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Year 2 - HN&S anatomy > 4 - Oral Cavity and Upper GI > Flashcards

4 - Oral Cavity and Upper GI Flashcards

1
Q

What is the buccal cavity?

A

the oral cavity (mouth)

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2
Q

List the three sets of tonsils found in the upper GI tract.

A

Palatine, Pharyngeal, Lingual

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3
Q

Between which two folds do the palatine tonsils lie?

A

Palatopharyngeal Fold

Palatoglossal Fold

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4
Q

Why does the GP gets you to say ‘aaaaaah’ when he inspects the inside of your mouth?
What would you expect to see?

A

It raises the soft palate and uvula and depresses the tongue, which are vagus-mediated effects.
It is to test the motor function of the vagus nerve.

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5
Q

When testing for the function of the vagus nerve, what would indicate a problem/lesion with the vagus?

A

(normally the usual should move upwards in the midline)

if there is an abnormality involving the vagus, the uvula will deviate AWAY from the side of the lesion

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6
Q

Describe the borders of the pharynx.

A

Base of the skull and the inferior border of the cricoid cartilage

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7
Q

What are the three parts of the pharynx and what are their borders?

A

Nasopharynx – down to the soft palate (pharyngeal isthmus)
Oropharynx – between the soft palate and the epiglottis
Laryngopharynx – between the epiglottis and the cricoid cartilage

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8
Q

What happens to the epiglottis when you swallow?

A

Retroflexion to cover the laryngeal inlet

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9
Q

What is the role of the soft palate in swallowing?

A

It elevates to close off the nasopharynx so that food doesn’t go into the nasal cavity

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10
Q

What is the Piriform Fossa and what is its clinical significance?

A

The piriform fossae are depressions on either side of the laryngeal inlet where food (commonly fish bones) get stuck
has a very sensitive innervation - can become very painful and cause coughing when food becomes lodged here

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11
Q

Which muscles aid the passage of a bolus of food down the oesophagus?

A

Superior, middle and inferior pharyngeal constrictor muscles

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12
Q

Which nerves provide sensory innervation of the pharyngeal wall?

A

Glossopharyngeal and Vagus (pharyngeal plexus)

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13
Q

Which nerves provide motor innervation of the pharyngeal constrictor muscles?

A

Vagus (and a bit of accessory)

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14
Q

Describe the changes that occur during swallowing.

A
  • mastication
  • Lift and retract the tongue (styloglossus and intrinsic muscles)
  • Bolus into oropharynx (palatoglossus)
  • Close off nasopharynx by raising soft palate
  • Raise the larynx – closed off by the epiglottis
  • Peristaltic wave of constrictor muscles
  • Relax cricopharyngeus, open oesophagus
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15
Q

Name the three salivary glands, describe their secretions and state the nerves that provide secretomotor innervation to them.

A

Parotid – serous – glossopharyngeal
Submandibular – serous – facial
Sublingual – mucous – facial

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16
Q

Which muscle does the parotid duct pierce and where does it open into the buccal cavity?

A

Buccinator

It opens next to the second upper molar

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17
Q

Name the main muscles of the tongue. Which nerve innervates all of this?

A

Genioglossus, Hyoglossus, Styloglossus
Intrinsic Muscles
These are all innervated by the hypoglossal nerve

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18
Q

What other muscle is associated with the tongue but isn’t innervated by the hypoglossal nerve?

A

Palatoglossus – it is innervated by the vagus

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19
Q

What tongue movements do the genioglossus and styloglossus perform?

A

Genioglossus – protracts the tongue

Styloglossus – retracts and elevates the tongue

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20
Q

To which side would the tongue move if a patient with a unilateral lesion in the hypoglossal nerve was asked to stick their tongue out?

A

Towards the side of the lesion because the genioglossus is used in protracting the tongue

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21
Q

What movement is palatoglossus responsible for?

A

Elevates the soft palate and moves the back of the tongue upwards

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22
Q

Describe the sensory innervation of the tongue.

A

Anterior 2/3 sensation – mandibular branch of trigeminal
Anterior 2/3 taste – facial
Posterior 1/3 everything – glossopharyngeal (and vagus)

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23
Q

To which structure in the brainstem do the neurons of taste go? It is considered the main taste centre within the brainstem.

A

Nucleus Solitarius

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24
Q

State the origin and insertion of the masseter and the movement that it is responsible for.

A

Zygomatic Arch
Lateral surface of the ramus of the mandible and the angle of the mandible

Elevates the mandible (allows forced closure of the mouth)

25
Q

State the origin and insertion of temporalis and the movement that it is responsible for.

A

Temporal Fossa
Coronoid Process

Elevates and retracts mandible

26
Q

What is the test for the mandibular branch of the trigeminal nerve?

A

clench your teeth

the masseter muscle will budge and can be palpated at the back of the mandible

27
Q

All of the muscle of mastication are innervated by the _____ nerve, EXCEPT _____

A

trigeminal
buccinator (innervated by the facial nerve)
(Buccinator is a muscle of the facial expression.)

28
Q

State the origin and insertion of the medial and lateral pterygoid muscles

A

Lateral – lateral pterygoid plate (and greater wing of sphenoid) TO neck of the mandible
Medial – lateral pterygoid plate, maxilla, palate TO angle of the mandible

29
Q

State the movements that the medial and lateral pterygoid muscles are responsible for.

A

Lateral – Movement – depresses and protracts mandible to open the mouth
Medial – Movement – elevates, protracts and lateral movement of mandible for chewing

30
Q

Describe the structure of the temporomandibular joint.

