, CHAPTER LIST
UNIT I: Orofacial Structures
Chapter 1: Face and Neck Regions
Chapter 2: Oral Cavity and Pharynx
UNIT II: Dental Embryology
Chapter 3: Prenatal Development
Chapter 4: Face and Neck Development
Chapter 5: Orofacial Development
Chapter 6: Tooth Development and Eruption
UNIT III: Dental Histology
Chapter 7: Basic Cell Properties and Processes
Chapter 8: Basic Tissue Properties and Processes
Chapter 9: Oral Mucosa
Chapter 10: Gingival and Dentogingival Junctional Tissue
Chapter 11: Head and Neck Structures
Chapter 12: Enamel
Chapter 13: Dentin and Pulp
Chapter 14: Periodontium: Cementum, Alveolar Process, and
Periodontal Ligament
UNIT IV: Dental Anatomy
Chapter 15: Overview of Dentitions
Chapter 16: Permanent Anterior Teeth
Chapter 17: Permanent Posterior Teeth
Chapter 18: Primary Dentition
Chapter 19: Temporomandibular Joint
Chapter 20: Occlusion
,Chapter 1: Face and Neck Regions
Question 1
During an extraoral examination, a clinician palpates a bony landmark just
anterior to the external auditory meatus to orient for an inferior alveolar nerve
block. Which structure is being identified?
A. Mastoid process
B. Coronoid process
C. Condylar process
D. Styloid process
Answer: C
Very deep rationale:
The condylar process of the mandible lies just anterior to the external auditory
meatus and forms part of the temporomandibular joint. Palpation of this
landmark helps orient the clinician to mandibular anatomy when positioning
the syringe for inferior alveolar nerve anesthesia. The mastoid process lies
posterior to the ear, the coronoid process is anterior and superior but not
palpable externally at rest, and the styloid process is deep and not typically
palpable.
Key words: condylar process, mandibular landmarks, local anesthesia, TMJ
orientation
Question 2
A patient presents with inability to wrinkle the forehead or close the eyelids on
the right side following parotid gland surgery. Which nerve has most likely
been damaged?
A. Trigeminal nerve (V)
B. Facial nerve (VII)
C. Glossopharyngeal nerve (IX)
D. Hypoglossal nerve (XII)
Answer: B
,Very deep rationale:
The facial nerve innervates all muscles of facial expression, including the
frontalis (forehead wrinkling) and orbicularis oculi (eyelid closure). Because the
facial nerve traverses the parotid gland, it is vulnerable during parotid surgery.
Trigeminal nerve injury would affect sensation or mastication, not facial
expression.
Key words: facial nerve, parotid gland, facial paralysis, cranial nerve VII
Question 3
Which muscle elevates the mandible during mastication and is palpated when
the patient clenches their teeth?
A. Buccinator
B. Medial pterygoid
C. Masseter
D. Temporalis
Answer: C
Very deep rationale:
The masseter is a powerful elevator of the mandible and is easily palpated on
the lateral surface of the ramus during clenching. Although the temporalis also
elevates the mandible, it is palpated in the temporal fossa rather than along
the mandibular angle. Buccinator assists with food control, not elevation.
Key words: masseter, mastication, mandibular elevation, muscle palpation
Question 4
A localized infection of the lower lip would most likely drain initially into which
lymph node group?
A. Submandibular
B. Submental
C. Deep cervical
D. Preauricular
Answer: B
,Very deep rationale:
The submental lymph nodes drain the central lower lip, floor of the mouth, and
mandibular incisors. Understanding lymphatic drainage is critical for
identifying the spread of infection or malignancy. Submandibular nodes drain
lateral lip regions, while preauricular nodes drain the temporal and parotid
regions.
Key words: lymphatic drainage, submental nodes, infection spread, lower lip
Question 5
Loss of sensation over the lower lip and chin following dental implant
placement suggests injury to which nerve?
