental anatomic form of each tooth such as cusps, ridges, developmental grooves, triangular grooves, pits, and developmental depressions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 4. Premolars erupt between 9 and 12 years of age. Premolars are the succedaneous teeth that

replace primary canines. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Premolars erupt between 10 and 12 years of age. Succedaneous teeth are permanent teeth that succeed or take the place of deciduous teeth. While it is true that premolars are succedaneous teeth, the premolars replace the primary molars.

REF: p. 147 | p. 151 | p. 155 | p. 157 OBJ: To understand how development occurs through the formation and fusion of the lobes NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. The lingual surface of premoN laU rsRisSfo mG edTfB ro.mChO oM w many lobes?

IrN a. One b. Two c. Three d. Not all premolars are formed from the same number of lobes.

ANS: D

The mandibular second premolar is formed from five lobes, three buccal and two lingual. The remaining premolars are formed from four lobes, three buccal and one lingual.

REF: p. 147 OBJ: To understand how development occurs through the formation and fusion of the lobes NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. All of the premolars usually have a transverse ridge that crosses an occlusal developmental

groove EXCEPT one. Which one is the EXCEPTION? a. Maxillary first b. Maxillary second c. Mandibular first d. Mandibular second ANS: C

While variation in anatomic grooves varies significantly, the mandibular first premolars are the only premolars that often have a transverse ridge that does not cross an occlusal developmental groove. In this tooth the mesial developmental groove extends from the mesial fossa lingually, between the mesial marginal ridge and the lingual cusp, and onto the lingual surface.

REF: p. 155 OBJ: To compare the mandibular first premolars with the mandibular second premolars (development, shape, and diversities of anatomic form) NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 7. As a rule, the mandibular first premolars are always smaller than the mandibular second

premolars. The most striking identifying feature of the mandibular first premolar is the mesiolingual developmental groove. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

The mandibular first premolars are always smaller than the mandibular second premolars. In most cases, the opposite is true with maxillary premolars. The mesiolingual developmental groove that separates the mesial marginal ridge from the lingual cusp is the most striking and characteristic feature of the mandibular first premolar.

REF: p. 155 GoTlaBrs.wCithOM OBJ: To compare the mandibuNlar firs the mandibular second premolars UR StIprNem (development, shape, and diversities of anatomic form) NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 8. Which premolar has the smallest lingual cusp? a. Maxillary first b. Maxillary second c. Mandibular first d. Mandibular second ANS: C

The lingual cusp of the mandibular first premolar is so small in height and width that it does not occlude with any of the maxillary teeth. For this reason the lingual cusp of the mandibular first premolar is considered afunctional.

REF: p. 163 OBJ: To compare the mandibular first premolars with the mandibular second premolars (development, shape, and diversities of anatomic form) NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 9. Which premolar has buccal and lingual cusps that are almost the same height? a. Maxillary first b. Maxillary second

c. Mandibular first d. Mandibular second e. None of the above ANS: B

From the distal view of a maxillary second premolar it is evident that the buccal and lingual cusps are almost equal in height. The buccal cusp is shorter than that of a maxillary first premolar.

REF: p. 151 | p. 154 OBJ: To discuss the major differences and similarities between the maxillary first and second premolars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 10. A prominent characteristic of the maxillary first premolar is a. a mesiolingual developmental groove b. a central fossa c. a mesial marginal developmental groove d. a distal marginal developmental groove ANS: C

On the mesial surface of the maxillary first premolar a prominent groove provides an identifying feature. Called the mesial marginal groove, it crosses the mesial marginal ridge and runs cervically from the occlusal third to the middle third of the crown. The mesial surface also can be identified by a mesial developmental depression located cervical to the mesial contact area.

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U S N T O REF: p. 150 OBJ: To discuss the major differences and similarities between the maxillary first and second premolars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 11. Any ridge that extends from the cusp tip to the central groove of the occlusal surface is called

a marginal ridge. When two marginal ridges join, after traversing the tooth buccolingually, they form a transverse ridge. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

An occlusal ridge that extends from a cusp tip to the central groove is called a triangular ridge.

When two triangular ridges join, after traversing the tooth buccolingually, they form a transverse ridge.

REF: p. 150 OBJ: To recognize and name the pertinent dental anatomic form of each tooth such as cusps, ridges, developmental grooves, triangular grooves, pits, and developmental depressions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding

12. The mandibular second premolar always has three cusps because this tooth always forms from

five lobes. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

This question illustrates the variability in formation of the dentition. While the mandibular second premolar typically has five lobes, three facial and two lingual, there are occasions where it has only four lobes. Also, while this tooth typically has three cusps, the four-lobe variety forms a version of the mandibular second premolar with only two cusps.

REF: p. 147 OBJ: To understand how development occurs through the formation and fusion of the lobes NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 13. Which type of cusp pattern does the letter “Y” represent on the mandibular second premolar

(how many total cusps)? a. 2 b. 3 c. 4 d. 6 ANS: B

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In the three-cusp type of mandibular second premolar, the groove pattern is commonly called a Y-groove pattern. The Y-groove pattern is by far the most dominant form, occurring much more frequently than the less prevalent two-cusp forms. Of the less prevalent two-cusp forms, the H-groove is more common that the U-groove.

REF: p. 160 OBJ: To compare the mandibular first premolars with the mandibular second premolars (development, shape, and diversities of anatomic form) NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 14. Each of the following is evident on a maxillary first premolar EXCEPT one. Which one is the

EXCEPTION? a. Mesial marginal groove b. Mesial developmental depression c. Mesial marginal ridge d. Distinct distal marginal ridge e. Two small, afunctional lingual cusp tips ANS: E

The maxillary first premolar has only two cusps, one lingual and one buccal. It is the mandibular second premolar that can have three cusps, with the two lingual cusps often described as small and afunctional. The maxillary first premolar is readily identified by the mesial marginal groove, which extends from the mesial marginal ridge cervically. Also apparent from the mesial aspect is the mesial developmental depression, located cervical to the contact area. This tooth has a mesial marginal ridge as well as a strong distal marginal ridge.

REF: p. 147 OBJ: To recognize and name the pertinent dental anatomic form of each tooth such as cusps, ridges, developmental grooves, triangular grooves, pits, and developmental depressions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 15. Which selection best describes the roots of the maxillary first premolar? a. Two roots, one mesial and one distal b. Two roots, one buccal and one lingual c. Fused roots d. One root only ANS: B

The maxillary first premolars are the only premolars that normally have two roots, a buccal and a lingual. It must be noted that occasionally only a single root is present on this tooth.

Even when only one root is present, two pulp canals can usually be found.

REF: p. 147 OBJ: To make comparisons between maxillary and mandibular premolars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeN thU . RSINGTT OB P:.BL COOMOM: Remembering 16. Mandibular first premolars typically have two roots, a mesial and a distal. An anomaly is

formation of a third auxiliary root. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Mandibular first premolars typically have one root. An anomaly is formation of two roots, one buccal and one lingual. In mandibular first premolars with two roots, a deep longitudinal groove separates the roots on the proximal sides.

REF: p. 147 OBJ: To compare the mandibular first premolars with the mandibular second premolars (development, shape, and diversities of anatomic form) NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 17. Figure “A” below is which tooth?

a. b. c. d.

Maxillary right second premolar Maxillary left second premolar Maxillary right first premolar Maxillary left first premolar

ANS: C

Figure “A” represents a maxillary right first premolar because it has two roots and an extremely well formed lingual cusp. Figure “A” depicts this tooth from a buccal view; note that from the contact area cervically, the distal surface is straight, whereas the corresponding mesial surface is more concave.

REF: pp. 147-148 | p. 151 OBJ: To identify an extracted premolar as maxillary or mandibular, first or second, right or left NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, COOMOM: Remembering including but not limited to: teeN thU . RSINGTT OB P:.BL 18. Figure “B” below illustrates a view of which surface?

a. b. c. d.

Buccal Lingual Mesial Distal

ANS: D

Figure “B” illustrates the distal surface of this tooth. Note the well-developed lingual cusp and that both the facial and lingual cusps are centered over their root.

REF: pp. 147-149 | p. 151 OBJ: To identify an extracted premolar as maxillary or mandibular, first or second, right or left NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 19. In figure “A” below, identify the tooth, the number of cusps, and groove pattern.

a. b. c. d.

Mandibular first premolar; two cusps; “C” groove pattern Mandibular second premolar; two cusps; “Y” groove pattern Mandibular first premolaN r; U twRoScI usp s; T “H ve pattern B”.gCroo NG OM Mandibular second premolar; two cusps; “U” groove pattern

ANS: D

Figure “A” depicts a mandibular second premolar. In the second premolar the mesial and distal marginal ridges are almost at a right angle to the buccal and lingual surfaces.

Conversely, in the first premolar the mesial and distal marginal ridges converge sharply toward the lingual side of the tooth. (Marginal ridges appear more “straight” in mandibular second premolars as compared to the first.)

This tooth has two cusps, a buccal and a lingual, and a “U” groove pattern. Note that in the two-cusp variety of mandibular second premolars, the groove pattern can have either a “U” or an “H” groove pattern. Also, the “U” pattern is sometimes described as “C.” REF: pp. 158-159 | p. 161 | p. 163 OBJ: To recognize and name the pertinent dental anatomic form of each tooth such as cusps, ridges, developmental grooves, triangular grooves, pits, and developmental depressions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 20. In figure “B” below, identify the tooth, the number of cusps, and groove pattern.

a. b. c. d.

Mandibular second premolar; two cusps; “H” groove pattern Mandibular second premolar; two cusps; “Y” groove pattern Mandibular first premolar; two cusps; “U” groove pattern Mandibular second premolar; three cusps; “U” groove pattern

ANS: A

Figure “B” depicts a mandibular second premolar. In the second premolar the mesial and distal marginal ridges are almost at a right angle to the buccal and lingual surfaces.

Conversely, in the first premolar the mesial and distal marginal ridges converge sharply toward the lingual side of the tooth. (Marginal ridges appear more “straight” in mandibular second premolars as compareNdU toRthe st.)TB.COM SIfir NG This tooth has two cusps, a buccal and a lingual, and an “H” groove pattern. Note that in the two-cusp variety of mandibular second premolars, the groove pattern can have either a “U” or an “H” groove pattern. Also, the “U” pattern is sometimes described as “C.” REF: pp. 158-159 | p. 161 | p. 163 OBJ: To recognize and name the pertinent dental anatomic form of each tooth such as cusps, ridges, developmental grooves, triangular grooves, pits, and developmental depressions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 21. In figure “C” below, identify the tooth, the number of cusps, and groove pattern.

a. b. c. d.

Mandibular second premolar; three cusps; “Y” groove pattern Mandibular first premolar; three cusps; “H” groove pattern Mandibular first premolar; three cusps; “U” groove pattern Mandibular second premolar; two cusps; “C” groove pattern

ANS: A

Figure “C” depicts a mandibular second premolar. In the second premolar the mesial and distal marginal ridges are almost at a right angle to the buccal and lingual surfaces.

Conversely, in the first premolar the mesial and distal marginal ridges converge sharply toward the lingual side of the tooth. (Marginal ridges appear more “straight” in mandibular second premolars as compareNdU toRthe st.)TB.COM SIfir NG This tooth has three cusps, one buccal and two lingual, and a “Y” groove pattern.

REF: pp. 158-159 | p. 161 | p. 163 OBJ: To recognize and name the pertinent dental anatomic form of each tooth such as cusps, ridges, developmental grooves, triangular grooves, pits, and developmental depressions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. Which of the following are located on the occlusal surfaces of premolars (Select all that

apply.)? a. Marginal ridges b. Transverse ridges c. Triangular ridges d. Premolar eminence ANS: A, B, C

Marginal ridges, transverse ridges, and triangular ridges are all present on occlusal surfaces of premolars. There is not a structure called the premolar eminence; however the canine eminence is an additional prominence of bone that supports the long canine roots.

REF: pp. 149-150

OBJ: To describe briefly the various occlusal forms possible for a mandibular second premolar NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. Which of the following are true of both maxillary first premolars and maxillary second

premolars (Select all that apply.)? a. Both have two cusps. b. Both have two roots. c. Both are formed from four developmental lobes. d. Both have two pulp horns.

ANS: A, C, D

Maxillary first premolars generally have two roots, whereas maxillary second premolars generally have only one root.

REF: p. 154 OBJ: To discuss the major differences and similarities between the maxillary first and second premolars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Which of the following are true of the maxillary second premolars (Select all that apply.)? a. Evidence of calcification is seen at 2 years of age. b. Completion of enamel formation occurs at 4 years of age. c. Eruption occurs at 11 to 13 years of age. d. Root formation is completed by 12 to 14 years of age.

ANS: A, D

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Completion of enamel formation occurs at 6 to 7 years of age. Eruption occurs at 10 to 12 years of age.

REF: p. 151 OBJ: To understand how development occurs through the formation and fusion of the lobes NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering TRUE/FALSE 1. Maxillary second premolars have a smoother, less detailed occlusal surface than first

premolars.

ANS: F

The crowns of maxillary second premolars have more secondary or supplemental grooves. In general, the groove pattern is more distinct in the first premolar. Also pertinent, the crown of the second premolar is less angular and more rounded than that of a first premolar.

REF: p. 150 | p. 153 | p. 155 OBJ: To discuss the major differences and similarities between the maxillary first and second premolars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

2. All premolars have lingual cusps that are afunctional.

ANS: F

The lingual cusp of the mandibular premolar is small and afunctional as compared with the lingual cusp of the maxillary premolar. The lingual cusp of maxillary premolar is extremely well formed.

REF: p. 147 OBJ: To understand how the form of a tooth relates to its ultimate function NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. The buccal cusp of a maxillary first premolar is longer than the buccal cusp of the second

premolar.

ANS: T

From the buccal view, it is evident that the buccal cusp of a maxillary first premolar is longer than the buccal cusp of the second premolar. Also note, a second premolar has the same general markings as the first, but they are not as well defined.

REF: p. 151 OBJ: To discuss the major differences and similarities between the maxillary first and second premolars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. Bicuspid means the same thing as premolars.

ANS: F

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Bicuspid means that a tooth has a total of two cusps. While this is true of the maxillary premolar, the mandibular varies between one and three cusps. The preferred term, premolar, is more accurate.

REF: p. 147 OBJ: To identify an extracted premolar as maxillary or mandibular, first or second, right or left NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. The maxillary first premolar has a canine fossa.

ANS: F

The canine fossa is located just below the infraorbital foramen in the body of the maxillae.

REF: p. 308 OBJ: To discuss the major differences and similarities between the maxillary first and second premolars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

Chapter 15: Molars Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The distal contact area of the mandibular right first molar is located on the distal cusp. This

contact area centered over the distal root. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

The distal contact area, an area of contact of one tooth with another in the same arch, is located on the distal cusp and is centered over the distal root. The mandibular right first molar has two roots, one mesial and one distal.

REF: p. 177 OBJ: To describe the details of the various molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2.

Which of the following is true of mandibular first and second molars? a. The two buccal cusps of both teeth are divided by a buccal groove. b. Only the mandibular first molar has a buccal groove dividing the two buccal cusps. c. Only the mandibular second molar has a buccal groove dividing the two buccal cusps.

N R I G B.C M d. Both mandibular first and sU NolaTrs haveOa fifth cusp. ecoS nd m ANS: C

Only in the mandibular second molar does a buccal groove separate the two buccal cusps. The two buccal cusps of the mandibular first molar are divided by the mesiobuccal groove. Note that only the mandibular first molar has five cusps. The fifth cusp is the distal cusp.

REF: pp. 177-178 OBJ: To make comparisons among the various molars: maxillary and mandibular, as well as first, second, and third molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Maxillary molars have sturdy anchorage because the two roots are connected to a single root

trunk. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The three roots of maxillary molars provide sturdy anchorage because they are trifurcated.

This means all three are connected to a single root, an arrangement that provides support against forces that would tend to displace them. The three roots are the mesiobuccal, distobuccal, and lingual. The lingual root is the longest, and the distobuccal is the shortest.

REF: p. 172 OBJ: To understand the anchorage of the roots as a resistance to forces of displacement NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 4. Maxillary molars have an oblique ridge. The oblique ridge is a marginal ridge. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: B

Maxillary molars have an oblique ridge that runs across the occlusal surface of the maxillary molars. The oblique ridge, unique to maxillary molars, is not a marginal ridge but instead is considered a transverse ridge because it crosses the surface diagonally rather than straight across.

REF: p. 168 OBJ: To describe the details of the various molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding

the mS axIilla ryTmBo. laC rs,OiM s considered a transverse ridge because it 5. The oblique ridge, unique to N UR NG runs in several directions. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The oblique ridge is found only on maxillary molars. Stated another way, it is unique to maxillary molars. It is considered a transverse ridge because it runs diagonally across the occlusal surface rather than in a straight manner.

REF: p. 168 OBJ: To describe the details of the various molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 6. The distolingual cusp of a maxillary first molar is quite small and considered afunctional. This

cusp occupies 10% of the lingual surface and the mesiolingual cusp occupies the remaining 90% of the lingual surface. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Although the distolingual cusp is quite small, it is considered functional, meaning it occludes with opposing teeth. The lingual surface of the maxillary first molar is occupied 40% by the distolingual cusp and 60% by the mesiolingual cusp.

REF: p. 170 OBJ: To describe the details of the various molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 7. Which molar’s occlusal groove pattern resembles a cross (+)? a. Maxillary first b. Maxillary second c. Mandibular first d. Mandibular second ANS: D

The main grooves of the mandibular first molar form a cross (+). The single buccal grove joins with the single lingual groove join on the occlusal surface. They bisect the central developmental groove, forming a cross pattern.

REF: pp. 182-183 | p. 187 OBJ: To describe the details of the various molars NAT: CDA: GCI.A.7. Identify basic oral and dental anatomy, physiology and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 8. Each of the following statements correctly describes maxillary molars EXCEPT one. Which

one is the EXCEPTION? a. Roots become shorter as the maxillary molar is more posterior. b. Second molar roots are clN ose r tog tMmolars.

R Ieth GerTthBa.n Cfirs U S N O c. Third molar roots are usually smaller than first or second molars. d. First molar roots show the most variation in root form of all three molars.

ANS: D

First molar roots show the least variation in root form. Although there is variability among the three roots of maxillary molars, there are several characteristics that occur frequently. The most predictable is that the roots of maxillary molars become shorter as the maxillary molar is more posterior. Hence, the maxillary first molar has the longest roots and the third molar, the shortest. Also progressing distally, the roots become smaller, more varied in shape, and less divided. The third molar often has fused roots.

REF: p. 173 | p. 180 | p. 184 OBJ: To describe the details of the various molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 9. Maxillary molars have at least four pulp horns. Mandibular molars have three pulp horns

except for the third molars, which have four. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Maxillary first and second molars have four pulp horns. Maxillary third molars can have between one and four. Mandibular first molars have five pulp horns; the second have four; and the third have four or five.

REF: p. 176 | p. 187 OBJ: To make comparisons among the various molars: maxillary and mandibular, as well as first, second, and third molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 10. Permanent maxillary first molars are classified as succedaneous teeth. They are generally the

largest of the three molars. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false, the second statement is true. d. Both statements are false.

ANS: C

Permanent molars are nonsuccedaneous because they do not replace primary teeth. Another term for nonsuccedaneous is accessional. Incisors, canines, and premolars are succedaneous teeth. The permanent maxillary first molars are generally the largest teeth in the arch.

REF: p. 165 OBJ: To make comparisons among the various molars: maxillary and mandibular, as well as first, second, and third molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding

N R I G B.C M

U S N T of maxillary O 11.1 All of the following terms are characteristic third molars EXCEPT one. Which 1 one is the EXCEPTION? . a. Congenitally missing b. Impacted c. Erupt between 18 and 25 years d. Show variations of the crown or roots ANS: C

Maxillary third molars erupt between 17 and 21 years of age. However, their root formation is completed between 18 and 25 years. Third molars, both maxillary and mandibular, are irregular, unpredictable, and show significant crown/root variation. These unpredictable teeth have a tendency to become impacted due to bone obstruction as well as poor angulation within bone. Although our ancestors had great use for third molars, a modern genetic trend is that they are commonly congenitally missing.

REF: pp. 171-173 OBJ: To make comparisons among the various molars: maxillary and mandibular, as well as first, second, and third molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 12. Each of the following structures is present on maxillary first molars EXCEPT one. Which one

is the EXCEPTION? a. Central pit

b. Buccal groove c. Lingual marginal ridge d. Distal pit ANS: C

Neither maxillary nor mandibular molars have lingual marginal ridges. A marginal ridge is an elevation of enamel forming the margin of a surface. In molars and premolars marginal ridges occur at mesial and distal margins of the occlusal surface.

REF: p. 168 OBJ: To make comparisons among the various molars: maxillary and mandibular, as well as first, second, and third molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 13. The mesial root of the mandibular first molar often has a. one pulp canal b. two pulp canals c. two distinct mesial roots d. dilaceration ANS: B

The mesial root of the mandibular first molar often houses two root canals: mesiobuccal and mesiolingual. Often, these two canals join into one single apical foramen.

REF: p. 187 OBJ: To make comparisons among the various molars: maxillary and mandibular, as well as first, second, and third molars NURSINGTB.COM NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 14. Maxillary and mandibular first molars have a fifth or supplemental cusp. This additional cusp,

the cusp of Carabelli, is located on the mesiolingual cusp tip. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Although the cusp of Carabelli is located on the mesiolingual cusp tip, this supplemental (fifth) cusp is not found on mandibular molars. While it is most common on maxillary first molars, it occasionally is present on maxillary second molars and rarely exists on maxillary third.

REF: p. 168 | p. 170 OBJ: To make comparisons among the various molars: maxillary and mandibular, as well as first, second, and third molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding

15. The calcification of both maxillary and mandibular first molars is evident at birth. The

calcification of maxillary third molars is evident at 5 years whereas calcification of mandibular third molars is evident at 7 years. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Calcification of both maxillary and mandibular first molars is evident at birth. Maxillary second molars exhibit calcification at three years; mandibular counterparts at 2 to 3 years.

Maxillary third molars exhibit calcification at 7 years whereas mandibular third molars exhibit calcification at 8 to 10 years.

REF: p. 165 | p. 169 | p. 177 | p. 180 | p. 182 OBJ: To compare the formations of first, second, and third molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 16. Compared with first molars, third molars most often have a. more roots b. longer roots c. closer roots d. less defined roots ANS: C

While root variation in molars is significant, a few general characteristics apply. The roots become closer together as theNmaRxillI ary G molB ar.bC ecoM mes more posterior.

U S N T

O

REF: p. 176 OBJ: To compare the formations of first, second, and third molars | To understand the anchorage of the roots as a resistance to forces of displacement NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 17. The root completion for the maxillary first molar is how many years of age? a. 6 b. 8 c. 9 to 10 d. 11 to 12 ANS: C

Root formation for the maxillary first molar is typically completed by 9 to 10 years of age.

This tooth erupts between 6 and 7 years of age.

REF: p. 165 OBJ: To understand the anchorage of the roots as a resistance to forces of displacement NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 18. Below is an illustration of the buccal surface of a mandibular right second molar. Structure

“a” depicts the

a. b. c. d.

mesiobuccal cusp buccal pit distobuccal cusp buccal groove

ANS: C

Structure “a” depicts the distobuccal cusp. Structure “b” depicts the buccal groove. Structure “c” depicts the buccal pit. Structure “d” depicts the mesiobuccal cusp. Note that this tooth has four cusps nearly equal in size. A single buccal groove separates the two buccal cusps and ends in the buccal pit.

REF: pp. 182-187 OBJ: To describe the details of the various molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 19. Below is an illustration of the buccal surface of a mandibular right second molar. Structure

NURSINGTB.COM

“b” depicts the

a. b. c. d.

buccal groove distobuccal cusp buccal pit mesiobuccal cusp

ANS: A

Structure “b” depicts the buccal groove. Structure “a” depicts the distobuccal cusp. Structure “c” depicts the buccal pit. Structure “d” depicts the mesiobuccal cusp. Note that this tooth has four cusps nearly equal in size. A single buccal groove separates the two buccal cusps and ends in the buccal pit.

REF: pp. 182-187

OBJ: To describe the details of the various molars

NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 20. Below is an illustration of the buccal surface of a mandibular right second molar. Structure

“c” depicts the

a. b. c. d.

mesiobuccal cusp buccal groove distobuccal groove buccal pit

ANS: D

Structure “c” depicts the buccal pit. Structure “d” depicts the mesiobuccal cusp. Structure “a” depicts the distobuccal cusp. Structure “b” depicts the buccal groove. Note that this tooth has four cusps nearly equal in size. A single buccal groove separates the two buccal cusps and ends in the buccal pit.

REF: pp. 182-187 OBJ: ToNdU esR crS ibI eN thG e dTeB ta. ilsCoO f tM he various molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 21. Below is an illustration of the buccal surface of a mandibular right second molar. Structure

“d” depicts the

a. b. c. d.

distobuccal cusp mesiobuccal cusp buccal groove buccal pit

ANS: B

Structure “d” depicts the mesiobuccal cusp. Structure “a” depicts the distobuccal cusp.

Structure “b” depicts the buccal groove. Structure “c” depicts the buccal pit. Note that this tooth has four cusps nearly equal in size. A single buccal groove separates the two buccal cusps and ends in the buccal pit.

REF: pp. 182-187 OBJ: To describe the details of the various molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering TRUE/FALSE 1. Accessional is another term for nonsuccedaneous.

ANS: T

Molars are accessional, or nonsuccedaneous, teeth. Succedaneous teeth are those that replace the primary teeth. The permanent incisors, canines, and premolars are succedaneous because they replace the deciduous incisors, canines, and molars, respectively.

REF: p. 165 OBJ: To describe the details of the various molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. The mesiobuccal root is the longest root on maxillary first and second molars.

ANS: F

On maxillary first and second molars the lingual root is usually longer than either of the two buccal roots, which are the saNmeRlenI gth.G B.C M

U S N T

O

REF: p. 166 OBJ: To compare the formations of first, second, and third molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Mandibular molars are wider mesiodistally than buccolingually.

ANS: T

The crowns of the mandibular molars are wider mesiodistally than buccolingually.

Conversely, the occlusal crowns of maxillary first molars are square to rhomboid shaped.

Maxillary second molars are rhomboid to heart shaped. Maxillary third molars are triangular or heart shaped.

REF: p. 177 | p. 187 OBJ: To understand the lobe formations of the crowns of molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. Roots of the mandibular molars are inclined mesially.

ANS: F

Root direction varies greatly in mandibular molars. The roots of the second molars are inclined distally and the roots of the third molars have a pronounced distal inclination. The first molar roots are relatively vertical. Note that the distal inclination increases as the tooth is more posterior.

REF: p. 173 | p. 184 OBJ: To understand the anchorage of the roots as a resistance to forces of displacement NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering MATCHING

Root and crown anatomy of molars varies significantly. The basis of a dental practitioner’s ability to evaluate and recommend appropriate treatment is based on a sound understanding of anatomical features. Match the descriptions with the appropriate teeth. a. Small distal cusp b. Cusp of Carabelli c. Four equal cusps d. Often has two fused roots e. Calcifies at three years of age 1.

2.

3.

4.

5.

Maxillary first molar Maxillary second molar Mandibular first molar Mandibular second molar Mandibular third molar

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1. ANS: B REF: p. 166 | p. 177 | p. 180 | p. 181 | p. 187 OBJ: To identify each molar NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The maxillary first molar has a supplementary cusp called the cusp of Carabelli. It is located on the mesiolingual cusp tip. The maxillary second molar calcifies at three years of age; the maxillary first molar calcifies at birth and the third at seven years of age. The mandibular first molar has five cusps; the fifth is a small distal cusp. The mandibular second molar has four equal cusps. Mandibular roots are closer together progressing from first to third. The roots of the third molars are very close together; they are often fused.

2. ANS: E REF: p. 166 | p. 177 | p. 180 | p. 181 | p. 187 OBJ: To identify each molar NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The maxillary first molar has a supplementary cusp called the cusp of Carabelli which is located on the mesiolingual cusp tip. The maxillary second molar calcifies at three years of age; the maxillary first molar calcifies at birth and the third at seven years of age. The mandibular first molar has five cusps; the fifth is a small distal cusp. The mandibular second molar has four equal cusps.

Mandibular roots are closer together progressing from first to third. The roots of the third molars are very close together; in fact they are often fused.

3. ANS: A REF: p. 166 | p. 177 | p. 180 | p. 181 | p. 187 OBJ: To identify each molar NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

NOT: The maxillary first molar has a supplementary cusp called the cusp of Carabelli which is located on the mesiolingual cusp tip. The maxillary second molar calcifies at three years of age; the maxillary first molar calcifies at birth and the third at seven years of age. The mandibular first molar has five cusps; the fifth is a small distal cusp. The mandibular second molar has four equal cusps.

Mandibular roots are closer together progressing from first to third. The roots of the third molars are very close together; in fact they are often fused.

4. ANS: C REF: p. 166 | p. 177 | p. 180 | p. 181 | p. 187 OBJ: To identify each molar NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The maxillary first molar has a supplementary cusp called the cusp of Carabelli which is located on the mesiolingual cusp tip. The maxillary second molar calcifies at three years of age; the maxillary first molar calcifies at birth and the third at seven years of age. The mandibular first molar has five cusps; the fifth is a small distal cusp. The mandibular second molar has four equal cusps.

Mandibular roots are closer together progressing from first to third. The roots of the third molars are very close together; in fact they are often fused.

5. ANS: D REF: p. 166 | p. 177 | p. 180 | p. 181 | p. 187 OBJ: To identify each molar NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The maxillary first molar has a supplementary cusp called the cusp of Carabelli which is located on the mesiolingual cusp tip. The maxillary second molar calcifies at three years of age; the maxillary first molar calcifies at birth and the third at seven years of age. The mandibular first molar has five cusps; the fifth is a small distal cusp. The mandibular second molar has four equal cusps.

Mandibular roots are closer together progressing from first to third. The roots of the third molars are very close together; in fact they are often fused.

COMPLETION

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1. In the figure below, “a” represents the

.

ANS:

mesiolingual triangular groove This is an illustration of the lingual surface of a maxillary right first molar. Structures “a” and “e,” the mesiolingual groove and distolingual triangular grooves, respectively, are branches of the central groove. Structures “b” and “d” are the mesiolingual and distolingual cusps.

Structure “c” is the fifth cusp, which is also called the cusp of Carabelli. It is a supplemental cusp location on the mesiolingual cusp.

REF: pp. 166-169 OBJ: To describe the details of the various molars

NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. In the figure below, “b” represents the

.

ANS:

mesiolingual cusp This is an illustration of the lingual surface of a maxillary right first molar. Structures “a” and “e,” the mesiolingual groove and distolingual triangular grooves, respectively, are branches of the central groove. Structures “b” and “d” are the mesiolingual and distolingual cusps.

Structure “c” is the fifth cusp, which is also called the cusp of Carabelli. It is a supplemental cusp location on the mesiolingual cusp.

REF: pp. 166-169 OBJ: To describe the details of the various molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development,

COOMOM: Remembering including but not limited to: teeN thU . RSINGTT OB P:.BL 3. In the figure below, “c” represents the

.

ANS:

fifth cusp This is an illustration of the lingual surface of a maxillary right first molar. Structures “a” and “e,” the mesiolingual groove and distolingual triangular grooves, respectively, are branches of the central groove. Structures “b” and “d” are the mesiolingual and distolingual cusps.

Structure “c” is the fifth cusp, which is also called the cusp of Carabelli. It is a supplemental cusp location on the mesiolingual cusp.

REF: pp. 166-169 OBJ: To describe the details of the various molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. In the figure below, “d” represents the

.

ANS:

distolingual cusp This is an illustration of the lingual surface of a maxillary right first molar. Structures “a” and “e,” the mesiolingual groove and distolingual triangular grooves, respectively, are branches of the central groove. Structures “b” and “d” are the mesiolingual and distolingual cusps.

Structure “c” is the fifth cusp, which is also called the cusp of Carabelli. It is a supplemental cusp location on the mesiolingual cusp.

REF: pp. 166-169 OBJ: To describe the details of the various molars NAT: CDA: GC I.A.7. IdentifyNbU asR icSoI raN l aG ndTdBe. ntaCl O anM atomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. In the figure below, “e” represents the

.

ANS:

distolingual triangular groove This is an illustration of the lingual surface of a maxillary right first molar. Structures “a” and “e,” the mesiolingual groove and distolingual triangular grooves, respectively, are branches of the central groove. Structures “b” and “d” are the mesiolingual and distolingual cusps.

Structure “c” is the fifth cusp, which is also called the cusp of Carabelli. It is a supplemental cusp location on the mesiolingual cusp.

REF: pp. 166-169 OBJ: To describe the details of the various molars NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

NURSINGTB.COM

Chapter 16: Deciduous Dentition Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The deciduous lateral incisors erupt prior to the central incisors. Lateral incisors erupt

between 13 and 19 months whereas central incisors erupt between 16 and 22 months. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

In the deciduous dentition, central incisors erupt slightly prior to lateral incisors. The eruption timelines in the second statement apply to first molars and canines, respectively. Central incisors erupt between 6 and 12 months; laterals erupt between 7 and 13 months.

REF: p. 190 OBJ: To know the eruption dates of the primary and secondary teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. The root of the mandibular canine is slightly shorter and more tapered than its maxillary

counterpart. Both roots taper facially and apically. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.NURSINGTB.C OM ANS: B

The mandibular root is slightly shorter and more tapered than the maxillary. Both roots taper lingually and apically. Also pertinent, both roots are triangular in cross section and are almost twice as long as their crowns.

REF: p. 197 OBJ: To compare the dental anatomic features of deciduous teeth with the other deciduous teeth and with their permanent counterparts NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 3. Primary teeth are whiter than their permanent successors. They are smaller in crown

dimension but have roots approximately the same size as the permanent dentition. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Deciduous teeth, typically white in color with a bluish cast, are usually lighter in color than the permanent teeth. They are smaller in both crown and root dimension than their permanent counterparts.

REF: pp. 190-191 OBJ: To understand the essential differences between deciduous and permanent teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 4. At 3 to 4 years of age, the coronal aspect of the root begins to resorb and continues apically

until the tooth is shed. The process of shedding the deciduous dentition and replacement by permanent successors is called exfoliation. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Exfoliation begins at 2 to 3 years of age. It is initiated by resorption of the apical end of the root and proceeds coronally until the entire tooth falls out (sheds).

REF: p. 190 OBJ: To know the eruption dates of the primary and secondary teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 5. The longer and more slender deciduous roots also flare more than those of the permanent

dentition because this arrangement allows room for the developing permanent tooth crowns. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement N NU OR RS thI eN reG asToB n. is C coOrM rect.

ANS: A

The architecture of the deciduous roots enables the crowns of the permanent dentition to develop without being crowded or compressed. Note that a key aspect to this arrangement is the longer, more slender, and tapering deciduous roots.

REF: p. 190 OBJ: To compare the dental anatomic features of deciduous teeth with the other deciduous teeth and with their permanent counterparts NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 6. Although it is much smaller, the deciduous maxillary second molar resembles its permanent

molar successor because the deciduous maxillary second molar has two equal-sized cusps divided by a buccal groove. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

The successor of the deciduous maxillary second molar is the permanent maxillary premolar!

Note that the permanent molars are nonsuccedaneous or accessional. However, the deciduous maxillary second molar does resemble the permanent maxillary first molar primarily because of the equal-sized buccal cusps divided by a buccal groove. Note that the referenced deciduous molar is smaller than the referenced permanent molar.

REF: p. 165 | p. 203 OBJ: To compare the dental anatomic features of deciduous teeth with the other deciduous teeth and with their permanent counterparts NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 7. The occlusal table is narrower buccolingually because the buccal and lingual surfaces of

deciduous molars taper occlusally. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

The degree of tapering in the occlusal direction of the buccal and lingual surfaces of deciduous molars is significantly more than that of permanent molars. This results in a much more narrower occlusal table of the occlusal surface buccolingually.

REF: p. 190 OBJ: To understand the importance and functions of deciduous teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeN thU . RSINGTT OB P:.BL COOMOM: Understanding 8. Each of the following is true of deciduous teeth as compared with permanent teeth EXCEPT

one. Which one is the EXCEPTION? a. Deciduous teeth are generally lighter in color. b. Dentin is thinner. c. Pulp horns extend higher occlusally. d. There is a pronounced cervical ridge. e. Enamel is thicker and more protective.

ANS: E

Enamel is much thinner, therefore less protective, in primary teeth than in permanent.

Deciduous teeth, generally lighter in color, usually appear white with a bluish cast. Dentin, which makes up the body of the tooth, is thinner in deciduous teeth. Pulp horns extend quite high occlusally, placing them much closer to enamel than the pulp horns in permanent teeth.

REF: p. 190 OBJ: To recognize whether a tooth is primary or secondary NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 9. Teeth that erupt between 16 and 22 months of age are the deciduous a. lateral incisors b. canines c. first molars

d. second molars ANS: B

Primary (deciduous) canines erupt between 16 and 22 months. With the exception of the second molars, which erupt between 21 and 33 months, the canines are the last to erupt. In contrast, the first teeth to erupt are the central incisors between 6 and 12 months.

REF: p. 190 OBJ: To know the eruption dates of the primary and secondary teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 10. The buccocervical ridges on the deciduous molars are quite pronounced. The second molar

shows the most prominence. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The most pronounced buccocervical ridge occurs on first molars. These prominences give deciduous crowns a bulbous appearance and accentuate the narrow cervical portion of deciduous roots. Note that the cervical ridge of enamel at the cervical third of anterior crowns is also more prominent in the deciduous dentition.

REF: p. 190 OBJ: To compare the dental anatomic features of deciduous teeth with the other deciduous teeth and with their permanent counterparts NAT: CDA: GC I.A.7. IdentifyNbasR ic oI ral aG nd dBe. ntaCl anM atomy, physiology, and development, including but not limited to: teethU .

S N TTOP: BLOOOM: Understanding

11. Decay progresses quickly in deciduous teeth due to each of the following EXCEPT one.

Which one is the EXCEPTION? a. Presence of high pulp horns b. Thinner enamel covering crowns c. Harder enamel d. Thinner dentin ANS: C

Enamel in deciduous teeth is not harder than that in permanent teeth. To clarify, if enamel were harder, this would make teeth more resistant to decay.

REF: pp. 190-191 OBJ: To compare the dental anatomic features of deciduous teeth with the other deciduous teeth and with their permanent counterparts NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 12. The root of the mandibular lateral incisor has a mesial and distal longitudinal grove running in

a circular fashion. The mandibular central incisor root does not have any grooves or depressions. a. Both statements are true. b. The first statement is true; the second statement is false.

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

ANS: C

The root of the mandibular lateral incisor has a mesial longitudinal groove and a mesial depression running lengthwise.

REF: p. 194 OBJ: To compare the dental anatomic features of deciduous teeth with the other deciduous teeth and with their permanent counterparts NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 13. An extra margin of space is available for the eruption of the permanent canine as well as the

first and second premolars because the formation of diastemas provides this extra space. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

As bone grows, the deciduous teeth develop spaces between them called primate spaces.

Leeway spaces, the particular spaces between the deciduous canines and the first molars as well as those between the first and second molars, allow an extra margin of space for the eruption of the permanent canine and the first and second premolars. Diastema is a more broad term referring to any spacing between teeth in the same arch.

N R I G B.C M

U S N theTimportance O and functions of deciduous teeth REF: p. 191 OBJ: To understand NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 14. Which deciduous root has two canals? a. Maxillary lateral incisor b. Maxillary second molar, mesiobuccal root c. Mandibular canine d. Mandibular second molar, mesial root ANS: D

Both the mandibular first and second molars have two root canals in their mesial root. Their distal root only has one canal. Like the mandibular molars, both maxillary molars have three canals, but the anatomy differs. Maxillary first and second molars have two canals in their buccal root and one canal in the lingual root. Canines and incisor have one root canal.

REF: p. 200 | p. 203 | p. 208 OBJ: To identify the various deciduous teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 15. Which is the largest root on deciduous maxillary molars? a. Mesiobuccal b. Mesiolingual c. Distobuccal

d. Lingual ANS: D

On both the deciduous maxillary first and second molars the lingual root is the largest. The distobuccal is the shortest on both molars. On the second molars, the mesiobuccal may be as long as the lingual.

REF: pp. 199-200 OBJ: To identify the various deciduous teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 16. Which of these deciduous molars are wider mesiodistally than faciolingually? a. First molars b. Second molars c. Maxillary molars d. Mandibular molars ANS: D

Both first and second mandibular molars are wider mesiodistally than buccolingually. First and second maxillary molars are wider buccolingually than mesiodistally.