A

It is a capsular joint
The capsule has an articular plate splitting it into two
The head of the mandible articulates with the articular tubercle of the temporal bone

31
Q

Describe the movements around the temporomandibular joint when opening the mouth.

A

When opening the mouth slightly there is a hinge action
When the mouth is opened further, the head of the mandible glides anteriorly on the articular tubercle of the temporal bone

32
Q

State the eight branches of the external carotid artery.

A 
Some 
Anatomists 
Like 
Fucking
Over
Poor
Medical
Students
(inferior to superior)
Superior Thyroid 
Ascending Pharyngeal 
Lingual
Facial
Occipital 
Posterior Auricular
Maxillary
Superficial Temporal
33
Q

At the level of what anatomical landmark does the common carotid artery bifurcate?

A

At the level of the laryngeal prominence (C4)

34
Q

Why does the facial artery have a wavy course across the mandible?

A

If it were taut, then when the mouth is opened the facial artery would rupture

35
Q

Which branch of the external carotid artery gives rise to the middle meningeal artery?

A

Maxillary

36
Q

Through which foramen does the middle meningeal artery enter the skull?

A

Foramen Spinosum

37
Q

State the five branches of the facial nerve.

A 
Temporal
Zygomatic
Buccal
Mandibular
Cervical

(tell zainab beauty means confidence)

38
Q

Where does the facial nerve exit the cranial cavity?
Where does the facial nerve emerge?
Where do the 5 branches emerge?

A

through the internal acoustic meatus (along with the vestibulocochlear nerve)
emerges through the stylomastoid foramen
5 branches emerge from the anterior border of the parotid gland

39
Q

What cranial nerve is the parotid gland innervated by?

A

CN IX - glossopharyngeal nerve

40
Q

What are the two main branches of the mandibular branch of the trigeminal nerve?

A

Lingual Nerve

Inferior Alveolar Nerve

41
Q

What are the functions of the lingual and inferior alveolar nerve?

A

Inferior Alveolar – innervates the lower teeth (this is the one that is stimulated in tooth ache)
Lingual – sensation (touch and taste) to the anterior 2/3 of the tongue AND secretomotor to the sublingual and submandibular salivary glands

42
Q

What fibres join the lingual nerve?

A

Some fibres of the facial nerve via the Chorda Tympani (this is why the lingual nerve is responsible for taste) - this is a branch of the main facial nerve

43
Q

Which cranial nerve provides all sensory innervation of the face?

A

Trigeminal Nerve

44
Q

Where does the mental nerve stem from?

Where does it exit the cranial cavity?

A

it is a branch of the inferior alveolar nerve (which is a branch of the mandibular)

exits via the mental foramen

45
Q

What is Bell’s Palsy and how may it present in a patient?

A

Facial nerve palsy

Inability to contract muscles of facial expression and altered taste

46
Q

Which nerves innervate the following muscles:

a. Temporalis
b. Masseter
c. Buccinator
d. Medial and Lateral Pterygoids
e. Pharyngeal Constrictors
f. Digastric
g. Mylohyoid

A 
a.	Temporalis 
Mandibular (trigeminal)
b.	Masseter 
Mandibular (trigeminal)
c.	Buccinator 
Buccal (facial)
d.	Medial and Lateral Pterygoids 
Mandibular (trigeminal)
e.	Pharyngeal Constrictors 
Sensory = Glossopharyngeal (IX) + Vagus (X)
Motor = Vagus (X) (and a bit of Accessory (XI))
f.	Digastric 
Anterior belly = Mandibular (trigeminal)
Posterior belly = Facial 
g.	Mylohyoid 
Nerve to mylohyoid – branch of inferior alveolar nerve (a branch of the mandibular)
47
Q

What are the branches coming off the inferior alveolar nerve?

A

Mental nerve – terminal branch (provides sensation to the front of the chin)
Nerve to mylohyoid

48
Q

What are the full numbers in a typical permanent set of teeth?

A

32
16 upper and 16 lower
8 incisors, 4 canines, 8 premolars and 12 molars (including 4 wisdom teeth)

49
Q

How many deciduous (baby) teeth are there?

A

20

in each quadrant: 2 incisors, I canine and 2 molars

50
Q

Which teeth are missing in the deciduous set compared to the adult set?

A

No premolars or wisdom teeth

51
Q

When do the first deciduous teeth erupt?

A

Around 6 months

52
Q

When is the deciduous set usually complete?

A

Around 20-24 months

53
Q

Why are the tonsils clinically important?

A

They are areas of lymphoid tissue so they can get infected and inflamed

54
Q

What is the simplest test of the glossopharyngeal nerve?

A

Test the patient’s gag reflex by sticking something down their throat

55
Q

How is the hypoglossal nerve tested?

A

Ask the patient to stick their tongue out

56
Q

How is the trigeminal nerve tested?

A

Sensory – touch the patient around the jawline, on the cheek and on the forehead (to test the three divisions)
Motor – ask the patient to clench their teeth and try to palpate the bulge of the masseter and temporalis

57
Q

How is the facial nerve tested?

A

Ask the patient to crease up their forehead by raising their eyebrows
Ask the patient to keep their eyes closed against resistance

58
Q

What is the mnemonic for branches of the external carotid artery?

A 
Some
Anatomists
Like
Freaking
Out
Poor
Medical
Students

Year 2 - HN&S anatomy (7 decks)

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