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ENT Week 1 2017/18 > 9: Anatomy 3 - salivary glands, tongue, palate & pharynx > Flashcards

9: Anatomy 3 - salivary glands, tongue, palate & pharynx Flashcards

1
Q

Which part of the pharynx lies posterior to the oral cavity?

A

Oropharynx

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2
Q

Is the hard palate anterior or posterior?

A

Anterior to soft palate

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3
Q

Which structures form the hard palate?

A

Palatine process of the maxilla

Palatine bone

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4
Q

What are three muscles which make up the floor of the mouth?

A

Mylohyoid

Geniohyoid

Anterior belly of digastric muscle

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5
Q

Which bone is found inferior to the oral cavity and floats freely?

A

Hyoid bone

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6
Q

Which surface of the tongue is the underside?

A

Ventral surface

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7
Q

Which veins can be seen on the ventral surface of the tongue?

A

Lingual veins

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8
Q

Which folds are found under the tongue?

A

Sublingual folds

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9
Q

What are the three pairs of major salivary glands?

A

Parotid glands

Sublingual glands

Submandibular glands

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10
Q

Which salivary gland is found just anterior and inferior to the ear?

A

Parotid gland

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11
Q

Which duct drains the parotid gland?

Where does it emerge?

A

Parotid duct

Buccal mucosa

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12
Q

Which salivary gland is found on the floor of the mouth?

A

Sublingual gland

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13
Q

Where do the sublingual glands drain?

A

Sublingual folds

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14
Q

What is found between the sublingual folds?

What drains here?

A

Sublingual caruncle

Submandibular glands via the submandibular ducts, which is quite confusing

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15
Q

What is the structure which links the ventral surface of the tongue to the floor of the mouth?

A

Frenulum

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16
Q

Which muscle of mastication is the parotid gland superficial to?

A

Masseter

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17
Q

Which cranial nerves innervate the

a) parotid gland
b) submandibular and sublingual glands?

A

a) CN IX - glossopharyngeal nerve

b) CN VII - facial nerve

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18
Q

Which salivary glands are innervated by

a) CN VII
b) CN IX?

A

a) Submandibular and sublingual glands (remember that facial nerve also does the lacrimal glands)

b) Parotid glands

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19
Q

How does CN VII supply the submandibular and sublingual glands?

What does it hitch a ride with?

A

Chorda tympani

CN V3 - lingual nerve branch

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20
Q

Where does CN IX synapse before supplying the parotid gland?

A

Otic ganglion

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21
Q

Which kind of muscle is the tongue made up of?

A

Skeletal muscle

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22
Q

Which cranial nerves supply the general sensory fibres for:

a) anterior 2/3rds of tongue
b) posterior 1/3rd?

A

a) CN V3

b) CN IX

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23
Q

Which structure in the tongue did the thyroid gland descend through during development?

A

Thyroglossal duct

via the foramen caecum

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24
Q

What is the foramen caecum?

A

Hole in the tongue where the thyroid descended during development

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25
Q

Through which tube did the thyroid gland descend during development?

A

Thyroglossal duct

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26
Q

Which direction does the larynx move in during swallowing?

A

UP

then DOWN

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27
Q

Which direction do the thyroid gland and its remnants move during swallowing?

Why?

A

UP then DOWN

They’re attached to the larynx

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28
Q

What are the four intrinsic muscles of the tongue?

A

Palatoglossus

Styloglossus

Hyoglossus

Genioglossus

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29
Q

What is the function of the extrinsic muscles of the tongue?

A

Change position of tongue during

mastication

swallowing

speech

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30
Q

What is the motor supply to the extrinsic muscles of the tongue?

What is the exception?

A

CN XII - hypoglossal nerve

Palatoglossus is innervated by CN VII

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31
Q

Which muscles

a) modify the SHAPE of the tongue
b) modify the POSITION of the tongue?

A

a) Intrinsic muscles

b) Extrinsic muscles

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32
Q

Which cranial nerve supplies MOST of the muscles of the tongue?

A

CN XII

Hypoglossal nerve

33
Q

Where in the brain does CN XII emerge from?

A

Medulla oblongata

34
Q

Through which hole in the ___ cranial fossa does CN XII pass?

A

posterior cranial fossa

hypoglossal canal

35
Q

Which bone is the hypoglossal canal found in?

A

Occipital bone

36
Q

How do you test CN XII?

A

Ask patient to stick their tongue out

37
Q

Which artery supplies the tongue?

A

Lingual artery

38
Q

Which important artery does the lingual artery arise from?

A

EXTERNAL carotid artery

39
Q

Which part of the lingual artery does CN XII pass lateral to?

A

Loop of the lingual artery

40
Q

Which nerve passes lateral to the loop of the lingual artery?

A

CN XII

Hypoglossal nerve

41
Q

Which tonsils are found on the lateral parts of the oral cavity, to either side of the uvula?

A

Palatine tonsils

42
Q

What structure lies between the right and left palatine tonsils?

A

Uvula

43
Q

What is the proper name for the gums?

A

Gingivae

44
Q

Which border of the lips is repaired by plastic surgeons when damaged?