REF: p. 202 | p. 208 OBJ: To identify the various deciduous teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. Which of the following statem ccur ibe the deciduous maxillary lateral incisor Nen URtsSaI NGatel TBy.deCscr OM

(Select all that apply.)? a. The crown is smaller than a central incisor’s crown. b. The root of the lateral incisor appears much longer than its crown. c. A common anomaly is that the maxillary lateral incisor appears peg-shaped. d. The lateral incisor shows considerable variation in form. e. This tooth appears similar to a deciduous central incisor.

ANS: A, B, E

Although the crown of the deciduous maxillary lateral is smaller than that of the central incisor in most dimensions, it closely resembles the central incisor. As compared with the central incisor, the root of the lateral appears much longer than the crown. The incorrect responses accurately describe the permanent maxillary lateral incisors, which show considerable variation in form and are often peg-shaped.

REF: pp. 192-193 OBJ: To identify the various deciduous teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. Which deciduous molars have three root canals (Select all that apply.)? a. Maxillary first b. Maxillary second c. Mandibular first d. Mandibular second

ANS: A, B, C, D

Although there is some variability, all deciduous molars have three root canals. The three roots of the maxillary molars, two buccal and one lingual, each have their own canal. The mandibular molars, each with two roots, also have three root canals. Two canals are in the mesial root and one canal is in the distal root.

REF: pp. 199-201 | p. 206 OBJ: To identify the various deciduous teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Which deciduous molar has three or four cusps, an oblique ridge, three roots, and often has no

distal pit (Select all that apply.)? a. Maxillary first b. Maxillary second c. Mandibular first d. Mandibular second ANS: A

The maxillary first molar may have three or four cusps and has three roots. If four are present, two are buccal and two are lingual. If three are present, only one is lingual. On the three-cusp form, only a central and a mesial pit (no distal pit) are evident, and an oblique ridge often unites mesiolingual and distofacial cusps.

REF: p. 199 OBJ: To identify the various deciduous teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. Which of the following statem ccur ibe the deciduous maxillary first molar Nen URtsSaI NGatel TBy.deCscr OM

(Select all that apply.)? a. This tooth closely resembles the permanent maxillary second premolar. b. This tooth is the most atypical of all maxillary molars. c. This tooth is the most typical of all maxillary molars, closely resembling deciduous maxillary second molars. d. Like all other maxillary molars, this tooth is wider buccolingually than mesiodistally. e. The crown may have three or four cusps.

ANS: B, D, E

The deciduous maxillary first molar does not resemble any other tooth, deciduous or permanent. For this reason, it is considered the most atypical of all molars. If four cusps are present, two are buccal and two are lingual. If three cusps are present, only one is lingual.

REF: pp. 197-199 OBJ: To compare the dental anatomic features of deciduous teeth with the other deciduous teeth and with their permanent counterparts NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering TRUE/FALSE 1. Deciduous canines erupt before first molars.

ANS: F

The opposite is true. Deciduous first molars erupt between 12 and 19 months. Canines erupt between 16 and 22 months. The second molars, erupting between 21 and 33 months, are the last deciduous teeth to erupt.

REF: p. 190 OBJ: To know the eruption dates of the primary and secondary teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. Deciduous maxillary molars have a well-developed cusp of Carabelli.

ANS: F

While permanent maxillary first molars generally have a well-developed cusp of Carabelli, this structure is poorly developed in the mesial dentition. Generally appearing on the mesiolingual root of both primary molars, it is classified as a tubercle because of its tiny size.

REF: p. 200 OBJ: To identify the various deciduous teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Root trunks of deciduous molars are long.

ANS: F

While roots of deciduous molars are longer than those of the permanent dentition, the root trunks are shorter. In all deciduous molars, the root trunk bifurcates immediately below the cervix of the tooth.

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REF: p. 190 | pp. 199-200 OBJ: To identify the various deciduous teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. The largest cusp on the deciduous maxillary second molar is the mesiolingual cusp.

ANS: T

The deciduous maxillary second molar has four well-developed cusps plus a very small supplementary fifth cusp of Carabelli (technically classified as a tubercle). The mesiolingual is the largest; the distolingual is the smallest with the exception of the fifth cusp.

REF: pp. 199-200 OBJ: To identify the various deciduous teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. The crown of a deciduous maxillary first molar is much larger than that of the maxillary

second molar; however the roots of the second molar are longer.

ANS: F

A deciduous maxillary second molar is much larger than a deciduous first molar in both crown and root formation.

REF: pp. 199-200 OBJ: To compare the dental anatomic features of deciduous teeth with the other deciduous teeth and

with their permanent counterparts NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering MATCHING

During the mixed dentition, it is often challenging to distinguish deciduous and permanent teeth. While there are many similarities, significant differences exist. Match the descriptive term with its corresponding tooth. a. Facial b. No mamelons are visible. c. Roots are almost twice the length of crowns. d. Resembles the permanent mandibular first molar e. Primary tooth that bears least resemblance to another tooth 1.

2.

3.

4.

5.

Maxillary first molar Buccal Primary mandibular second molar Maxillary central incisors Canines

1. ANS: E REF: p. 192 | p. 197 | p. 200 | p. 203 OBJ: To recognize whether a tooth is primary or secondary NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The primary tooth that bears the least resemblance to another tooth, permanent or deciduous, is the maxillary first molar. It is anNunR molM Uusua SIl ble NGndToBf.a C Oar and a premolar. Buccal is a term often substituted for facial. The primary mandibular second molar resembles a permanent mandibular first molar except that the second is smaller and has the typical deciduous molar constriction at the cervix of the crown. Mamelons are not visible on the maxillary central incisors, although interestingly they are visible on maxillary lateral incisors. The roots of canines are almost twice as long as their crowns.

As compared to incisors, the roots of canines are thicker with a more blunt apex. Note that the roots of the mandibular second molars are also twice as long as their crowns.

2. ANS: A REF: p. 192 | p. 197 | p. 200 | p. 203 OBJ: To recognize whether a tooth is primary or secondary NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The primary tooth that bears the least resemblance to another tooth, permanent or deciduous, is the maxillary first molar. It is an unusual blend of a molar and a premolar. Buccal is a term often substituted for facial. The primary mandibular second molar resembles a permanent mandibular first molar except that it is smaller and has the typical deciduous molar constriction at the cervix of the crown. Mamelons are not visible on the maxillary central incisors, although interestingly they are visible on maxillary lateral incisors. The roots of canines are almost twice as long as their crowns. As compared to incisors, the roots of canines are thicker with a more blunt apex. Note that the roots of the mandibular second molars are also twice as long as their crowns.

3. ANS: D REF: p. 192 | p. 197 | p. 200 | p. 203 OBJ: To recognize whether a tooth is primary or secondary NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The primary tooth that bears the least resemblance to another tooth, permanent or deciduous, is the maxillary first molar. It is an unusual blend of a molar and a premolar. Buccal is a term often substituted for facial. The primary mandibular second molar resembles a permanent mandibular first

molar except that it is smaller and has the typical deciduous molar constriction at the cervix of the crown. Mamelons are not visible on the maxillary central incisors, although interestingly they are visible on maxillary lateral incisors. The roots of canines are almost twice as long as their crowns. As compared to incisors, the roots of canines are thicker with a more blunt apex. Note that the roots of the mandibular second molars are also twice as long as their crowns.

4. ANS: B REF: p. 192 | p. 197 | p. 200 | p. 203 OBJ: To recognize whether a tooth is primary or secondary NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The primary tooth that bears the least resemblance to another tooth, permanent or deciduous, is the maxillary first molar. It is an unusual blend of a molar and a premolar. Buccal is a term often substituted for facial. The primary mandibular second molar resembles a permanent mandibular first molar except that it is smaller and has the typical deciduous molar constriction at the cervix of the crown. Mamelons are not visible on the maxillary central incisors, although interestingly they are visible on maxillary lateral incisors. The roots of canines are almost twice as long as their crowns. As compared to incisors, the roots of canines are thicker with a more blunt apex. Note that the roots of the mandibular second molars are also twice as long as their crowns.

5. ANS: C REF: p. 192 | p. 197 | p. 200 | p. 203 OBJ: To recognize whether a tooth is primary or secondary NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The primary tooth that bears the least resemblance to another tooth, permanent or deciduous, is the maxillary first molar. It is an unusual blend of a molar and a premolar. Buccal is a term often substituted for facial. The primary mandibular second molar resembles a permanent mandibular first molar except that it is smaller and has the typical deciduous molar constriction at the cervix of the crown. Mamelons are not visible on the maxillary central incisors, although interestingly they are visible on maxillary lateral incisors. The roots of canines are almost twice as long as their crowns. As compared to incisors, the roots of canines are thicker with a more blunt apex. Note that the roots of the mandibular second molars are aN lsU oR twS icI e aNsG loT ngBa. sC thO eirMcrowns.

Chapter 17: Basic Tissues Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Exocrine glands are considered ductless because although they secrete glandular products,

their ducts are lost after development of the gland. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Exocrine glands transport glandular secretions via a duct system; they are NOT ductless.

However endocrine glands lose their ducts after development of the gland and are considered ductless.

REF: pp. 223-224 OBJ: To describe the origin of glands and the ways in which they may be classified NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 2. Purkinje’s fibers are composed of specialized nerve cells. They conduct messages through the

heart to help it contract properly. a. Both statements are true.

R I G B.C M N b. The first statement is true; U the S secoN nd T statemeO nt is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Purkinje’s fibers are specialized muscle cells that act like nerves in the heart. They provide conduction of messages through the heart, enabling it to contract or beat properly.

REF: p. 235 OBJ: To discuss the three types of muscles and their functions, shapes and locations NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles and 5. nerves.

TOP: BLOOM: Understanding 3. The protective wall of all cells is called the cell membrane. The fluid within the cell

membrane is called plasma. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

All cells have a protective outer membrane appropriately called the cell membrane. Its function is to retain cellular fluids and keep unnecessary foreign material from invading. The fluid within the cell membrane is called the cytoplasm. Plasma is a blood fluid.

REF: p. 218 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Understanding 4. Cells are able to maintain their shape because solid rods called microfilaments bind to the cell

membrane as well as to other microfilaments. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Microfilaments are cellular organelles. These solid rods are found in all cells except mature erythrocytes (red blood cells). Microfilaments perform their cellular support functions in conjunction with microtubules, which are microscopic hollow rods and subunits of protein.

REF: p. 219 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Understanding 5. Cartilage is composed of each of the following EXCEPT one. Which one is the

EXCEPTION? a. Chondroblasts b. Chondrocytes c. Collagen d. Osteoblasts e. Ground substance

NURSINGTB.COM

ANS: D

Osteoblasts are cells that form bone and are not normal components of cartilage.

Chondroblasts form cartilage; chondrocytes break down cartilage. Cartilage contains fibers of either collagen of elastin.

REF: p. 227 OBJ: To describe the component, function, and location of general connective tissues NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 6. Hydroxyapatite crystals are packed into bone marrow, giving bone its hardness. These crystals

are composed of calcium and phosphate, which make bone hard. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Hydroxyapatite crystals are packed into the ground substance and fibers between the cells, giving bone its hardness. Bone marrow is the spongy bone tissue that is found in the middle of bone. It is called spongy or cancellous bone.

REF: p. 228

OBJ: To briefly describe the structure of bone and the two ways in which it is formed NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 7. Which of the following epithelial cells are flat? a. Simple squamous b. Stratum basal c. Stratum spinosum d. Stratum germinativum ANS: A

The word squamous means flat or platelike. Stratum spinosum cells, attached to cell walls by desmosomes, are star shaped. Stratum basale, also called stratum germinativum, is a single layer of cuboidal cells.

REF: pp. 220-222 OBJ: To define the function of epithelium, name the various types and their locations NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 8. Points of intracellular modifications that help hold cells together are called a. merocrine secretions b. desmosomes c. stratum spinosum d. basement membrane ANS: B

Desmosomes are points of intracellular modifications N Rcaus INeG B.C M that help hold cells together. They create a star-shaped appearanceUbeS thTey attacOh to adjacent cells (ultrastructurally/outside the cell wall) by a series of “spot welds.” Merocrine secretions work with the Golgi apparatus in “packaging” protein material. Stratum spinosum and the basement membrane are components of epithelial tissue.

REF: p. 222 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 9. Epithelial cells that grow downward into the connective tissue form a. transitional epithelium b. blood vessels c. glands d. stratum granulosum ANS: C

Most of the glands of the body are developed from epithelium. As the epithelium develops, some of the basal cells begin to grow downward into underlying connective tissue. A hollow cord of epithelial tissue is formed that later becomes a gland.

REF: p. 223 OBJ: To define the function of epithelium, name the various types and their locations NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering

10. The cells that form the inner lining of blood vessels originate from a. the ectoderm b. the entoderm c. the mesoderm d. any of the above ANS: C

Of the three embryonic tissue layers, the mesoderm is the middle layer. The inner lining of blood vessels originates from the mesoderm, which lies between the endoderm and ectoderm layers.

REF: p. 225 OBJ: To briefly describe the components and origin of blood cells, their functions and normal numbers NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 11. The nucleolus is a circumscribed area within the nucleus. The nucleolus controls the operation

of the cell. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The nucleolus, a circumscribed area within the nucleus, contains most of the cellular RNA. The operation of the cell is coNntrR olleI d byGtheBn.uC cleuM s.

U S N T

O

REF: p. 218 OBJ: To discuss the neuron, its parts, and function NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 12. Mitochondria are significantly responsible for metabolism because these organelles produce

and regulate energy. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Small, unusually oblong organelles known as mitochondria are responsible for energy production and the rate at which a cell uses energy—commonly referred to as the metabolism of the cell.

REF: p. 218 OBJ: To discuss the neuron, its parts, and function NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 13. An increase in cristae indicates a. foreign substances in the cell

b. less mitochondria in the cell c. a less active cell d. a more active cell ANS: D

Leaflike infoldings along the inner membrane of mitochondria are called cristae. Cristae have enzymes on their surface that aid in metabolism. Just as an increased number of mitochondria indicate increased cellular activity, an increase in cristae also indicates a more active cell.

REF: p. 218 OBJ: To discuss the neuron, its parts, and function NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 14. The MOST common type of multiple-layered epithelium is stratified squamous epithelium.

Stratified is synonymous with transitional. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Stratified squamous epithelium, the covering of the body and the oral mucosa, is the most common type of stratified epithelium. In soft tissue terminology, stratified is a term used to describe multilayered tissues. Transitional epithelium, another stratified tissue type, has the capability to change thickness and appearance as needed. It is a major tissue of the urinary system and is not synonymous with stratified squamous epithelium.

REF: p. 220 NURSINGTB.COM OBJ: To define the function of epithelium, name the various types and their locations NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 15. Cellular inclusions are accurately described by each of the following EXCEPT one. Which

one is the EXCEPTION? a. They are not produced by the cell. b. They are stored in the cell for use at a later time. c. They may be composed of lipids and glycogen. d. They contain solid rods that are composed of the protein actin. e. Upon release they travel to other parts of the body.

ANS: D

Solid rods that are composed of actin are not cellular inclusions but are a component of muscle cells called microfilaments. Cellular inclusions are not produced by the cell but rather are stored for use at a later time and can be transported to other locations. The lipid component of cellular inclusions is actually small spheres of fat; the glycogen is composed of multiple units of the sugar glucose.

REF: pp. 219-220 OBJ: To discuss the neuron, its parts, and function NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering

MULTIPLE RESPONSE 1. Which of the following are true of lysosomes (Select all that apply.)? a. Lysosomes are cell scavengers. b. Lysosomes contain enzymes that can consume the cell. c. Lysosomes are cellular organelles. d. They can digest foreign material. e. Lysosomes produce energy.

ANS: A, B, C, D

Lysosomes do not produce energy. This is a function of mitochondria, another cellular organelle. Lysosomes are circular structures that act as a scavenger and have the ability to release powerful digestive enzymes.

REF: p. 219 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 2. Which of the following are true of multilayered epithelia (Select all that apply.)? a. Transitional epithelium changes in thickness and appearance as the need arises. b. Stratified cuboidal epithelium is only found in select locations. c. Stratified columnar epithelium is commonly found throughout the body. d. Stratified squamous epithelium is the most common type of epithelium.

ANS: A, B, D

Stratified columnar epithelium, also called stratified cuboidal epithelium, is not commonly found. Consisting of several stacked rows of cuboidal or columnar cells, stratified columnar epithelium is generally foundNin R ct loGcatB nsCsucM Usele SI N Tio. O h as large ducts. Transitional epithelium, appropriately named because it changes as needs dictate, is a highly functional tissue found in the urinary system. Stratified squamous epithelium covers the body and also makes up the mucosa of the oral cavity.

REF: p. 222 OBJ: To define the function of epithelium, name the various types and their locations NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering TRUE/FALSE 1. The amnion is formed from the inner cell mass of the blastocyst.

ANS: T

After fertilization, the ovum divides into balls of multilayered cells called blastocysts. One of the membrane layers is called the amnion.

REF: pp. 226-227 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 2. Microfilaments are found in all cells.

ANS: F

Microfilaments, solid rods composed of protein subunits, are a component of all cells except mature erythrocytes (red blood cells).

REF: p. 219 OBJ: To briefly describe the components and origin of blood cells, their functions and normal numbers NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 3. Cellular inclusions are not produced by the cell.

ANS: T

Cellular inclusions are intermixed within the other organelles of the cytoplasm. These small spheres of fat (lipids) and multiple units of glucose (glycogen) are unique in that they are not produced by the cell but rather are stored in the cell to be used for energy at a later time and possibly another place.

REF: p. 219 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 4. Cartilage is generally noncalcified.

ANS: T

While cartilage is generally noncalcified, this supporting component of the body does calcify in areas such as the larynx.

N R I G B.C M

U S N T O REF: p. 227 OBJ: To describe the component, function, and location of general connective tissues NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 5. Bone resorption is involved in the process of bone remodeling.

ANS: T

Osteoclasts are cells that destroy or resorb bone. Osteoclasts work with osteoblasts, bone formative cells, in the constantly changing process of bone remodeling. Orthodontic therapy, where teeth move through bone, is an excellent example of bone remodeling.

REF: p. 229 OBJ: To briefly describe the structure of bone and the two ways in which it is formed NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering MATCHING

Basic tissues consist of epithelium, connective tissue, muscle, and nervous tissue. Dental practitioners must appreciate the anatomy and mechanisms involved as they affect health and disease. Match each tissue description with its corresponding structural component. a. A “drinking in”

b. c. d. e. f. g. h. i. j.

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Acts as a scavenger Responsible for energy production Considered ductless Single-celled respiratory glands Form small ducts within glands Has a duct system Found in urinary system Fluid-carrying vessels Epithelial cells that increase digestive absorption

Microvilli Columnar cells Lymphatic vessels Transitional epithelium Exocrine glands Endocrine glands Goblet cells Pinocytosis Lysosome Mitochondria

1. ANS: J REF: pp. 218-223 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering NOT: Microvilli, ultrastructural projections from cellular lumen, increase absorption within the digestive tract. Microvilli have N coU luR mS naI rN ceG llsTthBa. t pC acO kM together to form small ducts within glands.

Lymphatic vessels are part of the circulatory system and remove fluids associated with inflammation.

Transitional epithelium is able to change thickness and appearance as the need arises. It is found in the urinary system with primary concentration in the bladder and urethra. Endocrine glands are considered ductless because after glandular development the ducts are lost. Exocrine glands have ducts that transport products away from glands. Single-celled glands within the respiratory system are called goblet cells. During pinocytosis, a process called "drinking in," the cell membrane is pushed inward by a foreign product. Circular structures that act as cellular scavengers are called lysosomes.

Mitochondria are small, unusually long organelles that produce energy for cellular utilization.

2. ANS: F REF: pp. 218-223 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering NOT: Microvilli, ultrastructural projections from cellular lumen, increase absorption within the digestive tract. Microvilli have columnar cells that pack together to form small ducts within glands.

Lymphatic vessels are part of the circulatory system and remove fluids associated with inflammation.

Transitional epithelium is able to change thickness and appearance as the need arises. It is found in the urinary system with primary concentration in the bladder and urethra. Endocrine glands are considered ductless because after glandular development the ducts are lost. Exocrine glands have ducts that transport products away from glands. Single-celled glands within the respiratory system are called goblet cells. During pinocytosis, a process called "drinking in," the cell membrane is pushed inward by a foreign product. Circular structures that act as cellular scavengers are called lysosomes.

Mitochondria are small, unusually long organelles that produce energy for cellular utilization.

3. ANS: I REF: pp. 218-223 OBJ: To describe a cell and the function of its components

NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering NOT: Microvilli, ultrastructural projections from cellular lumen, increase absorption within the digestive tract. Microvilli have columnar cells that pack together to form small ducts within glands.

Lymphatic vessels are part of the circulatory system and remove fluids associated with inflammation.

Transitional epithelium is able to change thickness and appearance as the need arises. It is found in the urinary system with primary concentration in the bladder and urethra. Endocrine glands are considered ductless because after glandular development the ducts are lost. Exocrine glands have ducts that transport products away from glands. Single-celled glands within the respiratory system are called goblet cells. During pinocytosis, a process called "drinking in," the cell membrane is pushed inward by a foreign product. Circular structures that act as cellular scavengers are called lysosomes.

Mitochondria are small, unusually long organelles that produce energy for cellular utilization.

4. ANS: H REF: pp. 218-223 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering NOT: Microvilli, ultrastructural projections from cellular lumen, increase absorption within the digestive tract. Microvilli have columnar cells that pack together to form small ducts within glands.

Lymphatic vessels are part of the circulatory system and remove fluids associated with inflammation.

Transitional epithelium is able to change thickness and appearance as the need arises. It is found in the urinary system with primary concentration in the bladder and urethra. Endocrine glands are considered ductless because after glandular development the ducts are lost. Exocrine glands have ducts that transport products away from glands. Single-celled glands within the respiratory system are called goblet cells. During pinocytosis, a process called "drinking in," the cell membrane is pushed inward by a foreign product. Circular structures that act as cellular scavengers are called lysosomes.

Mitochondria are small, unusually long organelles that produce energy for cellular utilization.

5. ANS: G REF: pp. 218-223 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.3. IdentifyNbU asR icSoI raN l aG ndTdBe. ntaCl O anM atomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering NOT: Microvilli, ultrastructural projections from cellular lumen, increase absorption within the digestive tract. Microvilli have columnar cells that pack together to form small ducts within glands.

Lymphatic vessels are part of the circulatory system and remove fluids associated with inflammation.

Transitional epithelium is able to change thickness and appearance as the need arises. It is found in the urinary system with primary concentration in the bladder and urethra. Endocrine glands are considered ductless because after glandular development the ducts are lost. Exocrine glands have ducts that transport products away from glands. Single-celled glands within the respiratory system are called goblet cells. During pinocytosis, a process called "drinking in," the cell membrane is pushed inward by a foreign product. Circular structures that act as cellular scavengers are called lysosomes.

Mitochondria are small, unusually long organelles that produce energy for cellular utilization.

6. ANS: D REF: pp. 218-223 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering NOT: Microvilli, ultrastructural projections from cellular lumen, increase absorption within the digestive tract. Microvilli have columnar cells that pack together form small ducts within glands.

Lymphatic vessels are part of the circulatory system and remove fluids associated with inflammation.

Transitional epithelium is able to change thickness and appearance as the need arises. It is found in the urinary system with primary concentration in the bladder and urethra. Endocrine glands are considered ductless because after glandular development the ducts are lost. Exocrine glands have ducts that transport products away from glands. Single-celled glands within the respiratory system are called goblet cells. During pinocytosis, a process called "drinking in," the cell membrane is pushed inward by a foreign product. Circular structures that act as cellular scavengers are called lysosomes.

Mitochondria are small, unusually long organelles that produce energy for cellular utilization.

7. ANS: E REF: pp. 218-223 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering NOT: Microvilli, ultrastructural projections from cellular lumen, increase absorption within the digestive tract. Microvilli have columnar cells that pack together to form small ducts within glands.

Lymphatic vessels are part of the circulatory system and remove fluids associated with inflammation.

Transitional epithelium is able to change thickness and appearance as the need arises. It is found in the urinary system with primary concentration in the bladder and urethra. Endocrine glands are considered ductless because after glandular development the ducts are lost. Exocrine glands have ducts that transport products away from glands. Single-celled glands within the respiratory system are called goblet cells. During pinocytosis, a process called "drinking in," the cell membrane is pushed inward by a foreign product. Circular structures that act as cellular scavengers are called lysosomes.

Mitochondria are small, unusually long organelles that produce energy for cellular utilization.

8. ANS: A REF: pp. 218-223 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering NOT: Microvilli, ultrastructural projections from cellular lumen, increase absorption within the digestive tract. Microvilli have columnar cells that pack together to form small ducts within glands.

Lymphatic vessels are part of the circulatory system and remove fluids associated with inflammation.

Transitional epithelium is able to change thickness and appearance as the need arises. It is found in the urinary system with primary concentration in the bladder and urethra. Endocrine glands are considered ductless because after glandular development the ducts are lost. Exocrine glands have ducts that transport products away from glands. Single-celled glands within the respiratory system are called goblet cells. During pinocytosis, a process called "drinking in," the cell membrane is pushed inward by a foreign product. Circular structures that act as cellular scavengers are called lysosomes.

Mitochondria are small, unusuaN llyUlR onS gI orN gaGnT ellB es.thCaO t pM roduce energy for cellular utilization.

9. ANS: B REF: pp. 218-223 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering NOT: Microvilli, ultrastructural projections from cellular lumen, increase absorption within the digestive tract. Microvilli have columnar cells that pack together to form small ducts within glands.

Lymphatic vessels are part of the circulatory system and remove fluids associated with inflammation.

Transitional epithelium is able to change thickness and appearance as the need arises. It is found in the urinary system with primary concentration in the bladder and urethra. Endocrine glands are considered ductless because after glandular development the ducts are lost. Exocrine glands have ducts that transport products away from glands. Single-celled glands within the respiratory system are called goblet cells. During pinocytosis, a process called "drinking in," the cell membrane is pushed inward by a foreign product. Circular structures that act as cellular scavengers are called lysosomes.

Mitochondria are small, unusually long organelles that produce energy for cellular utilization.

10. ANS: C REF: pp. 218-223 OBJ: To describe a cell and the function of its components NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering NOT: Microvilli, ultrastructural projections from cellular lumen, increase absorption within the digestive tract. Microvilli have columnar cells that pack together to form small ducts within glands.

Lymphatic vessels are part of the circulatory system and remove fluids associated with inflammation.

Transitional epithelium is able to change thickness and appearance as the need arises. It is found in the urinary system with primary concentration in the bladder and urethra. Endocrine glands are considered ductless because after glandular development the ducts are lost. Exocrine glands have ducts that

transport products away from glands. Single-celled glands within the respiratory system are called goblet cells. During pinocytosis, a process called "drinking in," the cell membrane is pushed inward by a foreign product. Circular structures that act as cellular scavengers are called lysosomes.

Mitochondria are small, unusually long organelles that produce energy for cellular utilization.

NURSINGTB.COM

Chapter 18: Development of Orofacial Complex Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The time span from fertilization through two weeks of gestation is referred to as the period of

the ovum. The embryonic period of the fetus occurs from the third through the ninth week of gestation. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The period of the embryo, occurring from the third through the eighth weeks of gestation, immediately follows the period of the ovum. The period of the fetus takes place from the ninth through the 36th weeks of gestation.

REF: p. 238 OBJ: To be aware of the developmental stages of the human from fertilization to birth NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 2. Each of the following is true of the buccopharyngeal membrane EXCEPT one. Which one is

the EXCEPTION? a. The buccopharyngeal membrane is the point where the foregut and stomodeum share a common wall. NURSINGTB.COM b. The buccopharyngeal membrane forms the descending and sigmoid colon. c. This membrane is found near the future site of both the palatine tonsils and the posterior portion of the tongue. d. The buccal pharyngeal membrane breaks down at about weeks.

ANS: B

The descending and sigmoid colons are formed by the hindgut, which also forms the rectum of the large intestine. The connection between the oral cavity and the digestive tract forms when the buccopharyngeal membrane breaks down.

REF: p. 238 OBJ: To list the embryonic structures that form the face and discuss the approximate age of formation NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 3. The buccopharyngeal membrane is significant to head and neck anatomy because when it

breaks down at about 10 weeks, the connection between the oral cavity and the digestive tract is established. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct.

e. NEITHER the statement NOR the reason is correct.

ANS: D

The buccopharyngeal membrane breaks down at about weeks of gestation. While the membrane is intact the tube within the foregut is closed at the top. When the membrane breaks down, an opening is established between the foregut and a depression known as the stomodeum. The stomodeum forms the oral cavity and the oral pharynx. The foregut is the precursor to the upper portions of the digestive tract.

REF: p. 238 OBJ: To list the embryonic structures that form the face and discuss the approximate age of formation NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 4. Formation of a median palatine cyst occurs during migration of the palatal shelves because a

few epithelial cells remain embedded in connective tissue and fail to fuse. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

A median palatine cyst may occur during fusion of the palatal shelves. The reason correctly describes the retention of epithelial cells within connective tissues. Such retained cells are referred to as epithelial rests. Conversely, migration is a term used to describe movement of tissues, such as developmentN oU f tR heSuIpN peG rT lipB. .

FaCilO urMe of labial tissues to migrate may result in a cleft lip. Note the subtle distinction between the mechanisms of fusion and migration.

REF: p. 241 OBJ: To name the structures involved in the formation of the palate and the timing of its development NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 5. A unilateral cleft lip is the lack of connective tissue migration between one maxillary process

and the fused medial nasal processes. A bilateral cleft lip is the lack of connective tissue migration between both maxillary processes and the fused medial nasal processes. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

By the sixth week the two medial nasal processes should have fused together and, along with the maxillary processes, formed the upper lip. Note that the lateral nasal process takes no part in forming the upper lip. The medial nasal and maxillary processes begin to fuse at their lower end. The connection is known as the nasal fin.

REF: p. 241 | p. 244 OBJ: To discuss the embryonic structures involved in the development of the cleft lip and palate

NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 6. The foramen cecum is the point where the thyroid gland begins to develop. It is a small

depression near the eustachian tube. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The foramen cecum is a small depression in the middle third of the tongue. It is the point where the thyroid gland begins to develop and then migrates downward, eventually lying in the lower front of the neck region. The eustachian tube is located within the auditory process, the ear.

REF: p. 247 OBJ: To list the embryonic structures that form the face and discuss the approximate age of formation NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 7. A 3-week-old embryo is approximately 4 mm from the top of the head to the tail area. The

buccopharyngeal membrane begins to develop at this time. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are falseN . URSINGTB.COM ANS: B

The buccopharyngeal membrane begins to break down at about

weeks.

REF: p. 238 OBJ: To list the embryonic structures that form the face and discuss the approximate age of formation NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 8. The midgut forms all of the following EXCEPT one. Which one is the EXCEPTION? a. Small intestine b. Cecum c. Ascending colon d. Sigmoid colon e. Descending colon ANS: E

The descending colon is formed by the hindgut. Note that the tube that is the developing digestive tract is divided into three parts: the foregut, the midgut, and the hindgut.

REF: p. 238 OBJ: To describe the other structures arising from the pharyngeal arches NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering

9. The embryonic heart is seen as a bulge because it develops in an extremely anterior position. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

The embryonic heart, located in an extremely anterior position, pushes out of the upper body wall. This wall later becomes the thorax. As the thorax and ribs develop, the heart assumes a position inside the thoracic cage and no longer appears as a bulge.

REF: p. 238 OBJ: To describe the other structures arising from the pharyngeal arches NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Understanding 10. Which pharyngeal arch will degenerate after formation? a. Third b. Fourth c. Fifth d. Sixth e. None ANS: C

The fifth pharyngeal arch degenerates shortly after formation. It forms nothing of consequence.

N R I G B.C M

U S N T O REF: p. 238 OBJ: To describe the other structures arising from the pharyngeal arches NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 11. The first and second pharyngeal arches are the largest because they are formed earlier in the

developmental process. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: B

The first and second pharyngeal arches are located closest to the head; those in this position are the largest and those farther down are smaller in size.

REF: p. 238 OBJ: To describe the other structures arising from the pharyngeal arches NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 12. A globulomaxillary cyst results from improper fusion of the maxillary and mandibular

processes. This cyst lies between the maxillary lateral incisor and canine. a. Both statements are true. b. The first statement is true; the second statement is false.

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

ANS: C

Improper fusion between the primary palate and the palatal shelves can result in formation of a globulomaxillary cyst. Fusion is disrupted by embedded epithelial cells, called epithelial rests. Located between the maxillary lateral incisor and canine, this lesion causes distortion of surrounding tissues and disrupts alignment of teeth.

REF: p. 241 OBJ: To name the structures involved in the formation of the palate and the timing of its development NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 13. Migration refers to a. early tooth bud mesial drift b. deepening of the nasal pits c. increase in connective tissue of the upper lip d. fusion of the medial nasal process ANS: C

Migration refers to an increase in the connective tissue of the upper lip. More specifically, tissues migrate into the area of the groove that lies between the medial nasal and maxillary processes as they fuse.

REF: p. 239 OBJ: To discuss the mechanism involved in the development of the maxillary lip N asic RSora IN G B.Canatomy, M NAT: CDA: GC I.A.6. Identify bU l andTdental O physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 14. The hyoid arch is pharyngeal arch number a. I. b. II. c. III. d. IV. ANS: B

The hyoid arch is pharyngeal arch number II. Note that arches are numbered from the top of the head, beginning with Roman numeral I. The arches closest to the head are the largest, and those farther down are smaller in size.

REF: pp. 238-239 OBJ: To list the embryonic structures that form the face and discuss the approximate age of formation NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 15. By the end of the 11th week the upper lip has formed because the two medial nasal processes

have fused together. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related.

c. The statement is correct, but the reason and the timeline are NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

By the end of the sixth week the upper lip has formed. Prior to this the maxillary processes have enlarged and grown toward the midline. Note that the lateral nasal process takes no part in formation of the upper lip.

REF: p. 241 OBJ: To discuss the mechanism involved in the development of the maxillary lip NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 16. A cyst can form during the fusion of the palate. If the cyst develops along the fusion line of

the two palatal shelves, it is known as a globulomaxillary cyst. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

A cyst that forms along the fusion of the two palatal shelves is known as a median palatine cyst. A globulomaxillary cyst forms from improper fusion along between the primary palate and the palatal shelves.

REF: p. 241 OBJ: To name the structures iN nvolR vedI in thGe foB rm .aCtionMof the palate and the timing of its

U S N T O development NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 17. If the thyroid gland does not form normally, a red lump known as a lateral lingual swelling

develops. This abnormal formation is located on the floor of the mouth. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

If the cord of cells that forms the thyroid gland does not properly grow downward, a big red lump called a lingual thyroid forms at the back of tongue. Note that lingual means tongue, indicating that this thyroid formation is incorrectly located on the tongue. A lateral lingual swelling is one of the basic structures that makes up the tongue.

REF: p. 247 OBJ: To describe the other structures arising from the pharyngeal arches NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 18. Both muscles of mastication and muscles of facial expression are innervated by the fifth

cranial nerve. Muscles of mastication arise from the first pharyngeal arch and muscles of facial expression arise from the fifth cranial arch.

a. b. c. d.

Both statements are true.

The first statement is true; the second statement is false.

The first statement is false; the second statement is true.

Both statements are false.

ANS: D

Muscles of mastication are innervated by the fifth cranial nerve whereas the seventh cranial nerve innervates muscles of facial expression. Muscles of mastication arise from the first pharyngeal arch; the facial muscles arise from the second arch.

REF: p. 246 OBJ: To describe the other structures arising from the pharyngeal arches NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 19. The thyroid gland originates from a. the foramen cecum b. the anterior two-thirds of the tongue c. the posterior third of the tongue d. the midline of the inner surface of the pharyngeal arches e. all of the above ANS: A

The thyroid gland begins to develop in a small depression in the middle of the tongue known as the foramen cecum. Note that as it develops the thyroid gland migrates downward to the lower front neck region. Disruption of this migration results in a large lump at the back of the tongue called the lingual thyroid.

REF: p. 247 OBJ: ToNdesR thG e othBe. r sC trucM from the pharyngeal arches Ie N U crib Soral Otures arising NAT: CDA: GC I.A.3. Identify basic andTdental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 20. Landmarks that separate the pharyngeal arches are known as all except a. pharyngeal clefts b. pharyngeal grooves c. pharyngeal pouches d. pharyngeal openings ANS: D

Pharyngeal clefts, grooves, and pouches separate the arches. Pharyngeal arches are the external bulges in the future neck region. The depressions on the neck surface are known as pharyngeal grooves or clefts. Depressions on the inside are known as pharyngeal pouches.

There are not openings within the arches.

REF: p. 245 OBJ: To list the embryonic structures that form the face and discuss the approximate age of formation NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 21. Development of a cleft palate occurs between the 7th and the 11th week. If it occurs early,

only the soft palate or uvula will be affected. a. Both statements are true.

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

ANS: B

Fusion of the palatal processes is usually completed by about the 11th week. Development of a cleft palate occurs somewhere between the 7th and 11th week. If it occurs early, the entire palate will be open or cleft; if it occurs closer to the 11th week, only the soft palate or uvula will be affected.

REF: p. 241 OBJ: To discuss the embryonic structures involved in the development of the cleft lip and palate NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 22. Which ethnic group is most likely to have a combined cleft lip and palate? a. Caucasians b. Asians c. African Americans d. There is very little differentiation by ethnicity.

ANS: B

A combined cleft lip and palate occurs most frequently in people of Asian ethnicity.

Interestingly, clefts involving only the palate and not the lip occur equally in all races.

Another pertinent statistic, males tend to have more cleft lips, or combined lip and palate.

Females have more isolated cleft palates.

REF: p. 241 NURSINGTB.COM OBJ: To discuss the embryonic structures involved in the development of the cleft lip and palate NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. Which of the following are involved in formation of the tongue (Select all that apply.)? a. Lateral lingual swellings b. Tuberculum impar c. Fifth pharyngeal arch d. Copula e. Frontal prominence ANS: A, B, D

Basic structures involved in development of the tongue include the lateral lingual swellings, the tuberculum impar, and the copula. Also pertinent, a small depression in the middle of the tongue, the foramen cecum, is a developmental landmark. The fifth pharyngeal arch is not involved. It degenerates and forms nothing of consequence. The frontal prominence is the precursor to the forehead area.

REF: pp. 238-239 | p. 247 OBJ: To describe the mechanism involved in the development of the palate NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering

2. In a pregnant woman, which of the following are known to increase risk for having a baby

with a cleft lip or palate (Select all that apply.)? a. Smoking and other forms of tobacco use b. Prescription medications c. Environmental pollutants d. Family history e. Alcohol ANS: A, B, C, D, E

While hereditary factors are a significant risk factor, the other main factor is environmental.

Alcohol, tobacco, and drug usage, whether prescription or not, are all considered environmental factors.

REF: p. 245 OBJ: To discuss the embryonic structures involved in the development of the cleft lip and palate NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering TRUE/FALSE 1. Six pharyngeal arches can be seen in a 3-week-old embryo.

ANS: F

In a 3-week-old embryo three pharyngeal arches can be seen bulging out laterally. Eventually six of these arches will develop. The fifth, however, forms nothing of consequence and degenerates.

REF: p. 238 OBJ: To list the embryonic structures that form the face and discuss the approximate age of formation NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 2. The mandibular arch is divided into the maxillary and mandibular processes.

ANS: T

Growth within the upper surface of the mandibular arch becomes the maxillary process. At this time, the mandibular arch can be subdivided into mandibular processes below and maxillary processes above.

REF: pp. 238-239 OBJ: To list the embryonic structures that form the face and discuss the approximate age of formation NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 3. Rathke’s pouch forms the posterior part of the pituitary gland.

ANS: F

Rathke’s pouch forms the anterior and intermediate parts of the pituitary gland. The intermediate portion is known as the pars intermedia.

REF: p. 247 OBJ: To list the embryonic structures that form the face and discuss the approximate age of formation NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 4. During formation of the upper lip, the lateral and medial nasal processes fuse.

ANS: F

The lateral nasal process takes no part in forming the upper lip. It gets pushed up and out of the way.

REF: p. 239 OBJ: To discuss the mechanism involved in the development of the maxillary lip NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 5. The hyoid bone arises from the second and third pharyngeal arches.

ANS: T

The upper body of the hyoid bone arises from the second pharyngeal arch. The lower body of the hyoid arises from the third pharyngeal arch.

REF: p. 246 OBJ: To describe the other structures arising from the pharyngeal arches NAT: CDA: GC I.A.6. IdentifyNbasR ic oral and dBe. ntaCl anM atomy, physiology and development, U SI NGTOP: T BLOOM: O including but not limited to: oral cavity.

