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Neuro Exam 3: Anatomy > Anatomy: Oral and Submandibular regions > Flashcards

Anatomy: Oral and Submandibular regions Flashcards

1
Q

vestibule:

A
  • space b/w lips/cheeks and teeth
  • opens externally at oral fissure b/w lips
  • mm. of facial expression control its shape and size
  • parotid duct opens into vestibule opposite upper 2nd molar
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2
Q

innervation of lips?

A

upper lip = V2 via infraorbital branches

lower lip = V3 via mental and bucal branches

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3
Q

lymphatic drainage of lips?

A

submental nodes drains medial part of lips unilaterally

submandibular nodes drain all other regions - bilaterally

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4
Q

number of teeth?

A

32 permanent teeth; 16 deciduous (baby) teeth

  • 4 incisors, 2 canines, 4 premolars, 6 molars
  • appear around age 6-8
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5
Q

gingivae

A

mucous membrane and fibrous tissue attached to alveolar processes of the mandible and maxilla bones, and attached to neck of teeth

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6
Q

how are teeth innervated?

A

maxillary teeth: superior alveolar branches of V2

mandibular teeth: inferior alveolar branches of V3

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7
Q

how is maxillary gingivae innervated?

A
  1. Maxillary gingivae:
    - palatine portion: nasopalatine n (V2) and greater palatine n (V2)
    - vestibular portion: superior alveolar branches of V2
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8
Q

innervation of gingivae of mandibular teeth?

A

all inferior alveolar branches of V3

  • internal portion: lingual n (V3)
  • external: buccal n (V3) and mental branch of inferior alveolar n (V3)
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9
Q

lymphatic drainage of teeth/gingivae?

A

most lymph drainage is to submandibular lymph nodes

  • exception: mandibular incisors drain to submental lymph nodes
  • exception: 3rd maxillary molars drain directly to superior deep cervical lymph nodes.
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10
Q

terminal sulcus

A
  • V shaped groove on dorsum of tongue that separates anterior 2/3rds (body) from root (posterior 1/3)
  • represent embryonic site of oropharyngeal membrane
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11
Q

foramen cecum

A

remnant of thyroglossal duct

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12
Q

types of papillae

A
  • vallate (lie anterior and posterior to terminal sulcus)
  • filiform (most abundant, no taste buds)
  • fungiform
  • foliate (least abundant, located on lateral edges of tongue)
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13
Q

three intrinsic mm. of the tongue?

A

intrinsic mm. alter the shape of the tongue - they don’t move the tongue/change its position

  1. longitudinal (shorten;retract tongue, also curl tongue)
  2. vertical (flatten/broaden tongue)
  3. transverse (narrow/elongate tongue)
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14
Q

what do extrinsic mm. of tongue do?

A

alter position of tongue

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15
Q

genioglossus

A 
largest m. of tongue
O: mental spines of mandible
I: dorsum of tongue
N: hypoglossasl n (GSE)
fn: acting bilaterally: protrudes tongue
unilaterally: pushes tongue to opposite side
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16
Q

hyoglossus

A

O: hyoid bone
I: inferolateral side of tongue
N: hypoglossal - GSE
fn: retracts, depresses tongue

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17
Q

styloglossus

A

O: styloid process
I: superolateral side of tongue
N: hyoglossus (GSE)
fn: retracts; elevates tongue

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18
Q

Palatoglossus

A

O: soft palate
I: tongue
N: vagus n. (SVE)
fn: pulls tongue and soft palate together during swallowing - closes fauces

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19
Q

what are mm. of tongue innervated by?

A

genio, hyo, styloglossus all hypoglossus (GSE)

palatoglossus: vagus provides SVE

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20
Q

how would hypoglossal nerve lesion present?

A

when patient is asked to protrude tongue, tongue will deviate toward affected (paralyzed) side beceause functioning genioglossus m. pushes tongue contralaterally

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21
Q

sensory innervation to anterior 2/3 of tongue?

