Anatomy of the Oral Cavity and Tongue Flashcards
Lable the teeth indicated on the image and state how many an adult should have total
I = Incisor C = canine PM = pre-molars M = molars
Adults have up to 32 teeth including incisors,canine, premolars and molars
What 4 structures border the mouth?
Hard palate, alveolar processes, teeth and palatal arches
What is indicated by the black arrow?
Oral vestibule: this is a narrow area located between cheeks, lips, teeth and alveolar processes
What forms the anterior and posterior boarders of the hard palate?
What covers the entire palate?
Formed anteriorly by palatine processes on left and right maxilla and formed posteriorly by the palatine bone
Entire palate covered by mucosa
Where is the hard palate derived from?
Most develops from the 1st pharyngeal arch which divides into maxillary and mandibular portion. The hard palate is derived from the maxillary process
Palate develops from fusion of the primary and secondary palate, where do each of these derive from?
Primary palate from the Intermaxillary segment (A)
Secondary palate formed by two Palatine Processes from the maxillary prominences (B)
The two palates grow and fuse together at the midline
** C = soft palate
List 2 common abnormalities that result from failure of palates to fuse
List 3 common problems associated with these conditions
Cleft Lip and Cleft Palate
Result in: abnormal facial appearance, defective speech and trouble feeding
What is Cleft palate?
Give an example of an anterior vs posterior deformity
When two palatal shelves fail to meet and fuse with each other at the midline
Anterior deformities = cleft lip
Posterior deformities = cleft uvula
What supplies sensory innervation to the hard palate?
The maxillary branch of the trigeminal nerve (CN V)
What do the greater and lesser palatine nerves innervate?
The greater palatine nerve innervates the glandular structures of the hard palate
The lesser palatine nerves innervate the soft palate
What nerve innervates the mucous membrane of the anterior hard palate
The nasopalatine nerve (branch of V3)
When the maxillary nerve (V2) exits the pterygopalatine fossa what does it continue as?
Infraorbital nerve
What supplies sensation to the lower teeth
Inferior Alveolar Nerve which is a branch of V3 (mandibular nerve)
Which 2 foramen are seen on the image of the hard palate?
What nerves passes through each?
Incisive canals: nasopalatine nerve
Greater and lesser palantine foramina: greater and lesser palatine nerves
Describe the soft palate
Fibromuscular palate that attaches to the posterior hard palate… and hangs posterior and inferior into the oropharynx
Uvula projects inferiorly in midline
Ho do we test movement of the soft palate?
During CN testing ➞ ‘Gag reflex’
What is the afferent and efferent branch of the ‘Gag reflex’?
Why is the position of the soft palate tested important?
Afferent = CN IX and Motor = CN X
Depending on where we stimulate… the afferent branch may be either CN X (front of palate) OR CN IX (back of palate). Hence, if tested too far forward we are testing CN X
Label the image
What two arches are indicated on the image and how are they formed?
Which is the most posterior portion of the soft palate?
1st arch = Palatoglossal arch (most posterior portion of soft palate)
2nd arch = Palatopharyngeal arch
Both formed by muscle sitting under mucosa
What marks the boundary between oral cavity and oropharynx?
Palatoglossal arch
What is the region between the 2 arches?
Palatine tonsil fossa
What supplies motor innervation to the muscles of the palate arch
CN X
Describe the position of the oropharynx to the soft palate
Where are the Palatine tonsils located
Oropharynx is posterior and inferior to the soft palate
Palatine tonsils are located behind the tongue in the palantine tonsil fossa
What connects the floor of mouth and inferior aspect of tongue?
Tissue connection ➞ Lingual frenulum
What two duct openings are found in the floor of the mouth?
Sublingual and submandibular ducts have openings in floor of mouth
What nerve innervates all intrinsic and extrinsic muscles of the tongue?
Hypoglossal (CN XII)
What CN and specific branch provides general sensation to the tongue
Trigeminal (CN V)
Specifically the lingual nerve, a branch of the mandibular nerve (CN V3)
What supplies taste to the anterior 2/3 of the tongue?
Facial nerve (CNVII)
In the petrous part of the temporal bone, the facial nerve gives off three branches. The chorda tympani branch provides taste to ant 2/3
What supplies taste to the posterior 1/3 of the tongue?
Glossopharyngeal nerve (CN IX)
Both touch and taste are supplied by the same nerve for the post 1/3
*** Very back of tongue is CN X
What is the medical name for the condition ‘tongue-tie’?
Briefly describe this
Ankyloglossia: congenital anomaly that decreases mobility of the tongue due to an unusually short, thick lingual frenulum
List another congenital problem that may arise from the Lingual frenulum?
Frenulum can form between the Lip and alveolar process
What are the 3 salivary glands and where do they open?
Which does the Facial nerve pass through?
Parotid (serous), Sublingual (mucous) and Submandibular (both) ➞ open into the oral mucosa
Facial nerve passes through the parotid gland!!
What problems may occur within the salivary glands?
What specifically may occur in the submandibular gland
Stone/strictures may form
- Strictures tend to occur in the parotid gland
- Salivary duct stone in the submandibular known as siololithiasis
Give 4 functions of saliva
1) Digestion
2) Antibacterial (amylase, lysosymes)
3) Moisten food
4) Moisten mouth
5) Clean away food residue
What provides innervation to each of the salivary glands?
Parotid innervated by autonomics of CN IX
Sublingual and Submandibular innervated by autonomics of CN VII
Both PNS
What are the 2 parts to the tongue and what structure seperates these?
What is found at the apex?
Oral and Pharyngeal part separated with v-shaped groove known as the sulcus terminalis
At apex is foramen caecum
The tongue forms part of what 2 structures?
Forms part of oral cavity floor and anterior wall of oropharynx
What two bones anchor the root of the tongue?
Attached to the mandible and hyoid bone
Describe the intrinsic vs extrinsic muscles of the tongue (incl their function)
Intrinsic: vertical, longitudinal and transverse bundles that ALTER the shape of the tongue
Extrinsic: Move the tongue as a whole, pass to the tongue from the hyoid, mandible, styloid process and soft palate
The lingual artery is a branch of what?
ECA
Label the image of taste vs somatic sensation to the tongue
What is Waldeyer’s Ring and what structures is it comprised of?
A continuous band of lymphoid tissue that surrounds oral cavity and upper pharynx
Composed of: Adenoids, tubal tonsils, palatine tonsils and lingual tonsil
Label the image of Waldeyer’s Ring
Where do the lingual tonsils drain?
Drains into the jugulodigastric and deep cervical lymph nodes
(Deep cervical lymph node run deep to SCM)
Which way will the tongue point in a lesion?
TOWARDS
(T for tongue, T for towards)
What may be seen in palate cancer
Palate opening into the nasopharynx (hole in roof of hard palate)
What is a mucocele?
Benign lumps of mucous filled stuff in the oral cavity (can be caused by biting lips), generally harmless
What is Gingivitis?
Who may be at a higher risk
Inflammation of the gums due to poor oral hygiene, more common during pregnancy
What is the most common cancer of the oral cavity?
List 4 risk factors (SHAT)
Squamous cell cancers are the MOST common, can occur anywhere in the mouth
Risk factors:
- Smoking
- HPV
- Alcohol (heavy drinking )
- Tobacco use