Remembering 6. The trigeminal nerve innervates the first pharyngeal arch.

ANS: T

The cranial nerve that innervates the first pharyngeal arch is the trigeminal. Note that each pharyngeal arch contains a bar of cartilage, an artery, a cranial nerve, and mesodermal tissues.

Additionally, specific bone, cartilage, and muscle structures will develop from each of these arches.

REF: p. 245 OBJ: To describe the other structures arising from the pharyngeal arches NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 7. The stomodeum forms the oral cavity and the oral pharynx.

ANS: T

The stomodeum is a depression in the facial region of the embryo that is the beginning of the oral cavity.

REF: p. 238 OBJ: To list the embryonic structures that form the face and discuss the approximate age of formation NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development,

including but not limited to: oral cavity.

TOP: BLOOM: Remembering

NURSINGTB.COM

Chapter 19: Dental Lamina and Enamel Organ Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. At about the sixth embryonic week, there is a continued thickening in the dental lamina. These

localized thickenings correspond to the positions of the 20 teeth of the future primary dentition. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The thickening of the lamina dura that forms the 20 positions for the future primary dentition begins to occur at about the eighth embryonic week.

REF: p. 249 OBJ: To define dental lamina and indicate in what embryonic week it is first seen NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. The cells of the inner enamel epithelium (IEE) are structurally similar to the cells of the outer

enamel epithelium (OEE) because they both originate from the basal layer of the oral epithelium. a. Both the statement and the reason are correct and related. b. Both the statement and thN eU reR asSoI nN arG eT coB rr. ecC tO buMt are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Both the outer enamel epithelium (OEE) and the inner enamel epithelium (IEE) originate from low columnar or cuboidal cells of the basal layer of the oral epithelium. Appearance of these tissues, along with the stellate reticulum, is indicative of the cap stage of tooth development.

REF: p. 249 OBJ: To describe bud, cap, and bell stages and the various layers found in each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 3. Premolars are successional because they develop from a posterior growth of the dental, or

general, lamina. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

Note that premolars replace primary molars; premolars do not exist in the primary dentition.

While it is true that premolars are successional, they develop from a lingual extension to the general dental lamina. This is also true of permanent incisors and canines, the remaining successional teeth. (A synonymous term is succedaneous.) Contrast this with the permanent molars, which do not have primary precursors. The permanent molars develop from a posterior growth of the dental, or general, lamina.

REF: p. 250 OBJ: To define successional and vestibular laminae NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 4. Each of the following statements accurately describes aspects of the development of enamel

organ EXCEPT one. Which one is the EXCEPTION? a. Buds from the dental lamina project into deeper underlying connective tissue. b. The bud stage is the first stage in the development of enamel organ. c. Enamel organ will eventually form enamel and cementum of teeth. d. Cells in the middle of the buds come from outer layers of oral epithelium. e. Cells in the periphery of the buds come from deep layers of the oral epithelium.

ANS: C

Enamel organ will eventually form enamel. Cementum is formed by another embryonic component, the dental sac.

REF: p. 250 OBJ: To describe bud, cap, and bell stages and the various layers found in each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

NURSINGTB.COM

5. The dental sac is composed of several layers of flat mesodermal cells that partially surround

the dental papilla and enamel organ. The dental sac is another name for the dental lamina. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The dental sac is another name for the dental follicle. The dental sac is comprised of several rows of flattened cells that surround the portion of the dental papilla not in contact with the inner enamel epithelium (IEE). The dental sac also surrounds part of enamel organ. Both the dental sac and dental papilla arise from mesoderm.

REF: p. 252 OBJ: To describe dental papilla, dental sac, and their functions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 6. Without thickening of the vestibular lamina in an occlusal direction the vestibule would not

exist because clefting or splitting of the epithelium would not occur. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct.

e. NEITHER the statement NOR the reason is correct.

ANS: D

Formation of the vestibule is dependent on thickening of the epithelium in a facial or buccal direction from the lamina dura. This is followed by an epithelial clefting or splitting, which is critical to formation of the area of the mucobuccal or mucolabial fold in the future vestibule.

Without formation of this vestibular lamina, the vestibule would end at the level of the alveolar ridge.

REF: p. 250 OBJ: To define successional and vestibular laminae NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 7. The cells between the dental papilla and the outer enamel epithelium (OEE) compose the

stellate reticulum. Originating from deep layers of the oral epithelium, cells of the stellate reticulum are mesenchymal in origin. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The stellate reticulum lies between the inner enamel epithelium (IEE) and the outer enamel epithelium (OEE). Although cells of the stellate reticulum originate from superficial embryonic layers and appear mesenchymal, they are actually ectodermal cells. All other parts of enamel organ are also ectodermal. The dental papilla is a small area of condensed cells arising from mesoderm and located next to or deep to the IEE.

N R I G B.C M

U S N T O REF: p. 249 OBJ: To describe bud, cap, and bell stages and the various layers found in each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 8. The dental papilla is first seen in the a. early bud stage b. late bud stage c. cap stage d. bell stage ANS: B

The dental papilla, a small area of condensed cells arising from mesoderm and located near the inner enamel epithelium, is first seen in the late bud stage. It becomes more pronounced as it goes through the bell stage. The dental papilla forms both dentin and the pulp.

REF: p. 252 OBJ: To describe dental papilla, dental sac, and their functions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 9. Enamel organ originates from the a. endoderm b. ectoderm c. mesoderm

d. ameloblasts ANS: B

Cells of enamel organ originate from ectodermal tissue. Note that as enamel organ develops, the stellate reticulum forms between the inner enamel epithelium (IEE) and the outer enamel epithelium (OEE). Stellate reticulum is also ectodermal in origin.

REF: p. 249 OBJ: To describe bud, cap, and bell stages and the various layers found in each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 10. Cells of the outer enamel organ (OEE) constrict and morph into ameloblasts. Stellate

reticulum, in conjunction with ameloblasts, is responsible for enamel formation. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Cells of the inner enamel organ (IEE) elongate and change internally to become ameloblasts.

Ameloblasts are responsible for enamel formation. The stellate reticulum does not produce enamel.

REF: pp. 249-250 OBJ: To describe bud, cap, and bell stages and the various layers found in each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BL OOM: Understanding

N R I G B. C M U S N T O

11. The clefting that occurs in the thickened vestibular lamina eventually becomes a

mucogingival groove. The vestibular lamina is a thickening of oral epithelium in a lingual direction. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The vestibular lamina forms the area of the mucobuccal or mucolabial fold in the future vestibule. As the epithelium of the vestibular thickens in a facial or buccal direction, a clefting or splitting occurs. This is a key event in the formation of the fold within the vestibule.

Without these events the vestibule would end at the level of the alveolar ridge.

REF: p. 250 OBJ: To define successional and vestibular laminae NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 12. Skin, hair, enamel, and cementum can be adversely affected by ectodermal dysplasia because

this condition causes poor development of structures arising from ectoderm. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct.

d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Although ectodermal dysplasia can adversely affect tissues arising from ectoderm, cementum is not affected by this condition. Cementum is formed by the dental sac, which arises from mesoderm.

REF: p. 249 | p. 252 OBJ: To define dental lamina and indicate in what embryonic week it is first seen NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 13. The successional lamina forms all permanent teeth EXCEPT for one type. Which type is the

EXCEPTION? a. Incisors b. Canines c. Premolars d. Molars ANS: D

The successional lamina, a lingual extension to the side of each primary tooth, forms permanent incisors, canines, and premolars. These teeth are preceded, respectively, by the primary incisors, canines, and molars. Permanent molars develop from a posterior growth of the dental, or general, lamina and are nonsuccessional.

REF: p. 250 OBJ: To define dental lamina and indicate in what embryonic week it is first seen N asic RSora IN G B.Canatomy, M NAT: CDA: GC I.A.7. Identify bU l andTdental O physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 14. The outermost part of the structure of the cap stage is the outer enamel epithelium (OEE).

This tissue, a continuation of the basal layer of oral epithelium, is composed of predominately pyramidal and conical-shaped cells. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The OEE is a direct continuation of the basal layer of oral epithelium. These are low columnar or cuboidal cells.

REF: p. 249 OBJ: To describe bud, cap, and bell stages and the various layers found in each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 15. The appearance of the stratum intermedium differentiates the cap stage from the bell stage.

The stratum epithelium, the fourth layer of epithelium, lies between the inner enamel epithelium and the outer enamel epithelium. a. Both statements are true.

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

ANS: B

The stratum epithelium, comprised of several layers of flattened squamous cells, lies between the internal enamel epithelium and the stellate reticulum. It is the stellate reticulum that lies between the inner and outer enamel epithelium. All other aspects of the statements are correct.

REF: p. 249 OBJ: To describe bud, cap, and bell stages and the various layers found in each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 16. The stratum intermedium develops during which stage? a. Early bud b. Late bud c. Cap d. Bell ANS: D

The appearance of the stratum intermedium, a fourth layer of epithelium within enamel organ, marks the transition from the cap to the bell stage.

REF: p. 249 OBJ: To describe bud, cap, and bell stages and the various layers found in each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BL OOM: Remembering

N R I G B. C M U S N T O

17. The cells of the outer enamel epithelium (OEE) are indirectly responsible for enamel

formation because they elongate and become ameloblasts. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

After elongating and changing internally, the cells of the inner enamel epithelium (IEE) become ameloblasts. This transformation makes the cells of the IEE indirectly responsible for enamel formation by ameloblasts.

REF: p. 250 OBJ: To describe bud, cap, and bell stages and the various layers found in each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding TRUE/FALSE 1. The earliest signs of tooth development are seen during the 10th week in utero.

ANS: F

During the eighth week in utero, starting at the midline and spreading posteriorly, the dental lamina continues its thickening process. Twenty localized thickenings are formed as precursors to the 20 teeth of the primary dentition.

REF: p. 249 OBJ: To define dental lamina and indicate in what embryonic week it is first seen NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. The cap stage begins when the concavity of the tooth buds becomes slightly concave.

ANS: T

As tooth buds develop they seem to stretch from the dental lamina, with the deepest parts becoming slightly concave. It is at this point that the developing enamel organ progresses from the bud stage to the cap stage.

REF: p. 249 OBJ: To describe bud, cap, and bell stages and the various layers found in each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. The vestibular lamina forms in a lingual direction from the dental lamina.

ANS: F

The vestibular lamina is a thickening of oral epithelium in a facial or buccal direction from the dental lamina.

REF: p. 250 OBJ: ToNdef succ on. alCand URineSI NGessi TB OMvestibular laminae NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. The first stage of development of enamel organ is the cap stage.

ANS: F

The bud stage is the first stage of development of enamel organ. This stage begins with budding from the dental lamina at the 10 thickened areas in each arch. Initially the buds look like blobs of cells projecting into the deeper underlying connective tissue.

REF: p. 249 OBJ: To describe bud, cap, and bell stages and the various layers found in each NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. The dental lamina thickens first at the anterior midline.

ANS: T

The initial thickening of the lamina dura is gradual. It occurs initially in the area of the anterior midline and slowly spreads posteriorly toward the molar region. It takes only several weeks for this thickening to extend to the future sites of the deciduous molars.

REF: p. 249 OBJ: To define dental lamina and indicate in what embryonic week it is first seen

NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. The permanent molars develop from successional lamina.

ANS: F

The permanent molars are nonsuccessional because they do not replace primary teeth. These teeth develop from a posterior growth of the dental, or general, lamina. By contrast, the incisors, canines, and premolars are successional teeth. They develop from the successional lamina, which is an extension to the lingual side of each primary tooth.

REF: p. 250 OBJ: To define successional and vestibular laminae NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering MATCHING

An understanding of the formation of the dental lamina and enamel organ provides dental professionals with a foundation in embryology. Match each descriptive term with its appropriate anatomic formation. a. Forms permanent incisors, canines, and premolars b. Forms cementum c. Forms enamel d. Forms mucobuccal fold e. Forerunner of primary tooth germ f. Forms pulp 1.

2.

3.

4.

5.

6.

Dental papilla Enamel organ Dental lamina Successional lamina Dental sac Vestibular lamina

NURSINGTB.COM

1. ANS: F REF: pp. 249-250 | p. 252 OBJ: To define dental lamina and indicate in what embryonic week it is first seen | To define successional and vestibular laminae | To describe dental papilla, dental sac, and their functions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The dental papilla is a small area of condensed cells arising from mesoderm that forms dentin and the pulp. Enamel organ is an ectodermal epithelial structure that leads to formation of tooth enamel. Earliest signs of tooth development are evident during the sixth embryonic week when the oral epithelium (stratified squamous) forms a thickening known as the dental lamina. Permanent incisors, canines, and premolars are formed by a lingual extension to the dental lamina called the successional lamina. Cementum is formed by the dental sac, comprised of several rows of flattened cells that surround portions of the dental papilla. The vestibular lamina, a thickening of epithelium in a facial or buccal direction, forms the mucobuccal or mucolabial fold.

2. ANS: C REF: pp. 249-250 | p. 252 OBJ: To define dental lamina and indicate in what embryonic week it is first seen | To define successional and vestibular laminae | To describe dental papilla, dental sac, and their functions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development,

3.

4.

5.

6.

including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The dental papilla is a small area of condensed cells arising from mesoderm that forms dentin and the pulp. Enamel organ is an ectodermal epithelial structure that leads to formation of tooth enamel. Earliest signs of tooth development are evident during the sixth embryonic week when the oral epithelium (stratified squamous) forms a thickening known as the dental lamina. Permanent incisors, canines, and premolars are formed by a lingual extension to the dental lamina called the successional lamina. Cementum is formed by the dental sac, comprised of several rows of flattened cells that surround portions of the dental papilla. The vestibular lamina, a thickening of epithelium in a facial or buccal direction, forms the mucobuccal or mucolabial fold.

ANS: E REF: pp. 249-250 | p. 252 OBJ: To define dental lamina and indicate in what embryonic week it is first seen | To define successional and vestibular laminae | To describe dental papilla, dental sac, and their functions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The dental papilla is a small area of condensed cells arising from mesoderm that forms dentin and the pulp. Enamel organ is an ectodermal epithelial structure that leads to formation of tooth enamel. Earliest signs of tooth development are evident during the sixth embryonic week when the oral epithelium (stratified squamous) forms a thickening known as the dental lamina. Permanent incisors, canines, and premolars are formed by a lingual extension to the dental lamina called the successional lamina. Cementum is formed by the dental sac, comprised of several rows of flattened cells that surround portions of the dental papilla. The vestibular lamina, a thickening of epithelium in a facial or buccal direction, forms the mucobuccal or mucolabial fold.

ANS: A REF: pp. 249-250 | p. 252 OBJ: To define dental lamina and indicate in what embryonic week it is first seen | To define successional and vestibular laminae | To describe dental papilla, dental sac, and their functions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The dental papilla is a small area of condensed cells arising from mesoderm that forms dentin and the pulp. Enamel organ is aN nU ecR toS deI rm ialOsM tructure that leads to formation of tooth NaGl eTpiBthe.lC enamel. Earliest signs of tooth development are evident during the sixth embryonic week when the oral epithelium (stratified squamous) forms a thickening known as the dental lamina. Permanent incisors, canines, and premolars are formed by a lingual extension to the dental lamina called the successional lamina. Cementum is formed by the dental sac, comprised of several rows of flattened cells that surround portions of the dental papilla. The vestibular lamina, a thickening of epithelium in a facial or buccal direction, forms the mucobuccal or mucolabial fold.

ANS: B REF: pp. 249-250 | p. 252 OBJ: To define dental lamina and indicate in what embryonic week it is first seen | To define successional and vestibular laminae | To describe dental papilla, dental sac, and their functions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering NOT: The dental papilla is a small area of condensed cells arising from mesoderm that forms dentin and the pulp. Enamel organ is an ectodermal epithelial structure that leads to formation of tooth enamel. Earliest signs of tooth development are evident during the sixth embryonic week when the oral epithelium (stratified squamous) forms a thickening known as the dental lamina. Permanent incisors, canines, and premolars are formed by a lingual extension to the dental lamina called the successional lamina. Cementum is formed by the dental sac, comprised of several rows of flattened cells that surround portions of the dental papilla. The vestibular lamina, a thickening of epithelium in a facial or buccal direction, forms the mucobuccal or mucolabial fold.

ANS: D REF: pp. 249-250 | p. 252 OBJ: To define dental lamina and indicate in what embryonic week it is first seen | To define successional and vestibular laminae | To describe dental papilla, dental sac, and their functions NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

NOT: The dental papilla is a small area of condensed cells arising from mesoderm that forms dentin and the pulp. Enamel organ is an ectodermal epithelial structure that leads to formation of tooth enamel. Earliest signs of tooth development are evident during the sixth embryonic week when the oral epithelium (stratified squamous) forms a thickening known as the dental lamina. Permanent incisors, canines, and premolars are formed by a lingual extension to the dental lamina called the successional lamina. Cementum is formed by the dental sac, comprised of several rows of flattened cells that surround portions of the dental papilla. The vestibular lamina, a thickening of epithelium in a facial or buccal direction, forms the mucobuccal or mucolabial fold.

Chapter 20: Enamel, Dentin, and Pulp Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Enamel, dentin, and pulp develop from enamel organ. Enamel is derived from ectoderm

whereas dentin and pulp are derived from mesoderm. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Enamel develops from enamel organ, which is derived from ectoderm. Dentin and pulp develop from the dental papilla, which is derived from mesoderm.

REF: p. 254 OBJ: To discuss the interrelationship between enamel formation and dentin formation NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. During the mineralization stage of enamel rod calcification approximately half of the

hydroxyapatite crystals are deposited because the remaining half are deposited during the maturation stage. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, N buUt R thS eI reN asG onTiB s.

NC OO TM correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

It is important to remember that all the hydroxyapatite crystal that will ever exist in a particular area of enamel rod is deposited during the mineralization stage of rod calcification.

During the second stage of calcification, the maturation stage, the crystals grow in size and become packed together. Note that no crystals are deposited during the maturation stage.

REF: p. 255 OBJ: To understand the keyhole shape of enamel rod and the direction of the hydroxyapatite crystals in different areas of the cross section of rod NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 3. For both primary and permanent teeth the process of tooth development is the same.

Development occurs simultaneously in the anterior and posterior regions beginning at the cervical line and progresses toward the incisal/occlusal edges. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Tooth development is first seen in anterior teeth and later in posterior teeth. It begins at the tip of a cusp/incisal edge and progresses cervically. Also, development tends to occur slightly sooner in the mandibular arch.

REF: p. 255 OBJ: To describe the role of the dental papilla in the formation of enamel organ and the shaping of the crown NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 4. Enamel rod is somewhat parallel to the dentinoenamel junction (DEJ) because it runs all the

way from the DEJ to the surface of the tooth. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

Enamel rod is a column that runs all the way from the DEJ to the tooth surface in a direction perpendicular (90 degrees) to both the tooth surface and the DEJ. REF: p. 257 OBJ: To describe the properties of enamel and the makeup of enamel rod NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 5. After the ameloblast secretes the primary enamel cuticle it is called the reduced enamel

epithelium because it becomeNsU flR atte ned SI NGand TBb.leCnds OMwith outer enamel epithelial cells. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

This statement correctly describes the final phase of the ameloblast. The term reduced enamel epithelium is appropriate because the ameloblast is “reduced,” and it blends in with outer enamel epithelial cells. Note that the primary enamel cuticle, the final product of the ameloblast, is also called Nasmyth’s membrane.

REF: p. 258 OBJ: To describe the properties of enamel and the makeup of enamel rod NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 6. Young people are less susceptible to permanent pulpal damage than older people because with

age the smaller pulp loses its reserve cells and is less able to resist trauma. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

With age, the pulp becomes smaller due to accumulation of secondary and reparative dentin.

The diminished size as well as increased concentration of fibers renders the older pulp more susceptible to permanent pulpal damage.

REF: p. 262 OBJ: To describe the components and age changes of pulp NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 7. Each of the following is true of enamel lamellae EXCEPT one. Which one is the

EXCEPTION? a. Lamellae are cracks in enamel that rarely extend through enamel. b. Enamel lamellae may provide a pathway for bacteria into enamel. c. The most common type of lamellae is caused by trauma. d. Rapid changes in temperature from food and drink commonly cause lamellae. e. An infrequent type of lamellae is a developmental defect.

ANS: A

Lamellae are hairline cracks in enamel that may extend into dentin. An infrequent type is a developmental defect that results from cessation of enamel production by one or more ameloblasts. This defect leaves a space between enamel rods, which provides a potential pathway for bacteria.

REF: p. 258 OBJ: To define the following terms: striae of Retzius, hypoplastic enamel, hypocalcified enamel, enamel lamellae, enamel tuft, and enamel spindle NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeN th. R I GTOB P:.BL C OMOM: Remembering

U S N T

O

8. The multipointed cells that become dental papilla cells are called a. inner epithelium cells b. preameloblasts c. mesenchymal cells d. secretory cells ANS: C

Mesenchymal cells are large multipointed embryonic cells deep within the tooth bud. They are primitive cells of the mesodermal embryonic layer and have the ability to form a number of different tissues. During the cap stage, mesenchymal cells become cells of the dental papilla.

REF: p. 254 OBJ: To describe the role of the dental papilla in the formation of enamel organ and the shaping of the crown NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 9. Each of the following is true of the cells of the inner enamel epithelium (IEE) during the bell

stage EXCEPT one. Which one is the EXCEPTION? a. The cells increase in length. b. The cells prepare to become secretory cells. c. Their organelles increase.

d. There is a decrease in mitochondria.

ANS: D

The number of mitochondria, cells responsible for energy production, increase. There is also an increase in endoplasmic reticulum, and a more obvious Golgi apparatus.

REF: p. 254 OBJ: To describe the role of the dental papilla in the formation of enamel organ and the shaping of the crown NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 10. Dentin matrix creates a barrier between the dental papilla and the preameloblasts. With the

resulting fluid shift and change in polarity, the preameloblast becomes an ameloblast. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

The barrier between dentin matrix and dental papilla adversely affects the nutrient supply of the preameloblast. To compensate, new vascular channels penetrate enamel organ, enabling fluid nutrients to access the preameloblasts. With the resulting change in polarity the preameloblast becomes an ameloblast and is ready to secrete enamel matrix.

REF: p. 254 OBJ: To describe the role of the dental papilla in the formation of Enamel organ and the shaping of the crown NURSINGTB.COM NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 11. A sign that enamel production is completed is when a. the ameloblast moves away from dentinoenamel junction (DEJ) b. the striae of Retzius are seen c. the maturation stage of calcification is reached d. the ameloblast contacts the outer enamel epithelium (OEE) ANS: C

As the ameloblast moves away from the DEJ toward the OEE, it compresses the two middle layers—the stratum intermedium and the stellate reticulum. The sign for the ameloblast to cease enamel formation is when the ameloblast contacts the OEE. REF: p. 258 OBJ: To discuss the changes in the inner enamel epithelial cells that allows them to become enamel-forming cells NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 12. The dental papilla is derived from the ectoderm. It determines the shape of the developing

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

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

ANS: C

The dental papilla, which forms dentin and the pulp, is derived from mesoderm. The dental papilla seems to have genetic control over tooth shape (both crown and root).

REF: p. 254 OBJ: To describe the role of the dental papilla in the formation of enamel organ and the shaping of the crown NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 13. An enamel spindle is an ameloblastic process that becomes trapped in dentin. Enamel spindles

form in early development and are seen only histologically. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

An enamel spindle is an odontoblastic process, a cellular extension of the odontoblast, that becomes trapped between ameloblasts and ends up in enamel.

REF: p. 259 OBJ: To define the following terms: striae of Retzius, hypoplastic enamel, hypocalcified enamel, enamel lamellae, enamel tuft, and enamel spindle NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, NU B.C M Understanding including but not limited to: teeth . R SI NGTT OP: BLOOOM: 14. Each of the following accurately describes hypocalcified enamel EXCEPT one. Which one is

the EXCEPTION? a. Hydroxyapatite crystals are not full size. b. The tooth may be more caries prone. c. Enamel is less dense. d. Enamel is more than 96% inorganic.

ANS: D

Hypocalcified enamel is less than 96% inorganic. It results from insufficient growth of enamel crystals or an insufficient number of crystals originally deposited in the matrix.

REF: p. 255 OBJ: To define the following terms: striae of Retzius, hypoplastic enamel, hypocalcified enamel, enamel lamellae, enamel tuft, and enamel spindle NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 15. Each of the following is true of enamel EXCEPT one. Which one is the EXCEPTION? a. Enamel is the hardest structure of the body. b. Enamel is developed from the inner enamel epithelium, which is derived from

mesoderm. c. Enamel is about 96% inorganic.

d. Enamel structure is composed of the rod sheath and enamel rod.

ANS: B

Enamel is developed from enamel organ, which is derived from ectoderm.

REF: p. 254 OBJ: To describe the properties of enamel and the makeup of enamel rod NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 16. Enamel is generally yellowish in color but usually appears white because of the reflection of

the color of the underlying dentin. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Enamel is generally white but sometimes appears yellowish due to reflection of the color of the underlying dentin.

REF: p. 255 OBJ: To describe the properties of enamel and the makeup of enamel rod NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 17. The bulk of the dentinal material is called primary dentin or regular dentin. An area of higher

crystalline content immediately surrounding the dentinal tubules is called sclerotic dentin. a. Both statements are true.

N RSINGTB.C M b. The first statement is true; U the second statementOis false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The bulk of the dentinal material is called intertubular dentin. An area of higher crystalline content immediately surrounding the dentinal tubules is called peritubular dentin. (Hint: peri means around.) Regarding incorrect terminology, primary or regular dentin is the structure that exists when a tooth erupts into the oral cavity. In sclerotic dentin, a condition caused by occlusal trauma or decay, the empty dentinal tubules become filled with a dentin material.

REF: p. 259 | p. 262 OBJ: To describe the properties and components of dentin NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 18. Following mild trauma, which type of dentin is formed? a. Reparative b. Secondary c. Sclerotic d. Interglobular ANS: A

Reparative dentin is formed in response to local trauma and is located immediately beneath the area of trauma. By radiographically examining patterns of dentin it is possible to distinguish various types of trauma because different types occur in somewhat predictable areas. Secondary dentin is formed inside the regular dentin throughout life. Sclerotic and interglobular dentin are abnormalities in dentin formation.

REF: pp. 260-261 OBJ: To differentiate between primary, secondary, and reparative dentin NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 19. Pulp tissue consists of blood vessels, lymphatic vessels, nerves, fibroblasts, and collagen

fibers. The nerves of the pulp are primarily sensory and transmit both pain and thermal sensations. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

While the nerves of the pulp are primarily sensory, the only type of sensation they transmit is pain.

REF: p. 262 OBJ: To describe the components and age changes of pulp NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 20. The portion of enamel rod that contains most of the fibrous organic substance is the a. enamel rod NURSINGTB.COM b. enamel matrix c. ground substance d. enamel sheath ANS: D

Enamel sheath, also called the rod sheath, contains most of the fibrous organic components of enamel. Enamel structure contains two parts: enamel sheath and enamel rod. Enamel matrix consists of mucopolysaccharides and organ fibers. Within enamel matrix is a glue like material called ground substance.

REF: p. 255 OBJ: To describe the properties of enamel and the makeup of enamel rod NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 21. The typical enamel rod is shaped wider at the top and narrower at the bottom because the

hydroxyapatite crystals in those portions differ in size. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The typical enamel rod, described as being keyhole shaped, is wider at the top and narrower at the bottom. While the hydroxyapatite crystals are the same size, they are oriented in different directions.

REF: pp. 256-257 OBJ: To describe the properties of enamel and the makeup of enamel rod NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 22. The asymmetrical bulging end shape within the ameloblasts is called the a. imbrication lines b. striae of Retzius c. Tomes' process d. maturation phase ANS: C

When the ameloblasts produce the matrix and then deposit the crystals into the matrix, an asymmetrical bulge called the Tomes’ process of an ameloblast is formed. Imbrication lines are horizontal lines on the crown and are manifestations of the striae of Retzius. The maturation stage is the phase of enamel development where crystals grow in size until they are packed together.

REF: p. 257 OBJ: To describe the properties of enamel and the makeup of enamel rod NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 23. During the maturation stage of calcification, an ameloblast produces enamel at what rate? a. 0.02 mm per hour b. 2 mm per day NURSINGTB.COM c. 4 mm per day d. 10 mm per hour ANS: C

An ameloblast produces the matrix and enamel at a rate of about 4 mm per day. Every fourth day there is a change in the development of the rod, resulting in a brownish line called the striae of Retzius.

REF: p. 257 OBJ: To describe the properties of enamel and the makeup of enamel rod NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 24. Hundreds of odontoblasts are damaged when restoration is prepared and placed within a tooth.

Sclerotic dentin forms in response to the trauma. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

During restorative procedures 30,000 to 40,000 odontoblastic processes are damaged for every square millimeter of dentin that is cut. Reparative dentin forms in response to such local trauma.

REF: p. 260 OBJ: To differentiate between primary, secondary, and reparative dentin NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 25. Which of the following is NOT an abnormality in dentin? a. Interglobular dentin b. Sclerotic dentin c. Dead tracts d. Reparative dentin ANS: D

Poorly calcified areas of dentin that become entrapped are called interglobular dentin. A condition in which dentinal tubules are filled with a dentin material is called sclerotic dentin.

Dentinal tubules that are empty because of the death of the odontoblasts that originally occupied them are known as dead tracts. Reparative dentin is not an abnormality, but is formed in response to local trauma and is located immediately beneath the area of trauma.

REF: pp. 260-262 OBJ: To define the following terms: interglobular dentin, dead tracts, sclerotic dentin NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. Which of the following are true of pulp stones (Select all that apply.)? a. They are small, circular, calcified areas. b. They occur in about 50% of people aged 70 to 80 years.

Nfrom RSam INelo GTblasts.

B.CO M c. True pulp stones originate U d. False stones are most common. e. False stones resemble an onion cut in cross section.

ANS: A, D, E

Pulp stones, small, circular, calcified areas, occur in about 80% of people aged 70 to 80 years.

True pulp stones originate from odontoblasts and are very rare. The most common type are false stones, which are thought to originate from dead cells with concentric layers of calcium phosphate around them.

REF: pp. 262-263 OBJ: To describe and classify pulp stones NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. Once formed, the often stained primary cuticle can be removed by (Select all that apply.): a. Regular toothbrushing b. Dental scaling c. Dental prophylaxis d. Tooth bleaching ANS: A, B, C

The primary enamel cuticle, also called Nasmyth’s membrane, remains for many months until worn away by toothbrushing or other abrasion. Newly erupted teeth should never be subjected to tooth bleaching. Their pulp cavities and pulp horns are extremely large and very vulnerable to damage. Final calcification has not yet occurred.

REF: p. 258 OBJ: To describe the properties of enamel and the makeup of enamel rod NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering TRUE/FALSE 1. The dental papilla has genetic control over tooth shape.

ANS: T

The mesoderm of the dental papilla seems to have genetic control in determination of the shape of the developing tooth crown.

REF: p. 254 OBJ: To describe the role of the dental papilla in the formation of enamel organ and the shaping of the crown NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. Peripheral cells of the dental papilla are called ameloblasts.

ANS: F

Peripheral cells of the dental papilla become low columnar or cuboidal cells and are called N RSING TB.COM odontoblasts. They are locatedU adjacent to preameloblasts, precursors to enamel-producing ameloblasts.

REF: p. 254 OBJ: To describe the role of the dental papilla in the formation of enamel organ and the shaping of the crown NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Tooth development is first seen at the incisal edge or cusp tip.

ANS: T

With any single tooth, the identical process of tooth development is seen first at the tip of the cusp of a tooth and later spreads toward the cervical line.

REF: p. 254 OBJ: To describe the role of the dental papilla in the formation of enamel organ and the shaping of the crown NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. The reduced enamel epithelium secretes the primary enamel cuticle.

ANS: F

The primary enamel cuticle, also called Nasmyth’s membrane, is the last product of the ameloblast. Following production of this cuticle/membrane the ameloblast begins flattening out and blending with the outer epithelial cells in what is called the reduced enamel epithelium.

REF: p. 258 OBJ: To discuss the changes in the inner enamel epithelial cells that allows them to become enamel-forming cells NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. The primary abnormality seen in pulp is pulp stones.

ANS: T

Pulp stones, small, circular, calcified areas, are the primary abnormality seen in the dental pulp.

REF: p. 262 OBJ: To describe and classify pulp stones NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 6. The size of pulp horns and chambers do not vary significantly with age.

ANS: F

Newly erupted teeth have large pulp chambers and prominent pulp horns. As secondary dentin formation proceeds, a decrease in the size of the pulp canals, chambers, and pulp horns occurs.

NURSINGTB.COM

REF: p. 259 | p. 261 OBJ: To describe the components and age changes of pulp NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

Chapter 21: Root Formation and Attachment Apparatus Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Immediately prior to root formation, the point where layers of outer enamel epithelium (OEE)

meet inner enamel epithelium (IEE) is known as the cervical loop. This point is located at the most superficial point of enamel organ. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

During early root formation, the point where the OEE meets the IEE, known as the cervical loop, is located at the deepest part of enamel organ.

REF: p. 264 OBJ: To discuss the role of the epithelial root sheath in root formation and dentin formation NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. Development of the dentinocemental junction (DCJ) involves newly formed odontoblasts and

cementoblasts. The root sheath must separate from the dentinal surface to establish the dentinocemental junction (DCJ). a. Both statements are true.

R I G B.C M N b. The first statement is true; U the S secoN nd T statemeO nt is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

As the root sheath grows from the cervical line into deeper connective tissue, cells of the dental papilla become odontoblasts and begin to secrete dentin. Cellular influences cause the root sheath to breakup and separate from this newly formed dentinal surface. During this process, some of the dental sac cells begin to change into cementoblasts and begin to form cementum. This cementum is laid down against the previously formed dentin and establishes the dentinocemental junction (DEJ).

REF: p. 264 OBJ: To discuss the role of the epithelial root sheath in root formation and dentin formation NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 3. Root sheath cells that remain in the periodontal space are called epithelial rest cells. If they

later divide they form epithelial rests of Malassez. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Root sheath cells that remain in the periodontal space are called epithelial rest cells, or more formally, epithelial rests of Malassez. If they later divide they may lead to formation of periodontal cysts.

REF: p. 265 OBJ: To discuss the role of the epithelial root sheath in root formation and dentin formation NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 4. Acellular cementum contains trapped cementoblasts because they remain in the matrix after

secretion. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

There are two types of cementum, acellular and cellular. In the acellular type, cementoblasts remain on the surface of the newly formed cementum. In the cellular type, cells become entrapped as they secrete matrix. These trapped cells are called cementocytes.

REF: p. 265 OBJ: To describe the beginning of cementum formation, the two varieties, and where they are found NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 5. Root formation begins at theN cemRento ameB l ju nctiM on (CEJ) and proceeds to the root apex.

IenG .C

U S N T

O

During this process, the epithelial root sheath becomes the epithelial diaphragm. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

During the process of root formation both the epithelial root sheath and the epithelial diaphragm retain their individual identities. While they work in conjunction, they perform separate functions.

REF: pp. 264-265 OBJ: To discuss the role of the epithelial root sheath in root formation and dentin formation NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 6. The parts of the periodontal ligament embedded in cementum are known as cementocytes.

The periodontal fibers surrounded by alveolar bone on the other side of the tooth socket are known as Sharpey’s fibers. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Both the periodontal ligament embedded in cementum and the periodontal fibers surrounded by alveolar bone are known as Sharpey’s fibers. Cementocytes are cementoblasts that become entrapped in cellular cementum.

REF: p. 266 OBJ: To define periodontal ligament and list its various groups and subgroups of fibers NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 7. The alveolar bone that forms the tooth socket has a normal periosteum because this bone

contains numerous holes that allow for passage of blood vessels. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

The periosteum of bone that forms the tooth socket is considered atypical because it contains holes that enable the passage of blood vessels. The periosteum is a membrane that lines the outer surface of all bones, except at the joints of long bones.

REF: p. 267 OBJ: To define and diagram alveolar bone and its components NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones. 7. teeth.

TOP: BLOOM: Understanding 8. Bone undergoes a remodelinN g prR ocesIs wG herB ea. sC cemM entum does not because the metabolic rate

U S N T

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of bone is lower than that of cementum. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The metabolic rate of bone is much higher than that of cementum. Bone has the ability to remodel, which is illustrated by orthodontic movement of teeth. As pressure is placed upon a tooth, bone is resorbed by osteoclasts. New bone is formed by osteoblasts. Cementum does not undergo such a vital process.

REF: p. 270 OBJ: To briefly describe bone's reaction to pressure and tension and how this affects tooth movement NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 9. Each of the following are classified as alveolodental fibers EXCEPT one. Which one is the

EXCEPTION? a. Alveolar crest fibers b. Horizontal fibers c. Circular gingival fibers

d. Oblique fibers e. Apical fibers ANS: C

The circular gingival fibers are classified as gingival fibers. They run from the cementum into the free and attached gingival areas and tend to support the gingiva. The remaining selections are groups of alveolodental fibers that run in various directions from the cementum to the alveolar bone.

REF: p. 268 OBJ: To define periodontal ligament and list its various groups and subgroups of fibers NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 10. During the bell stage of root development the cervical loop is located at the deepest part of

enamel organ. The cervical loop and the epithelial diaphragm guide the shape and number of roots. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The epithelial root sheath and epithelial diaphragm guide the shape and the number of roots.

The manner in which the epithelial diaphragm grows inward determines whether a tooth will have one, two, or three roots. The vertical length of the root is controlled by growth of the epithelial root sheath.

N R I G B.C M

U S N T O REF: p. 264 OBJ: To discuss the role of the epithelial root sheath in root formation and dentin formation NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 11. Each of the following defects can occur during or after the breakup of the epithelial root

sheath EXCEPT one. Which one is the EXCEPTION? a. Periodontal cysts b. Accessory root canals c. Hypercementosis d. Enamel pearls e. Epithelial rests of Malassez ANS: E

Epithelial rests of Malassez, simply called epithelial rest cells, are cells that remain in dentin following breakup of the root sheath. The remaining selections can occur during this period due to disruption or inconsistencies of the deterioration of the epithelial root sheath.

REF: pp. 265-266 OBJ: To describe the fate of the epithelial root sheath NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 12. Which is the most common relationship of the cementum to enamel? a. Cementum meets enamel at a definite point or junction.

b. The cementum and enamel do not meet, exposing a portion of dentin. c. The cementum overlaps enamel. d. Enamel overlaps the cementum.

ANS: C

In about 60% of the population cementum overlaps enamel. In 30% the cementum meets enamel at a sharp junction, and in the remaining 10% of the population the cementum and enamel do not meet, thus leaving exposed dentin at the cervical line.

REF: p. 265 OBJ: To describe the beginning of cementum formation, the two varieties, and where they are found NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 13. Osteoclasts can resorb bone, cementum, and dentin because their ability to resorb tissues is

not specific to any one of these tissues. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

While osteoclasts are more adept at resorbing bone, their multinucleated cellular structure enables them to also resorb cementum and dentin.

REF: p. 266 OBJ: To describe the beginningNof cementum R INGTformation, B.C Mthe two varieties, and where they are found | To briefly describe bone's reactioU n to S pressure and tenO sion and how this affects tooth movement NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones. 7. teeth.

TOP: BLOOM: Understanding 14. The outer layer of cementum is lined with cementoblasts. Cementum has limited ability to

form throughout adulthood. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

Cementoblasts are cells that produce cementum. Although cementum does not have the higher metabolic function and remodeling capabilities of bone, it does have limited ability to change in response to stress.

REF: p. 266 OBJ: To describe the beginning of cementum formation, the two varieties, and where they are found | To briefly describe bone's reaction to pressure and tension and how this affects tooth movement NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 15. By definition, alveolar bone or alveolar process is bone of the upper or lower jaw that

comprises the lamina dura for teeth. Bone originates from the mesoderm.

a. b. c. d.

Both statements are true.

The first statement is true; the second statement is false.

The first statement is false; the second statement is true.

Both statements are false.

ANS: C

Lamina dura is a radiographic term denoting the cribriform plate and bundle bone. Alveolar bone or alveolar process by definition is bone of the upper or lower jaw that comprises the sockets for teeth. Bone is mesodermal in origin.

REF: p. 267 OBJ: To define and diagram alveolar bone and its components NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones. 7. teeth.

TOP: BLOOM: Understanding 16. Which of the following indicates occlusal trauma? a. A thickened lamina dura b. A layer of spongy bone c. Pointed (or pyramidal-shaped) interproximal alveolar bone d. Sharpey’s fibers in the alveolar bone ANS: A

The lamina dura is a radiographic landmark. It typically appears as a thin radiopaque (white) line surrounding the periodontal ligament. A thickened lamina dura in one or more teeth is frequently an indication of occlusal trauma.