A. Lingual nerve
B. Buccal nerve
C. Mental nerve
D. Inferior alveolar nerve (before branching)
Answer: C
Very deep rationale:
The mental nerve, a terminal branch of the inferior alveolar nerve, supplies
sensation to the chin and lower lip. Damage after implant placement in the
premolar region commonly affects this nerve. Lingual nerve injury affects
tongue sensation; buccal nerve affects cheek mucosa.
Key words: mental nerve, chin numbness, implant complications, sensory loss
Question 6
Which artery is most at risk during surgical procedures involving the posterior
maxilla?
A. Facial artery
B. Maxillary artery
C. Superficial temporal artery
D. Lingual artery
Answer: B
,Very deep rationale:
The maxillary artery, a terminal branch of the external carotid artery, supplies
deep facial structures including the posterior maxilla. It is particularly
vulnerable during oral surgery in this region. Facial and lingual arteries are
more superficial and anterior.
Key words: maxillary artery, posterior maxilla, surgical risk, blood supply
Question 7
A patient cannot protrude the mandible against resistance. Which muscle is
primarily responsible?
A. Temporalis
B. Masseter
C. Lateral pterygoid
D. Medial pterygoid
Answer: C
Very deep rationale:
The lateral pterygoid muscle is the primary muscle responsible for mandibular
protrusion and assists in opening the jaw. Dysfunction results in impaired
protrusive movements. The temporalis elevates and retracts the mandible,
while the masseter elevates.
Key words: lateral pterygoid, mandibular protrusion, mastication mechanics
Question 8
During an extraoral exam, asymmetry of the nasolabial fold is noted. This
finding most directly suggests dysfunction of which muscle?
A. Zygomaticus major
B. Buccinator
C. Orbicularis oris
D. Levator labii superioris
Answer: A
,Very deep rationale:
The zygomaticus major elevates the corner of the mouth during smiling,
contributing to the nasolabial fold. Weakness results in flattening of this fold, a
common sign of facial nerve dysfunction.
Key words: nasolabial fold, zygomaticus major, facial symmetry, facial nerve
Question 9
Which cranial nerve provides both sensory innervation to the face and motor
innervation to muscles of mastication?
A. Facial (VII)
B. Trigeminal (V)
C. Accessory (XI)
D. Glossopharyngeal (IX)
Answer: B
Very deep rationale:
The trigeminal nerve provides sensory innervation to the face (V1, V2, V3) and
motor innervation to muscles of mastication via V3. Facial nerve controls
expression but not mastication.
Key words: trigeminal nerve, mastication, facial sensation, cranial nerve V
Question 10
Swelling inferior to the angle of the mandible that becomes tender during
eating most likely involves which structure?
A. Sublingual gland
B. Submandibular gland
C. Parotid gland
D. Thyroid gland
Answer: B
Very deep rationale:
The submandibular gland lies inferior to the mandibular angle and produces
, saliva that increases during eating. Obstruction or infection commonly causes
meal-related pain and swelling.
Key words: submandibular gland, salivary obstruction, mandibular angle
Question 11
Which muscle primarily retracts the mandible following protrusion?
A. Lateral pterygoid
B. Medial pterygoid
C. Masseter
D. Temporalis
Answer: D
Very deep rationale:
The temporalis muscle retracts the mandible after protrusion due to its
posterior fiber orientation. This function is essential for coordinated chewing
cycles.
Key words: temporalis, mandibular retraction, chewing mechanics
Question 12
Damage to which nerve would most directly affect tactile sensation of the cheek
mucosa?
A. Mental nerve
B. Buccal nerve
C. Infraorbital nerve
D. Lingual nerve
Answer: B
Very deep rationale:
The buccal nerve (branch of V3) provides sensory innervation to the cheek
mucosa. It does not innervate the buccinator muscle, which is supplied by the
facial nerve.
