14 - Head + Neck - Oral cavity, Tongue, TMJ + Infratemporal fossa Flashcards
Name the boundaries of the oral cavity:
Sup: Soft + hard palate (maxilla + palatine bones)
Inf: Muscular diaphragm + tongue
Lat: Buccinators
Between which 2 muscles does the tonsillar fossa lie? Which tonsil is located here?
1) Palatoglossal muscle
2) Palatopharyngeal muscle
Palatine tonsil
Which salivary gland is most commonly affected by stone formation?
Submandibular gland
All muscles (except 1) of the tongue are innervated by which nerve?
CN XII
Exception = Palatoglossal = CN X
If a patient has a lesion of the left CN XII, what will happen if they try to stick their tongue out?
Tongue will deviate towards the side of the lesion
If a patient has a lesion of the left CN X, what will you see when they open their mouth?
Uvula deviation away from the side of the lesion
Which extrinsic muscle of the tongue is responsible for closing the oral cavity during swallowing?
Palatoglossus
What is ‘tonsillitis’ and name some common symptoms:
Inflammation of Palatine tonsil
- Sore throat
- Odyno/dysphagia
- Enlarged erythematous tonsils
What are the 4 signs accompanying tonsillitis which indicates a bacterial cause:
1) Cervical lymphadenopathy
2) Fever
3) Pus
4) Absence of cough
If a patient presents with sore throat, cough and enlarged tonsils, what is the most likely diagnosis and underlying cause?
Viral tonsillitis (viral as cough present)
- Rhinovirus
- Adenovirus
How can you differentiate between tonsillitis and a peritonsillar abscess?
Tonsillitis = usually bilateral, intact arches Quinsy = - usually unilateral - loss of posterior arch - severe throat pain - difficulty opening mouth - 'hot potato' voice - FEVER
Name the duct which drains from the parotid gland into the oral cavity:
Stenson’s duct
Name the duct which drains from the submandibular gland into the oral cavity:
Wharton’s duct
How does a salivary stone usually present?
Pain/swelling @ meal times
Which nerve gives general sensation to the anterior 2/3rds of the tongue?
CN V3 - Lingual nerve
Which nerve gives special sensory fibres to the anterior 2/3rds of the tongue?
PNS fibres of CN VII - on Chorda Tympani
Which nerve gives general and special sensory fibres to the posterior 1/3rd of the tongue?
CN IX
List the types of teeth from medial to lateral:
- Central incisor
- Lateral incisor
- Canine
- 1st + 2nd Premolars
- 1st + 2nd + 3rd Molars
Which nerve supplies the lower jaw and its teeth?
CN V3 - Inf. alveolar nerve
Name the articulating surfaces of the temporomandibular joint:
- Mandibular fossa (temporal bone)
- Articular tubercle (temporal bone)
- Mandibular condyle
What type of connective tissue lines the articulating surfaces of the temporomandibular joint?
Fibrocartilage
Which ligament associated with the temporomandibular joint prevents posterior dislocation?
Lateral ligament
What is the most common type of dislocation affecting the temporomandibular joint?
Anterior
ie blow to side of mandible when mouth is open = ant. dislocation of same side
What nerves are at risk during an anterior dislocation of the mandible (lock jaw)?
- CN V3 - Auriculotemporal
- CN VII
Name some common causes of TMJ pain:
- Bruxism (grinding)
- Osteoarthritis
- Anxiety
- Sleep disorders
- Excess alcohol/smoking
Where is the infratemporal fossa?
- Deep and inferior to zygomatic arch
- Deep to ramus of mandible
Name the borders of the infratemporal fossa:
Sup: Inf. greater wing of sphenoid Inf: Med. pterygoid attachment of mandible Ant: Post. maxilla Post: Cervical sheath Med: Lat. pterygoid plate of sphenoid Lat: Ramus of mandible
Which muscles lie within the infratemporal fossa?
- Masseter
- Medial pterygoid
- Lateral pterygoid
Which blood vessels lie within the infratemporal fossa?
- Maxillary artery
- Pterygoid venous plexus
Which nerves lie within the infratemporal fossa?
- Inf. alveolar (CN V3)
- Lingual (CN V3)
- Buccal (CN V3)
- Chorda tympani (CN VII)
- Otic ganglion
Describe a mandibular nerve block:
- Inject anaesthesia into infratemporal fossa via mandibular notch of ramus of mandible Blocks branches of CN V3: - Auriculotemporal - Inferior alveolar - Lingual - Buccal
Describe a inferior alveolar nerve block:
- Inject anaesthesia @ mandibular foramen
- Blocks sensation to 1/2 mandibular teeth