REF: p. 267 OBJ: To define and diagram alveolar bone and its components NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bonNes. R 7. teI eth.G B.C M TOP: BLOOM: Remembering

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17. The main fiber group for resisting occlusal stress is the a. interradicular b. apical c. horizontal d. oblique ANS: D

The oblique group of alveolodental fibers resists occlusal stress. This group runs from the cementum coronally into the alveolar bone. The remaining selections, each a component of the alveolodental fiber group, run from cementum to alveolar bone.

REF: p. 268 OBJ: To define periodontal ligament and list its various groups and subgroups of fibers NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 18. Sharpey’s fibers are part of the cementum. They are embedded in alveolar bone. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Sharpey’s fibers are the ends of the periodontal ligament and are embedded in cementum lying perpendicular to its surface.

REF: p. 268 OBJ: To define periodontal ligament and list its various groups and subgroups of fibers NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 19. The compact bone that is perforated in many places is the a. cortical plate b. cribriform plate c. bundle bone d. cancellous bone ANS: B

The cribriform plate, also called alveolar bone proper, forms the tooth socket. Like the cortical plate on the buccal or lingual surfaces, the cribriform plate is a compact bone. However, the cribriform plate has an atypical periosteum with numerous holes that allow for the passage of blood vessels.

REF: p. 267 OBJ: To define and diagram alveolar bone and its components NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones. 7. teeth.

TOP: BLOOM: Remembering 20. Bone reacts more favorably to stress than cementum because bone has a higher inorganic

content. a. Both the statement and the reason are correct and related. b. Both the statement and thN eU reR aso nN arG e co I Brr.ecCt bu Mt are NOT related.

S T O c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

Bone reacts more favorably to stress than cementum because bone has a much better blood supply and therefore a higher metabolic rate than cementum.

REF: p. 270 OBJ: To define and diagram alveolar bone and its components NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones. 7. teeth.

TOP: BLOOM: Understanding 21. When a tooth is moved orthodontically, all of the following should occur EXCEPT one.

Which one is the EXCEPTION? a. Tension on periodontal fibers b. Bone resorption c. Bone deposition d. Cementum regeneration ANS: D

During orthodontic therapy tension is placed on periodontal fibers, which causes reduced blood flow. This decrease in nutrients results in formation of osteoclasts, which resorb bone.

The process of bone remodeling also stimulates bone deposition by osteoblasts. While cementum has very limited repair processes, it does not regenerate in response to orthodontic pressures.

REF: p. 270 OBJ: To briefly describe bone's reaction to pressure and tension and how this affects tooth movement NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones. 7. teeth.

TOP: BLOOM: Remembering 22. The transseptal fibers run from the cementum into the free and attached gingival area. The

alveolodental fibers run from the cementum to the alveolar bone. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The transseptal fibers run from the cementum of the interproximal portion of one tooth, across the alveolar crest of bone, to the cementum of the interproximal portion of the adjacent tooth.

The function of the transseptal fibers is to hold teeth in interproximal contact. Note that the term transseptal literally means “across the septum.”

REF: p. 268 OBJ: To define periodontal ligament and list its various groups and subgroups of fibers NAT: CDA: GC I.A.2. IdentifyNbU asR icSoI ralNaG ndTdBen .taCl aOnMatomy, physiology and development, including but not limited to: bones. 7. teeth.

TOP: BLOOM: Understanding 23. In the two cross-sectional views of alveolar bone depicted below, structure “a” illustrates the

a. cribriform plate b. cortical plate c. spongy bone ANS: B

The cortical plate is a layer of compact bone on the buccal or lingual surface. The cribriform plate, also called the alveolar bone proper, is bone that forms the socket. Radiographically it is referred to as the lamina dura. Located between the cortical plate and the cribriform plate is a layer of spongy or cancellous bone.

REF: p. 269 OBJ: To define and diagram alveolar bone and its components NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones. 7. teeth.

TOP: BLOOM: Remembering 24. In the two cross-sectional views of alveolar bone depicted below, structure “b” illustrates the

a. cribriform plate b. spongy bone c. cortical plate ANS: A

NURSINGTB.COM

The cribriform plate, also called the alveolar bone proper, is bone that forms the socket.

Radiographically it is referred to as the lamina dura. The cortical plate is a layer of compact bone on the buccal or lingual surface. Located between the cortical plate and the cribriform plate is a layer of spongy or cancellous bone.

REF: p. 269 OBJ: To define and diagram alveolar bone and its components NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones. 7. teeth.

TOP: BLOOM: Remembering 25. In the two cross-sectional views of alveolar bone depicted below, structure “c” illustrates the

a. spongy bone b. cribriform plate c. cortical plate ANS: A

Located between the cortical plate and the cribriform plate is a layer of spongy or cancellous bone. The cribriform plate, also called the alveolar bone proper, is bone that forms the socket.

Radiographically it is referred to as the lamina dura. The cortical plate is a layer of compact bone on the buccal or lingual surface.

REF: p. 269 OBJ: To define and diagram alveolar bone and its components NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones. 7. teeth.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. Which of the following sensations can the nerves of the periodontal fibers transmit (Select all

that apply.)? a. Pain b. Heat c. Cold d. Pressure ANS: A, B, C, D

Unlike the nerves of the pulp, which can transmit only impulses of pain, the nerves of the periodontal space also have fibers that allow one to feel light touch and pressure and probably heat and cold.

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REF: p. 268 OBJ: To define periodontal ligament and list its various groups and subgroups of fibers NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 2. The organic components in cementum are (Select all that apply.) a. mucopolysaccharides b. hydroxyapatite crystals c. collagen fibers d. mineral salts e. water ANS: A, C

As in most hard substances in teeth, except for enamel, the organic component of cementum is primarily collagen fibers and mucopolysaccharides.

REF: p. 265 OBJ: To describe the beginning of cementum formation, the two varieties, and where they are found NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. Enamel pearls (Select all that apply.) a. are formed by cementocytes b. are usually found in root furcations

c. are small elevators of enamel d. dissolve after root completion e. often cause periodontal cysts ANS: B, C

Enamel pearls are small elevations of “out of place” enamel that form when retained epithelial root sheath cells become ameloblasts. They are usually found in bifurcations and trifurcations.

REF: p. 265 OBJ: To discuss the role of the epithelial root sheath in root formation and dentin formation NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering TRUE/FALSE 1. Root formation begins after the full crown has been calcified.

ANS: F

Root formation begins after the outline of the crown has been established but before the full crown is calcified.

REF: p. 264 OBJ: To discuss the role of the epithelial root sheath in root formation and dentin formation NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. The epithelial root sheath is between the dental papilla and the dental sac in early root

development.

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ANS: T

During early root formation the epithelial root sheath, also called Hertwig’s epithelial root sheath, is located between the dental papilla and the dental sac. The dental papilla is on the inside, and the dental sac is on the outside.

REF: p. 264 OBJ: To discuss the role of the epithelial root sheath in root formation and dentin formation NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. The epithelial diaphragm is parallel to the root sheath.

ANS: F

As the epithelial root sheath grows apically, its tip turns horizontally inward. This horizontally inclined turned-in portion is known as the epithelial diaphragm of the root sheath.

REF: p. 264 OBJ: To discuss the role of the epithelial root sheath in root formation and dentin formation NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. The cortical plate is typically compact bone with an atypical periosteum.

ANS: F

The periosteum (membrane covering bone) is considered typical or normal. Note that the cortical plate is composed of compact bone.

REF: p. 267 OBJ: To define and diagram alveolar bone and its components NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 5. The periodontal ligament develops from the mesodermal cells of the dental sac.

ANS: T

After cementum has begun forming the periodontal ligament develops from the middle layer of mesodermal cells of the dental sac.

REF: p. 268 OBJ: To define periodontal ligament and list its various groups and subgroups of fibers NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering

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Chapter 22: Eruption and Shedding of Teeth Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Active tooth eruption refers to the emergence of a crown into the oral cavity. This eruptive

process is usually divided into the pre-eruptive and posteruptive stages. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Active tooth eruption refers to the total life span of the tooth. There are three stages to the eruptive process: pre-eruptive, eruptive, and posteruptive.

REF: pp. 273-274 OBJ: To name the three stages of active tooth eruption and the points at which each one begins NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 2. The primary tooth is able to erupt because the gubernacular canal breaks down bone between

the tooth and the surface oral epithelium. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT coN rreUcR t, S buIt N thG eT reB as. oC nO is M correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

The gubernacular canal is formed by the gubernacular cord. With the help of macrophages and osteoclasts these structures enable the erupting tooth to move through bone and erupt into the oral cavity.

REF: pp. 273-274 OBJ: To name some of the forces in tooth eruption and which ones most likely have the greatest influence NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 3. Tooth eruption is dependent on the dental sac because this structure plays a role in the

formation of cementum, the periodontal ligament, and alveolar bone. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Tooth eruption, as well as alveolar bone growth and tooth development, is dependent on the ability of bone to form and resorb. These metabolic activities are very much dependent on the presence of the dental sac or dental follicle. The same mechanisms influence development of the periodontal ligament and cementum.

REF: p. 275 OBJ: To name some of the forces in tooth eruption and which ones most likely have the greatest influence NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 4. Vascular pressures in the periodontium seem to disrupt eruption because the pulsating blood

pressures interfere with cellular activity. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

It is thought that vascular pressures within the periodontium enhance cellular activity and positively influence tooth eruption. There is agreement that the “shock absorber” function of the periodontal ligament is a result of these vascular forces.

REF: p. 275 OBJ: To name some of the forces in tooth eruption and which ones most likely have the greatest influence NAT: CDA: GC I.A.7. IdentifyNbas ntaCl an URicSoIralNaGnd TdBe. OMatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 5. An ankylosed deciduous tooth will prevent the eruption of a permanent tooth because the

alveolar crest of bone fuses in the cervical area with dentin of a resorbing root. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

It is the cementum of the deciduous tooth that fuses with the cervical alveolar bone crest.

REF: p. 276 OBJ: To list and describe the factors that lead to a retained primary tooth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 6. In the pre-eruptive stage, all of the following occur EXCEPT one. Which one is the

EXCEPTION? a. Asymmetrical crown growth b. Slight crown movement c. Early root formation d. Filling in of tooth socket with bone

ANS: C

Root formation does not occur until the eruptive stage. This stage is also called the prefunctional eruptive stage. It begins with the development of the root.

REF: p. 273 OBJ: To name the three stages of active tooth eruption and the points at which each one begins NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 7. During the eruptive stage the reduced enamel epithelium fuses with the dental follicle to

create an eruptive force. The eruptive stage continues until the erupting teeth meet the opposing arch. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The reduced enamel epithelium fuses with the oral epithelium and forms one layer, the united oral epithelium. The tooth breaks through this layer and emerges into the oral cavity.

REF: p. 273 OBJ: To name the three stages of active tooth eruption and the points at which each one begins NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 8. Each of the following has a role in tooth eruption EXCEPT for one. Which one is the

EXCEPTION? NURSINGTB.COM a. Root elongation b. Periodontal ligament c. Vascular pressures d. Alveolar bone e. All have a role in tooth eruption.

ANS: E

All are closely interrelated and have a role in tooth eruption.

REF: pp. 274-275 OBJ: To name some of the forces in tooth eruption and which ones most likely have the greatest influence NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 9. Supraeruption is a. complete eruption b. the last phase of the posteruptive stage c. a tooth with an unusually long crown or root d. a tooth that erupts beyond the occlusal plane ANS: D

Supraeruption, also called hyper eruption, occurs if an opposing tooth is lost and the tooth continues to erupt. This can cause serious occlusal disharmony and restorative problems.

REF: p. 274 OBJ: To name some of the forces in tooth eruption and which ones most likely have the greatest influence NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 10. Supraeruption can cause serious problems in the replacement of the missing tooth because it

makes it difficult to reestablish the normal occlusal plane. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Supraeruption, also called hypereruption, occurs when an opposing tooth is lost and the tooth continues to erupt beyond the occlusal plane. Note that this can occur at any phase of life and has serious occlusal and restorative implications.

REF: p. 274 OBJ: To name some of the forces in tooth eruption and which ones most likely have the greatest influence NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 11. During the pre-eruptive stage bone is in a U-shaped crypt. When the root forms, osteoclasts

may deepen the crypt.

N R I G B.COM a. Both statements are true. U S N T b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Root formation occurs in the eruptive stage. During this stage osteoclasts may temporarily deepen the bony crypt by resorbing bone at the bottom to accommodate for the increase in root length.

REF: pp. 273-274 OBJ: To name the three stages of active tooth eruption and the points at which each one begins NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 12. The eruptive movement that pushes the crown of the tooth directly toward the surface is called

eccentric movement. Eccentric movement occurs during the eruptive stage. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The eruptive movement that pushes the crown directly toward the surface is called spatial movement. During spatial movement, the bottom of the socket fills with bone. Both spatial movement and eccentric movement occur during the pre-eruptive stage. Eccentric movement is characterized by growth of the crown in an off-centered pattern.

REF: p. 273 OBJ: To name the three stages of active tooth eruption and the points at which each one begins NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 13. In eccentric growth the crown of a tooth grows in a perfectly symmetrical pattern because all

areas grow proportionately as the crown enlarges. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Eccentric growth is also called off-center growth because it is characterized by an asymmetrical growth pattern. As the crown enlarges, it grows more in one area than in another. Asymmetrical growth causes the center point of the crown to shift so the tooth appears to have moved.

REF: p. 273 OBJ: To name the three stages of active tooth eruption and the points at which each one begins NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeN thU . RSINGTT OB P:.BL COOMOM: Understanding 14. As the permanent teeth become surrounded by bone, the successional lamina forms small

openings in the alveolar bone, known as a. pre-eruptive foramina b. successional lamina buds c. gubernacular canals d. bony crypt grooves ANS: C

The successional lamina, which buds off the dental lamina and forms permanent teeth, is characterized by small openings in bone called gubernacular canals. Under normal conditions the erupting permanent tooth follows the pathway of the gubernacular canals to reach the surface.

REF: pp. 273-274 OBJ: To discuss the fate of the epithelial layers covering the crown of the tooth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 15. The successional lamina is seen only facial/buccal to the anterior primary teeth because the

permanent anteriors erupt slightly lingual to their primary counterparts, while the permanent posterior teeth lie below the primary and erupt through their established alveolus. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related.

c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

The successional lamina is seen only lingual to the anterior primary teeth. Therefore, it is logical that the permanent anteriors erupt slightly lingual to their primary counterparts. Also note that permanent posterior teeth form posterior to the dental lamina.

REF: pp. 273-274 OBJ: To diagram or describe the origin and position of the permanent teeth as compared with the deciduous teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 16. A fully formed impacted third molar is technically in the posteruptive stage because the roots

are formed and this tooth would erupt if not impeded by another tooth. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: B

While it is true that this tooth would erupt if not impeded by another tooth, a fully formed impacted third molar is not in the posteruptive stage. This stage is defined by teeth coming into occlusion. Such a tooth is in the eruptive stage because the root is formed. The beginning of root formation defines theNeruR ptivI e staGge.B.C M

U S N T

O

REF: p. 274 OBJ: To name the three stages of active tooth eruption and the points at which each one begins NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 17. Deciduous ankylosis occurs when a. cementum is fused to the alveolar bone b. deciduous roots are fused to the permanent tooth crown c. deciduous roots are intertwined, twisted, or fused d. there is no permanent tooth to cause deciduous root resorption ANS: A

Ankylosis is defined by fusion of the alveolar crest in the cervical area with the cementum of a resorbing root. Typically, most of the primary root has resorbed, yet the tooth remains firmly in place. This prevents the permanent tooth below from erupting.

REF: p. 276 OBJ: To list and describe the factors that lead to a retained primary tooth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 18. It is possible for a child to have a deciduous tooth and its permanent counterpart at the same

time. This can occur when the permanent teeth erupt. a. Both statements are true.

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

ANS: B

The presence of a deciduous and permanent tooth at the same time occurs when the permanent tooth does not erupt in its normal position. This irregular development prevents resorption of the primary tooth root or roots. This is frequently seen in the anterior mandibular area where the permanent teeth erupt apically, rather than apically and labially.

REF: p. 276 OBJ: To discuss briefly what causes the shedding of primary teeth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 19. Which structure acts as a “shock absorber” during the eruption process? a. Alveolar bone b. Dental pulp c. Cementum d. Periodontal ligament e. All of the above ANS: D

There is reasonable agreement that the vascular pressures within the periodontal ligament support its function as a “shock absorber.”

REF: p. 275 OBJ: To name some of the forces in tooth eruption and which ones most likely have the greatest influence NURSINGTB.COM NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 20. Each of the following typically occurs with retained root tips EXCEPT one. Which one is the

EXCEPTION? a. Cyst formation b. Root tip resorption c. Root tip eruption d. Misaligned teeth ANS: A

Cyst formation is not associated with retained root tips. Root tips are often retained because malalignment of either primary or permanent teeth permits resorption of cervical areas yet prevents resorption of the root tips. The root fragments may remain for some time and eventually work their way to the surface.

REF: p. 277 OBJ: To list and describe the factors that lead to a retained primary tooth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 21. All of the following are characteristic of the posteruptive stage EXCEPT one. Which one is

the EXCEPTION? a. Root development b. Occlusal wear

c. Mesial drift d. Supraeruption ANS: A

Root development occurs during the eruptive stage. Because the posteruptive stage continues until teeth are lost or death occurs, occlusal wear due to prolonged masticatory stress and wear is common. Mesial drift, a physiologic phenomenon, is inherent to teeth. Supraeruption, also called hyper eruption, occurs when an opposing tooth is lost and the remaining tooth “searches” for its antagonist by continuing to erupt.

REF: p. 274 OBJ: To name the three stages of active tooth eruption and the points at which each one begins NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 22. The united epithelium is broken down by enzymatic action of Hertwig’s root sheath. Upon

breakdown of this epithelium the tooth emerges into the oral cavity. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

It is believed that the united epithelium is broken down by enzymatic action of the reduced enamel epithelium. The united epithelium is formed when the reduced enamel epithelium fuses with the oral epithelium. Hertwig’s root sheath is a key component to root development.

REF: p. 273 NURSINGTB.COM OBJ: To discuss the fate of the epithelial layers covering the crown of the tooth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Understanding 23. If a root is damaged during formation, which of the following would occur? a. Tooth eruption ceases. b. Tooth eruption continues. c. Root decay d. Ankylosis ANS: B

Extensive research has documented that developmental root damage does not prevent eruption. Root decay does not occur during the formative stage, nor does the root stop erupting due to formative root damage. Ankylosis prevents eruption of a permanent tooth due to fusion of cervical crestal alveolar bone with the cementum of a primary tooth.

REF: p. 274 OBJ: To name some of the forces in tooth eruption and which ones most likely have the greatest influence NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering MULTIPLE RESPONSE

1. Which of the following are necessary for the tooth eruption to occur (Select all that apply.)? a. The presence of the outer layers of enamel organ b. Osteoclastic activity c. The rhythmic cycle of bone development d. The absence of the dental sac e. The presence of the dental follicle ANS: A, B, C, D

The presence of the outer layers of enamel organ as well as osteoclastic activity is essential for the crown to erupt through soft tissue and bone. The cycle of bone development involves both osteoclasts that break down bone and osteoblasts that form bone. The presence of the dental sac, also called the dental follicle, is a key element of tooth eruption.

REF: pp. 273-275 OBJ: To name some of the forces in tooth eruption and which ones most likely have the greatest influence NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering TRUE/FALSE 1. In spatial movement, the crown develops while the tooth socket fills in with bone.

ANS: T

During spatial movement, the developing bone in the bottom of the socket pushes the crown toward the surface.

NURSINGTB.COM REF: p. 273 OBJ: To name the three stages of active tooth eruption and the points at which each one begins NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 2. The reduced enamel epithelium and the oral epithelium fuse into the united oral epithelium.

ANS: T

During the eruptive phase, the reduced enamel epithelium contacts the oral epithelium and these two layers fuse into the united oral epithelium. The tooth breaks through this layer and emerges into the oral cavity.

REF: p. 273 OBJ: To discuss the fate of the epithelial layers covering the crown of the tooth NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 3. The direction of tooth eruption is facial and apical.

ANS: F

For both the primary and secondary dentition, tooth movement in the eruptive stage tends to be occlusal and facial, more facial in the anteriors than in the posteriors.

REF: p. 273

OBJ: To name the three stages of active tooth eruption and the points at which each one begins NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 4. If Hertwig’s root sheath is destroyed the tooth will not erupt.

ANS: F

Hertwig’s root sheath influences root development; however research documents that teeth continue to erupt when this sheath is destroyed. This disproves the theory that the increase in root length is solely responsible for forcing the tooth into the oral cavity.

REF: p. 274 OBJ: To name some of the forces in tooth eruption and which ones most likely have the greatest influence NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering 5. Root elongation is the main factor in the tooth’s eruption into the oral cavity.

ANS: F

Root elongation or root length has been credited with forcing the tooth into the oral cavity.

However, experiments with alterations to Herwig’s root sheath have demonstrated teeth still erupt even after root growth has been stopped. So, while root elongation remains a factor, it is not the main factor.

REF: p. 274 OBJ: To name some of the forces in tooth eruption and which ones most likely have the greatest influence NURSINGTB.COM NAT: CDA: GC I.A.7. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: teeth.

TOP: BLOOM: Remembering

Chapter 23: Oral Mucous Membrane Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Lining mucosa that extends beyond the area of the tonsils is called the oral mucous

membrane. Lining mucosa is composed of stratified squamous epithelium. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Oral mucosa, also called oral mucous membrane, is the lining of the oral cavity. Its most posterior extension is the area of the tonsils.

REF: p. 278 OBJ: To name the three categories of mucosa and discuss where they are found NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 2. Masticatory mucosa is able to withstand trauma or compression during mastication because its

surface lacks keratin, an especially vulnerable surface covering. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT coN rreUcR t, S buIt N thG eT reB as. oC nO is M correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

Masticatory tissue withstands trauma and compression due to its protective keratinized or parakeratinized surface covering. Keratinized surfaces contain layers of dead cells; this layer is generally called the stratum corneum. Parakeratinized surfaces contain some dead cells and some that are dying. Note that dead cells do not contain nuclei.

REF: p. 278 OBJ: To name the three categories of mucosa and discuss where they are found NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 3. In attached gingiva, the junction of the epithelium and the connective tissue are tightly bound

because ridges and pegs of connective tissue project up into the epithelium. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

The manner in which epithelium and its connective tissue interdigitate determines how movable a type of tissue is. Attached gingiva is tightly attached to underlying connective tissue by ridges and pegs, which project from the connective tissue into the epithelial layer.

Note that attached gingiva is also tightly attached to underlying bone by similar mechanisms.

REF: p. 278 | p. 282 OBJ: To name the three categories of mucosa and discuss where they are found NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 4. Lack of stippling in the alveolar mucosa is due to epithelium that is not attached tightly to

bone. This is initially caused by increased interdigitation between connective tissue and surface epithelium. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Lack of stippling is initially caused by swelling or edema of the gingival tissues.

Interdigitation between connective tissue and surface epithelium affects the degree of attachment of epithelial surfaces to underlying connective tissue.

REF: p. 278 | p. 281 OBJ: To name the three categories of mucosa and discuss where they are found NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding

NURSINGTB.COM

5. Each of the following accurately describes submucosa EXCEPT one. Which one is the

EXCEPTION? a. It is the connective tissue beneath the mucosa. b. It contains blood vessels, nerves, and connective tissue. c. It helps determine the mobility of the mucosa d. The anteromedial portion of the hard palate contains extensive submucosa. e. It tends to contain fatty tissue, minor salivary glands, or both.

ANS: D

The anteromedial portion of the hard palate contains very little, if any, submucosa. This is also true of the surrounding gingiva. In such areas, the mucosa is tightly attached to the periosteum of the underlying bone. Submucosa helps determine the mobility of the mucosa by the length of its connective tissue ridges and pegs.

REF: p. 282 OBJ: To understand what the submucosa is and where it is found NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 6. Healthy oral mucosa often appears white because underlying nutritive collagen fibers reflect

through the thin mucosal epithelium. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct.

d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Healthy oral mucosa appears red because pigments from hemoglobin are carried to the surface. White areas in mucosal surfaces generally result from irritation. This causes increased cellular turnover and thicker epithelium, a condition similar to a callus. Collagen fibers are more abundant in connective tissue than in mucosa.

REF: p. 283 OBJ: To describe some of the changes seen in diseased gingiva NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 7. Each of the following structures is covered in masticatory mucosa EXCEPT one. Which one

is the EXCEPTION? a. Hard palate b. Soft palate c. Maxillary labial gingiva d. Mandibular lingual gingiva ANS: B

The soft palate is covered in masticatory mucosa.

REF: p. 278 OBJ: To name the three categories of mucosa and discuss where they are found NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering

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8. Each of the following is an indU icatS or oN f giT ngival oO r periodontal disease EXCEPT one. Which

one is the EXCEPTION? a. A sulcus depth of 2 mm b. Bleeding from the interdental papilla c. Loss of stippling d. Keratinization of the col ANS: A

A sulcus depth of 2 mm is considered healthy. The sulcus is the very shallow soft tissue groove immediately surrounding the cervical area of the tooth. Bleeding from the interdental papilla as well as loss of stippling is indicator of disease. The col, an inner portion of the interdental papilla, is nonkeratinized but may become keratinized from trauma.

REF: p. 280 OBJ: To describe some of the changes seen in diseased gingiva NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 9. The col is the part of the interdental papilla that a. is generally keratinized b. surrounds the tooth interproximally c. is apical to the contact area d. is part of the facial free gingiva e. the col is not part of the interdental papilla

ANS: C

The part of the interdental papilla that is apical to the contact area and connects the facial and lingual interdental papilla is known as the col. This is nonkeratinized.

REF: p. 278 OBJ: To name the three stages of keratinization of oral mucous membrane and discuss where these different types are found NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 10. Which gingival structure is located closest to the alveolar mucosa? a. Sulcular gingiva b. Free gingiva c. Attached gingiva d. Free gingival groove e. B and D ANS: C

The attached gingiva lies immediately coronal to the alveolar mucosa. The mucogingival junction demarcates these to structures. While the attached gingiva is pink in color, the alveolar mucosa is reddened by the underlying blood vessels and thinness of the mucosal epithelium. The alveolar mucosa is further distinguished by its lack of stippling and movable tissue.

REF: p. 281 OBJ: To describe the typical picture of normal gingiva NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering

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11.1 The attached gingiva is less movable than the adjacent alveolar mucosa because the attached 1 gingiva is loosely attached to its underlying connective tissue. . a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The attached gingiva is tightly connected to its underlying connective tissue and bone, which makes it less movable than the alveolar mucosa. By contrast, the alveolar mucosa is lightly connected to underlying connective tissue.

REF: p. 278 OBJ: To discuss the factors that affect the mobility of various types of mucosa NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 12. The length of connective tissue ridges and pegs that project into surface epithelium determines

how movable the epithelium is. The connective tissue is attached to underlying bone in all areas. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

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ANS: B

Connective tissue is attached to underlying bone in some areas or to fatty or muscle tissue in other areas. Movability of tissue is determined by the length of the connective tissue ridges and pegs that extend into epithelium.

REF: p. 278 OBJ: To discuss the factors that affect the mobility of various types of mucosa NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 13. Healthy gingiva is usually a. smooth b. glossy c. slightly blunted d. stippled e. All of the above ANS: D

Gingival tissue that is smooth is lacking the characteristically stippled, or dimpled, appearance. Stippling, caused by connective tissue fibers that attach epithelium to underlying bone, is a sign of health. Glossy gingival tissues indicate the presence of inflammation-manifested swelling and edema. Blunted papillae are a sign of disease or trauma.

REF: pp. 280-281 OBJ: To describe the typical clinical picture of normal gingiva NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering

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Ochewing by becoming thick and 14. The mucosa that responds to coUnstS ant N trauT ma from keratinized in a line corresponding to the occlusal surfaces of teeth is the a. buccal b. tongue c. lip d. soft palate ANS: A

The buccal mucosa, the mucosa of the cheek, is covered with lining mucosa that is highly movable and nonkeratinized. Constant trauma from chewing food or cheek biting will cause tissue changes typical of whitish lesions but is usually harmless.

REF: p. 281 OBJ: To name the three stages of keratinization of oral mucous membrane and discuss where these different types are found NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 15. Sleep apnea is caused by inadequate connective tissue of the hard palate. This condition

causes patients to experience deep sleep, but for very limited periods of time. a. b. c. d.

Both statements are true.

The first statement is true; the second statement is false.

The first statement is false; the second statement is true.

Both statements are false.

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ANS: D

Sleep apnea is caused by excess connective tissue of the soft palate. It not only causes snoring but prevents deep sleep because breathing stops for more than 20 seconds several times per hour.

REF: p. 282 OBJ: To describe some of the changes seen in diseased gingiva NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 16. In the maxillary arch, the lingual gingiva changes to alveolar mucosa, as it does in the

mandibular arch. Palatal mucosa is thick and keratinized. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

In the maxillary arch, the lingual gingiva does not change into alveolar mucosa but is directly continuous with the masticatory mucosa of the hard palate. This palatal mucosa is generally the thickest in the oral cavity and the most likely to be keratinized.

REF: pp. 278-279 OBJ: To name the three categories of mucosa and discuss where they are found NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 17. In which stage of passive eruption is the attached epithelium located on the cementum apical

to the CEJ? a. Stage I b. Stage II c. Stage III d. Stage IV

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ANS: D

In stage IV passive eruption the attachment epithelium is located entirely on the cementum apical to the CEJ. This condition, frequently referred to as gingival recession, is considered by some to be pathologic.

REF: p. 282 OBJ: To describe the four stages of passive eruption NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 18. During passive eruption the attachment epithelium moves from the crown of the tooth in an

apical direction. As the tooth breaks through the oral cavity the attachment epithelium is formed from the basement membrane. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The attachment epithelium is formed from the reduced enamel epithelium. The basement membrane separates the basal layer of cells from underlying connective tissue.

REF: p. 280 | p. 282 OBJ: To describe the four stages of passive eruption NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 19. Which lesion or condition contains thickened layers of stratum spinosum and stratum

corneum? a. White lesions b. Red lesions c. Mucocele d. Gingival inflammation ANS: A

Whitish lesions represent irritated tissues in which increased cellular multiplication has caused thickening. This mechanism is much like the formation of a callus. Histologically, mucosal layers that are thickened and whitish are the stratum spinosum and the stratum corneum. Such tissue changes represent keratinization.

REF: p. 281 OBJ: To describe some of the changes seen in diseased gingiva NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 20. Epithelial cells are generally pink in color because they reflect the surrounding gingival

tissues. a. Both the statement and the reason are correct and related. b. Both the statement and thN eU reR asSoI nN arG eT coB rr. ecC tO buMt are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Epithelial cells themselves have no color, but they may take up pigments produced by the body, carry them to the skin, and impart different hues of color to the skin. This is a different mechanism than reflecting the color of surrounding gingival tissues. Also note, thin transparent tissues such as alveolar mucosa look red because extensive blood vessels lie immediately below.

REF: p. 282 OBJ: To describe the typical clinical picture of normal gingiva NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding MULTIPLE RESPONSE 1. As keratinization increases, which of the following tend to increase (Select all that apply.)? a. Stratum corneum b. Stratum granulosum c. Stratum spinosum d. Nuclei

ANS: A, B, C

On the surface lining of the oral epithelium (stratified squamous) are layers of dead cells without nuclei called keratin. Three layers, the stratum corneum, the stratum granulosum, and the stratum spinosum, increase in thickness as keratinization increases.

REF: p. 278 OBJ: To name the three stages of keratinization of oral mucous membrane and discuss where these different types are found NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 2. Which of the following structures is covered with lining mucosa (Select all that apply.)? a. Mucosa of the cheeks b. Mucosa of the soft palate c. Floor of the mouth d. Col e. Alveolar mucosa f. Attached gingiva ANS: A, B, C, F

The col, which is part of the gingiva, as well as all aspects of the gingiva are covered in masticatory mucosa. Other structures covered with lining mucosa include the undersurface (ventral) surface of the tongue and the mucosa of the lips.

REF: p. 278 OBJ: To name the three categories of mucosa and discuss where they are found NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oraN l cav P:.B Rity.I GTOB CLOMOM: Remembering

U S N T

O

3. Which of the following accurately describe the gingival sulcus (Select all that apply.)? a. The average depth is about 2 mm. b. It is lined with stratified squamous epithelium. c. The attachment epithelium is located at the apical portion of the sulcus. d. The free gingival groove is always visibly apparent. e. The lining epithelium is keratinized.

ANS: A, B, C

The free gingival groove is often present but not always. The epithelium lining the sulcus is nonkeratinized. Also note, the attachment epithelium is also called the junctional epithelium.

REF: p. 280 OBJ: To describe the typical clinical picture of normal gingiva NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 4. Which term can be used to describe the epithelium that lines the sulcus (Select all that

apply.)? a. Sulcular b. Junctional c. Attachment d. Stratified squamous e. Keratinized

ANS: A, B, C, D

Sulcular epithelium describes the sulcus lining in health. The stratified squamous epithelium that lines the sulcus is nonkeratinized. The bottom of the sulcus is continuous with cells that attach to the tooth, known as the attachment epithelium or junctional epithelium.

REF: p. 280 OBJ: To describe the typical clinical picture of normal gingiva NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering TRUE/FALSE 1. Stratified squamous epithelium is keratinized.

ANS: F

Depending on its location stratified squamous epithelium can have various surface characteristics. It can be keratinized, parakeratinized, or nonkeratinized.

REF: p. 278 OBJ: To name the three stages of keratinization of oral mucous membrane and discuss where these different types are found NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 2. The interdental papilla is made up of both free and attached gingiva.

ANS: T

The free gingiva (marginal gingiva) and the attached gingiva combine to form interdental B.CtO Mextends coronally between the teeth. papilla. This structure forms N thU eR peS akIoNfGgT ingiva hat REF: p. 278 OBJ: To name the three categories of mucosa and discuss where they are found NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 3. A mucocele is a typical sebaceous gland found in the buccal mucosa.

ANS: F

A mucocele is a lesion usually found on the lip. Mucoceles are blister like and are usually caused by trauma to a minor salivary gland.

REF: p. 281 OBJ: To describe some of the changes seen in diseased gingiva NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 4. The redness of the oral mucosa is due to pigments in hemoglobin.

ANS: T

Epithelial cells have no color, but they can take up pigments produced by the body and carry them to the surface. The redness of mucosa is due to oxygen-carrying pigment in blood, known as hemoglobin.

REF: p. 282 OBJ: To describe the typical clinical picture of normal gingiva NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 5. Basement membrane appears as ridges and pegs projecting from connective tissue into its

surface epithelium.

ANS: F

Interdigitation is the term used to describe the connections between ridges and pegs from the connective tissue with surface epithelium. The basement membrane lies between the basal layer of cells and the underlying connective tissue.

REF: p. 278 OBJ: To name the three stages of keratinization of oral mucous membrane and discuss where these different types are found NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering

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Chapter 24: The Tongue Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The tongue develops from a swelling that arises out of the anterior portion of the pharyngeal

arches. This swelling develops from the future floor of the mouth. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The tongue develops from a swelling that arises out of the back part of the pharyngeal arches.

This occurs at about weeks.

REF: p. 284 OBJ: To describe the formation of the tongue as it relates to the germ layers and its pharyngeal arches of origin NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 2. The circumvallate papillae anatomically divide the anterior two-thirds of the palate from the

posterior one-third because they are positioned about two-thirds of the way back on the tongue. a. Both the statement and the reason are correct and related.

N reas RSonIN G correct B.CO M b. Both the statement and the U are T but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

The circumvallate papillae, also called the vallate papillae, divide the anterior two-thirds of the tongue from the posterior one-third. The group of 13 elevated and circular papillae are arranged in the shape of a V with the point of the V facing posteriorly.

REF: p. 285 OBJ: To describe the papillae of the tongue and their function NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 3. The tongue is an epithelial sac filled with muscle, connective tissue, and fat. Muscle

component is categorized as voluntary striated muscle. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The tongue does not contain fat. It is composed of muscle and connective tissues. Muscles can be controlled willfully and are generally referred to as skeletal muscle or voluntary striated muscle.

REF: p. 284 OBJ: To discuss the difference between extrinsic and intrinsic muscles of the tongue NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 4. The genioglossus muscle is considered extrinsic because it starts and ends wholly in the

tongue. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

Extrinsic muscles originate outside the tongue and run into it. The genioglossus muscle originates in the superior genial tubercle of the mandible and inserts into the midline of the tongue from the tip to the base. By contrast, muscles that start and end wholly in the tongue are called intrinsic.

REF: p. 284 OBJ: To discuss the difference between extrinsic and intrinsic muscles of the tongue NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding

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5. Muscles that elevate the posterior part of the tongue and pull it slightly backward are

categorized as a. superior longitudinal b. inferior longitudinal c. transverse d. genioglossus e. palatoglossus ANS: E

The palatoglossus pair of muscles, extrinsic in origin, elevates the posterior part of the tongue and pulls it slightly backward. The superior longitudinal, inferior longitudinal, and transverse groups are all intrinsic in origin. Both the superior longitudinal and the inferior longitudinal run from anterior to posterior within the tongue; the transverse group runs from side to side.

REF: p. 285 OBJ: To discuss the difference between extrinsic and intrinsic muscles of the tongue NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 6. The ventral surface of the tongue is keratinized. The dorsum of the tongue has thick

parakeratinized to keratinized epithelium. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true.

d. Both statements are false.

ANS: C

The underside of the tongue, referred to as the ventral surface, has very thin nonkeratinized epithelium. The uppermost surface, known as the dorsum of the tongue, can withstand more trauma because it is thick and parakeratinized to keratinized.

REF: p. 285 OBJ: To describe the papillae of the tongue and their function NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 7. Redness and enlarged tissue near the midline and just behind the vallate papillae may indicate

infection because this is the location of the lingual tonsil. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

The lingual tonsil, like the palatine tonsil, is lymphoid tissue that filters infectious material.

Redness and swelling in this area is a clinical indicator of potential problems.

REF: p. 287 OBJ: To describe the kinds of changes seen on the tongue that indicate health problems NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding

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8. Each of the following is involvU ed iS n thN e foT rmationOof the tongue EXCEPT one. Which one is

the EXCEPTION? a. Ectoderm b. Entoderm c. Mesoderm d. Odontoblast ANS: D

Odontoblasts are the cells that produce dentin. The epithelial covering of the tongue develops from ectoderm and entoderm. Muscles of the tongue arise from the middle germ layer, the mesoderm.

REF: p. 284 OBJ: To describe the formation of the tongue as it relates to the germ layers and its pharyngeal arches of origin NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 9. The anterior two-thirds of the tongue is covered with ectoderm-derived epithelium. This

portion of the tongue originates from the copula of the third arch. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The anterior two-thirds of the tongue develops from two lateral lingual swellings and a midline tuberculum impar. It is the posterior one-third that develops from the copula and the third arch.

REF: p. 284 OBJ: To describe the formation of the tongue as it relates to the germ layers and its pharyngeal arches of origin NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 10. Which of the following is a muscle that originates from an outside structure but inserts into

the tongue? a. Hyoglossus b. Genial tubercles c. Vertical group d. Circumvallate ANS: A

The hyoglossus, an extrinsic muscle, originates from outside the tongue but runs, or inserts, into it. By contrast, intrinsic muscles such as the vertical group of the tongue, start and end wholly in the tongue. Genial tubercles are small bony structures within the mandible.

Circumvallate papillae are located on the dorsum of the tongue.

REF: pp. 284-285 OBJ: To discuss the difference between extrinsic and intrinsic muscles of the tongue NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, NUles.

RSINGTTOP: B.C M Remembering including but not limited to: musc BLOOOM: 11. Which muscle group runs anterior to posterior and lies near the ventral surface of the tongue? a. Superior longitudinal group b. Inferior longitudinal group c. Transverse group d. Vertical group ANS: B

Both the inferior longitudinal and superior longitudinal muscle groups run anterior to posterior, however the inferior lies near the ventral (underside) surface of the tongue. Not surprisingly, the superior group is located on the top, or dorsal, surface of the tongue. The transverse group runs from side to side; the vertical group runs from top to bottom (dorsal to ventral). These four muscle groups are intrinsic in origin because they start and end wholly within the tongue.

REF: p. 284 OBJ: To discuss the difference between extrinsic and intrinsic muscles of the tongue NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 12. The genioglossus pair of muscles aids in each of the tongue actions EXCEPT one. Which one

is the EXCEPTION? a. Protrusion

b. Retrusion c. Elevation d. Depression ANS: C

Elevation of the tongue is accomplished by the palatoglossus pair of muscles. These extrinsic muscles run from the anterior soft palate down and slightly forward into the lateral borders of the tongue.