Key words: buccal nerve, cheek sensation, trigeminal branches
UNIT I: Orofacial Structures
Chapter 1: Face and Neck Regions
Chapter 2: Oral Cavity and Pharynx
UNIT II: Dental Embryology
Chapter 3: Prenatal Development
Chapter 4: Face and Neck Development
Chapter 5: Orofacial Development
Chapter 6: Tooth Development and Eruption
UNIT III: Dental Histology
Chapter 7: Basic Cell Properties and Processes
Chapter 8: Basic Tissue Properties and Processes
Chapter 9: Oral Mucosa
Chapter 10: Gingival and Dentogingival Junctional Tissue
Chapter 11: Head and Neck Structures
Chapter 12: Enamel
Chapter 13: Dentin and Pulp
Chapter 14: Periodontium: Cementum, Alveolar Process, and
Periodontal Ligament
UNIT IV: Dental Anatomy
Chapter 15: Overview of Dentitions
Chapter 16: Permanent Anterior Teeth
Chapter 17: Permanent Posterior Teeth
Chapter 18: Primary Dentition
Chapter 19: Temporomandibular Joint
Chapter 20: Occlusion
,Chapter 1: Face and Neck Regions
Question 1
During an extraoral examination, a clinician palpates a bony landmark just
anterior to the external auditory meatus to orient for an inferior alveolar nerve
block. Which structure is being identified?
A. Mastoid process
B. Coronoid process
C. Condylar process
D. Styloid process
Answer: C
Very deep rationale:
The condylar process of the mandible lies just anterior to the external auditory
meatus and forms part of the temporomandibular joint. Palpation of this
landmark helps orient the clinician to mandibular anatomy when positioning
the syringe for inferior alveolar nerve anesthesia. The mastoid process lies
posterior to the ear, the coronoid process is anterior and superior but not
palpable externally at rest, and the styloid process is deep and not typically
palpable.
Key words: condylar process, mandibular landmarks, local anesthesia, TMJ
orientation
Question 2
A patient presents with inability to wrinkle the forehead or close the eyelids on
the right side following parotid gland surgery. Which nerve has most likely
been damaged?
A. Trigeminal nerve (V)
B. Facial nerve (VII)
C. Glossopharyngeal nerve (IX)
D. Hypoglossal nerve (XII)
Answer: B
,Very deep rationale:
The facial nerve innervates all muscles of facial expression, including the
frontalis (forehead wrinkling) and orbicularis oculi (eyelid closure). Because the
facial nerve traverses the parotid gland, it is vulnerable during parotid surgery.
Trigeminal nerve injury would affect sensation or mastication, not facial
expression.
Key words: facial nerve, parotid gland, facial paralysis, cranial nerve VII
Question 3
Which muscle elevates the mandible during mastication and is palpated when
the patient clenches their teeth?
A. Buccinator
B. Medial pterygoid
C. Masseter
D. Temporalis
Answer: C
Very deep rationale:
The masseter is a powerful elevator of the mandible and is easily palpated on
the lateral surface of the ramus during clenching. Although the temporalis also
elevates the mandible, it is palpated in the temporal fossa rather than along
the mandibular angle. Buccinator assists with food control, not elevation.
Key words: masseter, mastication, mandibular elevation, muscle palpation
Question 4
A localized infection of the lower lip would most likely drain initially into which
lymph node group?
A. Submandibular
B. Submental
C. Deep cervical
D. Preauricular
Answer: B
,Very deep rationale:
The submental lymph nodes drain the central lower lip, floor of the mouth, and
mandibular incisors. Understanding lymphatic drainage is critical for
identifying the spread of infection or malignancy. Submandibular nodes drain
lateral lip regions, while preauricular nodes drain the temporal and parotid
regions.
Key words: lymphatic drainage, submental nodes, infection spread, lower lip
Question 5
Loss of sensation over the lower lip and chin following dental implant
placement suggests injury to which nerve?