A

GSA- lingual branch of V3

Taste, SVA - facial n. via corda tympani

22
Q

sensory to posterior 1/3 of tongue?

A

GVA: general sensory via glossopharyngeal n.
SVA: taste via glossopharyngeal n.

23
Q

sensory to epiglottic region?

A

GVA: general sensory via internal laryngeal branch of vagus n.
SVA: taste via superior laryngeal branch of vagus n.

24
Q

blood supply to tongue?

A

provided via lingual artery (branch of external carotid)

  • dorsal lingual a(posterior tongue/palatine tonsil)
  • sublingual a. (floor of mouth)
  • deep lingual a. (anterior tongue)
25
Q

venous supply to tongue?

A
  • lingual vv. drain tongue and floor of oral cavity directly to IJV
  • venae comitantes hypoglossi - drain floor of oral cavity and parallel course of hypoglossal n. to end of common facial v.
26
Q

lymphatic drainage of tongue?

A

posterior 1/3: superior deep cervical lymph nodes bilaterally

anterior 2/3:

  • lateral sides: submandibular nodes ipsilaterally
  • middle: inferior deep cervical nodes bilaterally
  • apex: submental nodes (bilaterally)
27
Q

where are tonsils located?

A

nasopharynx, orpharynx, oral cavity

  1. lingual: located deep to mucosa of posterior 1/3 of tongue
  2. pharyngeal: located within pharyngeal recess of nasopharynx
  3. palatine: located at opening of oropharynx; b/w palatoglossus and palatopharyngeal arches
  4. tubal: located at opening of auditory tube
28
Q

Waldeyer’s ring

A

4 groups of lymphoid tissue = pharyneal lymphoid ring

  • note: lymph nodes can become enlarged and occlude surrounding structures (fauces, opening of auditory tube; naspharynx).
  • lingual and palatine: occlue fauces
  • tubal: occlude auditory tube
  • phrayngeal: occlude nasopharynx
29
Q

adenoids

A

pharyngeal tonsils are inflamed - can occlude the nasopharynx

30
Q

3 types of salivary glands?

A
  1. Parotid glands (CN IX)
  2. Sublingual glands: lie in floor of oral cavity, covered with oral mucosa. forms sublingual fold on floor of mouth and opens into oral cavity via small ducts
  3. Submandibular glands: superficial portion lies witin submandibular triangle of neck, deep to mandible. deep portion wraps around posterior border of mylohyoid to pass b/w hyoglossus mm.
31
Q

submandibular duct

A

“Wharton’s duct” courses anteriorly from deep part of gland (between mylohyoid and hyoglossus) to open in floor of mouth on the sublingual caruncle

32
Q

what n. passes near submandibular duct?

A

lingual n. wraps aroudn the submandibular duct as they course forward

33
Q

PS innervation to parotid gland?

A
  • cell bodies: salivatory nucleus
  • pre fibers: travel with CN IX (glossopharyngeal n)
  • CN IX exits jugular foramen and gives tympanic branch which enters middle ear via tympanic canaliculus
  • travels through middle ear and reforms as lesser petrosal n, which exits middle ear via hiatus for lesser petroslal n. in middle cranial fossa exits via foramen ovale
  • post bodies: otic ganglion
  • post fibers: travel with auriculotemporal branch of V3

fn: major secretomotor, gland secretion

34
Q

symp innervation to all three salivatory glands?

A

pre bodies: T1-4
post bodies: SCG
post fibers: travel with external carotid n. to parotid tissue
fn: vasomotor

35
Q

which ganglion are post PS cell bodies located in for sublingual and submandibular glands?

A

submandibular ganglion

- ganglion is suspended from lingual n. within posterior floor of oral cavity.

36
Q

PS innervation of sublingual and submandibular glands?