REF: p. 285 OBJ: To describe briefly how tongue movement is accomplished NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 13. Contraction of the longitudinal muscles lengthens the tongue because this muscle group is

longest in length. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Contraction of the longitudinal muscles shortens the tongue. This occurs because the longitudinal muscles, both superior and inferior, run anterior to posterior within the tongue.

Note that shortening the tongue makes it wider and thicker.

REF: p. 284 OBJ: To describe briefly how tongue movement is accomplished NAT: CDA: GC I.A.4. IdentifyNbasR ntaCl anM physiology, and development, U icSoIralNaGnd TdBe. Oatomy,Understanding including but not limited to: muscles.

TOP: BLOOM: 14. Contraction of the vertical group of fibers causes the tongue to become longer and wider

because this muscle group runs from side to side. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: B

The vertical group of fibers runs from top to bottom, which is more accurately described as from the dorsal surface of the tongue to the ventral surface. Muscles that run from side to side are the transverse.

REF: p. 284 OBJ: To describe briefly how tongue movement is accomplished NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 15. How many elevations of circular raised papillae are located about two-thirds of the way back

on the dorsal surface of the tongue? a. 6 b. 9 c. 13

d. 20 ANS: C

There are about 13 circumvallate, also called vallate, papillae located about two-thirds of the way back on the top surface (dorsal) of the tongue. These circular elevations are arranged in a V shape, with the point of the V pointing posteriorly.

REF: p. 285 OBJ: To describe the papillae of the tongue and their function NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 16. The circumvallate papillae are also referred to filiform. The fungiform and vallate papillae are

located on the ventral surface of the tongue. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The circumvallate papillae are also referred to as the vallate papillae. This group of papillae are located on the posterior portion of the tongue. The fungiform papillae are tiny round raised spots on the anterior two-thirds of the tongue. Their color is redder in younger people.

REF: pp. 285-286 OBJ: To describe the papillae of the tongue and their function NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 17. When the transverse fiber group overextends, a condition called hairy tongue can result

N R I G B.C M

UenSts bN Te trapO because food and bacterial pigm ecom ped between the papillae. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Hairy tongue can occur if the papillae of the tongue elongate. This enables food, debris, and pigments to become trapped between the distended or elongated papillae.

REF: p. 287 OBJ: To describe the kinds of changes seen on the tongue that indicate health problems NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 18. Foliate papillae are located on which portion of the tongue? a. Anterior portion b. Posterior portion c. Ventral surface d. Posterior lateral borders ANS: D

In humans, the foliate papillae are not as well developed nor do they contain as many taste buds as in lower forms of animals.

REF: p. 287 OBJ: To describe the papillae of the tongue and their function NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 19. The area near the midline on the dorsum of the tongue, behind the vallate papillae, is known

as the a. lingual tonsils b. palatine tonsils c. circumvallate papillae d. dorsum ANS: A

Similar to the palatine tonsils, the lingual tonsils are lymphoid tissue and provide a defense mechanism against infection. Note that the vallate papillae are also called the circumvallate papilla and consist of approximately 13 round, raised papilla in a V-shaped configuration.

REF: p. 287 OBJ: To describe the papillae of the tongue and their function NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 20. The root of the tongue and the epiglottis develop from the copula. The arch of origin is the

fourth pharyngeal. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is falsN CeOnMt is true. e;UthReSseIcN onGdTsB tat. em d. Both statements are false.

ANS: C

The root of the tongue and the epiglottis develop from the epiglottal swelling, which is derived from the fourth pharyngeal arch. Note that the posterior of the tongue develops from the copula and the third arch.

REF: p. 284 OBJ: To describe the formation of the tongue as it relates to the germ layers and its pharyngeal arches of origin NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 21. The area MOST likely to develop undetected oral cancer is the a. fungiform papillae b. circumvallate papilla c. posterior lateral borders of the tongue d. ventral surface of the tongue ANS: C

The posterior lateral border of the tongue near the foliate papillae can become red and irritated. Because it is difficult to see, oral cancer can be obscured and overlooked within the folds of tissue.

REF: p. 287 OBJ: To describe the kinds of changes seen on the tongue that indicate health problems NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 22. The tongue begins to develop in the embryo, shortly after the buccopharyngeal membrane

ruptures. This event occurs at about weeks. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

At about weeks the buccopharyngeal membrane ruptures. At this point the tongue begins to develop as a swelling arising from the back part of the pharyngeal arches. This swelling develops from the future floor of the mouth.

REF: p. 284 OBJ: To describe the formation of the tongue as it relates to the germ layers and its pharyngeal arches of origin NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 23. The tongue muscles that run from side to side are from which group of muscles? a. Vertical b. Transverse c. Superior longitudinal NURSINGTB.COM d. Inferior longitudinal ANS: B

The transverse muscle group runs from side to side. Contraction of the transverse muscles may make the tongue become a little thicker and longer. This muscle group is considered intrinsic because it originates and ends wholly within the tongue.

REF: p. 284 OBJ: To discuss the difference between extrinsic and intrinsic muscles of the tongue NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 24. Microscopically the papillae that appear to rest in troughs and have many tiny taste buds are a. fungiform b. filiforma c. foliate d. circumvallate ANS: D

The circumvallate papillae, also called the vallate papillae, appear to rest in troughs and are surrounded by taste buds. Small salivary glands, the glands of von Ebner, surround and wash the taste buds.

REF: pp. 285-286 OBJ: To describe the papillae of the tongue and their function NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development,

including but not limited to: oral cavity.

TOP: BLOOM: Remembering

MULTIPLE RESPONSE 1. Which of the following have taste buds (Select all that apply.)? a. Foliate b. Filiform c. Fungiform d. Circumvallate ANS: A, C, D

The filiform papillae do not have taste buds. These papillae are tiny projections of parakeratinized to keratinized epithelium that probably only provide tactile sensation or the ability to know that something is on the tongue. Interestingly, the filiform papillae are well developed in cats.

REF: pp. 286-287 OBJ: To describe the papillae of the tongue and their function NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 2. Which muscles run anterior to posterior within the tongue (Select all that apply.)? a. Styloglossus b. Superior longitudinal c. Inferior longitudinal d. Genioglossus e. Transverse ANS: B, C

NURSINGTB.COM

The superior and inferior longitudinal muscle groups run anterior to posterior within the tongue. Like the transverse and vertical group they are categorized as intrinsic muscles. The styloglossus and genioglossus are extrinsic muscles because they originate from outside the tongue. The styloglossus begins in the styloid process; the genioglossus begins within the superior genial tubercles of the mandible.

REF: p. 284 OBJ: To discuss the difference between extrinsic and intrinsic muscles of the tongue NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering TRUE/FALSE 1. Muscles that have their origin and insertion within the tongue are extrinsic muscles.

ANS: F

Muscles that start and end wholly within the tongue are referred to as intrinsic muscles. By contrast, extrinsic muscles originate outside the tongue and run into it.

REF: p. 284 OBJ: To discuss the difference between extrinsic and intrinsic muscles of the tongue NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering

2. The lingual tonsils help to fight infection.

ANS: T

The lingual tonsils, located near the midline on the dorsum (upper surface) of the tongue just behind the vallate papillae, are lymphoid tissue. Like the palatine tonsils, these structures provide a defense against infection.

REF: p. 287 OBJ: To describe the kinds of changes seen on the tongue that indicate health problems NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 3. The tongue is similar to the gingiva in indicating a patient's overall health.

ANS: T

Both the gingiva and the tongue are good indicators of overall health.

REF: p. 287 OBJ: To describe the kinds of changes seen on the tongue that indicate health problems NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 4. The fungiform papillae do not have taste buds.

ANS: F

Although taste buds are not visible in fungiform papillae, they are present in small numbers.

N R I G B.C M

U S the N papillae T O the tongue and their function REF: p. 286 OBJ: To describe of NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering

Chapter 25: Histology of the Salivary Glands Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Salivary glands arise from a cord of epithelium that forms a tube. Their endpiece is pyramidal

in shape. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Although the endpiece of salivary glands is round or tubelike, the cells of both mucinous and serous acini are pyramidal in shape.

REF: p. 288 OBJ: To describe the components of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 2. Surrounding the acini are myoepithelial cells that inhibit salivary secretion because these cells

have the ability to contract like a muscle. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

N URSINGTB.COM

Surrounding the acini, secretory endpieces of salivary glands, are myoepithelial cells. These cells have a muscular component that squeezes the acinus and aids in secretion of saliva.

REF: p. 288 OBJ: To describe the components of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 3. Which structure is the MOST likely to break down starches into long-chain sugars? a. Mucous acini b. Serous acini c. Seromucous acini d. Connective tissue e. Salivary ducts ANS: B

A serous acinus is the primary source of amylase. This carbohydrate-splitting enzyme initiates the breakdown of starches into long-chain sugars.

REF: p. 288 OBJ: To describe the components of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering

4. Serous acini have ions similar to mucous acini but do not have mucins. A mucous secretion is

thinner and more watery. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The secretion of serous acini is thinner and more watery than that of mucous acini. It is the mucous component that makes mucous secretions thicker.

REF: p. 288 OBJ: To describe the components of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 5. Each of the following is true of salivary duct systems EXCEPT one. Which one is the

EXCEPTION? a. Depending on their size, salivary glands have varying numbers of lobules. b. Intralobulated refers to ducts that are located within the tubule. c. Interlobulated refers to ducts within connective tissue between lobules of the gland. d. Striation only occurs in interlobular ducts.

ANS: D

While striated cells occur in both intralobular and interlobular duct systems, they are much more common in intralobular ducts. The bases of the cells within striated ducts appear to be striped.

NURSING TB.COM

REF: p. 289 OBJ: To describe the duct system of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 6. Each of the following is true of the connective tissue capsule EXCEPT one. Which one is the

EXCEPTION? a. A salivary gland is surrounded by a connective tissue capsule. b. The connective tissue capsule sends partitions into the gland. c. The connective tissue capsule has varying numbers of lobules. d. The connective tissue capsule is a source of nerves and blood vessels.

ANS: C

Lobules are components of salivary duct systems.

REF: p. 289 OBJ: To describe the components of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 7. Secretory control comes from the central nervous system. Control of secretion is tied to

chewing, taste, and smell. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The parasympathetic division of the autonomic nervous system primarily controls salivary secretion.

REF: p. 290 OBJ: To describe how saliva is formed and modified before secretion NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 8. Each of the following accurately describes intercalated ducts EXCEPT one. Which one is the

EXCEPTION? a. Intercalated ducts are large and interlobulated. b. They drain directly into the acini. c. The cells of intercalated ducts are slightly taller than their nuclei. d. Intercalated ducts deliver secretions unchanged to the next set of ducts.

ANS: A

Intercalated ducts are very small and intralobulated. Also relevant, in some glands intercalated ducts are long and easily seen, whereas in others they are short and rarely seen.

REF: p. 289 OBJ: To describe the duct system of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 9. Acini are the a. mucous and serous secretions b. connective tissue capsules c. secretory end pieces NURSINGTB.COM d. intratubular ducts ANS: C

Acini are the secretory endpieces of salivary glands. There are two types of acinal cells, mucous acini and serous acini.

REF: p. 288 OBJ: To describe the components of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 10. The squid like appearance of a myoepithelial cell is due to a. cellular projections b. vasodilation c. intralobular ducts d. interlobular ducts ANS: A

Myoepithelial cells surrounding the acini have long cellular projections that resemble a squid.

REF: p. 288 OBJ: To describe the components of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 11. Intercalated ducts conserve water and electrolytes because ions such as sodium and potassium

are reabsorbed by capillaries and lymphatic vessels surrounding striated interlobular ducts.

a. b. c. d. e.

Both the statement and the reason are correct and related.

Both the statement and the reason are correct but are NOT related.

The statement is correct, but the reason is NOT correct.

The statement is NOT correct, but the reason is correct.

NEITHER the statement NOR the reason is correct.

ANS: D

Although striated interlobular ducts conserve water and electrolytes by the mechanism described, intercalated ducts are not striated. Note that while intercalated ducts are intralobular, their cells lack the stripe like appearance of striation.

REF: p. 290 OBJ: To describe the duct system of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 12. Secretory function can be modified by each of the following EXCEPT one. Which one is the

EXCEPTION? a. Chewing b. Taste c. Smell d. Dehydration e. Tubelike acinal endpieces ANS: E

The tubelike shape of acini is normal architecture. Secretory function is affected by many factors including chewing, taste, smell, and dehydration.

REF: p. 292 OBJ: ToNdesR hoG w sB ali. vaCis fM modified before secretion Ie N U crib Soral O ormed and NAT: CDA: GC I.A.3. Identify basic andTdental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 13. Which acini are MOST likely to have serous demilunes? a. Mucous b. Serous c. Seromucous d. All of the above ANS: C

Demilunes are found within seromucous acini. The mucous cells within a seromucous acinus form a tubelike structure; on the end is a half-moon cluster called a serous demilune.

REF: p. 288 OBJ: To describe the arrangement of the cells of a mixed salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 14. Serous acinus secretions are characterized by each of the following EXCEPT one. Which one

is the EXCEPTION? a. Serous secretions contain no mucins. b. More water content c. Small lumen d. Cuboidal in shape e. Primary source of amylase

ANS: D

Serous cells are pyramidal in shape. Note that mucous cells are also pyramidal. The absence of mucins makes serous secretions thinner and more watery than those of mucous cells. It is appropriate that the lumen in serous acini is smaller because the secretions are thinner.

Amylase is a carbohydrate-splitting enzyme.

REF: p. 288 OBJ: To describe the components of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 15. The primary function of excretory ducts is to carry saliva. However, the striated interlobular

ducts also modify salivary content as the fluid passes through them. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Nonstriated interlobular ducts are considered excretory ducts. These ducts do not modify salivary secretions but simply carry them to the surface of oral tissues. Secretory ducts, which are striated, modify salivary content as fluids pass through. Water and various ions are resorbed and conserved by secretory ducts.

REF: p. 290 OBJ: To describe the duct system of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering

N R I G B.C M

16. Intralobular ducts are located bU etwS eenNlobT ules. ThOey carry secretions to the next set of ducts. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Interlobular ducts are located between lobules. Intralobulated ducts are located within lobules.

A specific type of intralobular duct, the intercalated duct, carries secretions, unchanged, to the next set of ducts within the tubule.

REF: p. 290 OBJ: To describe the duct system of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 17. A duct that has infolds of the basal cell membrane is a striated duct. Intercalated ducts, also

striated, are very small and directly drain the acini. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

Striated ducts with infolds of the basal cell membrane have mitochondria that stain during laboratory evaluation. Staining makes the mitochondria appear striped, hence the term striated. Intercalated ducts do not have striations.

REF: p. 290 OBJ: To describe the duct system of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 18. Merocrine secretion is the process utilized by salivary acini to move saliva into the duct

system. While mucous and serous acini utilize only the merocrine process, seromucous acini also employ a process involving immunoglobulins and lysozymes. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Mucous, serous, and mucoserous acini all utilize the merocrine process to secrete, or move, their products. While immunoglobulins and lysozymes are beneficial components of all salivary acini, they are not specifically involved in secretion.

REF: p. 288 | p. 292 OBJ: To describe the arrangement of the cells of a mixed salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 19. Each of the following is carried in the saliva EXCEPT one. Which one is the EXCEPTION? a. Lysosomes NURSINGTB.COM b. Sodium c. Potassium d. Bicarbonate e. Golgi apparatus ANS: E

The Golgi apparatus is a structure composed of flat saclike layers within a cell that “package” cellular products for transportation outside the cell. Antibacterial properties of lysosomes protect the body from bacteria and are vital components of saliva. Salivary ions such as sodium, potassium, and bicarbonate help conserve water and electrolytes.

REF: p. 292 OBJ: To describe how saliva is formed and modified before secretion NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 20. The demilune surrounds the salivary gland and aids in the secretion of saliva. This structure

has a muscular component and long cellular projections. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The demilune is a half-moon cluster that secretes its product between the cell walls of underlying mucous cells. It is the myoepithelial cell that is described by both statements.

REF: pp. 288-289 OBJ: To describe the components of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 21. With electron microscopy mucous cells appear empty and frothy because they stain

exceptionally well. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Because mucous cells stain very poorly they appear frothy and empty with electron microscopy. However, a great number of mucous droplets will be visible.

REF: p. 288 OBJ: To describe the components of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 22. During formation, the “future saliva” is packaged by a membrane within the a. endoplasmic reticulum b. Golgi apparatus c. cytoplasm d. mitochondria N R I G B.C M

U S N T

O

ANS: B

The Golgi apparatus, a structure composed of flat saclike layers within a cell, packages cellular products and moves them into the cytoplasm of the mucous or serous acini. This is in preparation for transportation outside the cell.

REF: p. 292 OBJ: To describe how saliva is formed and modified before secretion NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. Which of the following are true of demilunes (Select all that apply.)? a. They are present in seromucous acini. b. They are a group of serous cells arranged in half-moon clusters. c. They are only present in connective tissue. d. They secrete their product between the cell walls of underlying mucous cells. e. They are the primary source of amalyse.

ANS: A, B, D

Serous demilunes are half-moon clusters found in seromucous acini. Note that seromucous acini produce both mucous and serous secretions. They are not present in connective tissues nor are they a source of the digestive enzyme amylase.

REF: p. 288 OBJ: To describe the arrangement of the cells of a mixed salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 2. Which ducts have mitochondria that appear striped when stained (Select all that apply.)? a. All intralobular b. Intralobular intercalated c. Intralobular secretory d. All interlobular e. Some interlobular ANS: C, E

There are two major duct categories, intralobular and interlobular. In the intralobular category, mitochondria within secretory ducts appear striped when stained whereas the mitochondria within intercalated do NOT. In the interlobulated some mitochondria within ducts appear striped when stained; others do not. Note that this characteristic-striped appearance upon staining is referred to as striation.

REF: p. 290 OBJ: To describe the duct system of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 3. All of the following are functions of saliva EXCEPT one. Which one is the EXCEPTION? a. It acts as a buffer. b. It has immunoglobulins to combat illness. c. It carries an enzyme to break down fats. d. It helps to prepare the boN CaOllM luU s oRfS foIoN dG wT heB n. sw owing.

ANS: C

Most saliva contains amylase, however this is a carbohydrate-splitting enzyme. It does not break down fat.

REF: p. 288 OBJ: To describe the functions of saliva NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering TRUE/FALSE 1. When cells secrete their products, the cell membrane is destroyed.

ANS: F

There is no damage to the cell wall of salivary glands from secretion of saliva.

REF: p. 288 OBJ: To describe how saliva is formed and modified before secretion NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 2. Intercalated ducts modify the salivary fluid that passes through them.

ANS: T

Intercalated ducts deliver secretions, unchanged, to the next set of ducts within the lobule.

Intercalated ducts are very small intralobular ducts that directly drain the acini.

REF: p. 289 OBJ: To describe the duct system of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 3. Mucous secretions contain 99% water.

ANS: T

Mucous secretions contain 99% water as well as very minor amounts of the enzyme amylase.

Also present are a number of inorganic ions such as sodium, potassium, and chloride.

REF: p. 288 OBJ: To describe the components of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 4. The acinus with the largest lumen is the serous type.

ANS: F

The mucous acinus has a larger lumen than a serous acinus.

REF: p. 288 OBJ: To describe the components of a salivary gland NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering

NURSINGTB.COM

Chapter 26: Osteology of the Skull Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The crista galli as well as the cribriform plate are part of the ethmoid bone. These structures

are located in a small area near the midline in the back of the skull. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The crista galli, cribriform plate, and ethmoid bone are located near the midline in the front of the skull. Immediately behind these bones is the sphenoid bone.

REF: p. 302 OBJ: To identify the various bones and sutures as seen from anterior, lateral, posterior, inferior, and interior views of the skull NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 2. Some people believe that temporomandibular joint problems are due to the squamosal suture

because unlike most sutures, which overlap one another, the squamosal suture butts up against surrounding sutures. a. Both the statement and the reason are correct and related. b. Both the statement and thN eU reR asSoI nN arG eT coB rr. ecC tO buMt are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The squamosal suture is unique in that it is an overlapping suture, whereas other sutures butt up against surrounding sutures. Some people believe this anatomy causes slippage in this suture and attempt to manually manipulate the suture to relieve TMJ pain.

REF: p. 299 OBJ: To identify the various bones and sutures as seen from anterior, lateral, posterior, inferior, and interior views of the skull NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 3. The mental foramen is found within the maxilla. The mental nerves and vessels to the upper

lip and facial anterior gingiva pass through the mental foramen. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The mental foramen is found within the mandible. The mental nerves and vessels to the upper lip and facial anterior gingiva pass through this foramen.

REF: p. 309 OBJ: To describe in detail the various parts and landmarks of the mandible NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 4. The anterior nasal spine is important radiographically because it is a landmark frequently used

to locate impacted third molars. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The anterior nasal spine, located at the lower end of the nasal cavity, is important radiographically because it is frequently used in lateral head films for orthodontics.

REF: p. 308 OBJ: To describe in detail the various parts and landmarks of the maxillae NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 5. The digastric fossae of the mandible can be seen laterally because they are located at the

inferior border of the mandible. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, N buUt R thS eI reN asG onTiB s.

NC OO TM correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Although the digastric fossae are located at the inferior border of the mandible, they can only be seen from a posterior view. Note that the digastric fossae are points of attachment for the anterior digastric muscle. The digastric fossae are located just beneath the genial tubercles, also called mental spines.

REF: p. 311 OBJ: To describe in detail the various parts and landmarks of the mandible NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 6. The position and size of the lingula is important to clinical dentistry because it often is

associated with mandibular tori. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The lingula, which means “little tongue,” is a projection of bone that partially covers the opening of the mandibular foramen. This is a point of attachment for the sphenomandibular ligament, whose location and size may at times affect the success of anesthetic injections.

REF: p. 311 OBJ: To describe in detail the various parts and landmarks of the mandible NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 7. The following bones of the skull are paired EXCEPT for one. Which one is the

EXCEPTION? a. Temporal b. Occipital c. Parietal d. Palatine e. All of the above are paired.

ANS: B

The occipital bone, located at the posterior portion of the skull, is a single bone. It is one of the eight bones of the neurocranium, all of which surround the brain.

REF: p. 297 OBJ: To name bones of the neurocranium and viscerocranium NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 8. The midline that shows fusion of the hard palate is called the a. anterior nasal spine b. median palatine suture c. mylohyoid line NURSINGTB.COM d. interparietal suture ANS: B

The median palatine suture goes down the middle of the hard palate. The anterior part of this suture may also be called part of the intermaxillary suture. The anterior nasal spine is located at the lower end of the nasal cavity. The mylohyoid line lies just in front of the mandibular foramen and is the attachment for the mylohyoid muscle. The interparietal suture, also called the sagittal suture, runs front to back at the top of the head.

REF: p. 299 | p. 302 | p. 310 OBJ: To describe in detail the various parts and landmarks of the maxillae NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 9. The genial tubercles are located on the a. internal anterior portion of the mandible b. external anterior portion of the mandible c. internal ramus d. external ramus ANS: A

The genial tubercles, also called mental spines, are attachments that aid in tongue movement and swallowing. The digastric fossae lie just below the genial tubercles at the inferior border of the mandible.

REF: p. 311 OBJ: To describe in detail the various parts and landmarks of the mandible NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 10. A person who is crying will typically experience a runny nose because tears flow from the

inner corner of the eye through the lacrimal gland. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

The lacrimal groove runs down from the inner corner of the eye and is the source from which tears flow into the nose, accounting for the runny nose that occurs when a person is crying.

REF: p. 309 OBJ: To describe in detail the various parts and landmarks of the maxillae NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 11. The vertical portion of the mandible is called the ramus. The mandible is made up of one

body, two alveolar processes, and two rami. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The mandible is made of one body and one alveolar process but two rami.

REF: p. 309 OBJ: To describe in detail the various parts and landmarks of the mandible NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 12. The structure that is composed of the vomer and the perpendicular plate of the ethmoid bone

is the a. inferior nasal conchae b. vertical nasal septum c. inferior orbit d. lateral nasal orbit ANS: B

Within the nasal cavity vertical nasal septum is composed of the vomer and the perpendicular plate of the ethmoid bone.

REF: p. 297 OBJ: To identify the various bones and sutures as seen from anterior, lateral, posterior, inferior, and interior views of the skull NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering

13. Within the medial body of the mandible are two fossae that house the sublingual and

submandibular salivary glands. These two fossae are called the coronoid notch and the coronoid process. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The sublingual and submandibular salivary glands lie within the sublingual and submandibular fossae, respectively. The coronoid notch and the coronoid process, also parts of the mandible, are located in the ramus of the mandible.

REF: p. 311 OBJ: To describe in detail the various parts and landmarks of the mandible NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 14. Each of the following structures is part of the hard palate EXCEPT one. Which one is the

EXCEPTION? a. Incisive foramen b. Median palatine suture c. Maxillary tuberosity d. Palatine bones ANS: C

The maxillary tuberosity is a bulging area of bone distal to the third molars.

REF: p. 299 | p. 308 NURSINGTB.COM OBJ: To identify the various bones and sutures as seen from anterior, lateral, posterior, inferior, and interior views of the skull | To name the openings, foramina, and canals as seen from the aforementioned views NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 15. There are 24 bones that makeup the skull. Fourteen bones makeup bones of the face. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

There are 22 bones that makeup the skull.

REF: p. 297 OBJ: To name bones of the neurocranium and viscerocranium NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 16. The suture at the top of the skull that marks the fusion of the parietal bones is the sagittal

suture. This structure is also called the lambdoid suture. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true.

d. Both statements are false.

ANS: B

The sagittal suture is also called the interparietal suture. The lambdoid suture, located toward the back of the head, is also called the parietooccipital suture.

REF: p. 299 | p. 302 OBJ: To identify the various bones and sutures as seen from anterior, lateral, posterior, inferior, and interior views of the skull NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 17. The mandibular foramen is located near the top of the ramus. The nerves and blood vessels for

the maxillary and mandibular posterior teeth and soft tissues enter the maxillae through the mandibular foramen. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The mandibular foramen is located about midway up the ramus. Nerves and blood vessels for the lower teeth and lip enter the mandible through the mandibular foramen.

REF: p. 310 OBJ: To name the openings, foramina, and canals as seen from the aforementioned views NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BL OOM: Understanding

N UR SI NG TB. CO M

18. The frontal lobe of the brain is within the a. anterior cranial fossa b. hypophyseal fossa c. foramen rotundum d. crista galli ANS: A

Visible from the anterior view of the skull, the anterior cranial fossa lies between the lesser wing of the sphenoid bone and the frontal bone. The frontal lobe of the brain is housed in the anterior cranial fossa.

REF: p. 302 OBJ: To describe the boundaries of the three cranial fossae and what lies within them NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 19. The following structures are ossicles EXCEPT one. Which one is the EXCEPTION? a. Conchae b. Malleus c. Incus d. Stapes ANS: A

Conchae are bones of the nasal passage. Ossicles are small bones in the ear. They aid in hearing.

REF: p. 297 | p. 299 OBJ: To name bones of the neurocranium and viscerocranium NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 20. In the body of the sphenoid is a depression called the hypophyseal fossa. The master gland,

the thyroid, lies in this fossa. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The master gland is the pituitary gland. It lies within the hypophyseal fossa.

REF: p. 302 OBJ: To describe the boundaries of the three cranial fossae and what lies within them NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding MULTIPLE RESPONSE 1. Which bones have parts that makeup the temporal fossa (Select all that apply.)? a. Frontal NURSINGTB.COM b. Parietal c. Sphenoid d. Zygomatic e. Temporal ANS: A, B, C, E

The zygomatic bones are not part of the temporal fossa. However, they do form part of the cheekbones.

REF: p. 299 OBJ: To describe the boundaries of the three cranial fossae and what lies within them NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 2. Which of the following are located within the orbit (Select all that apply.)? a. Superior orbital fissures b. Inferior orbital fissures c. Optic foramen d. Mastoid process ANS: A, C

The mastoid process projects from the temporal bone just behind the external auditory meatus or outer ear canal. The superior orbital fissure is located in the posterolateral part of the orbit.

REF: p. 297 | p. 299

OBJ: To identify the various bones and sutures as seen from anterior, lateral, posterior, inferior, and interior views of the skull | To name the openings, foramina, and canals as seen from the aforementioned views NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 3. Sutures visible from the superior aspect of the skull include (Select all that apply.) a. coronal suture b. lambdoid suture c. sagittal suture d. squamosal suture e. interparietal suture ANS: A, B, C, E

The sagittal suture, also called interparietal, runs between the coronal and lambdoid sutures on top of the skull. The squamosal suture is visible from the lateral view of the skull. It is located within the temporal fossa, between the squamous part of the temporal bone and the parietal bone.

REF: p. 299 | p. 302 OBJ: To identify the various bones and sutures as seen from anterior, lateral, posterior, inferior, and interior views of the skull NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 4. Bones which surround the brain include (Select all that apply.) a. frontal b. occipital NURSINGTB.COM c. zygomatic d. ethmoid e. temporal f. palatine ANS: A, B, D, E

The zygomatic and palatine are bones of the viscerocranium, or bones of the face. Bones that surround the brain are referred to as bones of the neurocranium.

REF: p. 297 OBJ: To identify the various bones and sutures as seen from anterior, lateral, posterior, inferior, and interior views of the skull NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 5. Which of the following are found within the nasal cavity (Select all that apply.)? a. Perpendicular plate of the ethmoid bone b. Canine eminence c. Inferior nasal conchae d. Vomer bone e. Mastoid process ANS: A, C, D

The canine eminence is a ridge of bone located over the maxillary canine. The mastoid process projects from the external auditory meatus, or outer ear canal.

REF: p. 297 | p. 299 OBJ: To name bones of the neurocranium and viscerocranium NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering TRUE/FALSE 1. The coronoid process is involved in the temporomandibular (TMJ) articulation.

ANS: F

The coronoid process has no role in the articulation of the TMJ. Located just anterior to the coronoid notch, or mandibular notch, the coronoid process is the attachment for the temporalis muscle, one of muscles of mastication.

REF: p. 309 OBJ: To describe in detail the various parts and landmarks of the mandible NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 2. The cribriform plate is the passageway for olfactory nerves from the nasal cavity to the brain.

ANS: T

Nerves from the nasal cavity pass through the cribriform plate on their way to the brain. These are olfactory nerves, more commonly known as the nerves of smell. The cribriform plate and the crista galli are parts of theNethRmoI id bG oneB . .C M

U S N T

O

REF: p. 302 OBJ: To identify the various bones and sutures as seen from anterior, lateral, posterior, inferior, and interior views of the skull NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 3. Another name for the mental spines is the interior nasal spine.

ANS: F

Mental spines are also known as genial tubercles. These are two small, grouped projections, one above and one below. They serve as attachments for muscles that aid in tongue movement and swallowing.

REF: p. 311 OBJ: To describe in detail the various parts and landmarks of the mandible NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 4. Alveolar eminences within the zygomatic process are most prominent on anterior teeth.

ANS: F

Alveolar eminences, most prominent on anterior teeth and sometimes the premolars, are bulges in the alveolar process.

REF: p. 308 OBJ: To describe in detail the various parts and landmarks of the maxillae NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering COMPLETION 1. The maxilla consists of a body and

processes.

ANS:

four The four processes of the maxillae are the frontal, zygomatic, alveolar, and horizontal palatine.

REF: p. 307 OBJ: To describe in detail the various parts and landmarks of the maxillae NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 2. Another name for the cheekbone is the

bone.

ANS:

zygomatic The upper area below the eyes down to the occlusal plane between the upper and lower teeth comprises the paired zygomatic or cheekbones and the paired maxillae.

REF: p. 297 NURSINGTB.COM OBJ: To identify the various bones and sutures as seen from anterior, lateral, posterior, inferior, and interior views of the skull NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 3. The

bone articulates with the condyle of the mandible to form the temporomandibular joint (TMJ).

ANS:

temporal The full name of the TMJ is derived from the two bones that articulate to form the joint: the maxillary temporal bone, which is part of the cranium (skull), and the condyle of the mandible.

REF: p. 309 OBJ: To identify the various bones and sutures as seen from anterior, lateral, posterior, inferior, and interior views of the skull NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 4. From the inferior view of the skull, the

palatine bone.

is located between the maxilla and the

ANS:

transverse palatine suture The transverse palatine suture runs across the posterior part of the hard palate between the maxillae and the palatine bones.

REF: p. 299 OBJ: To identify the various bones and sutures as seen from anterior, lateral, posterior, inferior, and interior views of the skull NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 5. The pterygoid processes each have two thin walls of bone that project backward, which are

called the

pterygoid plates.

ANS:

medial and lateral The medial and lateral pterygoid plates project backward in the paranasal sinus area.

REF: p. 299 OBJ: To describe the pterygoid processes of the sphenoid bone and their components NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 6. Normal eruption of

mandible.

ANS:

may be inhibited if there is insufficient growth in the

NURSINGTB.COM

third molars Growth of the mandible takes place in several areas. First, the alveolar process and body increase in width and height. The lengthening of the mandibular arch takes place by bone being added to the posterior border of the ramus and taken away from the anterior border. If there is insufficient growth, there may be no room for the normal eruption of mandibular third molars.

REF: p. 308 OBJ: To describe where growth takes place in the maxillae and mandible to allow for increase in arch length NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering

Chapter 27: Nose, Nasal Cavity, and Paranasal Sinuses Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The respiratory epithelium in the roof of the nasal cavity, upper surfaces of both the superior

concha, and nasal septum is modified. This tissue has nerve fibers that can perceive odors. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

The modified respiratory epithelium is called olfactory epithelium. It covers the roof of the nasal cavity and extends down onto the upper surface of the superior concha and upper nasal septum.

REF: p. 313 OBJ: To describe the function of the nasal cavity, nasal epithelium, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Understanding 2. Most of the openings into the nasal cavity from other areas are known as the sphenoid sinuses.

There are four pairs of paranasal sinuses. a. Both statements are true. b. The first statement is true; the second statement is false.

CeOnMt is true. c. The first statement is falsN e;UthReSseIcN onGdTsB tat. em d. Both statements are false.

ANS: C

Most of the openings into the nasal cavity from other compartments or cavities are known as the paranasal sinuses. The sphenoid sinuses are located in the body of the sphenoid bone just underneath the pituitary fossa, which is located in the middle cranial fossa.

REF: p. 315 OBJ: To define the terms nose, nasal cavity, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Understanding 3. The most complicated portion of the nasal cavity is its lateral walls because the upper half to

two-thirds is formed by parts of the ethmoid bone and the lower part is formed by portions of the mandible. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The lower portion of the lateral walls of the nasal cavity is formed by portions of the maxillae.

REF: p. 313

NURSINGTB.COM

OBJ: To understand the anatomy of the nose, nasal cavity, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Understanding 4. The ethmoid sinuses are frequently called the paranasal sinuses because they are not

single-paired sinuses but are divided into numerous small compartments. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

The ethmoid sinuses are frequently called the ethmoid air cells. They are not single-paired like the other paranasal sinuses but are subdivided into compartments called the anterior, middle, and posterior ethmoid air cells.

REF: p. 315 OBJ: To understand the anatomy of the nose, nasal cavity, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Understanding 5. The maxillary sinuses are the smallest of the paranasal sinuses. At birth, each maxillary sinus

is the size of a small pea. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are falseN . URSINGTB.COM ANS: C

The maxillary sinuses are the largest of the paranasal sinuses.

REF: p. 316 OBJ: To understand the anatomy of the nose, nasal cavity, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Understanding 6.

The major role of sinus cavities is warming the air that flows into the respiratory system because the air passes over the cilia, which have an increased internal temperature. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

The most popular theory explaining the role of sinuses has historically been that air is warmed by the sinuses as it passes through the respiratory system. The current general belief is that the hollow sinus cavities function to lighten the overall bone weight. Note that while cilia help filter air, there is not a temperature increase from the cilia.

REF: p. 317

OBJ: To describe the function of the nasal cavity, nasal epithelium, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Understanding 7. Each of the following is true of the maxillary sinus EXCEPT one. Which one is the

EXCEPTION? a. The maxillary sinuses are the largest of the paranasal sinuses. b. The maxillary sinuses open into the posterior end of the hiatus semilunaris through one or more openings. c. The superior border of the maxillary sinus is the floor of the orbit. d. The maxillary sinus is one anatomic structure that almost never varies among individuals. e. During a nasal infection, swelling occurs in the nasal mucosa.

ANS: D

Everyone’s maxillary sinus is different. This explains why sinus infections are so common and difficult to cure. Maxillary sinus openings vary significantly in number and size.

REF: p. 316 OBJ: To describe the relationship of maxillary teeth to the maxillary sinus in infections of either one NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 8. The most posterior–superior part of the nasal cavity is a. where the ethmoid meets the sphenoid bone. b. the choana. c. the superior nasal concha. d. the ethmoid bulla.

NURSINGTB.COM ANS: A

The most posterior–superior part of the nasal cavity is the sphenoethmoidal recess, the point where the ethmoid bone meets a portion of the body of the sphenoid bone.

REF: p. 313 OBJ: To describe the relationship of maxillary teeth to the maxillary sinus in infections of either one NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 9.

The lateral walls of the nasal cavity are formed by the inferior concha(e). The point where the ethmoid bone and the maxillae meet in the lateral wall is called the superior nasal concha. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The superior and middle nasal conchae form the lateral walls of the nasal cavity. The ethmoid bone and the maxillae meet at the inferior nasal concha.

REF: p. 313 OBJ: To discuss the anatomic relationship of the maxillary sinus and the maxillary teeth NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Understanding 10. Each of the following has a role in trapping contaminants that enter the nasal cavity EXCEPT

one. Which one is the EXCEPTION? a. Cilia b. Mucous c. Goblet cells d. Olfactory epithelium e. All of the above help to trap contaminants.

ANS: D

The respiratory epithelium has cilia, mucous, and goblet cells that remove contaminants from the nasal cavity. The conchae also are helpful. The olfactory epithelium, a modification of the respiratory epithelium, does not perform these functions.

REF: p. 313 OBJ: To describe the function of the nasal cavity, nasal epithelium, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 11. Under normal circumstances, sinuses are filled with a. fluid b. blood c. air d. bones of the cranium ANS: C

The sinuses are hollow cavitiN es tR hat I funcGtionBt. oC lighM ten the overall bone weight. When they U fill S with N T O fluid as a result of mucous edema. become irritated or infected they inflammatory REF: p. 317 OBJ: To understand the anatomy of the nose, nasal cavity, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 12. The deeper sinuses, particularly the ethmoid, are most commonly involved in sinus infections

that are difficult to localize. A new opening can be surgically created to assist with proper drainage. Note that the maxillary sinuses, while not as deep, commonly become infected. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Infections of the paired sphenoid sinuses cause pressure and congestion that are difficult to localize. These sinuses are located in the middle of the cranial fossa and the pressure associated with infections is deep in the middle of the head.

REF: p. 315 OBJ: To describe the relationship of maxillary teeth to the maxillary sinus in infections of either one NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Understanding

13. The crescent-shaped groove within the middle nasal concha is the a. sphenoethmoid recess b. hiatus semilunaris c. ethmoid bulla d. nasal aperture ANS: B

The hiatus semilunaris, which means half-moon shaped opening, lies within the middle nasal concha just above the middle meatus. The sphenoethmoid recess is the highest and most posterior part of the nasal cavity. The ethmoid bulla is an elevation within the ethmoid sinuses. The nasal aperture is the opening to the nose.

REF: pp. 315-316 OBJ: To understand the anatomy of the nose, nasal cavity, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 14. The cilia have hairlike projections that perceive odors because they are located within the

olfactory epithelium. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

The cilia have hairlike projecN tionRs thI at mGoveBc.oC tam Minants toward the front of the nasal U S N T nO passages. They are located within the respiratory epithelium. The olfactory epithelium, a modification of respiratory epithelium, has nerve endings that perceive odors.

REF: p. 313 OBJ: To describe the function of the nasal cavity, nasal epithelium, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Understanding 15. Infections of the frontal sinuses can cause pressure and pain just above the eye because these

sinuses are located just above the orbital cavity. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

The paired frontal sinuses are located in the frontal bone just above the orbital cavity.

Infections of the frontal sinuses cause pain and pressure just above the eye. These sinuses vary in size from person to person and frequently cross the midline.

REF: p. 315 OBJ: To describe the relationship of maxillary teeth to the maxillary sinus in infections of either one NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Understanding 16. In a young adult, the maxillary sinus generally lies between the maxillary canine and the a. premolars b. first molar c. second molar d. third molar ANS: D

In young adults, the maxillary sinus occupies an area from just posterior to the maxillary canine back to the area of the third molar.

