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LCRS 2 - HNS Part 2 > Anatomy of biting, chewing and swallowing > Flashcards

Anatomy of biting, chewing and swallowing Flashcards

1
Q

Buccal cavity?

A

=mouth

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2
Q

2 folds in the mouth

A 
Palatopharyngeal fold (palate to pharynx)
Palatoglossal fold (palate to tongue)
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3
Q

Locate the palatine tonsil

A

Between palatopharyngeal and palatoglossal fold

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4
Q

Posterior wall of the oral cavity

A

Oropharynx

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5
Q

What is the uvula

A

part of the soft palate

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6
Q

Why do doctors ask you to say ‘ahh’

A

Tests the vagus nerve (which provides most motor innervation to the levator palatine muscle)…. the soft palate incl. uvula should lift up….

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7
Q

What occurs if there is a problem with vagus nerve on one side of the soft palate

A

Levator palatine muscle won’t elevate, but the levator palatin muscle on the other side (where vagus is functioning) will elevate normal, so uvula will deviate towards the functioning side (which goes up!), so uvula will deviate AWAY from the lesion

(OPPOSITE with tongue)

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8
Q

3 components of the pharynx

A

Naso-, oro- and laryngo… posterior to airway is opening of eosophagus
Pharyngeal isthmus between naso-oro
Epiglottis between oro-laryngo

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9
Q

How is food stopped from going down airway

A

You will raise the layrnx, you retroflex the epiglottis and cover the airway

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10
Q

What is the hard and soft palate

A

Hard palate anterior, made up of formed by the palatine process of the maxilla and horizontal plate of palatine bone, and spans the arch formed by the upper teeth

Soft palate posterior with uvula in the midline

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11
Q

Area where food can get stuck inc. fishbones

A

Piriform fossa… on either side of the laryngeal orifice

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12
Q

Muscles of the pharynx and function

A

Constrictor muscle… pushes bolus into GI tract by sequential contraction…. (sup, mid, inf)

Sensory IX and X (pharnyngeal plexus= sensory)

Motor X (XI), constriction

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13
Q

Outline stages of swallowing

A

Lift and retract tongue (styloglossus, intrinsic)

Bolus into oropharynx (palatoglossus- surface representatin is the palataoglossal food)

Close off nasopharynx by raising soft palate

Raise the larynx, closed off by epiglottis

Peristaltic wave of constrictor muscles X and (XI)

Relax cricopharyngeus, open oesophagus

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14
Q

3 pairs of slaivary glands

A

Parotid (biggest), submandibular and sublingual

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15
Q

What type of liquid comes from each salivary gland

A

Parotid and submandibular mainly serous, sublingual maily mucus

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16
Q

Which cranial nerves are each salivary gland supplied by

A

Parotid- IX
Submandibular and sublingual- VII

FACIAL NERVE EMERGES from the parotid, but the facial nerve DOES NOT innervate it

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17
Q

Where does the fluid drain into mouth from parotid gland

A

Via parotid duct, which opens above the upper second molar

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18
Q

Which muscle does the parotid canal penetrate to get to second molar

A

Buccinator muscle

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19
Q

List the muscles of the tongue

A

styloglossus - to styloid process = help to retract
hyoglossus (to hyoid)
genioglossus (to mandible)
intrinsic muscles

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20
Q

Which cranial nerve supplies motor innervation to muscles of the tongue

A

XII

Apart from palatoglossus (vagus CNX)

21
Q

What is the attachment and function of genioglossus

A

To protrude the tongue….
Genioglossus emerges from mandible (anteriorly) and inserts onto tongue and hyoid bone…

It protrudes the tongue when this muscle contracts (kind of pulls it forward towards mandible when this muscle shortens)

22
Q

How to test genioglossus,. what is there is a problem with the nerve supplying this msucle

A

Ask them to stick tongue out…. if there is no innervation, the tongue is pulled forward on one side and not the other, and it pulled TOWARD the lesion

23
Q

What is the lingual nerve function

A

Sensation as well as taste perception… mixed cranial nerve

24
Q

What is the name of the ganglion under the tongue

A

Submandibular ganglion…. vagus innervation to salivary gland

25
Q

Compare the sensation vs taste innervation of the tongue

A

ANT 2/3. Taste= facial. Sensory= trigeminal

Posterior 1/3. Taste and sensation= glossopharyngeal….. SOME vagus

26
Q

Where does taste perception begin…

A

nucleus solitarius in medulla

27
Q

List superficial muscles of mastication and innervation

A

Masseter
zygomatic arch to lat surface of ramus and angle of mandible
elevates mandible (allows forced closure of mouth)

