Anatomy of the salivary glands, tongue, palate and pharynx

Question 1

Identify the labelled structures.

Answer 1

Clockwise from top:

Soft palate

Odontoid process of C2

Oropharynx

Epiglottis

Hyoid bone

Muscles of the floor of the mouth

Mandible

Upper and lower teeth

Upper and lower lips

Hard palate

Question 2

Identify the labelled structures

Answer 2

Right parotid duct

Buccinator

Sublingual ducts

Sublingual glands

Mylohyoid muscle

Submandibular duct

Deep and superficial part of the submandibular gland

Masseter

Right parotid gland

Question 3

What are the major salivary glands? How are they innervated by the parasympathetic system?

Answer 3

Parotid (glossopharyngeal)

Submandibular and sublingual (chorda tympani branch of facial nerve)

Question 4

What is the general and special sensory supply to the posterior 1/3rd of the tongue?

Answer 4

Glossopharyngeal nerve

Question 5

What is the general and special sensory supply to the anterior 2/3rds of the tongue?

Answer 5

General sensation: CN V3 (branch of trigeminal)

Special sensory: CN VII (facial nerve)

Question 6

Where can thyroglossal cysts/ectopic thyroid tissue be found?

Answer 6

Anywhere in the midline of the neck- this is the path of embrylogical migration of the thyroid

Question 7

What is the foramen caecum?

Answer 7

Origin of the thyroid gland in the oral cavity

Question 8

What is the terminal groove?

Answer 8

Junction between anterior 2/3rds and posterior 1/3rd of the tongue

Question 9

Identify the muscles stating their attachments

Answer 9

Palatoglossus

Genioglossus

Hyoglossus

Styloglossus

Question 10

What is the nerve supply to the extrinsic muscles of the tongue? What is the exception to this and how is it different?

Answer 10

Hypoglossal (CN XII) except palatoglossus (vagus)

Question 11

How can the function of the hypoglossal nerve be tested?

Answer 11

Ask patient to stick out tongue; should remain in midline. If the right nerve is damaged will deviate towards the right and vice versa

Question 12

How does the epithelium of the hard palate differ from the soft palate?

Answer 12

Both are stratified squamous, but only the hard palate is keratinised

Question 13

Label the bones of the hard palate

Answer 13

Top left, working clockwise:

Palatine processes of the maxillae

Median palatine suture

Right and left palatine bones

Lateral and median pterygoid plates of the sphenoid bone

Question 14

What is the role of the soft palate?

Answer 14

Acts as a “trapdoor”- stops food from entering the nose, directs air through the oral/nasal cavities, closes off the oropharynx during the gag reflex

Question 15

Which nerve supplies the muscles of the soft palate? What is the exception to this?

Answer 15

Vagus nerve. Exception is tensor veli palatini- CN V3

Question 16

How is the motor function of the soft palate tested?

Answer 16

Ask the patient to say “ahh”- the uvula should rise up in the midline. Deviation to one side indicates nerve pathology on the ipsilateral side