REF: p. 316 OBJ: To discuss the anatomic relationship of the maxillary sinus and the maxillary teeth NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 17. The opening of the maxillary sinus in the middle meatus region is located at approximately a. the floor of the sinus b. the floor of the orbital cavity c. one-third upward toward the medial wall d. two-thirds upward toward the medial wall e. None of the above ANS: D

Because the opening to the maxillary sinus is near the top of the space, drainage of fluids poses difficulties. During a nasal infection, edema causes swelling of the mucosa, which perpetuates infection in this iN ncuR batoIr-liG ke eB nv.irC onm Ment.

U S N T

O

REF: p. 316 OBJ: To discuss the anatomic relationship of the maxillary sinus and the maxillary teeth NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 18. Which is LEAST likely to interfere with the floor of the maxillary sinus during the extraction

of a maxillary molar? a. Impacted third molars b. A dilacerated root on a second molar c. A close relationship between the floor of the sinus to posterior root apices d. A microdont molar ANS: D

A microdont molar is least likely to interfere with the floor of the maxillary sinus because microdonts are very small teeth. It is likely that trauma to the floor of the maxillary sinus would be minimal due to sufficient surrounding tissue space.

REF: p. 317 OBJ: To discuss the anatomic relationship of the maxillary sinus and the maxillary teeth NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering TRUE/FALSE

1. The lateral margin of the external nose is known as an ala.

ANS: T

Each protruding lateral margin is known individually as a wing of the nose, or an ala.

REF: p. 313 OBJ: To understand the anatomy of the nose, nasal cavity, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 2. The vomer and ethmoid bones form the main part of the nasal septum.

ANS: T

A portion of the ethmoid bone and the vomer bone form the septum as well as the fibrocartilaginous part of the septum.

REF: p. 313 OBJ: To understand the anatomy of the nose, nasal cavity, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 3. The maxillae and the ethmoid form the interior portion of the floor of the nasal cavity.

ANS: F

The interior portion of the floor of the nasal cavity is formed by bones of the hard palate and the horizontal portion of the palatine bones.

N R I G B.C M

U S N T O REF: p. 313 OBJ: To understand the anatomy of the nose, nasal cavity, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 4. Both the anterior and middle ethmoid sinuses are located in the meatus of the superior nasal

concha.

ANS: F

Both the anterior and middle ethmoid sinuses are located in the base of the middle nasal concha.

REF: p. 315 OBJ: To understand the anatomy of the nose, nasal cavity, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 5. The pituitary fossa is located above the sphenoid sinuses.

ANS: T

Viewing the skull from a sagittal view, the pituitary fossa is located just above the sphenoid sinuses. Note that the pituitary is located within the hypophyseal fossa.

REF: p. 313 | p. 315

OBJ: To understand the anatomy of the nose, nasal cavity, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering COMPLETION 1. The area underneath each concha is known as a _

.

ANS:

meatus The area of the lateral nasal wall sheltered underneath each concha is known as the meatus of each concha. A meatus is a natural body opening or canal.

REF: p. 315 OBJ: To understand the anatomy of the nose, nasal cavity, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 2. The sinuses that are subdivided into numerous small compartments are the

sinuses.

ANS:

ethmoid The ethmoid sinuses, frequently called the ethmoid air cells, are subdivided into numerous compartments, which are furN therRdivI idedGintB o. anCteriM or, middle, and posterior ethmoid air cells.

U S N T

O

REF: p. 315 OBJ: To understand the anatomy of the nose, nasal cavity, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 3. The

ethmoid sinuses are located within the ethmoid bulla.

ANS:

middle The middle ethmoid sinuses, also called the middle ethmoid air cells, are located within the ethmoid bulla. Like the anterior ethmoids, the middle ethmoids are also located in the base of the middle nasal concha.

REF: p. 315 OBJ: To understand the anatomy of the nose, nasal cavity, and paranasal sinuses NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 4. Pain over the eye is most likely caused by infection in the ANS:

frontal

sinus.

The paired frontal sinuses are located in the frontal bone just above the orbital cavity.

Infections in these sinuses cause pressure and pain just above the eye.

REF: p. 315 OBJ: To describe the relationship of maxillary teeth to the maxillary sinus in infections of either one NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Remembering 5. It is possible that a periapical infection of a tooth may involve the

sinus.

ANS:

maxillary An area of concern is the relationship of the floor of the maxillary sinus to the teeth. In many instances, the floor of the sinus dips down under the tip of one or more roots of the posterior teeth.

REF: p. 317 OBJ: To describe the relationship of maxillary teeth to the maxillary sinus in infections of either one NAT: CDA: GC I.A. Identify basic oral and dental anatomy, physiology and development.

TOP: BLOOM: Understanding

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Chapter 28: Muscles of Mastication, Hyoid Muscles, and Sternocleidomastoid and Trapezius Muscles Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The temporal muscle has a very narrow origin. Contraction of the entire temporalis elevates

the mandible. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The temporal muscle, frequently called the temporalis muscle, has a very wide origin.

Contraction of the entire muscle pulls up the coronoid process and elevates the mandible, closing the mouth.

REF: p. 322 OBJ: To describe the origin, insertion, action, and nerve and blood supply of muscles of mastication NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 2. Contraction of only the posterior portion of the temporalis muscle retrudes the mandible

because this action also depresses the mandible. a. Both the statement and the reason are correct and related.

NUreas RSonIN G correct B.CO M b. Both the statement and the are T but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The temporalis muscle, also called the temporal muscle, has a very wide origin with both anterior and posterior fibers. Contraction of only the posterior fibers results in a horizontal pulling of the coronoid process. This action pulls the mandible backward, referred to as retruding the mandible.

REF: p. 321 OBJ: To categorize muscles according to their roles in elevation, depression, protrusion, and lateral excursion of the mandible NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 3. Muscles of mastication are innervated by the fifth cranial nerve because they develop from the

first (mandibular) pharyngeal arch. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

The fifth cranial nerve, the trigeminal nerve, is the nerve of the first pharyngeal arch. Also note, more specifically, muscles of mastication are innervated by the third part of the fifth cranial nerve, which is called the mandibular division.

REF: p. 318 OBJ: To describe the origin, insertion, action, and nerve and blood supply of muscles of mastication NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 4. Hyoid muscles have a role in depressing the mandible. This includes the suprahyoid and the

thyrohyoid muscles. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

Depression of the mandible is accomplished by the inferior head of the lateral pterygoid muscle plus the hyoid muscles. This includes the suprahyoid and the infrahyoid muscles.

When contracted, the thyrohyoid muscle either lifts the thyroid cartilage and raises the larynx or depresses the hyoid bone.

REF: p. 320 OBJ: To describe the origin, insertion, action, and nerve and blood supply of muscles of mastication NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding

NURSINGTB.COM

5. The hyoid bone, a portion of the zygomatic arch, is unusual because it articulates with no

other bone. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

The hyoid bone, located in the neck, is not a portion of the zygomatic arch. It is a horseshoe-shaped bone suspended beneath the mandible and is unusual because it articulates with no other bone. Its only connection with other bones is by muscles and ligaments.

REF: p. 320 OBJ: To describe the origin, insertion, action, and nerve and blood supply of muscles of mastication NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 6. Hyoid muscles located above the hyoid bone are called suprahyoid muscles. When contracted,

most muscles of this group elevate the mandible. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Contraction of the digastric, mylohyoid, and geniohyoid muscle depress the mandible.

Contraction of the remaining suprahyoid muscle, the stylohyoid, pulls the hyoid bone back and up.

REF: p. 320 | p. 324 OBJ: To categorize muscles according to their roles in elevation, depression, protrusion, retrusion, and lateral excursion of the mandible NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 7. During an extraoral examination, it is necessary to palpate beneath the sternothyroid muscle

because enlarged lymph nodes may be lying against the internal jugular vein in the neck. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

It is necessary to palpate beneath the sternocleidomastoid muscle to check for enlarged lymph nodes against the jugular vein.

REF: p. 325 OBJ: To categorize muscles according to their roles in elevation, depression, protrusion, retrusion, and lateral excursion of the mandible NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muN scU leR s.SINGTT OB P:.C BLOOMOM: Understanding 8. Which muscle of mastication does not have two origins? a. Medial pterygoid b. Lateral pterygoid c. Masseter d. Temporal ANS: D

The temporal muscle has one very wide origin from the entire temporal fossa and the fascia, which covers muscle. The remaining muscles of mastication have two origins.

REF: p. 319 OBJ: To describe the origin, insertion, action, and nerve and blood supply of muscles of mastication NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 9. All muscles of mastication insert into the disk of the TMJ. Blood supply to these muscles

comes from the maxillary artery, which is a branch of the carotid. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

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Of the four muscles of mastication, only the lateral pterygoid muscle has fibers that insert into the disk of the TMJ. REF: p. 318 | p. 320 OBJ: To describe functions of the sternocleidomastoid and trapezius muscles and their roles in referred pain to various areas, including the temporomandibular joint NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 10. The lateral pterygoid performs each of the following actions upon the mandible EXCEPT one.

Which one is the EXCEPTION? a. Depression b. Protrusion c. Retrusion d. Lateral movement ANS: C

Contraction of the lateral pterygoid pulls the condyle forward and helps protrude and depress the mandible. Lateral movement occurs when only one lateral pterygoid is contracted. The superior head of the lateral pterygoid functions primarily in what is sometimes called the power stroke.

REF: p. 320 OBJ: To categorize muscles according to their roles in elevation, depression, protrusion, retrusion, and lateral excursion of the mandible NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering

N R I G B.C M

U Sis unusual N T because O it has two nerves supplying it.

11.1 Innervation to the digastric muscle 1 a. Both the statement and the reason are correct and related. . b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Both the facial and trigeminal cranial nerves supply the digastric muscle. The anterior part of muscle is supplied by the trigeminal nerve and the posterior part is supplied by the facial nerve.

REF: p. 322 OBJ: To describe the origin, insertion, action, and nerve and blood supply of muscles of mastication NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles and 5. nerves.

TOP: BLOOM: Understanding 12. The shape of the hyoid bone resembles a a. circle b. straight line c. triangle d. horseshoe ANS: D

NURSINGTB.COM

The hypoid bone is a horseshoe-shaped bone suspended beneath the mandible, with the open end of the horseshoe pointed posteriorly.

REF: p. 320 OBJ: To name the suprahyoid and infrahyoid muscles and their roles in mandibular movement, swallowing, and phonation NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 13. The masseter muscle is probably the most powerful of muscles of suprahyoid group. When

the masseter contracts, it elevates the mandible, which closes the mouth. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The masseter muscle is probably the most powerful of muscles of mastication. It is not a member of the suprahyoid muscle group.

REF: p. 318 OBJ: To categorize muscles according to their roles in elevation, depression, protrusion, retrusion, and lateral excursion of the mandible NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 14. Each of the following is a muscle of the suprahyoid group EXCEPT one. Which one is the

EXCEPTION? a. Digastric b. Geniohyoid c. Mylohyoid d. Thyrohyoid ANS: D

The thyrohyoid muscle is a member of the infrahyoid muscle group. Hyoid muscles are divided into two groups – those above the hyoid bone are called the suprahyoid muscles and those below are called the infrahyoid muscles.

REF: pp. 320-322 OBJ: To name the suprahyoid and infrahyoid muscles and their roles in mandibular movement, swallowing, and phonation NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 15. Involuntary contraction and spasms of the sternomastoid and trapezius muscles can be caused

by migraine headaches. Some malocclusions can also cause such spasms. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

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Sensory nerve supply for these muscles is near the trigeminal nerve nucleus in the upper spinal cord. This can result from pain emanating from the area of the temporomandibular joint.

REF: p. 327 OBJ: To describe the functions of the sternocleidomastoid and trapezius muscles and their roles in referred pain to various areas, including the temporomandibular joint NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 16. The mylohyoid muscle originates from the mylohyoid line on the medial surface of each side

of the maxilla. The left and right muscles fuse into what is known as a raphe. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The mylohyoid muscle originates from the mylohyoid line on the medial surface of each side of the mandible.

REF: p. 322 OBJ: To name the suprahyoid and infrahyoid muscles and their roles in mandibular movement, swallowing, and phonation NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 17. Which muscle originates in tN he uR pper sternum and inserts into the thyroid cartilage?

U SINGTB.COM a. Sternohyoid b. Sternothyroid c. Thyrohyoid d. Sternocleidomastoid ANS: C

The thyrohyoid muscle originates from the oblique line on the lateral side of the thyroid cartilage, which serves as the insertion of the sternothyroid muscle. This muscle is a member of the infrahyoid group.

REF: p. 324 OBJ: To name the suprahyoid and infrahyoid muscles and their roles in mandibular movement, swallowing, and phonation NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 18. The larynx moves up and down during swallowing. The thyrohyoid muscle pulls the larynx

down. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

NURSINGTB.COM

During swallowing the thyrohyoid muscle contracts, elevating the thyroid cartilage of the larynx. Prevention of choking is accomplished by muscular contractions, which move the epiglottis over the opening of the larynx.

REF: p. 325 OBJ: To name the suprahyoid and infrahyoid muscles and their roles in mandibular movement, swallowing, and phonation NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 19. The mandible is elevated by each of the following EXCEPT one. Which one is the

EXCEPTION? a. Medial pterygoid b. Masseter c. Geniohyoid d. Temporal ANS: C

The geniohyoid muscle, a member of the suprahyoid group, does not elevate the mandible.

The remaining three selections are muscles of mastication, which elevate, protrude, and retrude the mandible. Muscles of mastication also cause the mandible to move laterally.

REF: p. 318 | pp. 320-321 OBJ: To categorize muscles according to their roles in elevation, depression, protrusion, retrusion, and lateral excursion of the mandible NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering

N R I G B.C M

U by S which N Tmuscle?

O 20.2 The floor of the mouth is formed 0 a. Stylohyoid . b. Geniohyoid c. Mylohyoid d. Digastric ANS: C

The mylohyoid muscle forms what is called the floor of the mouth. It is a member of the suprahyoid group whose action is depression of the mandible.

REF: pp. 322-323 OBJ: To name the suprahyoid and infrahyoid muscles and their roles in mandibular movement, swallowing, and phonation NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 21. The sternocleidomastoid muscle has an origin at the superior border of the scapula. When

muscle contracts it pulls the hyoid bone down. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

NURSINGTB.COM

The omohyoid has its origin at the upper border of the scapula (shoulder blade). Both the omohyoid and the sternocleidomastoid are members of the infrahyoid group. When contracted, both muscles pull the hyoid bone down.

REF: p. 324 OBJ: To name the suprahyoid and infrahyoid muscles and their roles in mandibular movement, swallowing, and phonation NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 22. The sternocleidomastoid muscle is innervated by which cranial nerve? a. Fifth b. Seventh c. Tenth d. Eleventh ANS: D

The sternocleidomastoid muscle is innervated by the 11th cranial nerve. During an extraoral examination, this muscle should be palpated to check for enlarged lymph nodes lying against the internal jugular vein in the neck.

REF: p. 325 OBJ: To describe the origin, insertion, action, and nerve and blood supply of muscles of mastication NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 23. If the left lateral pterygoid contracts, the mandible will move to the left because one of the

lateral pterygoid muscles actiN ng R tselfGaccBo. hes lateral excursion.

UbySiI N T mCplis OM a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Contraction of the left lateral pterygoid muscle will move the mandible to the right. While one lateral pterygoid is contracting, the opposite elevators of the mandible hold the other condyle in place.

REF: p. 324 OBJ: To categorize muscles according to their roles in elevation, depression, protrusion, retrusion, and lateral excursion of the mandible NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 24. Which muscle of mastication fans out widely at its origin? a. Masseter b. Temporal c. Medial pterygoid d. Lateral pterygoid ANS: B

NURSINGTB.COM

The temporal muscle, frequently called the temporalis muscle, has a very wide origin. Muscle fibers run in vertical, inclined, and horizontal directions. These fibers insert primarily on the medial side and the tip of the coronoid process.

REF: p. 318 OBJ: To describe the origin, insertion, action, and nerve and blood supply of muscles of mastication NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering TRUE/FALSE 1. The insertion of a muscle is attached to the more movable structure.

ANS: T

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

REF: p. 318 OBJ: To describe the origin, insertion, action, and nerve and blood supply of muscles of mastication NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 2. All muscles of mastication are attached to an area of the mandible.

ANS: T

There are four pairs of muscles of mastication, which are all attached to the mandible. They are primarily responsible for elevating, protruding, retruding, or causing the mandible to move N R I G B.C M U S N T O laterally.

REF: p. 318 OBJ: To categorize muscles according to their roles in elevation, depression, protrusion, retrusion, and lateral excursion of the mandible NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 3. The suprahyoid muscles are innervated by cranial nerves.

ANS: F

The suprahyoid muscles can be innervated by cranial or cervical nerves.

REF: p. 322 OBJ: To describe the origin, insertion, action, and nerve and blood supply of muscles of mastication NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 4. Muscles of mastication are innervated by the facial nerve.

ANS: F

Muscles of mastication are innervated by the trigeminal nerve.

REF: p. 318 OBJ: To describe the origin, insertion, action, and nerve and blood supply of muscles of mastication

NURSINGTB.COM

NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 5. The suprahyoid and thyrohyoid muscles control laryngeal movements.

ANS: F

The sternothyroid and thyrohyoid muscles control laryngeal movements. The suprahyoid is a group of muscles located above the hyoid bone and does not control laryngeal movements.

REF: p. 320 | p. 324 OBJ: To name the suprahyoid and infrahyoid muscles and their roles in mandibular movement, swallowing, and phonation NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 6. Spasms originating from the TMJ can be referred (as pain) to the sternocleidomastoid muscle

(SCM).

ANS: F

Spasms from muscles can be referred as pain to the TMJ. Muscles most frequently involved are the sternomastoid and the trapezius. Although the sternocleidomastoid (SCM) is a different muscle, it also is involved in referred pain.

REF: p. 325 | p. 327 OBJ: To describe the functions of the sternocleidomastoid and trapezius muscles and their roles in referred pain to various areas, including the temporomandibular joint NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muN scleR s. I GTOB P:.C BLOMOM: Remembering

U S N T

O

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Chapter 29: Temporomandibular Joint Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The thickened area surrounding the articular disk is called the temporomandibular ligament.

This ligament provides some resistance to lateral displacement. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The temporomandibular ligament is the thickened area between the articular tubercle and the lateral pole of the condyle.

REF: p. 328 OBJ: To diagram and label a sagittal section of the temporomandibular joint (TMJ) NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 2. The retrodiscal pad has very little nutritive supply because it is composed of dense connective

tissue that lacks blood and nerve supply. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT coN rreUcR t, S buIt N thG eT reB as. oC nO is M correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

The relatively loose connective tissue of the retrodiscal pad contains much of blood and nerve supply to the TMJ. Consequently, it is rich in nutritive elements.

REF: p. 328 OBJ: To diagram and label a sagittal section of the temporomandibular joint (TMJ) NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 3. Injury to the medial and lateral attachments to the articular disk rarely causes pain because

these areas do not have nerve supply. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Injury to the medial and lateral attachments of the disk can result in significant pain because these areas have nerve supply. Note that it is possible to damage the central portion of the disk without experiencing pain because this area lacks nerve supply.

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REF: p. 330 OBJ: To discuss probable causes of TMJ pain NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 4. The gliding movement of the TMJ occurs along the anterior slope of the articular eminence.

Specifically, this gliding movement occurs between the articular disk and the articular surface of the temporal bone. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The anterior gliding movement occurs along the posterior slope of the articular eminence.

Note that this movement occurs as the jaw opens, causing the disk and condyle to rotate on one another.

REF: p. 328 OBJ: To describe the two movements of the TMJ as the mouth opens and know where these movements take place NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 5. The TMJ has three distinct types of movement. They are rotational, gliding, and subluxating. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are falseN . URSINGTB.COM ANS: D

The TMJ has two distinct types of movement: rotational and gliding. Subluxation occurs when the mouth is opened wide and either will not close or pops back into position upon closing.

REF: p. 328 | p. 331 OBJ: To describe the two movements of the TMJ as the mouth opens and know where these movements take place NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 6. Bruxism can wear down teeth if it occurs over a long period of time. The more immediate

result of bruxism is the inability to close the mouth when it has been opened very wide. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Inability to close the mouth is referred to as subluxation. The more immediate result of bruxism is a sore and tired TMJ. REF: p. 331

OBJ: To de?9?ne disk derangement, subluxation, bruxism, and TMJ sounds

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NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 7. Each of the following is an osseous structure of the TMJ EXCEPT one. Which one is the

EXCEPTION? a. Mandibular fossa b. Condyle c. Articular disk d. Articular eminence ANS: C

The articular disk is a small fibrous pad of dense collagen tissue found between the temporal bone and the condyle of the mandible.

REF: p. 328 OBJ: To diagram and label a sagittal section of the temporomandibular joint (TMJ) NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 8. The inferior surface of the articular disk is concave in shape. The superior surface is flat with

a slightly bulging surface. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The inferior surface is concave contourMof the mandible. The superior surface is NUtoRmatch INGthe B.C S T concave and convex to match the contours of the O mandibular fossa and articular eminence.

REF: p. 328 OBJ: To diagram and label a sagittal section of the temporomandibular joint (TMJ) NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 9. The entire TMJ is surrounded by a thin epithelial capsule. The temporomandibular ligament is

a thickening on the medial side of this capsule. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The entire TMJ is surrounded by a thick fibrous capsule. On the lateral side of this capsule is a thickening called the temporomandibular ligament. Note that the ligament is located between the articular tubercle and the lateral pole of the condyle.

REF: p. 328 OBJ: To diagram and label a sagittal section of the temporomandibular joint (TMJ) NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding

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10. The intermediate zone is the thin middle area of the articular disk. The thick posterior area of

the articular disk is called the posterior zone. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The thick posterior area of the articular disk is called the posterior band. Also, the slightly thick anterior area of the disk is called the anterior band.

REF: p. 328 OBJ: To diagram and label a sagittal section of the temporomandibular joint (TMJ) NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 11. The slope of bone anterior to the mandibular fossa is the a. synovial cavity b. posterior tubercle c. coronoid process d. articular eminence ANS: D

The articular eminence is the slope of temporal bone in front of the mandibular fossa.

Synovial cavities are small saclike compartments situated above and below the articular disk.

The posterior tubercle, also a portion of the temporal, is behind the mandibular fossa. The coronoid process is the bony projection at the upper anterior ramus of the mandible.

N R I G B.C M

U S N T O REF: p. 328 | pp. 330-331 OBJ: To diagram and label a sagittal section of the temporomandibular joint (TMJ) NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 12. If the condyle glides too far forward, it may be unable to move back into its normal position.

When this occurs, the clinician can physically push the mandible down and posteriorly, away from the articular eminence. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

This situation describes subluxation. Not only does the condyle glide too far forward, it also moves too far anterior to the height of the articular eminence. For the clinician guiding the mandible back into position, it is advisable to wrap thumbs in gauze for protection if the patient should close down upon them.

REF: p. 331

OBJ: To define disk derangement, subluxation, bruxism, and TMJ sounds

NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding

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13. The synovial fluid prevents dislocation of the TMJ components because its lubricating

qualities allow surfaces to rub over one another without irritation. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Synovial fluid, a lubricating liquid secreted by the epithelial lining of the synovial cavities, allows surfaces to rub over each other without irritation.

REF: p. 328 OBJ: To define the role of a synovial cavity NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 14. The mandibular fossa is located on the a. posterior surface of the temporal bone b. inferior surface of the temporal bone c. anterior medial surface of the condyle d. posterior superior surface of the condyle ANS: B

Located on the inferior surface of the temporal bone, the mandibular fossa lies between the articular eminence and posterior tubercle. Inferior to the mandibular fossa is the articular disk, which is contoured to match both the mandibular fossa and the articular eminence.

REF: pp. 328-329 NURSINGTB.COM OBJ: To diagram and label a sagittal section of the temporomandibular joint (TMJ) NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 15. The contraction of the lateral pterygoid muscle a. elevates the mandible b. retracts the mandible c. moves the condyle forward d. moves the condyle posteriorly ANS: C

During the gliding phase of opening the mouth additional forward movement of the condyle is caused by contraction of the inferior head of the lateral pterygoid muscle.

REF: p. 329 OBJ: To describe the role of the superior posterior elastic lamina, the inferior posterior collagenous lamina, and the superior and inferior heads of the lateral pterygoid muscle as the jaw goes through its various functional movements NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 16. The temporomandibular ligament is a. an internal thickening of the medial side of the capsule b. an internal thickening of the lateral side of the capsule

c. attached to the articular tubercle and the medial side of the neck of the condyle d. attached to the posterior border of the ramus ANS: B

The lateral side of the TMJ capsule is thickened between the articular tubercle and the lateral pole of the condyle. This thickened area is the temporomandibular ligament.

REF: p. 328 OBJ: To diagram and label a sagittal section of the temporomandibular joint (TMJ) NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 17. The articular disk is a fibrous pad of which tissue type? a. Collagen b. Elastic c. Epithelial d. Calcified ANS: A

The articular disk is a small fibrous pad of dense collagen tissue. To adapt to adjacent structures, its upper surface is concave and convex and its lower surface is concave.

REF: p. 328 OBJ: To diagram and label a sagittal section of the temporomandibular joint (TMJ) NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 18. The temporomandibular ligament helps prevent displacement of the condyle in each of the

NUone RS IN GTone B.C MEXCEPTION? following directions EXCEPT .W hich is O the a. Lateral b. Posterior c. Inferior d. Rotational ANS: D

Rotational forces are not prevented by the temporomandibular ligament. Note that during jaw opening the elastic lamina pulls posteriorly on the articular disk. This causes rotational movement in the lower synovial cavity between the disk and the condyle.

REF: pp. 328-329 OBJ: To describe the role of the superior posterior elastic lamina, the inferior posterior collagenous lamina, and the superior and inferior heads of the lateral pterygoid muscle as the jaw goes through its various functional movements NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 19. Generally, popping and clicking noises in the TMJ area are a result of arthritic changes. These

noises can be heard with the aid of a stethoscope. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Arthritis is only one of a number of factors that cause popping and clicking noises. The noises can be the result of anterior displacement of the condyle, malocclusion, bruxism, and arthritis.

REF: pp. 330-331 OBJ: To discuss probable causes of TMJ pain NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 20. If the condyle moves too far anteriorly (during typical functions), it may move to the height of

the articular eminence. This movement frequently causes difficulty in opening the mouth. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Such anterior movement of the condyle frequently results in subluxation. Difficulty in closing the mouth occurs.

REF: p. 331 OBJ: To de?9?ne disk derangement, subluxation, bruxism, and TMJ sounds NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 21. Night guards are MOST often prescribed for a. malocclusion b. bruxism c. stress d. popping and clicking noiN seU s iR nS oI peN niG ngTtB h. em CoOuMth ANS: B

Night guards are frequently prescribed to eliminate the excessive wear to teeth caused by bruxism. Note that nightguards are also utilized for the other conditions.

REF: p. 331 OBJ: To define disk derangement, subluxation, bruxism, and TMJ sounds NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 22. Referred pain is pain perceived at a location other than the site of the painful stimulus. Pain of

this nature almost always originates in a nearby structure. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Referred pain can originate far away from the perceived stimulus, or from close by. A classic example of referred pain is TMJ pain, which often comes from spasm in neck muscles and muscles of mastication.

REF: p. 330 OBJ: To discuss probable causes of TMJ pain NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones; 4. muscles.

TOP: BLOOM: Understanding

MULTIPLE RESPONSE 1. Which of the following accurately describe the area immediately surrounding the

temporomandibular joint (Select all that apply.)? a. The entire TMJ is surrounded by a thick fibrous capsule. b. The lateral side of the capsule is thickened between the articular tubercle and the condyle. c. The temporomandibular ligament is a thickening on the lateral side of the capsule. d. The condyle is displaced medially by the temporomandibular ligament. e. The temporomandibular ligament provides some resistance to lateral displacement.

ANS: A, B, C, E

The temporomandibular ligament, a thickening on the lateral side of the TMJ capsule between the articular tubercle and the condyle, prevents the condyle from being displaced too far inferiorly and posteriorly. It also provides some lateral resistance. Medially, there are two other ligaments that control movement in that direction.

REF: pp. 328-329 OBJ: To diagram and label a sagittal section of the temporomandibular joint (TMJ) NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering TRUE/FALSE 1. The mandibular fossa is the area between the condyle and the coronoid process.

ANS: F

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The mandibular fossa is found on the temporal bone between the posterior tubercle and the articular eminence.

REF: pp. 328-329 OBJ: To diagram and label a sagittal section of the temporomandibular joint (TMJ) NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 2. The retrodiscal pad lies between the two posterior lamina of the disk.

ANS: T

Running from the upper posterior part of the disk is an elastic lamina. Running from the lower posterior border of the disk is a collagenous lamina. The retrodiscal pad lies between these two posterior lamina. A lamina is a tissue layer.

REF: p. 328 OBJ: To describe the role of the superior posterior elastic lamina, the inferior posterior collagenous lamina, and the superior and inferior heads of the lateral pterygoid muscle as the jaw goes through its various functional movements NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 3. The temporomandibular joint (TMJ) has one synovial cavity.

ANS: F

The TMJ has two synovial cavities, one upper and one lower.

REF: p. 328 OBJ: To define the role of a synovial cavity NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 4. The articular disk is loosely attached to the condyle and the mandibular fossa.

ANS: F

The articular disk is attached both medially and laterally to the poles of the condyle.

REF: p. 328 OBJ: To diagram and label a sagittal section of the temporomandibular joint (TMJ) NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering 5. Subluxation occurs when the mandible is opened wide.

ANS: T

Subluxation is a condition that occurs when the mouth is opened too wide and does not close.

It also is the term that describes the popping back into position of the mandible.

REF: p. 331 OBJ: To define disk derangement, subluxation, bruxism, and TMJ sounds NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Remembering

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Chapter 30: Muscles of Facial Expression Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The facial nerve innervates muscles of facial expression and mastication. The facial nerve is

the fifth cranial nerve. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

While the facial nerve innervates muscles of facial expression, the trigeminal nerve innervates muscles of mastication. The facial nerve is the seventh cranial nerve; the trigeminal nerve is the fifth cranial nerve.

REF: p. 318 | p. 333 OBJ: To name the various groupings or locations of muscles of facial expression and their nerve innervations NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 2. The posterior auricular muscle can raise the ear. Fibers of this poorly developed muscle run

forward. a. Both statements are true. b. The first statement is trueN ;U thR eS seI coN nG dT staBte.mCeO ntMis false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The posterior auricular muscle is probably the best developed of the ear muscles. Fibers run forward to insert into the posterior part of the ear.

REF: p. 333 OBJ: To name the various groupings or locations of muscles of facial expression and their nerve innervations NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 3. The upper end of fibers of the platysma attach to the inferior border of the mandible. The

platysma moves the skin over the neck, but it doesn't change the facial expression. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The platysma contributes to pulling the corners of the mouth down, as in a grimace. Its attachment to the inferior border of the mandible makes this possible.

REF: p. 333 | p. 335 OBJ: To name the various groupings or locations of muscles of facial expression and their nerve innervations NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 4. The dilator naris raises the nostrils. This muscle causes the nostrils to flare or dilate. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The dilator naris pulls down on the nostrils, which causes them to flare or dilate.

REF: p. 335 OBJ: To name the various groupings or locations of muscles of facial expression and their nerve innervations NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 5. The orbicularis oris and orbicularis oculi circle the oral cavity. Muscles of the orbicularis

oculi circle the lips like a purse string. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

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The orbicularis oculi circles the eye; the orbicularis oris circles the oral cavity. Note that the Latin term orbicularis relates to the word circular. Muscles of the orbicularis oris circle the lips like a purse string, and all the surrounding muscles interlace with them.

REF: p. 333 OBJ: To name all muscles surrounding the mouth and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 6. The mentalis muscle fibers originate in the mental foramen. These fibers terminate by

inserting into the skin of the chin. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Mentalis muscle fibers originate on the anterior surface of the mandible just beneath the lateral incisors. Contraction pulls the skin of the chin up.

REF: p. 337 OBJ: To name all muscles surrounding the mouth and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding

7. Muscles grouped around the mouth do not influence tooth alignment because abnormal

pressures from one muscle group are balanced by muscles of other groups. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Abnormal pressures caused by muscles grouped around the mouth can influence tooth alignment as well as facial expression, speech, and mastication. Abnormal muscular pressures are not necessarily balanced by other muscles.

REF: p. 336 OBJ: To name all muscles surrounding the mouth and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 8. The epicranius muscle is known by what other name? a. Anterior auricular b. Frontalis c. Occipitofrontalis d. Platysma ANS: C

The epicranius muscle, also called the occipitofrontalis, is a paired muscle with groups connected by a broad flat banNd oR is. mCuscM Uf fas SIcia N.GTh TB Ole allows for movement of the scalp, which can result in squinting or an expression of surprise.

REF: p. 333 | p. 335 OBJ: To describe the other muscles of facial expression and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 9. Muscle that arises from the superior nuchal line of the occipital bone and the mastoid area is

the a. b. c. d.

orbicularis oculi occipital belly of the epicranius muscle superior auricular posterior auricular

ANS: D

The posterior auricular muscle arises in the area of the occipital bone and mastoid area. A convenient logic device: the mastoid bone is located behind (posterior) the ear and auricular refers to ear.

REF: p. 333 OBJ: To describe the other muscles of facial expression and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering

10. The orbicularis oculi raises the eyelids because fibers of this muscle attach to the medial and

lateral borders of the orbit. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Contraction of fibers of the orbicularis oculi closes the eyelids. Conversely, as inferred by its name, contraction of another ocular muscle, the levator palpebrae superioris, opens the eyelid.

REF: p. 335 OBJ: To describe the other muscles of facial expression and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 11. Both the corrugator and the platysma pull the eyebrow up. The corrugator muscle has fibers

that extend to the lateral part of the eyebrow, whereas the procerus has fibers that extend to the medial end of the eyebrow. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Both the corrugator and the procerus pull an end of the eyebrow down. The corrugator extends to the lateral end of tN heUbRrow prB oc.eC rus extends to the medial end of the brow.

SI; NthGe T OM Both can express a frown; the procerus can express a frown or a squint.

REF: p. 335 OBJ: To describe the other muscles of facial expression and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 12. Which muscle opens and closes the nostrils? a. Nasalis b. Naris c. Dilator naris d. Compressor naris ANS: A

The nasalis opens and closes the nostrils. It is composed of two parts. The dilator naris causes flaring or dilating; the compressor naris causes closure or compression.

REF: p. 335 OBJ: To describe the other muscles of facial expression and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 13. Which muscle originates from the lower rim of the orbit? a. Orbicularis oris

b. Procerus c. Levator labii superioris d. Levator anguli oris ANS: C

The levator labii superioris originates from the lower rim of the orbit and inserts into the upper eyelid. As the term levator indicates, this muscle raises the upper (superior) labii (lid).

This muscle is supplied by the III cranial nerve (oculomotor). Therefore, it is considered a muscle of the orbit and not a facial muscle.

REF: p. 336 OBJ: To describe the other muscles of facial expression and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 14. Which muscle plays a role in mastication? a. Buccinator b. Orbicularis oris c. Levator labii superioris d. Depressor labii inferioris ANS: A

Although the buccinator is a muscle of facial expression, it also plays a role in mastication. It has connections to the medial surface of the mandible and the buccal alveolar bone of maxillary molars. This muscle is involved in chewing, crushing, and grinding food between the molars. It is frequently referred to as an accessory muscle of mastication. Again, the buccinator is a facial muscle, not a muscle of mastication.

N R I G B.C M

U S N T O REF: p. 337 OBJ: To discuss the role of the buccinator muscle in mastication NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 15. The orbicularis oris is probably the most important muscle of the mouth because in addition to

its role in forming facial expressions, this muscle is also referred to as an accessory muscle of mastication. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

The buccinator is probably the most important muscle of the mouth. Its dual role of forming facial expressions and mastication make it unique and valuable. The orbicularis oris surrounds the mouth and interlaces with all other muscles surrounding the mouth.

REF: p. 337 OBJ: To discuss the role of the buccinator muscle in mastication NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 16. Muscle that originates from the pterygoid hamulus to the medial surface of the mandible at the

posterior end of the mylohyoid line is the

a. b. c. d.

buccinator levator labii superioris depressor labii inferioris orbicularis oris

ANS: A

The buccinator also attaches to the maxillary and mandibular molars and makes up the musculature of the cheek.

REF: p. 337 OBJ: To discuss the role of the buccinator muscle in mastication NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 17. Which muscle compresses the lips? a. Levator labii superioris b. Depressor labii inferioris c. Levator anguli superioris d. Orbicularis oris ANS: D

The orbiscularis oris muscle closes and compresses the lips. It circles the lips like a purse string and interlaces with all surrounding muscles. The levator labii superioris elevates the upper lip. The depressor labii inferioris pulls the lower lip down into a pout. The levator anguli superioris pulls the angles of the mouth up and toward the midline.

REF: p. 334 | pp. 336-337 OBJ: To name all muscles surrounding the mouth and their origins, insertions, and actions NAT: CDA: GC I.A.4. IdentifyNbasR ic oI ral aG nd dBe. ntaCl anM atomy, physiology, and development, including but not limited to: muscU les.S

N TTOP: BLOOOM: Remembering

18. The levator palpebrae superioris is not considered a facial nerve because it is not innervated

by the facial nerve. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

This muscle, which raises the upper eyelid, is considered a muscle of the orbit. A variation from the other nerves of the face, which are innervated by the facial nerve (VII), this nerve is innervated by the III cranial nerve. This nerve is called the oculomotor nerve.

REF: p. 335 OBJ: To describe the other muscles of facial expression and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding 19. The levator palpebrae superioris muscle is considered a muscle of the orbit because it is

supplied by both the oculomotor and facial nerves. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related.

c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The levator palpebrae superioris is supplied only by the oculomotor nerve. It is a muscle of the orbit (the eye).

REF: p. 335 OBJ: To name the various groupings or locations of muscles of facial expression and their nerve innervations NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Understanding MULTIPLE RESPONSE 1. Which of the following can be influenced by abnormal pressure from muscles that surround

the mouth (Select all that apply.)? a. Mastication b. Facial expression c. Ability to close eyelids d. Raising the upper eyelid e. Speech patterns ANS: A, B, E

Abnormal pressures from muscles surrounding the mouth can affect mastication, facial expression, and speech patterns. The orbicularis oculi closes the eyelids; the levator palpebrae superioris raises the upper eyN elU idR . SINGTB.COM REF: p. 336 OBJ: To name all muscles surrounding the mouth and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 2. Which does NOT have a role in frowning (Select all that apply.)? a. Corrugator b. Procerus c. Mentalis d. Buccinator ANS: C, D

Although they are muscles that surround the mouth, neither the mentalis nor the buccinator are involved in frowning. Both the corrugator and the procerus attach to the eyebrow.

Contraction causes a frown in the corrugator and a frown or squint in the procerus.

REF: p. 333 | p. 335 OBJ: To describe the other muscles of facial expression and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 3. Which of the following are true of the buccinator muscle (Select all that apply.)? a. It is probably the most important muscle of the mouth.

b. c. d. e.

It has no role in mastication.

It originates from the pterygomandibular raphe.

It originates from the buccal alveolar bone of maxillary molars.

It makes up the musculature of the cheek.

ANS: A, C, D, E

While the buccinators is a facial muscle, it is frequently referred to as an accessory muscle of mastication because it plays a major role in mastication. Note that it originated from both the pterygomandibular raphe as well as the buccal alveolar bone of maxillary molars and corresponding mandibular molars.

REF: p. 337 OBJ: To discuss the role of the buccinator muscle in mastication NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering TRUE/FALSE 1. Muscles of the scalp move the scalp in a forward but not a backward movement.

ANS: F

Muscles of the scalp allow for its mobility both forward and backward.

REF: p. 333 OBJ: To describe the other muscles of facial expression and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering

IaNxGillTaBto.jC 2. Fibers of the platysma run froNm em usO t bMelow the clavicle in a broad sheet.

UtRhS ANS: F

Fibers of the upper end of the platysma run from the mandible, near the angles of the mouth and the skin of the face. They run in a broad sheet to the chest, ending just below the clavicle.

REF: p. 333 OBJ: To describe the other muscles of facial expression and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 3. The action of the orbicularis oris is to close and compress the lips.

ANS: T

The orbicularis oris circles the oral cavity. While closing and compressing the lips, this muscle interlaces with surrounding muscles and circles the lips like a purse string.

REF: pp. 335-336 OBJ: To describe the other muscles of facial expression and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 4. Fibers of the mentalis muscle cross the midline.

