12 Oral Cavity Flashcards
During examination, a patient’s uvula is deviated to the right. Which nerve is affected in this deviation?
An injury to the left vagus nerve would cause the uvula to become deviated to the right because the vagus nerve innervates the musculus uvulae muscle that make up the core of the uvula.
A patient has squamous cell carcinoma on their lower lip. Which lymph nodes will most likely be first involved?
The submental lymph nodes drain approx. the ant. 2/3 of the mouth and tongue, including the lower lips.
The occipital nodes serve the inferoposterior aspect of the head.
The parotid nodes lie anterior the ear and serve the region of the lateral aspect of the eye, the parotid gland and anterior ear.
The retropharyngeal nodes lie posterior the pharynx and drain the posterior aspect fo the throat and pharynx.
During examintion, it was noted a patient’s tongue deviated toward the right when she was asked to protrude it. Which nerve is injured?
A right hypoglossal nerve injury would result in deviation of the tongue toward the affected side when the tongue is protruded, due mainly to the unilateral contraction of the left genioglossus.
Examination reveals a lesion in the tympanic plexus in the middle ear cavity. Since the pregang. PS fibers that pass through the plexus have been lost, which condition will be seen during examination?
PS innervation of the parotid gland is provided by axons carried CN IX that emerge from the tympanic plexus of the middle ear as the lesser petrosal nerve. These synapse at the otic ganglion, which supplies the secretory PS innervation to the parotid gland.
Which nerve collects sensation from the hard palate?
The greater palatine nerve is responsible for sensory innervation of the hard palate.
The lesser palatine nerve supplies the soft palate and palatine tonsil but is not involved in supply to the hard palate.
A child has ankyloglossia. Which surgical procedure would be most appropriate for this condition?
Ankyloglossia (tongue-tie) is characterized by a lingual frenulum that extends all the way to the tip of the tongue. It can be treated by cutting the lingual frenulum.
A patient’s right shoulder droops, exhibits considerabl weakness in turning his head to the left and his tongue points to the right when he attempts to protrude it. Which nerves are affected?
Paralysis of the right accessory and right hypoglossal nerves is present in this patient.
Drooping of the right shoulder occurs as a result of paralysis of the trapezius as a result of injury to the right accessory nerve. Loss of accessory nerve would also result in weakness in turning the head to the left, which is a fxn of the right SCM muscle.
The tongue deviation to the right is due to unopposed activity of the left tongue muscles since the right hypoglossal nerve (which innervates the right tongue muscles) is affected.
An infant has hypoplasia of the mandible, underdev. of the bones of the face, downward-slanting palpebral fissures, defects of the lower eyelids and deformed external ears. Abnormal dev. of which of the pharyngeal arches produce these symptoms?
The first pharyngeal arch, which is associated with the mandible, is responsible for Meckel’s cartilage, malleus, incus and mandible.
A patient’s palate elevates asymmetrically, being pulled up toward the right. Which muscle is paralyzed?
The uvula would move toward the intact right side. This is because the intact levator veli palatini would be unopposed by the opposite, paralyzed left levator veli palatini
A patient is given sublingual nitroglycerin for reducing blood pressure. Which structure is likely the route of absorption of this drug?
The deep lingual vein is located most superficially on the underside of the tongue.
A patient has their submandibular gland and its duct removed. Which nerve is most prone to injury?
The lingual nerve initially courses directly underneath the mucosa of the floor of the mouth and superficial to the submandibular gland.
The lingual nerve is part of the mandibular division of the trigeminal nerve (V3) and carries fibers from chorda tympani, a branch of the facial nerve.
A patient has recurrent infxns of his palatine tonsils (tonsilitis). Which lymph nodes are most likely to become visibily enlarged during tonsilitis?
The jugulodigastric node, aka the tonsillar lymph node, receives drainage from the palatine tonsils, tongue and pharynx. It is often enlarged during tonsilitis.
The submandibular lymph nodes drain the back of the tongue, gums, upper lip, parts of lower lip and sides of face. They drain into the deep cervical group of nodes.
The submental nodes drain the tip of the tongue bilaterally, the lower lip, and floor of the mouth.
A patient has their conjunctiva of the eye infected. Which lymph node groups would be first involved in the infxn?
The preauricular lymph nodes aka deep parotid nodes. They are located deep to the parotid gland and drain lymph from the posterior orbit.
The superficial parotid lymph nodes drain the lateral angles of the eyelids, aspects of the nose and the external acoustic meatus.
The jugolodigastric aka tonsillar nodes receive drainage from all of the superior nodes of the face and drian the tonsils.
The submental lymph nodes drain the tip of the tongue and chin.
A surgeon accidentally damages the nerve that lies in the tonsillar fossa, deep to the palatine tonsil. What is most likely to result from this injury?
The glossopharyngeal nerve emerges from the surface of the medulla and travels laterally in the pontine cistern to enter the anterior compartment of the jugular foramen.
It gives off the tympanic nerve, which supplies the middle ear, a carotid branch to innervate the carotid body, the nerve to the stylopharyngeus, pharyngeal branches, a lingual branch and a tonsillar branch.
The tonsillar branch provides afferent fibers for the tonsillar mucosa and the lingual branch conveys common sensation and taste from the post. part of the tongue.
