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Boies > Chapter 14: Embryology, Anatomy and Physiology of the Oral Cavity, Pharynx, Esophagus and Neck > Flashcards

Chapter 14: Embryology, Anatomy and Physiology of the Oral Cavity, Pharynx, Esophagus and Neck Flashcards

1
Q

Derive from embryonic foregut

A
  1. Oral cavity
  2. Pharynx
  3. Esophagus
  4. Nasal cavity
  5. Teeth
  6. Salivary glands
  7. Anterior pituitary
  8. Thyroid
  9. Larynx
  10. Trachea
  11. Bronchi
  12. Alveoli of the lungs
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2
Q

Forms when the primitive stomodeum (fusion of the ectoderm and endoderm breaks down)

A

Mouth

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3
Q

Formed by elements of the medial and lateral nasal processes and the maxillary processes

A

Upper lips

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4
Q

Derived from the 2nd branchial region

Supplied by the facial nerve

A

Muscles of the lip

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5
Q

Has a characteristic bowed appearance

A

Vermilion border of the lips

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6
Q

Derived from the dental lamina, which give rise to the cementum and enamel of the definitive teeth

A

Teeth

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7
Q

Supplied by the branches from the maxillary and mandibular branches of the trigeminal nerve

A

Teeth

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8
Q

Palate is formed in 2 parts:

A
  1. Premaxilla: containing the incisor teeth and derived from the medial nasal process
  2. Posterior palate: both hard and soft palate, formed by fusion of the palatal shelves
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9
Q

Lateral to the tongue and if the tongue does not descend, the palatal plates cannot fuse
This is the basis of the cleft palate associated with the micrognathia of the Pierre Robin syndrome

A

Palatal plates

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10
Q

Formed from several epithelial eminences in the floor of the mouth

A

Tongue

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11
Q

Derived mainly from the 1st branchial region
Supplied by the lingual nerve, with the chorda tympani branch of the facial nerve supplying the taste buds and the secretomotor supply of the submandibular gland

A

Anterior tongue

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12
Q

Supplies all the sensation to the posterior 3rd of the tongue

A

Glossopharyngeal nerve

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13
Q

Derived from postbranchial myotomes that migrate forward, bringing with them the hypoglossal nerve

A

Muscles of the tongue

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14
Q

Arises from the foramen cecum in the posterior part of the tongue
Migrates along the thyroglossal duct into the neck
Migration does not occur: lingual thyroid

A

Thyroid

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15
Q

May persist and may be tucked up behind the body of the hyoid bone

A

Remnants of the thyroglossal duct

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16
Q

Anterior to the free margin of the soft palate, anterior tonsillar pillar and base of the tongue

A

Oral cavity

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17
Q

Divisions of pharynx

A
  1. Nasopharynx: extends from the base of the skull to the level of the soft palate
  2. Oropharynx: extends from this level to the level of the epiglottis
  3. Laryngopharynx/hypopharynx
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18
Q

Composed mainly of the bulk of the orbicularis oris muscle

Supplies by the facial nerve

A

Lips and cheeks

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19
Q

Is red due to a thin squamous epithelial covering

A

Vermilion

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20
Q

Region between the internal mucosa of the cheek and the teeth

A

Vestibule of the mouth

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21
Q

Opens opposite the upper 2nd molar

A

Parotid duct

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22
Q

Teeth are supported by:

A
  1. Superior: maxillary alveolar ridge

2. Inferior: mandibular alveolar ridge

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23
Q

Infant dentition consists of

A

2 incisors
1 canine tooth
2 molar teeth

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24
Q

Adult dentition consists of

A

2 incisors
1 canine
2 premolar
3 molar

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25
Q

Area between the upper and lower posterior molars

A

Retromolar trigone

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26
Q

Palate is made up of:

A

Anterior: bone of the hard palate
Posterior: highly muscular soft palate

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27
Q

Can be raised to seal the nasal pharynx from the oral cavity and oropharynx
Inability to make such seal–>abnormal speech (rhinolalia aperta) and difficulty in swallowing

A

Soft palate

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28
Q

Opens anteriorly on either side of the lingual frenulum

Failure of the salivary glands to secrete saliva causes a dry mouth or xerostomia

A

Submandibular ducts

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29
Q

Mobile muscular organ
Anterior 2/3: mobile
Posterior: fixed

A

Tongue

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30
Q

Muscles of the tongue are supplied by

A

Hypoglossal nerve

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31
Q

Innervation of the anterior 2/3 of the tongue (common sensation)

A

Lingual nerve

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32
Q

Innervation of the posterior 1/3 of the tongue

A

Glossopharyngeal nerve

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33
Q

Supplies taste to the anterior 2/3 of the tongue

A

Chorda tympani

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34
Q

Site of origin of the thyroglossal duct

A

Foramen cecum at the apex of the V

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35
Q

Provides general sensation to the tongue

A

Lingual nerve

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36
Q

Transverses the mandible and exits through the mental foramen
Provides sensation to the lower lip region

A

Mental nerve

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37
Q

Behind the mucosa of the posterior wall of the pharynx

A

Superior

  1. Basisphenoid
  2. Basiocciput
  3. Anterior portion of the atlas
  4. Bodies of the axis
  5. Other cervical vertebrae
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38
Q

Nasopharynx opens…

A

Anterior: into the nose via the posterior choanae
Superior: adenoids lies on the mucosa of the roof of the nasopharynx
Lateral: opening of the cartilaginous ET occupies a region anterior to a recess (fossa of Rosenmüller)

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39
Q

Enters the pharynx via the fossa of Rosenmüller

A

Tensor palatini

40
Q

Functions of tensor palatini

A
  1. Tenses the palate

2. Opens the ET

41
Q

Innervation of tensor palatini

A

Mandibular nerve via the otic ganglion

42
Q

Communicates anteriorly with the oral cavity

A

Oropharynx

43
Q

Anterior tonsillar pillar is composed of..