ANS: T

Some mentalis muscle fibers cross the midline to meet mentalis fibers on the other side.

REF: p. 337 OBJ: To name all muscles surrounding the mouth and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 5. The risorius muscle pulls the corners of the mouth down as in a frown.

ANS: F

The very poorly developed risorius muscle aids in smiling. It is a very small muscle and an apparent continuation of the platysma muscle.

REF: p. 334 | p. 338 OBJ: To name all muscles surrounding the mouth and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muscles.

TOP: BLOOM: Remembering 6. All of muscles surrounding the oral cavity interlace with the orbicularis oris.

ANS: T

Orbicularis oris muscles surround the lips like a purse string, and all muscles surrounding the lips interlace with them. The action is to close and compress the lips.

REF: p. 336 OBJ: To describe the other muscles of facial expression and their origins, insertions, and actions NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology, and development, including but not limited to: muN scleR s. I GTOB P:.BL C OMOM: Remembering

U S N T

O

Chapter 31: Soft Palate and Pharynx Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The pharynx has four components. The laryngeal pharynx is a middle component of the

pharynx. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The pharynx has three components: the upper, middle, and lower. The laryngeal pharynx is the lower component.

REF: p. 340 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 2. Muscles of the oral pharynx seal off the nasal cavity from the oral cavity. This action also

narrows the space between the two palatine tonsils. a. Both statements are true. b. The first statement is true; the second statement is false.

CeOnMt is true. c. The first statement is falsN e;UthReSseIcN onGdTsB tat. em d. Both statements are false.

ANS: C

Muscles of the soft palate seal off the nasal cavity from the oral cavity. They also narrow the space between the two palatine tonsils. These actions help direct food away from the respiratory system.

REF: p. 339 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Understanding 3. The posterior faucial pillar is formed by the palatopharyngeal muscle. When constricted, it

depresses the pharynx and elevates the larynx. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

When contracted, the palatopharyngeal muscle narrows the posterior faucial pillar and elevates both the pharynx and larynx.

REF: p. 339 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Understanding 4. The palatoglossal muscle is misnamed because although it originates in the palate, it inserts

into the floor of the mouth near the hyoid bone. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

The palatoglossal muscle is appropriately named because it originates in both the hard and soft palates and inserts into the tongue. More specifically this muscle inserts into the posterior and lateral parts of the tongue. Note that glossal means tongue.

REF: p. 339 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Understanding 5. Each of the following is true about the uvula EXCEPT one. Which one is the EXCEPTION? a. It is a tubercle located within the soft palate. b. It is formed by two smallNbanR U dsSoIfNmGusTcBle..C OM c. It originates from the posterior end of the hard palate. d. When contracted its muscle shortens and broadens. e. The uvula is innervated by the 10th and 11th cranial nerves.

ANS: A

The uvula is not a tubercle; it is a small fold of tissue that hangs down in the throat from the posterior part of the soft palate.

REF: pp. 339-341 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 6. The levator veli palatini helps open the auditory tube because this muscle pulls the soft palate

laterally. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The levator veli palatine helps open the auditory tube if it is edematous and closed. The action of this muscle is to pull the soft palate back and up. Note the term levator, which means elevate.

REF: p. 339 OBJ: To describe the interrelationship of all of these muscles in chewing, swallowing, and speech NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Understanding 7. All of the pharyngeal constrictors originate from the posterior end of the hard palate. These

three muscles overlap one another in their insertion into the midline raphe. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The pharyngeal constrictors insert into the midline raphe where they overlap each other. The uvula originates from the posterior end of the hard palate.

REF: p. 340 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Understanding 8. The pharyngeal elevator and dilator muscles are essential to chewing food because these

muscles aid in elevating and N dilaR Uting SIthe NGpha TBry.nCx.OM a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

The pharyngeal elevator and dilator muscles are essential to swallowing. Contraction of these muscles elevates and dilates the pharynx, actions necessary for food to move beyond the pharynx.

REF: p. 344 OBJ: To describe the interrelationship of all of these muscles in chewing, swallowing, and speech NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Understanding 9. The vertical fold of tissue in front of and behind each palatine tonsil is the a. anterior faucial pillar b. posterior faucial pillar c. palatoglossal fold d. palatopharyngeal fold e. All of the above ANS: E

The vertical fold in front of and behind each tonsil is called the anterior faucial pillar and the posterior faucial pillar, respectively. Alternate names are the palatoglossal and palatopharyngeal folds.

REF: p. 339 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 10. The palatoglossal muscle originates about halfway back the length of the palate because its

point of origin is at the posterior end of the hard palate and the anterior end of the soft palate. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

The point of origin, at the junction of the hard and soft palates, is about two-thirds of the way back the length of the palate.

REF: p. 339 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Understanding

N R I G B.C M

N Tand posterior O 11.1 The structure located between U the S anterior pillars is the 1 a. palatine tonsil . b. fauces c. uvula d. palatoglossal fold e. None of the above ANS: A

The palatine tonsil is located between the anterior and posterior pillars on the side of the throat wall. The pillars are also called the palatoglossal and palatopharyngeal folds.

REF: p. 339 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 12. The levator veli palatini elevates the posterior end of the soft palate. It joins the tensor veli

palatini in tensing the soft palate. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The levator veli palatine elevates, but does not tense, the posterior end of the soft palate. The tensor veli palatine may slightly tense the anterior portion of the soft palate, however its main function is to open the auditory tube when it is closed.

REF: p. 339 OBJ: To describe the interrelationship of all of these muscles in chewing, swallowing, and speech NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 13. The structure that helps to open the auditory tube, if it is edematous and closed, is the a. palatoglossal muscle b. palatopharyngeal muscle c. levator veli palatine d. stylopharyngeal muscle ANS: C

If the auditory tube is edematous and closed, the lavatory veli palatini pulls the posterior end of the soft palate up and back to contact the posterior pharyngeal (throat) wall.

REF: p. 339 OBJ: To describe the interrelationship of all of these muscles in chewing, swallowing, and speech NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Remembering 14. Pharyngeal elevator muscles elevate and dilate the pharynx. These actions are necessary to

prevent food from entering the esophagus. a. Both statements are true.N R I G B.C M U S N T O b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Food should enter the esophagus. Elevation and dilation of the pharynx ensures that food is properly directed toward the esophagus.

REF: p. 344 OBJ: To describe the interrelationship of all of these muscles in chewing, swallowing, and speech NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Understanding 15. Each of the following is true of the middle pharyngeal muscle EXCEPT one. Which one is the

EXCEPTION? a. It originates from the posterior, upper part of the hyoid bone. b. It crosses the stylohyoid ligament. c. It inserts into the median raphe. d. Contraction constricts the pharyngeal opening. e. Contraction forces food down toward the esophagus.

ANS: B

The middle pharyngeal muscle originates from both the stylohyoid ligament and the posterior, upper part of the hyoid bone. Note that constriction of the pharyngeal opening forces food toward the esophagus.

REF: pp. 343-344 OBJ: To describe the interrelationship of all of these muscles in chewing, swallowing, and speech NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Remembering 16. Contraction of each of the following muscles forces food down toward the esophagus

EXCEPT one. Which one is the EXCEPTION? a. Superior pharyngeal constrictor muscle b. Middle pharyngeal constrictor muscle c. Inferior pharyngeal constrictor muscle d. Stylopharyngeal muscle ANS: D

Note that the action of the superior, middle, and inferior pharyngeal constrictor muscles is to constrict the pharyngeal opening and force food toward the esophagus. Appropriately these three muscles are categorized as pharyngeal constrictors. By contrast, the stylopharyngeal, appropriately categorized as an elevator and dilator, elevates and dilates the pharynx.

REF: p. 340 | pp. 343-344 OBJ: To describe the interrelationship of all of these muscles in chewing, swallowing, and speech NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Remembering 17. The stylopharyngeal muscle N is thR e prI imaG ry dBil. atC or oM f the pharynx. This muscle originates in

U S N T

O

the end of the auditory tube in the lateral wall of the nasal pharynx. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The stylopharyngeal muscle originates from the medial side of the base of the styloid process.

It is the salpingopharyngeal muscle that originates from the end of the auditory tube in the lateral wall of the nasal pharynx.

REF: p. 344 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Understanding 18. During speech the soft palate moves both forward and backward. The backward movement is

accomplished by the levator veli palatini. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

During speech, the soft palate moves up and back to contact the posterior pharyngeal wall.

This is accomplished primarily by the levator veli palatine as well as muscles of the uvula.

REF: p. 344 OBJ: To describe the interrelationship of all of these muscles in chewing, swallowing, and speech NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 19. Enlarged nostrils give the voice a definite nasal tone because this condition prevents the soft

palate from adapting to the posterior pharyngeal wall. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

Enlarged pharyngeal tonsils prevent the soft palate from adapting to the posterior pharyngeal wall, commonly called the throat. Enlarged nostrils are not a factor. Note that pharyngeal tonsils are called adenoids.

REF: p. 344 OBJ: To describe the interrelationship of all of these muscles in chewing, swallowing, and speech NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Understanding 20. Peristaltic contractions take pNlaU ceRiS nI thN e GTB.COM a. pharynx b. esophagus c. epiglottis d. larynx ANS: B

Wavelike constrictions of the digestive tube take place in the esophagus. This action is created by involuntary smooth muscle and moves food through the digestive system.

REF: p. 344 OBJ: To describe the interrelationship of all of these muscles in chewing, swallowing, and speech NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. Which of the following accurately describe the pharynx (Select all that apply.)? a. The pharynx has three components. b. Three groups of muscles are associated with the pharynx. c. There are three pairs of pharyngeal constrictors. d. All pharyngeal constrictors insert into a midline tendon into the median raphe.

ANS: A, C, D

The pharynx has two groups of muscles – one group that constricts and another that elevates and dilates. The median raphe is a midline tendon in the posterior throat wall into which the three muscles of the constrictor group insert.

REF: p. 340 | p. 343 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Remembering 2. The vertical fold of tissue in front of and behind each palatine tonsil is the (Select all that

apply.) a. anterior faucial pillar b. posterior faucial pillar c. palatoglossal fold d. palatopharyngeal fold ANS: A, B, C, D

The vertical fold in front of and behind each tonsil is called the anterior faucial pillar and the posterior faucial pillar, respectively. Alternate names are the palatoglossal and palatopharyngeal folds.

REF: p. 339 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering

NURSINGTB.COM

3. In swallowing, the pharyngeal muscles perform which of the following (Select all that

apply.)? a. Dilate b. Elevate c. Compress d. Depress ANS: A, B, C, D

During swallowing elevators and dilators lift and widen the pharynx to receive the bolus of food. Next, constrictors compress the upper part of the oral pharynx and push (depress) food into the laryngeal pharynx.

REF: p. 344 OBJ: To describe the interrelationship of all of these muscles in chewing, swallowing, and speech NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Remembering 4. The esophagus is composed of which type(s) of muscle (Select all that apply.)? a. Smooth b. Skeletal c. Voluntary d. Involuntary ANS: A, B, C, D

The upper half of the esophagus is voluntary skeletal muscle. The lower half is involuntary smooth muscle.

REF: p. 344 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Remembering TRUE/FALSE 1. The soft palate consists of three pairs of muscles.

ANS: F

The soft palate consists of five pairs of muscles that help seal off the nasal cavity from the oral cavity.

REF: p. 339 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Remembering 2. The uvula is a paired muscle.

ANS: T

The uvula is formed by two small bands of muscle. This small folded structure hangs down in the throat from the posterior N paU rtRoS f tI heNsGoT ft B pa.laCteO. M REF: pp. 339-340 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Remembering 3. The stylopharyngeal muscle does not dilate the pharynx, however it does elevate it.

ANS: F

Contraction of the stylopharyngeal muscle causes dilation and elevation of the pharynx. This is the primary dilator of the pharynx.

REF: p. 344 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Remembering 4. The superior pharyngeal constrictor muscle and the buccinatorfacial muscle have the same

point of origin.

ANS: T

Both the superior pharyngeal constrictor and the buccinator originate in the same three locations. The points of origin are the medial pterygoid plate and its hamular process; the buccal aspect of the maxillary and mandibular alveolar processes; and the pterygomandibular raphe.

REF: pp. 339-340 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Remembering 5. Although the palatopharyngeal muscle elevates the pharynx, it also acts upon the soft palate.

ANS: T

In addition to elevating both the pharynx and larynx, the palatopharyngeal muscle narrows the posterior faucial pillar (of the palate). These actions are necessary to receive the food that is to be swallowed.

REF: p. 340 | p. 344 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx | To describe the interrelationship of all of these muscles in chewing, swallowing, and speech NAT: CDA: GC I.A.4. Identify basic oral and dental anatomy, physiology and development, including but not limited to: muscles and 6. oral cavity.

TOP: BLOOM: Remembering 6. Food moves directly from the pharynx to the stomach.

ANS: F

Food moves from the pharynN xU toRthSeIeN soG phTaB gu.sC , tO heM n to the stomach.

REF: p. 344 OBJ: To describe the interrelationship of all of these muscles in chewing, swallowing, and speech NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering 7. The pterygomandibular raphe is a cartilage nodule that runs between the medial pterygoid

plate and esophagus.

ANS: F

The pterygomandibular raphe is connective tissue of a tendon. It runs between the medial pterygoid plate and the buccal aspect of the maxillary and mandibular alveolar processes.

REF: p. 340 OBJ: To describe the origins, insertions, actions, and nerve supplies of muscles of the soft palate and pharynx NAT: CDA: GC I.A.6. Identify basic oral and dental anatomy, physiology and development, including but not limited to: oral cavity.

TOP: BLOOM: Remembering

Chapter 32: Arterial Supply and Venous Drainage Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. From the aorta, blood flows through the thorax. In the thorax, the aorta ends as common

paired iliac arteries. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The aorta ends in the pelvis as common paired iliac arteries. Note that from the thorax blood flows to the abdomen.

REF: p. 346 OBJ: To trace blood from the time it returns from the vena cava to the heart, out, and back until it returns again from the overall body NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Understanding 2. The external carotid artery has numerous branches that supply the head and neck area with

blood. The ascending pharyngeal artery is a branch within the anterior branch. a. Both statements are true. b. The first statement is true; the second statement is false.

CeOnMt is true. c. The first statement is falsN e;UthReSseIcN onGdTsB tat. em d. Both statements are false.

ANS: B

Unlike the internal carotid, the external carotid has numerous branches. They are the anterior, medial, and posterior. The ascending pharyngeal artery is the only branch of the medial branch.

REF: p. 346 OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Understanding 3. Each of the following statements is true of the maxillary artery EXCEPT one. Which one is

the EXCEPTION? a. It is a terminal branch of the external carotid artery. b. It diverges from the external carotid at the level of the neck of the condyle. c. The maxillary artery has about 5 branches. d. This artery supplies teeth and muscles of mastication. e. The maxillary artery enters the pterygopalatine fossa behind and below the eye.

ANS: C

There are about 15 branches of the maxillary artery. Note that branches pertinent to dentistry supply muscles of mastication, teeth, the oral and nasal cavities, and the coverings of the brain. Prior to entering the pterygopalatine fossa, this artery travels forward in an area known as the infratemporal fossa.

REF: p. 347 OBJ: To trace blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 4. The external jugular vein drains most of the facial area. Blood from the facial area passes out

of the skull through the mental foramen. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The internal jugular vein drains most of the facial area as well as much of the brain area.

Blood from these areas exits the skull through the jugular foramen.

REF: p. 351 OBJ: To trace the venous drainage from teeth and oral cavity back to the heart NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Understanding 5. Following a superior alveolar nerve block, a hematoma near maxillary molars can occur

because the buccal artery is very close to the maxillary tuberosity. a. Both the statement and thN eU reR aso nN arG e co I Brr.ecCt an Md related.

S T O b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

Hematomas can form near maxillary molars because the pterygoid plexus of veins is very close to the maxillary tuberosity. There is a high risk of piercing these veins with incorrect needle angulation. The buccal branch of the maxillary artery runs through the cheek area.

REF: p. 349 | p. 351 OBJ: To discuss the possible problems associated with a posterior superior alveolar injection NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Understanding 6. Each of the following structures is supplied by branches of the internal carotid artery

EXCEPT one. Which one is the EXCEPTION? a. Eyes b. Brain c. Coverings of the brain d. Cheek ANS: D

The internal carotid artery has no branches in the neck but goes up to enter the skull. It supplies the eyes, the brain, and some limited regions of covering of the brain. The buccal branch of the external carotid supplies the mucosa of the cheek.

REF: p. 346 | p. 349 OBJ: To discuss the possible problems associated with a posterior superior alveolar injection NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 7. The common carotid artery divides into the external and internal arteries. The division occurs

at the hyoid bone. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

At about the level of the larynx the common carotid divides into external and internal arteries.

REF: p. 346 OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Understanding 8. A pressure point on the mandible for control of facial bleeding is located a. where the lingual artery and vein cross the inferior border of the mandible b. where the facial artery and vein cross the inferior border of the mandible c. between the mental arteryNanR retro vein INmGaTndBib.uClaOr M Ud S d. at the linguofacial trunk ANS: B

After giving off a submental branch, the facial artery and vein crosses the inferior border of the mandible. Clinically, this point is considered a pressure point. Compression can be applied to stop facial bleeding.

REF: p. 347 OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Applying 9. The common carotid artery runs within the carotid sheath along with the internal jugular vein.

The vagus nerve lies immediately beneath the carotid sheath. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The common carotid artery runs within the carotid sheath along with the internal jugular vein and the vagus nerve.

REF: p. 346

OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Understanding 10. The facial artery is the blood supply for all of the following EXCEPT one. Which one is the

EXCEPTION? a. Muscles of facial expression b. Upper and lower lips c. Skin of facial expression d. Sides of the nose e. Oral and nasal cavities ANS: E

The maxillary artery supplies the oral and nasal cavities, as well as coverings of the brain, muscles of mastication, and teeth.

REF: pp. 346-347 | p. 349 OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 11. The lingual and the facial arteries a. supply the tongue b. travel the same path, parallel to each other c. often join together before branching separately d. supply labial gingival of mandibular teeth ANS: C

NURSINGTB.COM

Quite frequently, the lingual and facial arteries come off the external carotid as one branch and then split. This branch is referred to as the linguofacial trunk.

REF: p. 347 OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 12. The medial and lateral pterygoid muscles are supplied by which artery? a. Maxillary b. Facial c. Lingual d. None of the above ANS: A

The ptygeroid branches of the maxillary artery supply the medial and lateral pterygoid muscles. The courses of the pterygoid branches vary.

REF: p. 349 OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering

13. The buccal gingiva of the posterior maxillary teeth is supplied by the infraorbital artery. This

artery is a division of the maxillary artery. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The posterior superior alveolar artery, a division of the maxillary artery, supplies the buccal gingiva of the posterior maxillary teeth.

REF: p. 349 OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Understanding 14. The maxillary artery has branches that supply all of the maxillary and mandibular teeth. It also

supplies the tongue and floor of the mouth. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The maxillary artery diverges from the external carotid at the level of the neck of the condyle.

Branches of the maxillary artery supply all of the maxillary and mandibular teeth as well as many gingival areas. The tongue and floor of the mouth are supplied by the lingual artery, which is not a branch of the m illarI y. G B.C M NaxR

U S N T

O

REF: pp. 346-347 OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Understanding 15. The pterygopalatine artery supplies most of the nasal cavity. At the sphenopalatine foramen, it

emerges as the nasopalatine artery to anastomose with the greater palatine artery. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The pterygopalatine artery emerges from the incisive papilla, where it connects (anastomoses) with the greater palatine artery.

REF: p. 350 OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Understanding 16. The maxillary anterior teeth are supplied by which branch of the maxillary artery? a. Anterior superior alveolar

b. c. d. e.

Posterior superior alveolar Descending palatine Pterygopalatine None of the above

ANS: A

The anterior superior alveolar artery (ASA), a branch of the infraorbital artery, supplies the maxillary anterior teeth after traveling into bone in front of the maxillary sinus.

REF: p. 350 OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 17. The superficial temporal vein and the mandibular vein form the retromandibular vein. The

retromandibular vein divides into an inferior and a superior retromandibular vein. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The maxillary vein and the superficial temporal vein form the retromandibular vein, which divides into anterior and posterior retromandibular veins.

REF: p. 351 OBJ: To trace the venous drainage from teeth and oral cavity back to the heart NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bloN od vResseIls. G B.C M TOP: BLOOM: Understanding

U S N T

O

18. Blood from the brachiocephalic vein flows into the vena cava and into the a. external jugular vein b. internal jugular c. superior vena cava d. heart ANS: D

The brachiocephalic veins, formed by junctions of the external jugular, subclavian, and internal jugular, flow into the superior vena cava and on into the heart.

REF: p. 352 OBJ: To trace blood from the time it returns from the vena cava to the heart, out, and back until it returns again from the overall body NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 19. An untreated infection at the bridge of the nose may cause serious damage because such

infections can spread into a venous sinus near the base of the brain. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Such infections may spread through the superior ophthalmic veins into the cavernous sinus, a venous sinus near the base of the brain. Left untreated in this location, the infection may stagnate, causing serious infection and/or death.

REF: p. 352 OBJ: To trace the venous drainage from teeth and oral cavity back to the heart NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Understanding 20. The retromandibular vein connects the internal and external jugular veins. Sometimes a

branch of the retromandibular vein is missing, which will affect the size of the jugular vein. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

When the posterior or anterior branch of the retromandibular vein is missing, more blood is shunted to either the external or internal jugular vein. This causes differences in the sizes of these veins.

REF: p. 352 OBJ: To trace the venous drainage from teeth and oral cavity back to the heart NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Understanding MULTIPLE RESPONSE

NURSINGTB.COM

1. Which of the following accurately describe the common carotid artery (Select all that apply.)? a. The common carotid artery runs within the carotid sheath. b. The common carotid runs with the vagus nerve and the internal jugular vein. c. The common carotid lies lateral to the sternothyroid muscle. d. At about the level of the thyroid the common carotid artery divides. e. The common carotid artery divides into the external carotid and the internal

carotid.

ANS: A, B, E

The common carotid artery lies beneath the sternocleidomastoid muscle, which runs along the side of the neck. Note that the sternothyroid muscle arises from the sternum and pulls the larynx down upon contraction. Also, the common carotid divides at about the level of the larynx.

REF: p. 346 OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 2. Which of the following correctly describe venous drainage from the external jugular veins

(Select all that apply.)? a. The external jugular veins empty into the subclavian veins. b. The subclavian veins are in the neck. c. The brachiocephalic veins flow into the superior vena cava.

d. From the superior vena cava blood flows into the heart.

ANS: A, C, D

Subclavian veins are in the arm. Note that after the external jugular empties into the subclavian, these veins join the internal jugular and form the brachiocephalic veins.

REF: p. 351 OBJ: To trace the venous drainage from teeth and oral cavity back to the heart NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 3. Which of the following are characteristics of a hematoma (Select all that apply.)? a. Superficial bleeding on skin b. Bruising c. Swelling d. Throbbing, severe pain e. Discoloration ANS: B, C, E

Hematomas, caused by blood escaping into tissue spaces, can be upsetting to patients.

Swelling, bruising, and discoloration are classic symptoms. Hematomas do not bleed because the surface tissue remains intact. There generally is not severe pain or throbbing.

REF: p. 351 OBJ: To define hematoma NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 4. Which branch of the retromandibular vein may be missing (Select all that apply.)? a. Anterior NURSINGTB.COM b. Posterior c. Superior d. Inferior ANS: A, B

Often either the posterior or anterior branch of the retromandibular vein is missing, which causes a maldistribution of blood between the external and internal jugular veins. This causes differences in sizes of these two veins.

REF: p. 352 OBJ: To trace the venous drainage from teeth and oral cavity back to the heart NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering TRUE/FALSE 1. The right atrioventricular valve is also known as the tricuspid valve.

ANS: T

Blood enters the heart through the right atrium. When passing to the right ventricle, blood flows through the right atrioventricular valve, also called the tricuspid valve.

REF: p. 346 OBJ: To trace blood from the time it returns from the vena cava to the heart, out, and back until it returns again from the overall body

NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 2. The inferior alveolar artery is a branch of the maxillary artery.

ANS: T

The more important branches of the maxillary artery in the infratemporal fossa are the inferior alveolar, temporal, masseteric, pterygoid, middle meningeal, and buccal branches.

REF: p. 349 OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 3. The pterygopalatine artery supplies the soft palate area.

ANS: F

The lesser palatine artery supplies the soft palate. The pterygopalatine artery supplies the nasal pharynx, portions of the palate including the anterior portion, the nasal cavity, and the maxillary tuberosity.

REF: p. 349 OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 4. The blood supply to the tongue comes from the lingual artery.

ANS: T

NURSINGTB.COM

The lingual artery supplies the tongue and the floor of the mouth. This artery branches off the carotid below the facial artery then travels beneath the hyoglossus muscle of the tongue.

REF: p. 346 OBJ: To trace the blood supply from the heart to all areas of the oral cavity, including teeth NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering 5. The external jugular vein empties into the subclavian vein.

ANS: T

After descending and crossing the lateral surface of the sternomastoid muscle, the external jugular vein empties into the subclavian vein. The subclavian drains parts of the temporal, maxillary, and posterior auricular areas.

REF: pp. 351-352 OBJ: To trace the venous drainage from teeth and oral cavity back to the heart NAT: CDA: GC I.A.1. Identify basic oral and dental anatomy, physiology and development, including but not limited to: blood vessels.

TOP: BLOOM: Remembering

Chapter 33: Salivary Glands Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The parotid gland produces the most salivary volume of the major glands. It produces about

60% to 65% of salivary volume. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The submandibular gland produces the most salivary volume, 60% to 65% of the total salivary resting volume.

REF: p. 353 OBJ: To name and locate each of the major and minor glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 2. Eating can be painful for a person with mumps because chewing and swallowing cause

stimulation of the sublingual gland. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct.

NOR I reas GTonB.C M e. NEITHER the statement NU RS the N is coOrrect.

ANS: C

While it is true that eating can be painful for a person with mumps, note that this viral infection primarily occurs in the submandibular gland. The submandibular gland is also called the submaxillary gland.

REF: p. 353 OBJ: To name and locate each of the major and minor glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 3. The submandibular gland is called a mixed gland because it includes both serous and

epithelial cells. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The submandibular gland includes both serous and mucous cells. Although almost two-thirds of the cells in this gland are serous, the mucous component results in a slightly viscous secretion.

REF: p. 353

OBJ: To classify each of the glands according to its type of secretion

NURSINGTB.COM

NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 4. The major salivary gland ducts are located in the mandibular area because the tissues of the

floor of the mouth are highly vascular. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

While the tissues in the floor of the mouth are highly vascular, this statement does not explain salivary duct locations. The parotid gland duct pierces the buccinator muscle and opens into the oral cavity opposite the maxillary second molar. The submandibular and sublingual ducts open in the floor of the mouth.

REF: pp. 353-354 OBJ: To describe the development of the ducts and the ductless glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 5. The glossopalatine glands are located in the hard palate posterior to the rugae. They are purely

serous glands. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

NURSINGTB.COM

The glossopalatine glands are located in the anterior fold of tissue in front of the palatine tonsil. These minor salivary glands are purely mucous. Rugae are small ridges of tissue extending laterally across the anterior of the hard palate.

REF: p. 5 | p. 355 OBJ: To name and locate each of the major and minor glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 6. The submandibular gland produces a highly watery secretion because although it is a mixed

gland, almost two-thirds of the cells in this gland are serous. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

Interestingly, the smaller portion of mucous cells overrides the serous cells and produces a slightly viscous secretion. Mucous secreting cells, with a thicker and stickier secretion, comprise only one-third of the secretory cells in the submandibular gland. Serous cells comprise the remaining two-thirds.

REF: p. 353

OBJ: To classify each of the glands according to its type of secretion

NURSINGTB.COM

NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 7. Which salivary gland can be palpated below the inferior border of the mandible? a. Submandibular b. Sublingual c. Parotid d. Posterior lingual ANS: A

The submandibular gland, also called the submaxillary gland, is located below and to the posterior part of the body of the mandible. The sublingual, the smallest of the three major salivary glands, can be palpated in the anterior floor of the mouth near the mandibular canines. The parotid is located in the buccal mucosa opposite the maxillary second molars.

The posterior lingual is located on the posterior third of the tongue near the lingual tonsils.

REF: pp. 353-355 OBJ: To name and locate each of the major and minor glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 8. Which is NOT a location for minor salivary glands? a. Labial mucosa b. Buccal mucosa c. Palatal area d. Glossopalatine area e. All of the above are locations.

ANS: E

NURSINGTB.COM

The labial glands are located in the labial mucosa of the upper and lower lips. The buccal glands, located on the inner cheek region, are similar to the labial glands, differing only in location. The palatine glands are located in both the soft and hard palates. The glossopalatine glands are located down into the anterior fold of tissue in front of the palatine tonsil. Note that each of these minor salivary glands is named for its location.

REF: pp. 354-355 OBJ: To name and locate each of the major and minor glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 9. The sublingual gland can appear larger than normal in an edentulous patient because loss of

the mandibular ridge of bone makes this gland appear to bulge up in the mandibular vestibule. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The apparent bulge occurs in the floor of the mouth when the mouth is opened wide. In an edentulous patient, this is not unusual and is not cause for alarm unless the area is irritated from a denture.

REF: p. 354

OBJ: To name and locate each of the major and minor glands

NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 10. The parasympathetic nervous system controls salivary secretions. It also controls blood flow

to the salivary glands. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Salivary function is controlled by the parasympathetic division of the autonomic nervous system. Blood flow, which is important to salivation, is controlled by the sympathetic nervous system.

REF: p. 356 OBJ: To describe the difference between major and minor salivary glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 11. Each of the following is true of the parotid gland EXCEPT one. Which one is the

EXCEPTION? a. It is a purely serous gland. b. It provides about 25% of the resting salivary volume. c. The duct pierces the buccinator muscle. d. It is located within the mental foramen.

ANS: D

The parotid gland is located oNn thRe sI urface oBf . the mM asseter muscle, behind the ramus of the U ofStheNG T C O mental foramen is located on the lateral mandible, and on the medial side ramus.

The side of the mandibular beneath the premolars.

REF: p. 353 OBJ: To describe the difference between major and minor salivary glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 12. The submandibular gland is located below and toward the posterior part of the body of the

mandible. It can be palpated in the chin beneath the mandibular molars. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

The submandibular gland can be palpated as lump in the neck. Specifically, it can be found medial to the angle of the mandible within a small depression where the facial artery and vein cross the mandible.

REF: p. 353 OBJ: To name and locate each of the major and minor glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding

13. The lingual salivary glands are classified as major salivary glands and divided into several

groups. The anterior lingual glands, found near the tip of the tongue, are mostly serous in nature. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Although it is true that the lingual salivary glands are divided into several groups, they are classified as minor glands. One group, the anterior lingual glands, found near the tip of the tongue, is mostly mucous in nature.

REF: p. 356 OBJ: To classify each of the glands according to its type of secretion NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 14. The palatine glands are responsible for taste perception because they contain special

taste-enhancing cells. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

The primary function of the lingual glands of von Ebner is to wash off taste buds so that they can perceive new tastes.

NURSINGTB.COM REF: p. 356 OBJ: To classify each of the glands according to its type of secretion NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 15. Which gland is located in the area of the anterior tonsillar pillar? a. Palatine b. Glossopalatine c. Posterior lingual d. Submandibular ANS: B

The glossopalatine glands are located posterior to the lateral parts of the palate and down into the anterior fold of tissue in front of the palatine tonsil.

REF: p. 355 OBJ: To name and locate each of the major and minor glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 16. The labial glands are primarily located on the labial gingiva. These purely serous glands

provide watery lubrication for all labial areas. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true.

d. Both statements are false.

ANS: D

The labial glands, classified as minor salivary glands, are located in the upper and lower lips and open onto the inner surface. These mixed glands are composed of both serous and mucous secretory cells.

REF: p. 354 OBJ: To classify each of the glands according to its type of secretion NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 17. The minor salivary glands produce enough saliva to mix with food. They are smaller than the

major salivary glands but have longer ducts. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

The minor salivary glands produce only a small amount of saliva to keep the mucosa moist.

Ducts of minor glands are much smaller and shorter than those of major glands with less branching. Minor glands are arranged in clusters throughout the mouth, each with its own duct opening.

REF: p. 354 OBJ: To classify each of the glands according to its type of secretion NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding

N R I G B.C M

18. Each of the following minor saU livaS ry gN lanT ds is locOated on the tongue EXCEPT one. Which

one is the EXCEPTION? a. Anterior lingual b. Glands of von Ebner c. Posterior lingual d. Glossopalatine ANS: D

The glossopalatine minor salivary glands are located in the fold of tissue in front of the palatine tonsil. The anterior lingual are located on the tip of the tongue. The glands of von Ebner are located beneath the vallate papillae (also called circumvallate papillae) on the posterior dorsal (top) surface of the tongue. The posterior lingual, true to their name, are located near the lingual tonsils on the posterior third of the tongue.

REF: pp. 354-355 OBJ: To name and locate each of the major and minor glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. Which of the following accurately describe features of the sublingual salivary gland (Select all

that apply.)? a. It is classified as a major salivary gland.

b. c. d. e.

It is the smallest of the three pairs of major salivary glands.

It is composed mostly of serous cells with some isolated mucous cells.

The secretion of the sublingual gland is the most watery of the three major glands.

The sublingual gland has more visible demilunes capping mucous acini than other glands.

ANS: A, B, E

The submandibular salivary glands, located in the anterior floor of the mouth next to the anterior canines, are composed mostly of mucous cells. For this reason, secretion from the sublingual glands is even more viscous than that of the submandibular (submaxillary) gland.

The sublingual gland is surrounded by minor sublingual glands. Note that demilunes are half-moon clusters formed on the end of salivary acini.

REF: p. 288 | p. 353 OBJ: To name and locate each of the major and minor glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 2. Which of the following is a function of saliva (Select all that apply.)? a. Lubrication of the oral mucosa b. Production of enamel c. Assisting in speech d. Breakdown of starches e. Aids in swallowing ANS: A, C, D, E

Although elements of saliva protect tooth enamel, enamel is produced by ameloblasts.

N R I G B.C M

U S N OBJ: T ToOdescribe the function of saliva REF: p. 292 | p. 353 NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 3. The sublingual caruncle is the opening for which salivary ducts (Select all that apply.)? a. Major sublingual b. Parotid c. Submandibular d. Anterior lingual ANS: A, C

The sublingual caruncle is a small elevation at the base of the lingual frenum. The parotid gland opens into the buccal mucosa opposite the maxillary second molar. The anterior lingual glands open near the tip of the tongue on either the dorsal or ventral (upper or lower) surface of the tongue.

REF: p. 353 OBJ: To describe the development of the ducts and the ductless glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering TRUE/FALSE 1. Mumps is a bacterial infection of the parotid gland.

ANS: F

Mumps is a viral infection of the parotid gland, and possibly other glands, that causes pain during secretion.

REF: p. 353 OBJ: To classify each of the glands according to its type of secretion NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 2. Most of the ducts of the sublingual gland open along the sublingual fold.

ANS: T

The one major duct and several minor ducts of the sublingual gland open in a line along the fold of tissue beneath the tongue known as the sublingual fold.

REF: p. 354 OBJ: To describe the development of the ducts and the ductless glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 3. The glands of von Ebner are purely serous glands.

ANS: T

Formally called the lingual glands of von Ebner, these purely serous glands are located beneath the vallate papillae near the opening into the trough of the gland. These glands enable perception of new tastes because they wash off the taste buds.

REF: p. 355 OBJ: To classify each of the glands according to its type of secretion NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, TOP: BLOOM: Remembering including but not limited to: glaN nds/R lymI phatG ics. B.C M

U S N T

O

4. The sublingual gland is lingual to the mandibular canine.

ANS: T

The sublingual gland, as well as its minor sublingual glands, is located lingual to the mandibular canine. The minor glands surround the major sublingual gland.

REF: p. 353 | p. 355 OBJ: To name and locate each of the major and minor glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 5. There is a major maxillary gland as well as several minor submaxillary glands.

ANS: F

This statement applies to the sublingual gland. Surrounding the major sublingual gland are numerous minor sublingual glands. They open in a row of ducts along the sublingual fold in the floor of the mouth.

REF: pp. 353-354 | p. 356 OBJ: To name and locate each of the major and minor glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering

6. Minor salivary glands are most often pure mucous cells.

ANS: T

Although most minor salivary are pure mucous cells, a smaller percentage are pure serous and even less are mixed. Mucous secretions aid minor salivary glands in their role of keeping mucosal surfaces moist.

REF: p. 354 OBJ: To describe the difference between major and minor salivary glands NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering

NURSINGTB.COM

Chapter 34: Nervous System Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The spinal nerve divides into a dorsal and a ventral primary ramus. This division occurs in the

gray matter. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

At the point where the dorsal and ventral roots meet is the beginning of the spinal nerve. At this point the spinal nerve divides into a small dorsal primary ramus and a larger ventral primary ramus. This division occurs some distance after the roots have left the gray matter of the spinal cord.

REF: p. 358 OBJ: To describe the general makeup of a spinal nerve NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 2. The 12 pairs of thoracic nerves are distributed in the thorax and lumbar regions because all

spinal nerves are distributed by region from the neck to the toes. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related.

R e IreNason GTB.C M c. The statement is correct, N buUt thS is NOO T correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

The 12 thoracic nerves are distributed only to the thoracic or chest area. Similarly, the five lumbar nerves are distributed to the lower back region. Note that distribution of spinal nerves is to their appropriate region.

REF: p. 357 OBJ: To describe the general makeup of a spinal nerve NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 3. During times of stress incoming light is blocked to protect the eyes. This is accomplished by

dilation of the pupils, a function of the sympathetic nervous system. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

During times of stress the pupils dilate to enhance vision by letting in more light. This is a function of the sympathetic nervous system.

REF: p. 361

OBJ: To describe the components and general function of the autonomic nervous system NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 4. The sympathetic nervous system is also known as the craniofacial outflow. A term commonly

used to describe the sympathetic nervous system is the “fight-or-flight mechanism.” a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The sympathetic system, commonly known as the “fight-or-flight mechanism,” is also called the thoracolumbar outflow. The craniosacral outflow is another term for the parasympathetic system. Both the parasympathetic and the sympathetic systems comprise the anatomic nervous system.

REF: p. 361 OBJ: To describe the components and general function of the autonomic nervous system NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 5. Which nerve supplies muscle that moves the eye downward and laterally? a. Oculomotor b. Trigeminal c. Optic d. Trochlear ANS: D

NURSINGTB.COM

Although the optic and oculomotor involve other aspects of the eye and sight, the trochlear nerve is responsible for downward and lateral movement of the eye. The innervated muscle is the superior oblique.

REF: p. 360 OBJ: To name the 12 cranial nerves and their general function NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 6. Each of the following cranial nerves is involved in motor or sensory eye innervation EXCEPT

one? Which one is the EXCEPTION? a. I b. II c. III d. IV e. VI ANS: A

Cranial nerve I, the olfactory, provides sensory neurons from the nose to the brain. Cranial nerve II, the optic nerve, provides special sense of sight from the eye to the brain. The oculomotor, cranial nerve III, supplies motor neurons that move the eye and contract the pupil. The trochlear nerve, IV, supplies muscle that moves the eye downward and laterally.

The abducens, cranial nerve VI, supplies muscle that moves the eye laterally.

REF: pp. 360-361 OBJ: To name the 12 cranial nerves and their general function NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 7. Each of the following is a parasympathetic function EXCEPT one. Which one is the

EXCEPTION? a. Slows heart rate b. Decreases salivary gland secretion c. Increases blood supply to digestive system d. Decreases respiratory rate ANS: B

Decreased salivary flow occurs with stimulation of the sympathetic nervous system which is also referred to as the “fight-or-flight mechanism.” Conversely, parasympathetic function increases digestive mechanisms, including salivary flow. Appropriately called the vegetative system, the parasympathetic nervous system slows down the heart and respiration while increasing blood supply to the digestive system.

REF: p. 361 OBJ: To discuss the nerves and pathways involved in parasympathetic innervation to major salivary glands NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 8. Each of the following cranial nerves has sensory function EXCEPT one. Which one is the

EXCEPTION? a. Olfactory b. Optic c. Statoacoustic d. Hypoglossal

NURSINGTB.COM

ANS: D

The hypoglossal nerve supplies only motor neurons to most of the intrinsic and extrinsic muscles of the tongue. An exception is the palatoglossus, which is supplied by the vagus nerve (X) as well as portions of the spinal accessory nerve (XI) that run with the vagus nerve.

