TMJ and General health

 
TMJ and General health



Nervous system of the head & neck (µÎ°æ ºÎÀÇ ½Å°æ°è)


1. ½Å°æ°èÅëÀÇ ±¸ºÐ

½Å°æ°è´Â ÁßÃ߽Űæ°è (nervous system) ¿Í ¸»ÃʽŰæ°è (peripheral nervous system) ·Î ±¸ºÐÇÏ¸ç ´õ ¼¼ºÐÇÏ¸é ´ÙÀ½°ú °°´Ù.

A> ÁßÃ߽Űæ°è(central nervous system)

1) ³ú (brain)- Àü³ú (forebrain,), Áß³ú(mid brain), Èijú(hindbrain)
2) ô¼ö (spinal cord)

B> ¸»ÃʽŰæ°è (peripheral nervous system)

1 ³ú ô¼ö½Å°æ°è(cerebro spinal nervous system)
1.1 ³ú½Å°æ(cranial nerve),
1.2 ô¼ö½Å°æ (spinal nerves)
2 ÀÚÀ²½Å°æ°èautonomic nervous system)
2.1 ±³°¨½Å°æ°è( sympathetic nerve)
2.2 ºÎ±³°¨½Å°æ (parasympathetic nerve)
À̵éÀÇ ±¸ºÐ Áß¿¡¼­ ¾È¸é ¹× ±¸°­°ú °ü°èµÇ´Â °ÍÀº ³ú½Å°æ (cranial nerves) °ú ÀÚÀ²½Å°æ°è (autonomic nervous
system)ÀÌ´Ù.

±×¸²10-1 CNS &PNS SYSTEM P.364 Human ANATOMY & PHYSIOLOGY 4TH EDITIONELAINE N.MARIEB ¿¡¼­ Àοë

2. ³ú½Å°æ (cranial nerves)

³ú¿¡¼­´Â 12½ÖÀÇ ³ú½Å°æÀÌ ³ª¿À¸ç °¨°¢, Áö°¢, ¿îµ¿ ¹× ºÎ ±³°¨¼ºÀ¸·Î ÀÛ¿ëÇÑ´Ù. ³ú½Å°æÀº ³úÀÇ ÇØ´ç ½Å°æ ÇÙÀÇ À§Ä¡¿¡ µû¶ó ¾Õ¿¡¼­ºÎÅÍ ¼ø¼­´ë·Î ¹øÈ£¸¦ ºÙ¿© ½Å°æÀÇ ¸íĪ´ë½Å »ç¿ëÇϱ⵵ ÇÑ´Ù.

* 12 CRANIAL NERVE

1) olfactory nerve ( ÈĽŰæ )-°¨°¢½Å°æ (ÈĽŰæ)
2) optic " (½Ã½Å°æ )- (Áö°¢½Å°æ)
3) oculo motor " (µ¿¾È½Å°æ)- ¿îµ¿½Å°æ, ÀϺΠºÎ ±³°¨½Å°æ
4) trochlear " (ȰÂ÷½Å°æ)- ¿îµ¿½Å°æ
5) trigeminal n. (»ïÂ÷½Å°æ)-È¥ÇսŰæ
6) abducens n. (¿ÜÀü½Å°æ)-¿îµ¿½Å°æ
7) facial n. (¾È¸é½Å°æ)-È¥ÇսŰæ, ÀϺΠºÎ ±³°¨½Å°æ
8) vestibulo-cochlear n. (³»ÀÌ ½Å°æ) - Áö°¢½Å°æ, (ÆòÇü°¨°¢ ¹× û°¢)
9) glosso-pharyngeal n. (¼³ÀÎ ½Å°æ) - È¥ÇսŰæ(ÀϺΠºÎ ±³°¨½Å°æ)
10) vagus n. (¹ÌÁֽŰæ)- È¥ÇսŰæ(ÀϺΠºÎ ±³°¨½Å°æ
11) accessory n. (ºÎ½Å°æ)- ¿îµ¿½Å°æ
12) hypoglossal n.(¼³ÇÏ ½Å°æ)- ¿îµ¿½Å°æ
13) Olfactory nerve ( ÈĽŰæ )-Èİ¢À» ³ªÅ¸³»´Â °¨°¢½Å°æÀ¸·Î¼­ ºñ°­ÀÇ »óÈĵκΠÁ¡¸·¿¡ Á¸ÀçÇϸç Èİ¢ °¨°¢ÀÇ afferent impulse¸¦ Àü´ÞÇÑ´Ù.
14) Optic nerve(½Ã½Å°æ)- Áö°¢½Å°æÀ¸·Î¼­ ¾È±¸ÀÇ ¸Á¸·(retina)¿¡ ÀÖ´Â ¼¼Æ÷Ãþ¿¡ ÀÖ´Â ½Å°æ¼¼Æ÷Ãþ¿¡¼­ ¹Þ¾ÆµéÀÎ ºûÀÇ ÀÚ±ØÀ» ½Ã°¢ ÁßÃß·Î Àü´ÞÇÑ´Ù.

