Anatomy- Salivary glands, Tongue, Palate and Pharynx Flashcards
where is the oral vestibule
between the lips and the teeth
what is the order of the pharynxs from top to bottom
nasopharynx
oro
laryngo
where is the definitve choanae
between the nasopharynx and nasal cavity (infront of entrance to eustachian tube)
what divides the naso and oro pharynx
the low tip of the soft palate
what makes up the epiglottis
laryngeal cartilage
what is the boundary between the laryngopharynx and the oropharynx
tip of the epiglottis
what is the oral cavity
everything above the tongue and below the hard palate
what level is the hyoid bone at
C3, in line with inferior aspect (base) of the mandible
what is the frenulum
connects the tongue to the base of the oral cavity
what is the sublingual caruncle
bump in the fremulum- opening for the submandibular glands
what is the sublingual fold
where the sublingual glands secrete mucous into
what veins are on the floor of the night
deep lingual veins
what muscles make up the floor of the mouth
geniohyoid (genio=back of chin)
mylohyoid
what innervates the geniohyoid
C1 (cervical spine nerve) via hypoglossal nerve
what innervates the mylohyoid
CN V3
what is the purpose of the free edge of the mylohoid
allows the submandibular gland to curl up
can allow infections to spread down into the neck
what are the major salivary glands
3 bilateral pairs
- parotid
- submandibular
- sublingual
what are the minor salivary glands
1000’s in oral mucosa
basal secretion to keep mouth moist
what stimulates salivation
thoughtm sight, smell of food/ food in mouth
painful oral conditions (teething, fractures mandible)
where does the parotid gland secrete into the mouth
by the upper 2nd molar
where are the parotid salivary glands
infront of/below ear
how does the submandibular gland secrete into the mouth
enters floor of mouth and secretes via the lingual caruncle
how does the sublingual gland secrete into the mouth
lays in floor of mouth, secretes via several ducts superiorly
what can salivary duct clogging/blockage cause
swelling due to back up of secretions
e.g in parotid transient swelling during meal times
what ‘pathetic’ innervates the salivary glands mostly
parasympathetics
what is the innervation of the submandibular and sublingual salivary glands
parasympathetics axons (secretorymotor) of chorda tympani branch of CN VII via the lingual branch of CN V3
what nerve supplies the muscles of facial expression
CN VII
what is the innervation of the partoid gland
parasympathetic innervation (secretomotor) from CN IX, hitches a ride of branches of CN V3 (otic ganglion)
what type of muscle is the tongue
skeletal
what is the tongue covered in
mucosa
what is the innervation of the posterior 1/3rd of the tongue (vertical part of tongue)
taste and general sensory by CN IX
what is the innervation of the anterior 2/3rds of the tongue (horizontal part of tongue)
general sensory CN V3
taste CN VII
what do filiform papillae sense
touch, temp
why there is a high conc of them at the tip of the tongue
what papillae have taste buds
foliate
vallate
fungiform
what separates the horizontal (posterior 1/3rd) and vertical (anterior 2/3rds) of the tongue
sulcus terminus
what is the path of the developing thyroid
originates in the pharynx
descends through the foramen caecum of the tongue
what can you get in the migratory path of the thryoid
thryoglossal cysts or ectopic thyroid tissue
what holds the tongue in place
4 pairs of skeletal muscles- palatoglossus, styloglossus, genioglossus, hyoglossus (name tells you where they’ve come from)
what is the role of the extrinsic muscles of the tongue
function to change the position of the tongue during mastication, swallowing and speech
where are and what is the role of the intrinsic muscle of the tongue
mainly dorsally/posteriorly
modify the shape of the tongue during function
what is the innervation of the extrinsic muscles of the tongue
all supplied by hypoglossal (CN XII) except the palatoglossus which is vagus
how does CN XII attach to the CNS
rootlets that attach to the medulla oblongata
how does CN XII leave the skull
hypoglossal canal (occipital bone) (anterior wall of foramen magnum)
what is the extracranial course of CN XII
descends in neck lateral to carotid sheath
at level of hyoid bone passes anteriorly towards the lateral aspect of the tongue - supplies most of the muscles of the tongue
passes anteriorly through neck lateral to the loop of the lingual artery
how do you clinically test CN XII
ask patient to stick tongue out
if both CN XII functional then tongue tip will remains in the midline
in unilateral CN XII damage tongue will point TOWARDS the injured side
what muscle pushes the tongue out of the mouth
genioglossal
what is the blood supply to the tongue
lingual artery- comes off the external carotid artery
what passes medial and lateral to the hypoglossus