REF: p. 361 OBJ: To name the 12 cranial nerves and their general function NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 9. The tenth cranial nerve has motor innervations to the root of the tongue and epiglottis. It

supplies both motor and sensory innervation to muscles of the pharynx and larynx. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The tenth cranial nerve, the vagus, provides only sensory innervation to the root of the tongue and epiglottis. This includes taste and general sensations arising from the root of the tongue.

REF: p. 368

OBJ: To describe the nerves and areas involved in general and special sensation of the tongue NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 10. The parasympathetic nervous system is called the craniosacral outflow because fibers from

this system come off the brain and spinal cord at the sacral level. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

This statement correctly describes the origin of the term craniosacral outflow. Similarly, the sympathetic nervous system comes off the spinal cord at the 12 thoracic levels and the first two lumbar levels; thus, the name thoracolumbar outflow.

REF: p. 361 OBJ: To describe the components and general function of the autonomic nervous system NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 11. The autonomic nervous system is composed of preganglionic and postganglionic neurons.

These neurons diverge (separate) in a ganglion within the nervous system. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are falseN . URSINGTB.COM ANS: B

The preganglionic and postganglionic neurons synapse, or join, in a ganglion outside the central nervous system. A ganglion is an accumulation of cell bodies of the postganglionic neurons outside the CNS. REF: p. 361 OBJ: To describe the components and general function of the autonomic nervous system NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 12.

There are 31 pairs of spinal nerves. Twelve are in the thorax or chest region and eight are in the cervical or neck region. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

Additionally, five are in the lumbar or lower back region; five are in the sacral or hip region; and one is in the coccygeal or tailbone region.

REF: p. 357 OBJ: To describe the general makeup of a spinal nerve NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,

including but not limited to: nerves.

TOP: BLOOM: Understanding

13. The olfactory and optic are the only cranial nerves that are not paired because they are

centrally located in the intravertebral foramina. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

All 12 cranial nerves are paired. They attach directly to the brain, each with a separate function. Unrelated to their paired status is their exit from the spinal canal through the intervertebral foramina.

REF: pp. 359-360 OBJ: To name the 12 cranial nerves and their general function NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 14. Which part of the spinal cord is arranged in the shape of a butterfly? a. Gray matter b. White matter c. Myelinated axons d. Dorsal root ganglion ANS: A

The gray matter resides centrally in the spinal cord and consists of cell bodies of both motor and sensory neurons (refer toNFigR e. whCiteM U . 34 SI-3).

NGThTB Omatter, composed of myelinated axons, surrounds the gray matter. The dorsal root ganglion is a collection of sensory neuron cell bodies.

REF: pp. 357-358 OBJ: To name the basic components of the nervous system NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 15. The ophthalmic division is a branch of which nerve? a. Optic b. Oculomotor c. Trigeminal d. Facial e. None of the above ANS: C

The ophthalmic division is a main branch of the trigeminal nerve. It is the first branch, usually denoted as V1. The maxillary division (V2) and the mandibular division (V3) are the remaining of the three main trigeminal branches.

REF: p. 361 OBJ: To name the specific branches of the trigeminal nerve and which areas of the face, teeth, and oral cavity each branch supplies NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering

16. The facial nerve innervates each of the following structures EXCEPT one. Which one is the

EXCEPTION? a. Stylohyoid muscle b. Submandibular gland c. Lacrimal gland d. Soft palate ANS: D

The soft palate is innervated by the trigeminal nerve (V), the vagus nerve (X), and the spinal accessory nerve (XI). The facial nerve (VII) innervates the remaining structures.

REF: p. 361 | p. 364 | p. 368 OBJ: To name the 12 cranial nerves and their general function NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 17. The maxillary division of the trigeminal nerve follows the same pathway as the maxillary

artery. The maxillary nerves and arteries generally have the same names. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

The maxillary division of the trigeminal nerve (V2) follows the same pattern of distribution and very similar nomenclature to those of the maxillary artery. Both the artery and the nerve are distributed to the maxillaN ry teRethIandGoraB caC vityM U S N Tl. O , the nasal cavity, the skin of the cheek, the midface, and temporal region.

REF: p. 363 OBJ: To name the specific branches of the trigeminal nerve and which areas of the face, teeth, and oral cavity each branch supplies NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 18. The mental nerve supplies sensation to the floor of the mouth, the lingual mandibular

gingivae, and the anterior two-thirds of the tongue. The mental nerve is joined by the chorda tympani, a branch of the facial nerve, to supply the submandibular and sublingual salivary glands. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Both statements correctly describe the lingual nerve, one of the largest branches of the mandibular division of the trigeminal nerve. The mental nerve is a small branch of the inferior alveolar nerve.

REF: pp. 366-367 OBJ: To describe the nerves and areas involved in general and special sensation of the tongue

NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 19. Sensation to the skin of the mandibular lip and chin is supplied by which nerve? a. Mylohyoid b. Mental c. Lingual d. Auriculotemporal ANS: B

The mental nerve is a small branch of the inferior alveolar nerve, which comes out of the mental foramen laterally to supply the skin of the lower lip and chin as well as the mucosa of the lip and labial gingiva. The mylohyoid is a small motor branch of the inferior alveolar nerve. The lingual nerve supplies sensation to the floor of the mouth, the lingual mandibular gingivae, and the anterior two-thirds of the tongue. The auriculotemporal supplies the areas above and in front of the ear.

REF: p. 366 OBJ: To name the specific branches of the trigeminal nerve and which areas of the face, teeth, and oral cavity each branch supplies NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 20. Sensation to the maxillary labial gingiva is supplied by the nasopalatine nerve because this

nerve branches off the infraorbital as it travels to supply the maxillary anterior teeth. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, N buUt R thS eI reN asG onTiB s .C NOO TM correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: E

The anterior superior alveolar nerve, the second branch of the infraorbital, supplies the maxillary labial gingiva. The nasopalatine nerve supplies the nasal septum and gingiva lingual to the anterior maxillary teeth.

REF: pp. 364-365 OBJ: To name the specific branches of the trigeminal nerve and which areas of the face, teeth, and oral cavity each branch supplies NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 21. The nasopalatine nerve leaves the nasal cavity through which foramen? a. Sphenopalatine b. Incisive c. Greater palatine d. Infraorbital ANS: B

The nasopalatine nerve exits the nasal cavity through the incisive foramen. It supplies the lingual gingiva adjacent to the maxillary central and lateral incisors.

REF: p. 364 OBJ: To name the specific branches of the trigeminal nerve and which areas of the face, teeth, and oral cavity each branch supplies NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 22. When the tip of the tongue feels pain from hot soup, the lingual division of the facial nerve is

innervated because the lingual nerve supplies sensation to the anterior two-thirds of the tongue. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: D

The anterior two-thirds of the tongue is innervated by sensory fibers of the lingual division of the posterior division of the mandibular division of the trigeminal nerve. A separate nerve, the facial nerve (cranial nerve VII), does not provide perception of pain. However, a small branch of the facial nerve, the chorda tympani, carries special sensory fibers of taste perception from the anterior two-thirds of the tongue.

REF: pp. 366-367 OBJ: To describe the nerves and areas involved in general and special sensation of the tongue NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 23. The infraorbital nerve suppliN es seRnsaI tionGto B ea. chCofM the following EXCEPT one. Which one is

the EXCEPTION? a. Maxillary lingual gingiva b. Maxillary anterior teeth c. Part of the maxillary sinus d. The lower eyelid

U S N T

O

ANS: A

The maxillary lingual gingiva, also called the palatal gingiva, is supplied by both the greater and lesser palatine nerves. They originate from the descending palatine nerve, which is a branch of the maxillary division (V2) of the trigeminal nerve.

REF: pp. 363-365 OBJ: To name the specific branches of the trigeminal nerve and which areas of the face, teeth, and oral cavity each branch supplies NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 24. The mucosa of the mandibular lip and labial gingiva will be anesthetized following an inferior

alveolar injection because the buccal nerve branches out laterally to supply these areas. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

In addition to the mandibular teeth, the inferior alveolar nerve block will anesthetize the lip and labial gingiva because the mental nerve branches out laterally from the inferior alveolar.

Note that the mental nerve also supplies the skin of the lower lip and chin. The buccal nerve spreads out on the surface of the buccinator muscle and supplies the buccal mandibular gingivae posterior to the mental foramen.

REF: p. 366 OBJ: To name the specific branches of the trigeminal nerve and which areas of the face, teeth, and oral cavity each branch supplies NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 25. Which nerve goes up into the orbit and exits to supply the skin of the cheek and temple? a. Descending palatine b. Zygomatic c. Infraorbital d. Sphenopalatine ANS: B

The zygomatic nerve, a division of the maxillary division of the trigeminal nerve, supplies the skin of the cheek and the temple. It also provides parasympathetic innervation to the lacrimal gland of the eye.

REF: p. 365 OBJ: To name the specific branches of the trigeminal nerve and which areas of the face, teeth, and R I G B.C M oral cavity each branch supplies N NAT: CDA: GC I.A.5. Identify bU asicSoraN l andTdental O anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 26. Which of the following structures generally does not have sensory innervation from the

posterior superior alveolar nerve? a. Mesiobuccal root of the maxillary first molar b. Distobuccal root of the maxillary first molar c. Maxillary second molar d. Maxillary buccal gingiva of maxillary molars ANS: A

The mesiobuccal root of the maxillary first molar is generally innervated by the middle superior alveolar nerve, which is a branch of the infraorbital nerve. The remainder of the maxillary first molar is innervated by the posterior superior alveolar nerve. Thus, to anesthetize this tooth, both injections are necessary.

REF: pp. 363-365 OBJ: To name the specific branches of the trigeminal nerve and which areas of the face, teeth, and oral cavity each branch supplies NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering MULTIPLE RESPONSE

1. Which of the following accurately describe functions of the brain (Select all that apply.)? a. It may file information in memory for future reference. b. It may act immediately to incoming stimuli. c. It coordinates muscle contraction. d. It coordinates glandular secretion. e. Authorities theorize that humans utilize approximately 60% of their mental

capacity.

ANS: A, B, C, D

Authorities estimate that humans normally use only 10% of our mental capacity. They further theorize that unused cells can be called upon to reestablish damaged pathways.

REF: p. 357 OBJ: To name the basic components of the nervous system NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering TRUE/FALSE 1. The central nervous system is made up of the brain and the spinal cord.

ANS: T

The nervous system is divided into the central and peripheral systems. The brain and the spinal cord are the two main components of the central nervous system (CNS).

REF: p. 357 OBJ: To name the basic components of the nervous system NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BL OOM: Remembering

NUR SI NG TB. CO M

2. The olfactory nerve has sensory and motor functions.

ANS: F

The olfactory nerve has sensory function only. It provides a special sense of smell from the nose to the brain.

REF: p. 360 OBJ: To name the 12 cranial nerves and their general function NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 3. Eyesight is supplied by cranial nerves II and III. ANS: F

While the oculomotor nerve, cranial nerve III, supplies muscles that move the eye and cause pupil dilation, only the second cranial nerve provides the special sense of sight from the eye to the brain.

REF: p. 360 OBJ: To name the 12 cranial nerves and their general function NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 4. Motor supply to the tensor veli palatini comes from the trigeminal nerve.

ANS: T

The trigeminal nerve supplies motor innervation to a soft palate muscle called the tensor veli palatine. A similar muscle, the tensor tympani of the middle ear, also receives motor supply from the trigeminal nerve.

REF: p. 360 | p. 364 | p. 366 OBJ: To name the specific branches of the trigeminal nerve and which areas of the face, teeth, and oral cavity each branch supplies NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 5. The abducens nerve is responsible for equilibrium.

ANS: F

The statoacoustic nerve is responsible for both hearing and equilibrium, also known as balance. The abducens nerve supplies motor neurons to the lateral rectus, muscle that moves the eye laterally.

REF: pp. 360-361 OBJ: To name the 12 cranial nerves and their general function NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 6. An intercalated neuron is a shorter neuron that runs between the two neurons.

ANS: T

An intercalated neuron carries a message from the sensory side to the motor side without it having to go to the brain. It is shorter than other neurons. This shortcut in the nervous system is known as a reflex arc.

NURSINGTB.COM REF: p. 357 OBJ: To describe how a sensory impulse causes a motor response NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering

Chapter 35: Lymphatics and Spread of Dental Infection Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. Lymph nodes are grouped together into small clusters. The clusters are interconnected by

connective tissue. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Clusters of lymph nodes are interconnected by channels that are also called tubules.

REF: p. 369 OBJ: To briefly discuss the function of the lymphatic system NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 2. The lymphatic system is part of the overall lymphoid system. The immune system, which

includes the blood vessels, is a separate system. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

NURSINGTB.COM

The lymphoid system, and its lymphatic system, is a component of the immune system. The blood vessels (circulatory system) are an integral component of each system.

REF: p. 369 OBJ: To briefly discuss the function of the lymphatic system NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 3. Bacteria and other microorganisms that have invaded tissue spaces are often prevented from

causing illness because the lymphatic system filters fluids and combats infection during periods of rest. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

The lymphatic system, with its ability to filter extracellular fluids, continually performs its disease preventive functions.

REF: p. 369 OBJ: To briefly discuss the function of the lymphatic system NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding

4. Lymph nodes fighting an infection become enlarged and tender because lymphocytes within

the node have begun multiplying and combating infection. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

This statement embodies the role of lymph nodes. If the infection is successfully combated in within lymph nodes, it will subside.

REF: pp. 369-370 OBJ: To briefly discuss the function of the lymphatic system NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 5. When blood plasma filtrate enters the lymphatic tubules, it is called lymphatic fluid.

Lymphatic fluid empties into the venous system at the junction of the carotid veins. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: D

Blood plasma filtrate enters the lymphatic tubules and is called lymphatic fluid. Lymphatic fluid empties into the internal jugular and subclavian veins. Note that the carotids are the arterial counterpart of the jugular veins.

NURSING TB.COM

REF: p. 369 OBJ: To briefly discuss the function of the lymphatic system NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 6. The mandibular third molars drain into the upper deep cervical nodes. These nodes drain into

the retropharyngeal nodes located behind the throat wall. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: B

Maxillary third molars also drain into the deep cervical nodes. The retropharyngeal nodes, as well as numerous other groups, drain into the deep cervical node group. This group is located on the lateral surface of the internal jugular vein.

REF: p. 370 OBJ: To diagram and label the major groups of lymph nodes that drain teeth and the oral cavity NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 7. A subtle difficult to diagnose pattern of infection spreads through fascial spaces. A fascial

space exists between layers of muscles or layers of connective tissue. a. Both statements are true.

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

ANS: C

Infection that spreads through fascial spaces (or layers) displays dramatic clinical symptoms, spreads quickly, and is not difficult to diagnose. It has broken out of the lymph and circulatory channel and spreads through tissue or muscle layers.

REF: p. 370 OBJ: To discuss briefly the concept of fascial space infection NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 8. A buccal abscess of a mandibular molar initially drains into the a. sublingual space b. buccal vestibule c. lateral pharyngeal space d. parapharyngeal space ANS: B

Buccal abscesses typically originate at the apex of a root and initially drain into the buccal vestibule. Such lesions are often called gumboils.

REF: p. 370 | p. 372 OBJ: To discuss briefly the concept of fascial space infection NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering

N R I G B.C M

9. Each of the following areas draU ins S intoNtheTsubmaO ndibular nodes EXCEPT one. Which one is

the EXCEPTION? a. Maxillary third molars b. Mandibular canines c. The floor of the mouth d. Most of the tongue e. The hard palate ANS: A

The maxillary molars, which drain into the upper deep cervical nodes, are the only maxillary teeth that do not drain into the submandibular nodes.

REF: pp. 369-370 OBJ: To name the primary lymph drainage of all teeth NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 10. The mandibular incisors are drained by which nodes? a. Submental b. Submandibular c. Lower deep cervical d. Upper deep cervical ANS: A

The mandibular incisors drain into a very small accumulation of nodes, the submental group.

This group is found beneath the chin and also receives drainage from the tip of the tongue and the midline of the lower lip and chin.

REF: p. 369 OBJ: To diagram and label the major groups of lymph nodes that drain teeth and the oral cavity NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 11. Infections at the apices of teeth cause swelling either mesial or distal to the involved tooth. A

swelling of apical origin occurring in the vestibule is sometimes called a gumboil. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Apical (end of root) infections cause swelling in one of two directions: buccal or lingual. Most buccal swellings lead to a swelling in the vestibule sometimes called a gumboil.

REF: p. 370 OBJ: To discuss briefly the concept of fascial space infection NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 12. Lymphatic fluid empties into which system? a. Glandular b. Endocrine c. Arterial NURSINGTB.COM d. Venous ANS: D

After several trips through nodules and tubules, filtered lymphatic fluid empties into the venous system at the junction of the internal jugular and subclavian veins and travels back to the heart.

REF: p. 369 OBJ: To briefly discuss the function of the lymphatic system NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 13. When a throat infection begins, the first group of nodes to become involved is the

retropharyngeal nodes because they are behind the throat wall. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Many people who have sore throats first notice the tenderness in the upper deep cervical nodes. These nodes receive drainage from the retropharyngeal nodes.

REF: p. 370

OBJ: To diagram and label the major groups of lymph nodes that drain teeth and the oral cavity NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 14. Each of the following nodes drains into the upper deep cervical nodes EXCEPT one. Which

one is the EXCEPTION? a. Submandibular b. Retropharyngeal c. Parotid d. Mental ANS: D

Although technically the mental nodes drain directly into the submandibular, it must be noted that the submandibular drains into the upper deep cervical.

REF: pp. 369-370 OBJ: To diagram and label the major groups of lymph nodes that drain teeth and the oral cavity NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 15. Infections of mandibular premolars and anterior teeth spread into the sublingual space because

the disease breaks out of bone below the mylohyoid line. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

NURSINGTB.COM

Infections in mandibular teeth tend to take a somewhat predictable course. Because the roots of the premolars and anterior teeth are located above the mylohyoid line, infection in these areas breaks out of bone above the mylohyoid line and spreads to the spaces in the floor of the mouth, referred to as the sublingual space.

REF: p. 370 OBJ: To discuss briefly the concept of fascial space infection NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 16. Infections of mandibular molars spread into the submental space because the disease breaks

out of bone below the mylohyoid line. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Infections in mandibular teeth tend to take a somewhat predictable course. Because the roots of the molars are located below the mylohyoid line, infection in molar areas breaks out of bone below the mylohyoid line and spreads to the space beneath the chin, referred to as the submental space.

REF: p. 370 OBJ: To discuss briefly the concept of fascial space infection NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding 17. Which of the following cannot easily be palpated? a. Retropharyngeal b. Submental c. Submandibular d. Upper deep cervical ANS: A

The retropharyngeal nodes cannot be easily palpated because they are located behind the throat wall. However, retropharyngeal nodes drain into the upper deep cervical lymph nodes, which can be palpated.

REF: p. 370 OBJ: To diagram and label the major groups of lymph nodes that drain teeth and the oral cavity NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 18. A fascial infection of the submental space would spread to which space? a. Posterior mediastinum b. Sublingual c. Retropharyngeal d. Parapharyngeal ANS: D

Untreated infection in the submental spaces M travels to the mylohyoid muscle and N refe RSrred Ifascial GTasB.C Nto reaches an area of the pharynxU the lO ateral pharyngeal or parapharyngeal space.

From here the infection can spread to the posterior mediastinum (back of the chest) and become deadly within a short period of time.

REF: p. 370 OBJ: To explain how a fascial space infection may spread from the oral cavity to the thorax NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 19. A swelling below the eye is MOST likely caused by infection from the a. lacrimal duct b. maxillary sinus c. maxillary canine d. auricular ANS: C

Infections involving the maxillary teeth react in a unique pattern. Swelling below the eye is a classic example of infection arising from a maxillary canine tooth. Note that if such an infection drains into the buccal vestibule or palate, it typically will not progress to the ocular area.

REF: p. 372 OBJ: To discuss briefly the concept of fascial space infection NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering

20. Which cancerous structure would be MOST difficult to successfully treat? a. Root of tongue b. Tip of tongue c. Lesion on upper lip d. Incisive papilla ANS: A

Because of anatomical location and lymphatic drainage patterns, a cancerous lesion in the root of the tongue is difficult to treat. Cancerous cells from this lesion have only two groups of nodes to filter through prior to reaching the bloodstream. Conversely, a malignant lesion on the tip of the tongue has four levels of lymphatic drainage prior to entering bloodstream.

REF: p. 370 OBJ: To define the terms primary, secondary, and tertiary nodes of involvement as they relate to lymph drainage NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 21. Ludwig’s angina refers to an infection in which space? a. Submental b. Sublingual c. Lateral pharyngeal d. Parapharyngeal ANS: A

Ludwig’s angina is a swelling in the submental space beneath the chin. If not treated, this infection can spread by graviN ty toRdisItanG t locBa. tioCns.M If the infection reaches the mediastinum, U S death N Tcan O in a short period of time. back of the chest, or thoracic cavity, occur REF: pp. 370-371 OBJ: To define Ludwig's angina NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 22. An infection from the upper deep cervical nodes would next move into the a. fascial spaces b. lower deep cervical nodes c. retropharyngeal nodes d. retropharyngeal spaces ANS: B

Located about two inches above the clavicle, the lower deep cervical nodes drain the upper deep cervical nodes and many nodes at the back of the neck.

REF: p. 370 OBJ: To define the terms primary, secondary, and tertiary nodes of involvement as they relate to lymph drainage NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering

23. The distribution pattern of lymphatic vessels has been well determined by scientists. This

information can be used as a diagnostic tool and as a means of slowing the spread of infection and cancer. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: A

An understanding of the distribution of nodes and their drainage patterns enables doctors to formulate an accurate diagnosis and prognosis.

REF: p. 369 OBJ: To briefly discuss the function of the lymphatic system NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Understanding TRUE/FALSE 1. Lymphadenopathy cannot be diagnosed without a biopsy.

ANS: F

Lymphadenopathy is manifested by swollen and tender lymph nodes and is diagnosed based upon symptoms and palpations. A biopsy is not needed for most cases.

REF: p. 369 OBJ: To diagram and label the major groups of lymph nodes that drain teeth and the oral cavity NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, NUs/ly RSmph INatic GT TOP: BLOOM: Remembering including but not limited to: gland s. B.C OM 2. The maxillary premolars are drained by the submental nodes.

ANS: F

All maxillary teeth with the exception of the third molars drain into the submandibular nodes.

Numerous other structures, including the submental nodes, drain into the submandibular nodes.

REF: p. 369 OBJ: To name the primary lymph drainage of all teeth NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 3. All lymphatic vessels in the head and neck area ultimately drain into the junction of the

internal jugular and subclavian veins.

ANS: T

After several trips through nodules and tubules, filtered lymphatic fluid empties into the venous system at the junction of the internal jugular and subclavian veins and travels back to the heart.

REF: p. 369 OBJ: To diagram and label the major groups of lymph nodes that drain teeth and the oral cavity NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development,

including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering

4. Infections that reach the posterior mediastinum can be fatal.

ANS: T

Infection within the posterior mediastinum, which is the back of the chest or thoracic cavity, can be fatal if not treated within a short period of time. Untreated dental infection in the sublingual and submental spaces can spread beneath and behind the mylohyoid muscle. From here it extends to the pharyngeal spaces; if it reaches the mediastinum the person may die within a short period of time.

REF: p. 371 OBJ: To explain how a fascial space infection may spread from the oral cavity to the thorax NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 5. A swelling in the cheek is usually related to an infection in the maxillary canine.

ANS: F

A swelling in the cheek is usually related to an infection in a posterior tooth. Untreated infection in the maxillary canine can manifest as swelling below the eye.

REF: p. 372 OBJ: To name the primary lymph drainage of all teeth NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering 6. Maxillary infections around the eye or cheek can spread to the lateral pharyngeal space.

ANS: T

NURSINGTB.COM

Maxillary infections react differently than other oral sites because of anatomic features.

Infections that do not open into the maxillary buccal vestibule or onto the palate may spread to the nasal cavity, the maxillary sinus, or soft-tissue spaces of the cheek or eye.

REF: p. 372 OBJ: To name the primary lymph drainage of all teeth NAT: CDA: GC I.A.3. Identify basic oral and dental anatomy, physiology and development, including but not limited to: glands/lymphatics.

TOP: BLOOM: Remembering

Chapter 36: Anatomical Considerations of Local Anesthesia Brand/Isselhard: Anatomy of Orofacial Structures, 9th Edition MULTIPLE CHOICE 1. The buccal bone of the maxilla is much less porous than that of the mandible. This makes it

easier for the anesthetic solution to penetrate the buccal bone of the maxilla and reach the apices of the maxillary teeth. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

The buccal bone of the maxilla is much more porous than that of the mandible.

REF: p. 373 OBJ: To understand the anatomy of the maxillary nerve as it relates to administration of local anesthesia | To understand the anatomy associated with mandibular blocks NAT: CDA: GC I.A.2. Identify basic oral and dental anatomy, physiology and development, including but not limited to: bones.

TOP: BLOOM: Understanding 2. None of the following anesthetics can be used for mandibular supraperiosteal injections

EXCEPT one. Which one is the EXCEPTION? a. Lidocaine b. Articaine NURSINGTB.COM c. Mepivacaine d. Prilocaine ANS: B

Only articaine effectively penetrates the mandibular bone. One cannot use lidocaine, mepivacaine, or prilocaine which are the most common local anesthetic agents because they do not effectively penetrate the denser mandibular bone.

REF: p. 379 OBJ: To understand the anatomy associated with mandibular blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 3. All of the following are major concerns with nerve blocks EXCEPT one. Which one is the

EXCEPTION? a. Bruising b. Injecting into a blood vessel c. Tearing a blood vessel d. Puncturing a nerve ANS: A

Anesthetic solution injected into a blood vessel continues on the path of that blood vessel.

Anesthetic delivered into the posterior alveolar vein travels into the facial vein and the maxillary vein both leading into the internal jugular vein and then into the brachiocephalic vein and eventually to the lungs and the heart where it is pumped all over the body. A patient could therefore feel numbness in their toes, ears, or even fingers. If this anesthetic contained a vasoconstrictor unwanted serious cardiovascular events could result. Everything from fainting to a stroke or even a heart attack could occur.

REF: p. 375 OBJ: To understand the major concerns associated with different local anesthetic nerve blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 4. A crossover effect is created when nerves and blood vessels do not stop at the midline because

some nerve branches crossover into an area innervated by another adjacent nerve. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

If the crossover nerve comes from the right side at the midline, it innervates something on the left side. Giving an anesthetic on the left side in this case does not work because the nerve that crossed over from the right innervates this area. When dealing with anesthetics in the areas of the central incisors it is sometimes necessary to anesthetize both sides due to this crossover effect. Crossover nerves occur not only at the midline but between areas affected by different N fect RScan INals GT B.C M nerve branches. A crossover efU o occurOat the junction between areas adjacent to each other but typically innervated by two different nerve branches. If one nerve block does not affect the desired target area, a second nerve block (that normally serves the adjacent area) might be required.

REF: p. 378 OBJ: To understand the anatomy of the maxillary nerve as it relates to administration of local anesthesia NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 5. There are three palatal nerve blocks that provide anesthesia to the palatal periodontium and

gingiva; they affect only the lingual tissues. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

There are two palatal nerve blocks that provide anesthesia to the palatal periodontium and gingiva (nasopalatine and greater palatine). Neither of these two blocks anesthetizes the pulp of teeth nor the associated buccal periosteum and gingiva; only lingual tissues are affected.

REF: p. 378

OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 6. The greater palatine nerve block anesthetizes all of the following EXCEPT one. Which one is

the EXCEPTION? a. Anterior hard palate b. The posterior lateral hard palate c. Palatal gingiva d. Periodontium of the maxillary posterior teeth ANS: A

The nasopalatine nerve block anesthetizes the anterior hard palate.

REF: p. 378 OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 7. The goal of local anesthesia is to block the innervation from the nerve branches as they try to

send their messages back to the brain through the nerves. To do this, the anesthetic solution must reach the nerve branch somewhere between the targeted area to be anesthetized and the nerve trunk. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement N NU OR RS thI eN reG asToB n. is C coOrrMect.

ANS: A

The closer the anesthetic is to the nerve trunk, the more area is affected by the anesthetic.

REF: p. 376 OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 8. The auriculotemporal nerve may be anesthetized with a a. Gow-Gates nerve block b. Vazirani-Akinosi nerve block c. buccal nerve block d. mental block ANS: A

The Vazirani-Akinosi nerve block may cover the same areas as the Gow-Gates except it does not affect the auriculotemporal nerve. The buccal nerve block anesthetizes the buccal gingiva and periodontium. The mental block provides anesthesia to the associated facial periodontium and gingiva of the mandibular premolars and anterior teeth.

REF: p. 382 OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development,

including but not limited to: nerves.

TOP: BLOOM: Remembering

9. All of the following are reasons a Varizani-Akinosi nerve block may be used EXCEPT one.

Which one is the EXCEPTION? a. Trismus b. Injury c. Root canal d. Temporomandibular joint dysfunction ANS: C

A Varizani-Akinosi nerve block is used when patients cannot open their mouth very wide.

This inability to open one’s mouth usually contraindicates any treatment other than that directed toward correcting these symptoms. It requires more skill to perform and takes more time to take effect.

REF: p. 379 OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 10. Vasoconstrictors contain preservatives to increase effectiveness. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but are NOT related. c. The statement is correct, but the reason is NOT correct. d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: C

NURSINGTB.COM

Preservatives are added to vasoconstrictors to increase shelf life. If a patient is allergic to sulfites, this allergy limits the patient to local anesthetic agents without vasoconstrictors, like epinephrine.

REF: p. 374 OBJ: To understand the major concerns associated with different local anesthetic nerve blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 11. Maxillary nerve blocks anesthetize a smaller area of tissue than local infiltrations or

supraperioteal injections. A local anesthetic is deposited in the vicinity of a major nerve trunk and it anesthetizes the area the nerve innervates from that point on. a. Both statements are true. b. The first statement is true; the second statement is false. c. The first statement is false; the second statement is true. d. Both statements are false.

ANS: C

Maxillary nerve blocks anesthetize a broader area of tissue than local infiltrations or supraperioteal injections. The maxillary branch of the fifth cranial nerve gives off the posterior superior alveolar branch in the area posterior and superior to the maxillary tuberosity. The remaining branch continues on to become the middle superior alveolar nerve branch. The middle superior alveolar nerve continues on to join with the anterior superior alveolar nerve. Both of these latter nerves also have branches that ascend upward to meet the infraorbital nerve which emerges from the infraorbital foramen.

REF: p. 375 OBJ: To understand the anatomy of the maxillary nerve as it relates to administration of local anesthesia NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 12. What is the most commonly used mandibular block? a. The Gow-Gates nerve block b. Posterior superior alveolar nerve block c. Middle superior alveolar nerve block d. Inferior alveolar nerve block ANS: D

The most common mandibular block is the inferior alveolar nerve block. This injection anesthetizes both the inferior alveolar nerve and the lingual nerve. The Gow-Gates mandibular nerve block affects more tissue area than the inferior alveolar nerve block but requires more time to initiate and become effective. The posterior superior alveolar nerve block anesthetizes the maxillary molars and their associated bone, gingiva, and buccal periodontium. The middle superior alveolar nerve block anesthetizes the maxillary premolars, their associated bone,

.cCcaOl Mroot of the maxillary first molar. gingiva, buccal periodontiumN ,U anR dS thI eN mG esTioBbu

REF: p. 379 OBJ: To understand the anatomy associated with mandibular blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 13. Infiltration anesthesia affects a. teeth only b. the peridontium only c. teeth and peridontium d. the gingiva only ANS: D

The infiltration anesthesia affects the gingiva and not teeth in the immediate area. The supraperiosteal affects teeth, periodontium, and gingiva.

REF: p. 373 OBJ: To understand the anatomy involved in infiltration, supraperiosteal and nerve block injections NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 14. The regional nerve block affects a much larger area and more teeth because it affects larger

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

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

ANS: B

The regional nerve block affects a much larger area and more teeth because it affects a number of nerves rather than just a single nerve. Regional blocks may affect an area far removed from the original injection site. A regional block may or may not affect teeth, but definitely affects the periodontium and gingiva of a large or small area because the area anesthetized is close to a nerve trunk.

REF: p. 373 OBJ: To understand the anatomy involved in infiltration, supraperiosteal and nerve block injections NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Understanding 15. Most dental procedures only require a facial supraperiosteal injection EXCEPT one of the

following. Which one is the EXCEPTION? a. Composite resin restoration b. Periodontal debridement c. Extraction d. Periodontal surgery ANS: A

A composite resin restoration would only require a facial supraperiosteal injection. A broader anesthetic would be needed for a procedure involving the lingual gingiva, as in periodontal debridement, an extraction, or periodontal surgery.

REF: p. 373 NURSINGTB.COM OBJ: To understand the anatomy involved in infiltration, supraperiosteal and nerve block injections NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 16. To anesthetize the maxillary premolars and their associated bone, the following procedure

would be used: a. Middle superior alveolar nerve block b. Nasopalatine nerve block c. Buccal nerve block d. Gow-Gates block ANS: A

The middle superior alveolar nerve block anesthetizes the maxillary premolars and their associated bone, gingiva, buccal periodontium, and the mesiobuccal root of the maxillary first molar. The nasopalatine nerve block affects the hard and soft tissues of the palatal periodontium and gingiva of the six anterior teeth. A buccal nerve block is used for the buccal gingiva and periodontium of the molar teeth. A Gow-Gates block anesthetizes all of the mandibular teeth on one side, their lingual periodontium and gingiva, the periodontium and gingiva of the premolars and anterior teeth, the floor of the mouth and lip on one side, the anterior two-thirds of the tongue. In addition, this block also anesthetizes the soft tissues covering the zygomatic bone, some temporal areas, and the digastric and mylohyoid muscles.

REF: p. 375 | p. 378 | p. 381 OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks

NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering MULTIPLE RESPONSE 1. Which block can cause a hematoma? (Select all that apply.) a. Anterior superior alveolar nerve block b. Posterior superior alveolar nerve block c. Infraorbital nerve block d. Gow-Gates nerve block ANS: B, C

The posterior superior alveolar nerve, artery, and vein are all located together within the pterygopalatine fossa just distal and superior to the tuberosity of the maxilla. They are not covered by bone at this point. A needle could easily puncture or barely scrape a nerve, artery, or vein. If this occurs, it would be painful but also could cause a bleeding situation from a blood vessel, the nerve, if punctured or even touched, emits an extremely painful reaction (nerve shock). If a bleeding situation occurs, a swelling followed by a hematoma will result. If the needle is delivered further distally, even more serious bleeding and other traumatic events could occur. An infraorbital nerve block can be painful and can cause a hematoma in the lower eye lid, so the clinical conditions must warrant the risk associated with this block.

REF: p. 375 | p. 377 | pp. 380-381 OBJ: To understand the major concerns associated with different local anesthetic nerve blocks BLOOM: Remembering NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BL OOM: Remembering

N R I G B. C M U S N T O

2. What are two ways to lessen the pain from injecting into tissue? (Select all that apply.) a. Inject very slowly b. Be sure the patient is calm c. Have the patient tense his or her jaw muscles d. Use pressure anesthesia ANS: A, D

When injected slowly, the anesthesia solution is absorbed into the tissue and eliminates a burning sensation. Using pressure anesthesia requires putting pressure on the injection site prior to injecting the solution. A cotton-tipped applicator is applied to the injection site for 30 to 60 seconds before the injection, during the injection, and a few seconds after the injection.

This causes nerve innervations to respond to the pressure long enough to cause a slight numb sensation. If the pressure is relieved in any way, there is an immediate recovery and the patient will feel the pain.

REF: p. 379 OBJ: To understand the major concerns associated with different local anesthetic nerve blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 3. Which of the following preexisting medical conditions should be considered before making

decisions concerning anesthesia? (Select all that apply.) a. High blood pressure

b. Glaucoma c. Kidney and liver disease d. Diabetes ANS: A, C, D

The following medical conditions of the patient should always be considered before administration of anesthetic agents: high blood pressure, diabetes, drug interactions with the medications may affect the type and volume of anesthetic and use a vasoconstrictor. In selecting the anesthetic agent, it is important to recognize the way the anesthetic is detoxified may be compromised by a diseased liver or kidney.

REF: p. 374 OBJ: To understand the anatomic considerations during administration of local anesthesia NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering TRUE/FALSE 1. All of the mandibular teeth are innervated by the inferior alveolar nerve.

ANS: T

Anesthetic solution needs to be delivered posterior to the target area so that the agent can intercept the transmission of the nerve impulses which are sent posteriorly, back toward the trigeminal nerve ganglion.

REF: p. 379 OBJ: To understand the anatomy associated with mandibular blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, NUs.RSINGTTOP: B.C M Remembering including but not limited to: nerve BLOOOM: 2. There are five maxillary nerve blocks delivered from the facial side.

ANS: F

There are four maxillary nerve blocks delivered from the facial side: posterior superior alveolar nerve block, middle superior alveolar nerve block, anterior superior alveolar nerve block, infraorbital nerve block.

REF: p. 375 OBJ: To understand the anatomy of the maxillary nerve as it relates to administration of local anesthesia NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 3. The nerve exits the tooth at the root apex.

ANS: T

If the anesthetic solution reaches this area it will anesthetize the tooth.

REF: p. 373 OBJ: To understand the anatomy of the maxillary nerve as it relates to administration of local anesthesia NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering

4. It is necessary to have a good understanding of the root’s width in order to properly perform

supraperiosteal injections.

ANS: F

Knowledge of the root’s length is necessary in order to properly perform supraperiosteal injections. The anesthetic solution penetrates the gingiva and bone and drops down via gravity into the area of the root apex. The local anesthetic is predictable, but only anesthetizes the tooth below the injection and its buccal tissue.

REF: p. 373 OBJ: To understand the anatomy of the maxillary nerve as it relates to administration of local anesthesia NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 5. The injection site for maxillary injections is not directly above the target area but one-half

tooth distal to the target.

ANS: F

The injection site for mandibular injections is one-half tooth distal to the target. If one wants to anesthetize the mandibular first molar, the injection site would be between the mandibular first and second molar (one-half tooth further distal to the target site). This is because the anesthetic solution needs to penetrate bone and arrive at the inferior alveolar nerve in a location posterior to the target area.

REF: p. 374 OBJ: To understand the anatomy associated with mandibular blocks NAT: CDA: GC I.A.5. IdentifyNbU asR icSoI raN l aG ndTdBe. ntaCl O anM atomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 6. A mental block affects the facial periodontium and gingiva of the mandibular premolars and

anterior teeth to the midline.

ANS: T

Teeth are not affected by a mental block.

REF: p. 381 OBJ: To understand the anatomy associated with mandibular blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering 7. Manual pressure is applied at the injection site during use of a mental block.

ANS: F

Manual pressure is used in an incisive block. This allows the premolar and anterior teeth to the midline to be anesthetized. If enough anesthetic can enter the canal, the following tissues will become numb: the premolars and anterior three teeth; their associated facial periodontium and gingiva, but not their lingual tissues.

REF: p. 379 OBJ: To understand the anatomy associated with mandibular blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering

MATCHING

Match the area with the procedure used to anesthetize it: a. Local infiltration b. Anterior superior alveolar nerve block c. Gow-Gates nerve block d. Nasopalatine nerve block 1.

2.

3.

4.

Auriculotemporal nerves Small soft tissue area Maxillary anterior teeth Hard and soft tissues of the palatal periodontium and gingiva of the six anterior teeth

1. ANS: C REF: p. 373 | p. 376 | pp. 378-381 OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering NOT: The Gow-Gates nerve block is used to anesthetize the auriculotemporal nerves.

2. ANS: A REF: p. 373 | p. 376 | pp. 378-381 OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering NOT: Local infiltration is the term used for anesthesia of a small soft tissue area and not teeth or bone.

3. ANS: B REF: p. 373 | p. 376 | pp. 378-381 OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks N asic RSora IN G B.Canatomy, M NAT: CDA: GC I.A.5. Identify bU l andTdental O physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering NOT: An anterior superior alveolar nerve block anesthetizes the maxillary anterior teeth (canine, lateral, and central) along with their associated bone, gingiva, buccal periodontium, and the maxillary lip to the midline.

4. ANS: D REF: p. 373 | p. 376 | pp. 378-381 OBJ: To understand the different areas anesthetized by the maxillary and mandibular nerve blocks NAT: CDA: GC I.A.5. Identify basic oral and dental anatomy, physiology and development, including but not limited to: nerves.

TOP: BLOOM: Remembering NOT: A nasopalatine nerve block affects the hard and soft tissues of the palatal periodontium and gingiva of the six anterior teeth (canine to canine). All six anterior teeth are affected by one anesthetic nerve block.