±×¸²10-2 Olfactory nerve P.468 Human ANATOMY & PHYSIOLOGY 4TH EDITIONELAINE N.MARIEB ¿¡¼­ ÀÎ¿ë ±×¸²10-3 P.469 optic nerve Human ANATOMY & PHYSIOLOGY 4TH EDITIONELAINE N.MARIEB ¿¡¼­ Àοë

15) Oculo motor " ( µ¿¾È½Å°æ)-¿îµ¿½Å°æ( ÀϺΠºÎ±³°¨½Å°æ) À¸·Î¼­ 4°³ÀÇ ±ÙÀ°(inf.oblique,sup.inf.medial rectus )ÀÇ ¿îµ¿°ú ¾È °Ë(eyelid)À» ¿Ã¸®°ÔÇÏ´Â Levator palpebrae sup.±ÙÀ°ÀÇ ¿îµ¿.


±×¸²10-4 P.469 Oculomotor nerve Human ANATOMY & PHYSIOLOGY 4TH EDITIONELAINE N.MARIEB ¿¡¼­ Àοë

16)Trochlear " (ȰÂ÷½Å°æ)- ¿îµ¿½Å°æÀ¸·Î¼­ sup.oblique muscles ÀÇ ¿îµ¿


±×¸²10-5 Trochlear Nerve P.469 Human ANATOMY & PHYSIOLOGY 4TH EDITIONELAINE N.MARIEB ¿¡¼­ Àοë

17) Trigeminal n. (»ïÂ÷½Å°æ)-È¥ÇսŰæÀ¸·Î¼­ ±× Áß Áö°¢½Å°æÀº ¾ó±¼, ¸Ó¸®ÀÇ ÇǺÎ, Ä¡¾ÆÀÇ Á¡¸·À» Áö¹èÇÏ°í ¿îµ¿½Å°æÀº ÀúÀÛ ±Ù ¾Ç ¼³°ñ ±Ù°ú ¾ÇÀ̺¹±ÙÀÇ Àüº¹À» Áö¹èÇÑ´Ù. ¿©±â¿¡¼­ 3°¡Áö·Î branch µÈ´Ù.
1 Ophthalmic division(¾È½Å°æ)- ¼ø¼ö Áö°¢½Å°æÀ¸·Î¼­ ant.scalpÀÇ ÇǺÎ,upper eyelid,& nose,nasal cavitymucosa, cornea,
and lacrimal gland.ÀÇ °¨°¢À» Áö¹èÇÑ´Ù.
2 Maxilary division (»ó¾Ç½Å°æ)-¼ø¼öÁö°¢½Å°æÀ¸·Î¼­ Nasal cavity ,mucosa,,palate,upper teeth, skin of cheek, upper lip, lower eye lid ¸¦ Áö¹èÇÑ´Ù.
Mandibular division(ÇϾǽŰæ)-Áö°¢½Å°æ ¹× ¿îµ¿½Å°æÀ¸·Î¼­ ant.tongue(except taste bud), lower teeth, skin of chin, temporal region of scalp,ÀÇ °¨°¢À» Áö¹èÇϰí,ÀúÀÛ±ÙÀÇ proprioceptor ¹× ¿îµ¿½Å°æÀ» Áö¹èÇÑ´Ù.


±×¸²10-6 P.470 Trigeminal nerve Human ANATOMY & PHYSIOLOGY 4TH EDITIONELAINE N.MARIEB ¿¡¼­ Àοë

18) Abducens Nerve(¿ÜÀü½Å°æ)-Áַο ½Å°æÀ¸·Î¼­ lateral rectus ÀÇ ¾È±¸ÀÇ È¸Àü¿îµ¿ À» Áö¹è


±×¸²10-7 P.469 Human ANATOMY & PHYSIOLOGY 4TH EDITIONELAINE N.MARIEB ¿¡¼­ Àοë

19) Facial Nerve(¾È¸é½Å°æ)-È¥ÇսŰæÀ¸·Î¼­ ÁÖ·Î motor·Î¼­ ¾ó±¼ÀÇ ½Å°æÀ» Áö¹èÇϸç 5°³ÀÇ Branch ·Î ¼¼ºÐµÈ´Ù. Temporal,
zygomatic, buccal, mandibular, cervical
1 ¾ó±¼±ÙÀ°ÀÇ motor impulse ¸¦ Àü´ÞÇÑ´Ù.
2 ºÎ±³°¨ motor impulse¸¦ lacrimal gland, nasal and sublingual gland¿¡ Àü´ÞÇÑ´Ù.
3 ÇôÀÇ ant. 2/3 taste budÀÇ sensory impulse ¸¦ Àü´ÞÇÑ´Ù.


