11) Oral Cavity and Tongue Flashcards
What forms the roof of the oral cavity?
Hard and soft palate
What forms the floor of the oral cavity?
Tongue and other soft tissues
What forms the lateral walls of the oral cavity?
Cheek (buccinator muscles)
What forms the anterior opening of the oral cavity?
Oral fissure
What forms the posterior opening of the oral cavity?
Oropharyngeal isthmus
What is the oral vestibule?
Space between teeth and cheeks/lips
What is the oral cavity proper?
Space between teeth to palatopharyngeal arch, uvula and epiglottis
What is the anterior arch of the oropharyngeal isthmus and what muscle forms this?
Palatoglossal arch by palatoglossus muscle
What is the posterior arch of the oropharyngeal isthmus and what muscle forms this?
Palatopharyngeal arch by palatopharyngeus muscle
What is the function of the muscles of the soft palate?
Elevate soft palate during swallowing and yawning
What forms the hard palate?
Maxilla and palatine bone
What is the innervation to the soft palate?
Vagus nerve (pharyngeal branch)
In terms of the uvula, how does damage to the vagus nerve present?
Stronger side is unopposed so pulls uvula away from side of affected nerve
Why is the gag reflex important?
Prevents choking
What would be seen upon testing of the gag reflex?
Lift of soft palate
Describe the nervous arc in the gag reflex:
Afferent limb: glossopharyngeal
Efferent limb: vagus
Name the teeth found in a normal adult:
Central incisors, lateral incisors, canines, pre-molars and molars
Describe the nervous supply to the lower jaw:
Inferior alveolar nerve (V3)
A patient presents to you with loss of sensation over lower jaw after being punched in the same area, what is likely to have happened?
Mandibular fracture causing damage to inferior alveolar nerve running in mandibular fossa
What are the 4 extrinsic muscles of the tongue?
Genioglossus
Hyoglossus
Styloglossus
Palatoglossus
What are the functions of the extrinsic muscles of the tongue?
Anchor tongue to hyoid and mandible
Allow tongue to change position
What are the 4 intrinsic muscles of the tongue?
Superior longitudinal, vertical, transverse and inferior longitudinal
What are the functions of the intrinsic muscles of the tongue?
Change shape of the tongue
Describe the sensory innervation to the tongue:
Anterior 2/3rds:
General: lingual (V3)
Special: chorda tympani (VII)
Posterior 1/3rd: glossopharyngeal (IX)
How would a person with damage to right hypoglossal nerve present?
Tongue deviating to right side
Through which duct to parotid gland secretions enter the oral cavity?
Stenson’s duct
Through which duct to submandibular gland secretions enter the oral cavity?
Wharton’s duct
A patient comes to you and states that they get a swelling on their lower jaw while eating. What is the likely diagnosis?
Salivary stone in submandibular duct
What is tonsillitis?
Inflammation of palatine tonsil
How does tonsillitis present?
Sore throat
Odynophagia/dysphagia
Tonsils enlarged and erythematous
What are some viral causes of tonsillitis?
Rhinovirus and adenovirus
What are some bacterial causes of tonsillitis?
Beta-haemolytic strep
How would you differentiate between viral and bacterial tonsillitis?
Viral: dry cough
Bacterial: cervical lymphadenopathy, fever and pus
What is a severe complication of bacterial tonsillitis?
Peritonsillar abscess (Quinsy)
What are the common causes of peritonsillar abscess?
Strep pyogenes
S. aureus, H. influenza or mixed flora
How would those with a peritonsillar abscess present?
Systemically unwell, trismus, drooling, unilateral abscess
How would you tell the difference between tonsillitis and peritonsillar abscess?
Anterior arch remains, exudate and bilateral swelling in tonsillitis but not in quinsy