arteries (lingual) pass medial
nerves (hypoglossal) pass lateral
what pharyngeal arch forms the palatine tonsils
2nd pharyngeal arch
what are the arches of the soft palate
skeletal muscles covered in mucosa
what goes in the greater and lesser palatine foramina
branches of CN V2 and branches of the maxillary artery
what lines the soft palate
non-keratinised stratified squamous epithelium
what lines the hard palate
keratinised stratified squamous epithelium
what bones form the hard palate
maxilla (anterior) and palatine (posterior aspect) bones
where is the scaphoid fossa
the pterygoid plate
what are palatal rugae
transverse mucosal ridges- assist in breaking down food
where is the pterygoid hamulus
hook like structure on the sphenoid bone
what are the five muscles of the soft palate
tensor veli palatini palatopharyngeus palatoglossus musculus uvulae levator veli palatini
what is the innervation and role of tensor veli palatini
CN V3
tenses palatine aponeurosis
what is the innervation and role of levator veli palatini
CN X
lifts palatine aponeurosis
what is the innervation and role of palatopharyngeus
CN X
lifts pharynx and thyroid cartilage
what is the innervation and role of palatoglossus
CN X
brings tongue and soft palate together
what is the innervation and role of musculus uvulae
CN X
shortens uvula
what is the innervation of the muscles of the soft palate
all supplied by CN X expect tensor veli palatini CN V3
what is the role of the soft palate
stops food entering the nose during swallowing
directs air into the nose/ mouth during speech, sneezing, coughing and vomiting
closes off the entrance into the oropharynx during the gag reflex
how can the soft palate be used to clinically test CN X
ask patient to say ahhh
if nerves normal uvula should lift in the midline
if unilateral pathology uvula will be pulled AWAY from the non functioning side
what is the innervation of the muscles of the pharynx
all innervated by CN X except stylopharyngeus (IX)
what are the two layers of pharynx muscles
outer circular layer (3 constrictor muscles, contracts pushing food inferiorly)
inner longitudinal layer (3 paired vertical muscles, contract and pull larynx superiorly shortening pharynx during swallowing)
what types of muscles are in the pharynx
skeletal- voluntary
what are the circular muscles of the pharynx
superior, middle and inferior constrictors
what do the gaps in the circular pharynx muscles allow
‘gateway to the mouth’ for CN IX, lingual artery, stylopharyngeus muscle
what pharynx muscles overlap each other
circular
in what way do the circular muscles of the pharynx contract
sequentially- peristalsis action
what innervates the circular muscles of the pharynx
CN X via the pharyngeal plexus
where do all circular muscles of the pharynx insert
onto the midline raphe
what is the only muscle in the pharynx to be innervated by CN IX
stylopharyngeus
what nerve does stylopharyngeus pass through the gateway to the mouth with
CN IX
what are the longitudinal muscles of the pharynx
stylopharyngeus
palatopharyngeus
salpingopharyngeus
where do all the longitudinal muscles of the pharynx insert
onto posterior border of thyroid cartilage
what is the role of the longitudinal muscles of the pharynx
elevate pharynx and larynx
what innervates palatopharyngeus and salpingopharyngeus
CN X
what is in the nasopharynx
choanae torus tubarius (above opening of the eustachian tube) pharyngeal recess salpingopharyngeal fold opening to eustachian tube
what is in the oropharynx
palatine tonsils palatoglossal arch palatopharyngeal arch
lingual tonsil
what is in the laryngopharynx
laryngeal aditus (inlet) piriform fossa (recess)
what is the role and position of the waldeyers tonsillar ring
within mucosa of the naso and oropharynx
defence against invading pathogens
how many pairs of tonsils do you have - name them
4 pharyngeal (adenoid) tubal palatine lingual
what are regional nodes
the group of lymph nodes that first receive the lymph that has drained from a given structure
what are the regional nodes for the tip of the tongue
submental nodes
where are the submental nodes
in the neck posterior to the mental process of the mandible
where are submandibular nodes
superficial to the submandibular gland
what nodes drain the palatine tonsils
jugulo-diagastric
where are the deep cervical nodes
in the carotid sheath
what are lymph nodes like in infection
swollen painful soft smooth not fixed (stuck to) adjacent structures improve rapidly with antibiotics etc.
what are lymph nodes like in cancer
swollen not painful hard irregular fixed
do not improve
where do midline structures usually drain
bilaterally (across the midline)
where are the parotid nodes
pre auricular
where are the mastoid nodes
post auricular
where do you palpate the deep cervial nodes
along the internal jugular vein
where do you palpate the superficial cervical nodes
along the external jugular vein