Temporalis- THIN
temporal fossa to coronoid process of mandible
elevates and retracts mandible

All mastication from trigeminal

28
Q

List deep muscles of mastication and innervation

A

Lateral pterygoid:

  • sphenoid /lat pterygoid plate to neck of mandible
  • depresses and protracts mandible to open mouth

Medial pterygoid

  • lat pterygoid plate of sphenoid/ maxilla/palate to angle of mandible
  • elevates, protracts and lateral movement of mandible for chewing

Trigeminal
(vs buccinator is cn7)

29
Q

Where does the mandible articulate in the temperomandibular joint

A

It articulates into the mandibular fossa of the temporal bone

30
Q

What kind of joint is the temperomandibular joint

A

Joint capsule

Two synovial cavities separated by articular disc

31
Q

Other importnat component of the temporomandibular joint

A

the articular tubercle anteriorly

32
Q

State the movement in the temporomandibular joint when opening the jaw slightly vs widely

A

Slightly- hinge action between the head of the mandible and the mandibular fossa of the temporal bone

Widely opened- both hinge movement within the mandibular fossa, but the head of the mandible also GLIDES anteriorly to the articular tubercle of the temporal bone

Reason of articular disc = allow protrusion/retraction as well as elevation/depression

33
Q

What can occur in anteriotly dislocated jaw dyslocation

A

Jaw opens so widely that it glides across the articular tubercle of temporal bone into the infratemporal fossa (where there are vessels and nerves)

34
Q

How can you put mandible back in place

A

Must put thumbs on back molars, push down (to get passed the articular tubercle) and then back into the mandibilar fossa

35
Q

At what level does the common carotid bifurcate

A

Laryngeal prominence

36
Q

Branches of the external cartotid artery

A 
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal
37
Q

What does thesuperior thyroid penetrate

A

thyroid cartilage

38
Q

Why is ascending pharyngeal artery hard to see

A

It originates posteriorly

39
Q

Route of the facial artey

A

Around the inferior border of the mandible up to medial canthas of the eye

It has a loop that allows lovement as it goes around the mandible which is alwayss opening and closing

40
Q

Which important artery emerges from the maxillary artery

A

The middle meningeal artery—-> this branch comes through formaen spinosum

41
Q

What is the course of the facial nerve when it exits the

A

It emerges from pontomedullary junction,and then passes through the interal auditory meatus with the vestibulocochlear nerve.

It passes through the temporal bone and emerges from the stylomastoid foramen

Passes underneath the parotid and then the 5 branches of the facial nerve emerge from the anterior border of the parotid gland….. PAROTID GLAND IT NOT INNERVATED BY THE FACIAL NERVE

42
Q

List the 5 branches of the facial nerve emerging from the parotid

A

Temporal, zygomatic, buccal, mandibular and cervical (supplying the platysma)
You can test facial nerve by asking them to look up and should have creases in forehead

43
Q

Name the course and then two branches of the mandibular nerve

A

Mandibular nerve passes through thhe foramen ovale and then splits into:

  1. Inferior alveolar nerve…. passes into the back of the mandible and it travels through the mandible. Sensory nerve for lower dentition.
  2. The lingual nerve supplies sensory innervation to anterior 2/3 so contains V3 fibres. But it also has facial nerve branches from the chorda tympani (branch of the facial nerve emerging in the temporal bone). Information flow in chorda timpani bidiretional…. they are parasympathetic to submandibular ganglion (to submandibular and sublingual salivary gland) AND taste fibres from the anterior 2/3 of the tongue!!!!
44
Q

What is the terminal branch of the inferior alveolar nerve

A

The mental nerve (relating to mens=chin)

45
Q

How to test V3

A

sensory to the chin

46
Q

Dermatomes of head and neck

A

V1 = forehead + eyeball (corneal reflex)
V2 = below eyes + nose + cheeks + upper teeth
V3 = lower teeth + tongue + chin + thin strip of skin on lateral side of face going up to temples (think of sideburns)
Posterior of head is C2-C3
Neck is C4-C5

47
Q

Innervation of the buccal caviy

A

Hard palate: Greater palatine, nasopalatine nerves (both V2)

Soft palate: lesser palatine nerve (V2)

Floor of oral cavity: lingual nerve (V3)

Cheeks: Buccal nerve (=V3, distinct from buccal branch of facial nerve!)

48
Q

What is the name and function of the recess at the back of the tongue

A

Epiglottice vallecula (recess which allows saliva to collect until next swallow so the saliva doesn’t constalty evoke a swallow reflex)

LCRS 2 - HNS Part 2 (5 decks)

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