±×¸²10-8 P.470 Facial nerve Human ANATOMY & PHYSIOLOGY 4TH EDITIONELAINE N.MARIEB ¿¡¼­ Àοë

20) Vestibulo-cochlear n. (³»À̽Űæ)-Áö°¢½Å°æ,(ÆòÇü°¨°¢ ¹× û°¢)
1 vestibular branch(ÀüÁ¤½Å°æ)- ÆòÇü°¨°¢ÀÇ afferent impulse¸¦ Àü´Þ
2 cochlear branch(¿Í¿ì½Å°æ)- û°¢ afferent impulse¸¦ Àü´Þ


±×¸²10-9 Vestibulo-cochlear n. P.470 Human ANATOMY & PHYSIOLOGY 4TH EDITIONELAINE N.MARIEB ¿¡¼­ Àοë

21) Glosso-pharyngeal n. (¼³ÀνŰæ)-È¥ÇսŰæ(ÀϺκα³°¨½Å°æ) À¸·Î¼­ Áö°¢½Å°æÀº ÇôÀÇ ÈÄ1/3 Áö°¢ ¹× ¹Ì°¢À» ´ã´çÇϸç swallowing , gag reflex ¸¦ ´ã´çÇÏ´Â sup.pharyngeal muscleÀÇ motor impulse ¸¦ Áö¹èÇϸç parotid salivary glandÀÇ ºÎ±³°¨ ½Å°æÀ» Áö¹èÇÑ´Ù.


±×¸²10-10 P.472 Human ANATOMY & PHYSIOLOGY 4TH EDITIONELAINE N.MARIEB ¿¡¼­ Àοë

22) Vagus n. (¹ÌÁֽŰæ)- È¥ÇսŰæ(ÀϺκα³°¨½Å°æ)À¸·Î¼­ ¿îµ¿½Å°æÀº Èĵαٰú ¿¬±¸°³ ¹× ÀεÎÀÇ ±ÙÀ°À» Áö¹èÇϸç, ÀϹÝÁö°¢ ½Å°æÀº ÀεÎ,ÈĵÎ,½Äµµ,±â°üÁö,Æó,½ÉÀå ¹× º¹ºÎÀÇ ³»ÀåÀ» Áö¹è ÇÑ´Ù. Ư¼öÁö°¢½Å°æÀº Èĵΰ³ºÎ±ÙÀÇ ÇôÀÇ ¹Ì°¢À» Áö¹èÇϸç, ºÎ ±³°¨½Å°æÀº ÈäºÎ ¹× º¹ºÎ³»ÀåÀÇ ÆòȰ±ÙÀ» Áö¹èÇÑ´Ù.


±×¸²10-11 P.471 Human ANATOMY & PHYSIOLOGY 4TH EDITIONELAINE N.MARIEB ¿¡¼­ Àοë

23) Accessory n. (ºÎ½Å°æ)- ÁÖ·Î ¿îµ¿½Å°æÀ¸·Î¼­ ½Â¸ð ±Ù°ú Èä¼â À¯µ¹ ±ÙÀ» Áö¹èÇÑ´Ù


±×¸²10-12 P.471 Human ANATOMY & PHYSIOLOGY 4TH EDITIONELAINE N.MARIEB ¿¡¼­ Àοë

24) hypoglossal n.(¼³ ÇÏ ½Å°æ) - Áַο½Å°æÀ¸·Î¼­ ÇôÀÇ intrinsic &extrinsic muscle¿¡ somatic motor fiber¸¦ Àü´ÞÇϸç ÇôÀÇ ¿¬Çϳª speech¿¡ °ü¿©ÇÑ´Ù.


