Hi, this is Dr. Kingston,
and in this video I'll be talking about the hard palate.
Our objectives here are to understand what bones make up
the hard palate and to identify
the neurovascular supply for the region.
The hard palate is hard
specifically because it's supported by a plate of bone.
So same plate of bone that
separates the oral cavity from the nasal cavity.
It is primarily composed of
the palatine process of the maxilla.
That is this part here.
All right, so starting way up close
to the teeth and extending posteriorly
here to where we see this transition to
a smoother palatine bone.
So this is the palatine process of the maxilla
and the horizontal plates of the palatine bone.
Now because it is bony,
any neurovasculature traveling through it
will have to tunnel its way.
And so to accommodate that,
we see three sets of foramina.
Anteriorly we have one incisive foramen,
and then posteriorly on either side,
we have a greater palatine foramen
and a lesser palatine foramen.
The neurovasculature that we see
travelling through these holes is going to do so
specifically to serve the mucosa
that line the hard palate within the oral cavity.
So everything that we're going to see
here is either a branch
of the maxillary artery or of the maxillary nerve.
And if you think of those general positions
within the face,
you'll realize we're going to have to send some branches
inferiorly to reach the mucosa
on the oral surface of the palate.
So for the artery,
the descending palatine artery is going
to leave the pterygopalatine fossa.
So that's just this little space right here.
And that's going to enter into
the greater palatine canal.
And as it does so,
it's going to change its name to
the greater palatine artery to match.
The greater palatine nerve
is going to branch from the pterygopalatine ganglion,
which is up here.
So that sends another branch down here.
The greater palatine nerve is going to join
up with the greater palatine artery and they're going
to travel together through
that greater palatine foramen to get
onto the oral surface here of the hard palate.
Okay.
Now, once they have reached this position on the palate
the greater palatine artery is going to send off
a couple little branches and it is going to
supply pretty much the entire hard palate.
The greater palatine nerve, however,
has a little bit shorter range and it's going to supply
everything up to about these premolars.
So this general area here,
from the canines on through
the incisors then, so this area anteriorly,
we have a second nerve that is going to come down from
the nasal cavity in order to
bring innervation to the mucosa here.
And that is the nasopalatine nerve.
So I will switch your attention over
to this image here and you can just make out
the outline of the nasopalatine nerve as it
travels down the septum
that separates the right and left nasal cavities.
That is going to travel down
through that maxillary process,
I'm sorry, through the palatine process of the maxilla.
And that is going to pass through the incisive foramen,
which is the name for that
pathway it takes down through there.
And that will innervate the palate,
posterior to the incisors,
but anterior, I should say,
anterior to the posterior part of the canine.
That this was a pretty quick objective,
but let's give you
a practice question here to think it through anyway.
So correct answer here is a, the central incisor.
So traveling through the maxilla
here in the incisive canal,
we have the nasopalatine nerve,
which is going to innervate the mucosa,
covering the hard palate from
the incisors all the way back through the canine.
So this anterior portion, premolar, you know,
it might affect the premolar mucosa
a little bit, but probably not.
Second, first molar are
definitely too far posterior in the mouth to be affected.
And that is the end.
Thank you for watching.