A

pre bodies: salivatory nucleus
pre fibers: travel with facial n. (CN VII)
- CN VII courses along posterior wall of middle ear and gives rise to chorda tympani n. chorda tympani n. exits middle ear through petrotympanic hiatus to enter infratemporal fossa. here chorda tympani joins lingual n.
post bodies: submandibular ganglion
post fibers: travel with lingual branch of V3

fn: secretomotor, stimulates salivation

37
Q

middle ear infections?

A

both corda tympani and lesser petrosal n course through middle ear, thus infections can cause dry mouth (xerostomia)

38
Q

boundaries of submandibular region?

A

inferior: anterior and posterior bellies of digastric m.
superior: mandible
roof: cervical investing fascia
floor: mylohoid m.

39
Q

what are components of submandibular region?

A

submandibular gland
facial a
CN XII
suprahyoid mm.

40
Q

digastric m.

A

O: ant belly: digastric fossa of mandible
post belly: mastoid notch of temporal bone
I: hyoid
N: anterior: anterior belly of V3
posterior: cervical branch of facial n. (CN VII)
fn: depresses mandible; elevates hyoid

41
Q

stylohyoid

A

O: styloid process
I: hyoid
N CN VII
fn: elevates and retract hyoid

42
Q

mylohyoid

A 
forms floor of oral cavity
O: mandible
I: midline raphe and hyoid
N: mylohyoid branch of V3
fn: elevates hyoid and floor of mouth; assists with opening mouth if hyoid is fixed
43
Q

geniohyoid

A

O: mental spines of mandible
I: hyoid bone
n: C1 via hypoglossal
fn: elevates hyoid; when hyoid is fixed it opens mouth

44
Q

what a. supplies submandibular and oral regions?

A

lingual a (branch of external carotid a.)

  • dorsal lingual
  • sublingual
  • deep lingual
45
Q

what vv. supply submandibular and oral regions?

A 
lingual vv (to IJV)
venae comitantes hypoglossi (to common facial v.)
46
Q

sublingual abosprtion of drugs

A

certain drugs such as nitroglycerin (tx of angina) need rapid absorption. because lingual vv. drain directly to IJV, drugs can be placed in sublingual region and are rapidly abosrbed into bloodstream. mucosa is thin here.

47
Q

lingual n. what is its course?

A
  • Branch of V3, enters oral cavity psoteriorly from infratemporal fossa, courses through paralingual space (b/w hyoglossus and mylohyoid mm.)
  • wraps around submandibular duct in course
  • pierces tongue laterally
48
Q

what does lingual n. provide? what does it distribute

A
  • branch of V3
  • provides GSA to floor of mouth and anterior 2/3 of tongue
  • distribues:
    1. SVA (taste) via chorda tympani
    2. GVE-P via chorda tympani
49
Q

chorda tympani n.

A
  • CN VII branch that is given off in middle ear
  • C.T. exits middle ear via petrotympanic fissure to enter infratemporal fossa
  • mergest with lingual n (V3) to travel to oral cavity
  • carries:
    1. SVA to anterior 2/3 of tongue
    2. GVE-P (PS fibers) to submandibular ganglion to be distributed to submandibular sublingual glands
50
Q

hypoglossal n.

A
  • enters oral cavity from submandibular region
  • passes laterally to occipital a. and enters paralingual space
  • provides:
    1. GSE: extrinsic tongue mm. (except palatoglossus)
    2. GSE: intrinsic mm. of tongue
51
Q

glossopharyngeal n.

A
  • enters oral cavity posteriorly from pharyngeal region
  • after passing b/w superior and middle constrictor mm, CN IX travels forward to pierce tongue posteriorly
  • provides:
    1. GVA: posterior 1/3
    2. SVA: posterior 1/3 of tongue
52
Q

Vagus n.

A
  • internal branch of superior laryngeal n. will enter oral cavity posteriorly from pharyngeal region
  • after passing in b/w the middle and inferior constrictor mm. the internal laryngeal n. will ascend to supply the epiglottic region of tongue
  • provides:
    1. GVA: epiglottic
    2. SVA: epiglottic region of tongue

Neuro Exam 3: Anatomy (12 decks)

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