±×¸²10-13 P.471 Human ANATOMY & PHYSIOLOGY 4TH EDITIONELAINE N.MARIEB ¿¡¼­ Àοë


3. FACIAL NERVE
a. temporal br.
b. zygomatic br.
c. buccal br.
d. man. "
e. cervical br.


4. DERMATOME

¿ì¸® ¸öÀÇ skin Àº somatic sensory neuronÀÌ À־ skinÀÇ impulseÀ» spinal cord ¿Í brain stem À¸·Î Àü´ÞÇÑ´Ù.
¸ðµç spinal nerve´Â sensory & motor neuron Æ÷ÇÔÇϰí ÀÖÀ¸¸ç, Ư¡ÀûÀ¸·Î °è¼ÓÇÏ¿© ¸ðµç body ¸¦ control Çϰí ÀÖ´Ù.

CUTANOUS NERVE

a. lesser occiptal n.-C2
b. greater " n.-C2 C3
c. ant. cutanous n. -C2 C3
d. supraclavicular n. -C3 C4
e. cervical br. of facial n.


±×¸²10-14 P.483 Human ANATOMY & PHYSIOLOGY 4TH EDITIONELAINE N.MARIEB ¿¡¼­ Àοë


5. SPINAL NERVES(31)

¿ì¸® ¸öÀÇ skin Àº somatic sensory neuronÀÌ À־ skinÀÇ impulseÀ» spinal cord ¿Í brain stem À¸·Î Àü´ÞÇÑ´Ù.
¸ðµç spinal nerve´Â sensory & motor neuron Æ÷ÇÔÇϰí ÀÖÀ¸¸ç, Ư¡ÀûÀ¸·Î °è¼ÓÇÏ¿© ¸ðµç body ¸¦ control Çϰí ÀÖ´Ù.

a. cervical spinal nerves - 8
b. thoraic " " -12
c. lumbar " " -5
d. sacral " " - 5
e. coccyx " " - 1



±×¸²10-15 The anatomical chart series classic library edition p.15


6. NERVE SUPPLY OF SCALP

a. pre-auricular nerve
1) motor group
2) sensory "
b. post- auricular nerve


7. MAND. NERVE BRANCH

ANT POST
1) lat. pterygoid br. 1) auricular temporal nerve.
2) masseteric br. 2) middle meningeal nerve.
3) temporal br. 3) lingual nerve.
4) buccal br. 4) inf. alveolar nerve. - mental foramen.
- supply mucous membr. a) mylohyoid bt.
of cheek. gum, b) dental br.
first molar & premolar c) incisor br.



±×¸² 10-16 mandibular nerve nerve from plate 40 Netter?s anatomy


8 MAX . NERVE BRANCH

Ao - gasserian ganglion
1. cranial cavity - meningeal br
2. spinopalatine fossa
a) 2 br. go spinopaltine fossa
b) zygomatic br.
(1) zygomatic temporal br. - lacrimal gland
(2) zygomatic facial n. - skin of zygomatic bone
3. infra orbital canal
middle sup. dental n. - third molar
ant. sup. dental n. - incisor, canine
4. face
labial - lips
nasal - skin of nose
palpebral - skin 7 conjuntiva

±×¸² 10-17 maxillary nerve from plate 40 Netter¡¯s anatomy


9. CHORDA TYMPANI

- descending br. of facial nerve ff communication
a) optic ganglion
b) lingual nerve
supply
1) dorsum of ant. 2/3 tongue
2) sub mandibular gland lingual gland sub lingual gland



±×¸² 10-18 Chorda tympani from plate 40 Netter¡¯s anatomy


10. ¾È¸é ¹× ±¸°­°ú °ü°èµÇ´Â ½Å°æ

a) C5-3Â÷½Å°æ (trigeminal nerve)
b) C7-¾È¸é½Å°æ(facial n. )
c) C9-¼³ÀνŰæ(glossopharyngeal n.)
1 C12(¼³ÇϽŰæ(hypoglossal n.)


11. »ïÂ÷ ½Å°æ(Trigeminal nerve)

