Anatomy and Innervation of the Palate

Question 1

Describe the hard palate location and what it is bounded by:

Soft palate:

Answer 1

Hard palate: located anteriorly, bounded by dentition

Soft palate: sits posteriorly, composed of soft tissue mucosa overlying musculature

Question 2

Answer 2

Question 3

How many bones make up the hard palate?

Name these bones:

Which feature of these bones are part of the palate?

Answer 3

• 4 bones
• Right and left maxilla
• Right and left palatine bones
• Palatine processes of maxillae
• Horizontal plates of palatine bones

Question 4

What type of epthelium makes up:

a) the hard palate
b) the soft palate

Answer 4

a) hard palate: keratinised stratified squamous epithelium, which is tough, thick and protective
b) soft palate: non-keratinised stratified squamous epithelium, less protective as does not come up against as much insult as hard palate

Question 5

Answer 5

Question 6

Label diagram and give a brief description of each:

Answer 6

Incisive papilla - mound of mucosa overlying incisive canal

Palatal rugae - ridges, mechanical breakdown of food

Palatine raphe - zipping together of R and L structures - development of palatal shelf

Question 7

What is a cleft palate?

List some complications associated with a cleft palate:

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Answer 7

• embryological defect, with or without lip involvement, due to failure of lateral palatine processes to meet and fuse

Complications include:

• speech
• dental health
• feeding
• hearing

Question 8

What do all of these nerves have in common?

Answer 8

They are all branches of the maxillary division of the trigeminal nerve.

Question 9

Where does the nasopalatine nerve pass through and what does it supply?

Answer 9

The nasopalatine nerve passes through the incisive foramen and supplies palatal gingivae of anterior teeth, and mucosa of the anterior palate

Question 10

Answer 10

Question 11

Describe the pathway of lymphatic drainage for the following areas:

a) anterior part of hard palate:
b) remainder of hard palate and soft palate:

Answer 11

a) submandibular nodes to deep cervical nodes
b) retropharyngeal nodes to deep cervical nodes OR directly to deep cervical nodes

Question 12

Where does the palatine tonsil lie?

Answer 12

• Between the two arches

Question 13

Answer 13

Question 14

What is the function of:

a) levator veli palatini
b) tensor veli palatini
c) palatoglossus

Where are the following muscles:

a) palatopharyngeus
b) musculus uvulae

Answer 14

a) levator veli palatini - elevates the palate
b) tensor veli palatini - tenses palate
c) palatoglossus - palate towards tongue
a) palatopharyngeus - a longitudinal muscle of the pharynx
b) musculus uvulae - in uvula

Question 15

What are all the skeletal muscles of the soft palate innervated by?

Are there any exceptions?

Answer 15

All the skeletal muscles of the soft palate are supplied by CN X and part of CN XI except from tensor veli palatini which is supplied by mandibular division of CN V

Question 16

Where does the tensor veli palatini attach?

What does its tendon do?

What do the tendons on each side do and what do they form?

Answer 16

• attaches superiorly to the sphenoid bone
• its tendon turns medially around pterygoid hamulus and enters the soft palate
• the tendon flattens out within the soft palate and joins with the tendon of the opposite muscle to form the palatine aponeurosis

Question 17

Answer 17

Question 18

Where are the following muscles situated?

a) levator veli palatini
b) tensor veli palatini

Give another name for the auditory tube

What muscles encase the pharynx?

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Answer 18

a) levator veli palatini - from petrous temporal bone to soft palate
b) tensor veli palatini - from sphenoid bone to soft palate

Another name for the audtory tube is the Eustachian tube

• superior constrictor of pharynx
• middle constrictor of pharynx

Question 19

How do you clinically test the function of the vagus nerve?

Explain the results you may observe:

Answer 19

• Ask patient to open mouth and say ‘‘ahh’’

If nerves are functioning normally, the uvula should lift straight up in the midline

If there is a unilateral nerve pathology the uvula will pull away from the non-functioning side by the normal side e.g. if uvula pulls to LHS, potential nerve pathology on RHS

Question 20

Functions of the soft palate:

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Answer 20

• acts as a trapdoor
• stops food from entering the nasal cavity during swallowing
• directs air into nose or mouth during speech, sneezing, coughing and vomiting
• helps to close off entrance to oropharynx during gag reflex

Question 21

What are tonsillar crypts?

Answer 21

The space where palatine tonsils have been removed

Question 22

Answer 22