A

Vermillion border

45
Q

Which bones form the majority of the hard palate?

A

Palatine process of the maxilla

Palatine bones

46
Q

Which hole is found just posterior to the front 4 incisors?

A

Incisive foramen

47
Q

Which plates, found at the back of the hard palate, serve as attachment for important muscles of mastication?

A

Medial and lateral pterygoid plates

48
Q

Which bone do the medial and lateral pterygoid plates belong to?

A

Sphenoid bone

49
Q

What are the two important muscles of the soft palate?

A

Right and left…

LEVATOR VELI PALATINI

TENSOR VELI PALATINI

50
Q

What do the levator veli palatini muscles do?

Why is this useful?

A

Lift the soft palate upwards

Stops food from entering the nasopharynx

51
Q

What do the tensor veli palatini muscles do?

What’s useful about this?

A

Tense the soft palate

Helps levator veli palatini to raise the soft palate

52
Q

Which cranial nerve supplies

a) levator veli palatini
b) tensor veli palatini?

A

a) CN X

b) CN V3

53
Q

Which muscles of the soft palate are supplied by

a) CN V3
b) CN X?

A

a) Tensor veli palatini

b) Levator veli palatini

54
Q

Which part of the oral/nasal cavity closes off the nasopharynx to stop food from entering it?

Which part of the larynx closes off the respiratory tract to stop aspiration of stuff?

A

Soft palate (posterior)

Epiglottis

55
Q

How do you test the muscles of the soft palate?

Which cranial nerves are you testing?

A

Ask patient to say AAAAH

CN V3 and CN X

56
Q

What happens if nothing is wrong when you test

a) CN XII
b) CN V3 and CN X?

A

a) Tongue remains in midline

b) Uvula remains in midline

57
Q

What happens if there’s nerve damage when you test

a) CN V3 and CN X

b) CN XII?

A

a) Uvula deviates AWAY from damaged side (because muscles still work on the opposite side)

b) Tongue droops ON damaged side (because muscles aren’t working)

58
Q

What are the two types of muscle found in the pharynx?

A

Circular muscles

Longitudinal muscles

59
Q

What are the three circular muscles of the pharynx?

A

Superior, middle and inferior constrictor muscles

60
Q

What type of muscle makes up the constrictor muscles of the pharynx?

A

Skeletal muscle

61
Q

Which cranial nerve innervates virtually all of the muscles of the pharynx?

What is the exception?

A

CN X

Stylopharyngeus, one of the longitudinal muscles, which is CN IX (glossopharyngeal)

62
Q

Where do all of the constrictor muscles of the pharynx insert?

A

Midline raphe

63
Q

What is another name for the upper oesophageal sphincter?

A

Cricopharyngeus

64
Q

Apart from the circular muscles, which other muscles do the pharynx?

A

Longitudinal muscles

65
Q

Which type of pharyngeal muscle are stylopharyngeus, palatopharyngeus and salpingopharyngeus?

Which cranial nerves innervate them?

A

Longitudinal muscle

Palatopharyngeus, salpingopharyngeus are both CN X like the rest

Stylopharyngeus is CN IX

66
Q

What is the origin of stylopharyngeus?

A

Styloid process of the temporal bone

67
Q

What is the origin of palatopharyngeus?

A

Hard palate

68
Q

What is the origin of salpingopharyngeus?

A

Eustachian tube

just to make things confusing

69
Q

What is the common insertion of stylopharyngeus, palatopharyngeus and salpingopharyngeus?

A

Posterior border of thyroid cartilage

70
Q

Looking at the pharynx from the back, what are the openings into the nasal cavity called?

A

Choana

71
Q

What is the ring of lymphoid tissue, found in the pharynx, called?

A

Waldeyer’s ring

72
Q

The tonsils are all examples of ___ tissue.

A

lymphoid

73
Q

Where do all the salivary lymphatics drain?

Which area of the neck is this structure found in?

A

Deep cervical lymph nodes

Carotid sheathe

74
Q

Which lymph nodes should you examine in an OSCE?

A

Submental

Submandibular

Pre-auricular

Post-auricular

Occipital

Anterior and posterior triangles

75
Q

When you palpate the pre-auricular and post-auricular areas, what are you actually feeling?

A

Anteriorly: parotid lymph nodes

Posteriorly: mastoid lymph nodes

76
Q

When you palpate the anterior and posterior triangles of the neck, what are you feeling for?

A

Superficial and deep cervical nodes

77
Q

What are two common causes of lymph node enlargement?

A

Infection

Malignancy

78
Q

What are some differences between infected and cancerous lymph nodes in terms of

a) pain
b) texture
c) mobility
d) reaction to antibiotics?

A

a) Infected nodes are painless, cancerous nodes are painful

b) Infected nodes are soft and smooth, cancerous nodes and hard and irregular

c) Infected nodes are mobile, cancerous nodes are fixed to structures

d) Infected nodes clear up, cancerous nodes don’t

79
Q

Why do you need to examine both sides in a lymph node exam?

A

Because lymph node drainage often crosses over and by doing one side only you may miss something

ENT Week 1 2017/18 (10 decks)

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