Áö°¢ ¹× ¿îµ¿ÀÇ È¥ÇսŰæÀ¸·Î Áö°¢Àº ¾È¸é ¹× µÎºÎÀÇ ÇǺÎ,±¸°­¹× ºñ°­ÀÇ Á¡¸·
±×¸®°í Ä¡¾Æ¹× ÁöÁöÁ¶Á÷¿¡ ºÐÆ÷Çϰí, ¿îµ¿Àº ÀúÀÛ±Ù, ¾Ç¼³°ñ±Ù ¹× ¾ÇÀÌ º¹±ÙÀüº¹ÀÇ ¿îµ¿À» ´ã´çÇÑ´Ù.
»ïÂ÷½Å°æÀº ³ú¿¡¼­ ³ª¿Í ÃøµÎ°ñÀÇ ÃßüÀÇ »ïÂ÷½Å°æ¾ÐÈç (trigeminal impression) ¿¡ ÀÖ´Â »ïÂ÷½Å°æÀý¿¡¼­ (trigeminal ganglion) ¿¡ À̸£°í, »ïÂ÷½Å°æÀý¿¡¼­ ´ÙÀ½ 3°³ÀÇ ½Å°æ°¡Áö°¡ ³ª¿Â´Ù.
Á¦ 1 Áö - ¾È ½Å°æ (ophthalmic n.)
Á¦ 2 Áö - »ó¾Ç½Å°æ (maxillary n.)
Á¦ 3 Áö - ÇϾǽŰæ (mandibular n.)


12. ÀÚÀ²½Å°æ°è(Autonomic system)

ÀÚÀ²½Å°æÀº ±³°¨½Å°æ(Sympathetic nerve)°ú ºÎ±³°¨½Å°æ(parasympathetic nerve)À¸·Î ±¸ºÐµÇ¸ç Ç÷°ü,¼±,³»Àå,µî¿¡ ºÐÆ÷ÇÏ¿© ¹«ÀÇ½Ä ¶Ç´Â ¹Ý»çÀûÀ¸·Î Á¶ÀýÇÑ´Ù. Áï HoemeostasisÀ» À¯ÁöÇÑ´Ù. CNSÀÇ control ¾øÀÌ ÀÚµ¿ÀûÀ¸·Î function µÇ±â ¶§¹®¿¡ ANS¶ó ºÒ¸®Áö¸¸ »ç½ÇÀº hypothalamus ,medulla oblongata ¿¡ ÀÇÇØ¼­ Á¶Àý ¹Þ´Â´Ù.

A. Autonomic motor neuron


1 preganglionic neuron - cell body °¡ brain or spinal cord ³»¿¡ ÀÖ´Â myelinated axonÀ» preganglionic fiber ¶ó ºÎ¸£¸ç postganglionic neuron °ú synapse µÈ´Ù.
Sympathetic division ÀÇ cell bodies of preganglionic neuron Àº 12°³ÀÇ thoracic segment ÀÇ lateral gray horn °ú lumbar segmentÀÇ 1-2 or 3ÀÌ´Ù. para Sympathetic divisionÀÇ of preganglionic neuronÀº cranial nerve ¥² ¹ø oculomotor , ¥¶¹ø facial nerve, ¥¸¹ø Glosso-pharyngeal n. ¥¹¹ø vagus nerveÀÇ 4 ½ÖÀÇ ÇÙ¿¡ Á¸ÀçÇϰí sacral segmentÀÇ 2¹øÂ°¿¡¼­
4¹øÂ°ÀÇ lateral gray horn °ú brain stem¿¡ Á¸ÀçÇÑ´Ù.

2 postganglionic neuron- ÀüÀûÀ¸·Î CNS ¹Ù±ùÂÊ¿¡ Àִµ¥ cell body ¿Í dendrite´Â autonomic ganglion ¿¡ Á¸ÀçÇϰí preganglionic fiber ¿Í synapse µÈ´Ù.unmyelited µÈ Axon of postganglionic neuronÀ» postganglion fiber ¶ó ÇÑ´Ù.




±×¸² 10-19 Autonomic motor neuron p.489 from principles anatomy &physiology 8 th edition


B. Autonomic Ganglia

1. Sympathetic ganglia

Skull base¿¡¼­ºÎÅÍ coccyx ±îÁö vertebral column¿¡ ¾çÂÊÀ¸·Î ¼öÁ÷À¸·Î ¹è¿­µÇ¾î ÀÖ´Ù. Sympathetic divisionÀ¸·Î preganglionic fiberÀ» ÀνÄÇϹǷΠpara vertebral ganglia ¶ó°íµµ ÇÑ´Ù.



±×¸² 10-20 P.490 from principles anatomy &physiology 8 th edition

2. prevertebral (collateral) ganglion

Sympathetic divisionÀ¸·Î preganglionic fiberÀ» ÀνÄÇϸç ÀÌ groupÀº spinal columnÀÇ ¾ÕÂÊ¿¡ À§Çϸç large abdominal artery ¿Í ±ÙÁ¢µÇ¾î ÀÖ´Ù.


±×¸² 10-21 P.491 from principles anatomy &physiology 8 th edition


3 parasympathetic ganglia
preganglionic fiber°¡ terminal ganglia¿Í synapse µÇ¾î ÀÖ´Ù.