A. Lingual nerve
B. Buccal nerve
C. Mental nerve
D. Inferior alveolar nerve (before branching)
Answer: C
Very deep rationale:
The mental nerve, a terminal branch of the inferior alveolar nerve, supplies
sensation to the chin and lower lip. Damage after implant placement in the
premolar region commonly affects this nerve. Lingual nerve injury affects
tongue sensation; buccal nerve affects cheek mucosa.
Key words: mental nerve, chin numbness, implant complications, sensory loss
Question 6
Which artery is most at risk during surgical procedures involving the posterior
maxilla?
A. Facial artery
B. Maxillary artery
C. Superficial temporal artery
D. Lingual artery
Answer: B
,Very deep rationale:
The maxillary artery, a terminal branch of the external carotid artery, supplies
deep facial structures including the posterior maxilla. It is particularly
vulnerable during oral surgery in this region. Facial and lingual arteries are
more superficial and anterior.
Key words: maxillary artery, posterior maxilla, surgical risk, blood supply
Question 7
A patient cannot protrude the mandible against resistance. Which muscle is
primarily responsible?
A. Temporalis
B. Masseter
C. Lateral pterygoid
D. Medial pterygoid
Answer: C
Very deep rationale:
The lateral pterygoid muscle is the primary muscle responsible for mandibular
protrusion and assists in opening the jaw. Dysfunction results in impaired
protrusive movements. The temporalis elevates and retracts the mandible,
while the masseter elevates.
Key words: lateral pterygoid, mandibular protrusion, mastication mechanics
Question 8
During an extraoral exam, asymmetry of the nasolabial fold is noted. This
finding most directly suggests dysfunction of which muscle?
A. Zygomaticus major
B. Buccinator
C. Orbicularis oris
D. Levator labii superioris
Answer: A
,Very deep rationale:
The zygomaticus major elevates the corner of the mouth during smiling,
contributing to the nasolabial fold. Weakness results in flattening of this fold, a
common sign of facial nerve dysfunction.
Key words: nasolabial fold, zygomaticus major, facial symmetry, facial nerve
Question 9
Which cranial nerve provides both sensory innervation to the face and motor
innervation to muscles of mastication?
A. Facial (VII)
B. Trigeminal (V)
C. Accessory (XI)
D. Glossopharyngeal (IX)
Answer: B
Very deep rationale:
The trigeminal nerve provides sensory innervation to the face (V1, V2, V3) and
motor innervation to muscles of mastication via V3. Facial nerve controls
expression but not mastication.
Key words: trigeminal nerve, mastication, facial sensation, cranial nerve V
Question 10
Swelling inferior to the angle of the mandible that becomes tender during
eating most likely involves which structure?
A. Sublingual gland
B. Submandibular gland
C. Parotid gland
D. Thyroid gland
Answer: B
Very deep rationale:
The submandibular gland lies inferior to the mandibular angle and produces
, saliva that increases during eating. Obstruction or infection commonly causes
meal-related pain and swelling.
Key words: submandibular gland, salivary obstruction, mandibular angle
Question 11
Which muscle primarily retracts the mandible following protrusion?
A. Lateral pterygoid
B. Medial pterygoid
C. Masseter
D. Temporalis
Answer: D
Very deep rationale:
The temporalis muscle retracts the mandible after protrusion due to its
posterior fiber orientation. This function is essential for coordinated chewing
cycles.
Key words: temporalis, mandibular retraction, chewing mechanics
Question 12
Damage to which nerve would most directly affect tactile sensation of the cheek
mucosa?
A. Mental nerve
B. Buccal nerve
C. Infraorbital nerve
D. Lingual nerve
Answer: B
Very deep rationale:
The buccal nerve (branch of V3) provides sensory innervation to the cheek
mucosa. It does not innervate the buccinator muscle, which is supplied by the
facial nerve.
Key words: buccal nerve, cheek sensation, trigeminal branches
