14. Oral Cavity And Pharynx

Question 1

What nerve innervates all of the intrinsic and extrinsic muscles of the tongue?

Answer 1

Hypoglossal nerve.

Question 2

How many intrinsic muscles of the tongue are there?

Answer 2

4 pairs.

Question 3

What are the 4 extrinsic muscles of the tongue?

Answer 3

Genioglossus.
Hypoglossus.
Styloglossus.
Palatoglossus.

Question 4

What 2 nerves innervate the anterior 2/3 of the tongue?

Answer 4

Sensation - CN V trigeminal (Vc).

Taste - CN VII Facial.

Question 5

What nerve innervates the posterior 1/3 of the tongue?

Answer 5

Sensation and taste - glossopharyngeal.

Question 6

What are the 3 salivary glands?

Answer 6

Submandibular.
Parotid.
Sublingual.

Question 7

Where do most salivary gland stones occur?

Answer 7

Submandibular glands.

Question 8

What do salivary stones usually occur as a result of?

Answer 8

Dehydration leading to reduced salivary flow.

Question 9

Give 2 symptoms of salivary stones.

Answer 9

Pain in gland.
Swelling.
Infection.

Question 10

Give 3 symptoms of tonsilitis.

Answer 10

Fever.
Sore throat.
Pain/difficulty swallowing.
Cervical lymph nodes.
Bad breath.

Question 11

Give 4 signs/symptoms of a peritonsillar abscess.

Answer 11

Severe throat pain.
Fever.
Bad breath.
Drooling.
Difficulty opening mouth.
Quinsy.
Deviated uvula.

Question 12

What are the boundaries of the nasopharynx and what does it contain?

Answer 12

Base of skull (C1 and C2) to upper border of the soft palate (nasal cavity).
Contains the pharyngeal tonsil and opening of Eustachian tube.

Question 13

What are the boundaries of the oropharynx and what does it contain?

Answer 13

Soft palate (oral cavity) to epiglottis (C2 and C3).
Contains - palatine tonsils.

Question 14

What are the boundaries of the laryngopharynx and what does it contain?

Answer 14

From oropharynx to oesophagus so epiglottis (larynx) to cricoid cartilage (C4, C5 and C6).
Contains - pisiform fossa.

Question 15

What are the 3 longitudinal muscles which elevate the pharynx and larynx during swallowing, and what is each innervated by?

Answer 15

Stylopharyngeus - CN IX glossopharyngeal nerve.
Palatopharyngeus - CN X pharyngeal branch of vagus nerve.
Salpingopharngeus - CN X pharyngeal branch of vagus nerve.

Question 16

What are the 3 pharyngeal constrictor muscles? What nerve are they all innervated by?

Answer 16

Superior pharyngeal constrictor.
Middle pharyngeal constrictor.
Inferior pharyngeal constrictor - 2 parts the thyropharyngeal and cricopharyngeal.
All supplied by CN X vagus nerve.

Question 17

Where can a Killian’s dehiscence lead to a Zenker’s diverticulum (pharyngeal pouch)?

Answer 17

Weakness between the thyropharyngeal and cricopharyngeal parts of the inferior pharyngeal constrictor.

Question 18

What can lead to a Zenker’s diverticulum (pharyngeal pouch) forming through a Killians dehiscence?

Answer 18

Failure of the upper oesophageal sphincter to relax.
Abnormal timing of swallowing, so higher pressure in laryngopharynx and weakness in inferior constrictor muscle produces outpouching.

Question 19

Name 3 symptoms of Zenker’s diverticulum (pharyngeal pouch) and why these symptoms occur.

Answer 19

Bad breath.
Regurgitation of food.
Occasional choking on fluids,.
General difficulty swallowing.
All related to food material collecting in the pouch or disruption of swallow.

Question 20

What is seen in damage to CN IX and X with regards to swallowing?

Answer 20

Absent gag.
Uvula deviated away from the lesion.
Dysphagia.
Taste impairment.
Loss of sensation in the oropharynx.

Question 21

What causes damage to CN IX and X?

Answer 21

Medullary infarct.

Jugular foramen fracture.

Question 22

What is seen in damage to CN XII with regards to swallowing?

Answer 22

Wasted tongue.

Tongue deviation and fasiculations.

Question 23

Give 3 causes of dysphagia.

Answer 23

Stroke.
Progressive neurological disease eg Parkinson’s, MS.
COPD.
Dementia.

Question 24

Give 3 signs/symptoms of dysphagia

Answer 24

Coughing and choking.
Sialorrhoea.
Recurrent pneumonia.
Change in voice/speech.
Nasal regurgitation.