A

Palatoglossus muscle

44
Q

Posterior tonsillar pillar is composed of…

A

Palatopharyngeus

45
Q

Muscles of tonsillar pillar is innervated by…

A

Pharyngeal plexus of nerves

46
Q

Muscles help close the posterior oropharynx

A

Muscles of tonsillar pillar

47
Q

Composed of lymphoid tissue covered by squamous epithelium containing many crypts

A

Tonsil

48
Q

Represents the remnant of the endodermal opening of the 2nd branchial arch (this is where a 2nd branchial fistula or internal sinus will open)

A

Cleft above the tonsil

49
Q

Infection may collect between the capsule of the tonsil and the loose surrounding tissues and may track up toward the base of the soft palate

A

Peritonsillar abscess

50
Q

Opens anteriorly into the introitus of the larynx

A

Hypopharynx

51
Q

Attached to the base of the tongue by 2 lateral and 1 midline frenulum (these produce 2 valleculae on either side)

A

Epiglottis

52
Q

Develops through the posterior pharyngeal wall below the inferior constrictor and above the cricopharyngeus

A

Zenker’s diverticulum

53
Q

An area in which the air passages from the nose to the larynx cross the food passages from the mouth to the esophagus

A

Pharynx

54
Q

Dysfunction of pharyngeal musculature

A
  1. Difficulty in swallowing

2. Aspiration of saliva or food into the tracheobronchial tree

55
Q

In the early embryo…

A

No well-defined neck separating the thorax from the head

56
Q

Is formed as the heart, which originally below the foregut, migrates into the thorax and the branchial apparatus develops its final form

A

Neck

57
Q

Is the reason why many of the structures of the neck migrate caudally

A

Migration of the heart

58
Q

Never develops in man

Only derivative is the ligamentum arteriosum

A

5th arch

59
Q

Ever visible externally

A

Only 4 arches

60
Q

Each of the branchial arches contains…

A
  1. Cartilaginous bar
  2. Artery
  3. Nerve
  4. Some mesenchyma that will form muscle
61
Q

Each of the branchial arches contains…

A
  1. Cartilaginous bar
  2. Artery
  3. Nerve
  4. Some mesenchyma that will form muscle
62
Q

Area between the ectoderm and endoderm

A

Closing plate

63
Q

Located posterior to the cartilaginous arch, artery and nerve

A

Ectodermal cleft and endodermal pouch

64
Q

Abnormal persistence of parts of the branchial apparatus can lead to…

A
  1. Cyst
  2. Sinus
  3. Fistula
65
Q

May result in a cyst or sinus lying parallel to and even reduplicating the external ear canal

A

Persistence of the ectoderm of the 1st branchial arch

66
Q

Requires identification and dissection of the facial nerve

A

Excision of a 1st branchial cleft cyst

67
Q

Abnormal in the Treacher Collins syndrome

A

Bony derivatives of the 1st arch

68
Q

May form a persistent stapedial artery that passes through the crura of the stapes (presence of such artery, impossible to perform a stapedectomy)

A

Artery of the 2nd arch

69
Q

External openings of the 2nd, 3rd and 4th arches are covered over by growth of an area

A

Epipericardial ridge

70
Q

Epicardial ridge fuses with the 2nd branchial arch, burying the opening of the 2nd, 3rd and 4th branchial grooves as an ectodermal cyst, which degenerates

A

Cervical sinus of His

71
Q

The tract of a branchial cleft cyst must…

A

Pass superior to the hypoglossal nerve

72
Q

Will open anterior to the SCM, pass into the neck anterior to the common and ICA, between the ICA and ECA, and then above the glossopharyngeal and hypoglossal nerves to reach the tonsil

A

Second branchial fistula

73
Q

Will open anterior to the SCM, pass posterior to the common and ICA and above the hypoglossal nerve but below the glossopharyngeal nerve and stylopharyngeus, to enter the pharynx above the region supplied by the superior laryngeal nerve

A

3rd branchial fistula

74
Q

May persist as a tract from the inferior pharynx to the region of the thyroid and may occasionally be a cause of suppurative thyroiditis

A

Remnant of the 4th branchial pouch

75
Q

Pharyngeal blood supply derives from various branches of the…

A

External carotid system

76
Q

Pharyngeal blood supply (anastomoses)

A
  1. Terminal branches of the internal maxillary artery
  2. Tonsillar branch of the facial artery
  3. Dorsal lingual branch of the lingual artery
  4. Branch of the superior thyroid artery
  5. Ascending pharyngeal artery
77
Q

Sensory supply to the nasopharynx and oropharynx and base of the tongue

A

Pharyngeal plexus of the glossopharyngeal nerve

78
Q

Pharyngeal lymphatic drainage

A

Retropharyngeal and lateral pharyngeal chains with subsequent passage into the deep cervical nodes

79
Q

Nasopharyngeal malignancies often metastasize into the…

A

Posterior cervical chain

80
Q

Functions of pharynx

A
  1. Respiration
  2. Deglutition
  3. Voice resonance
  4. Articulation
81
Q

3 stages of deglutition

A

First: voluntary movement of food from the mouth into the pharynx
Second: transport of food through the pharynx (involuntary)
Third: passage of the bolus through the esophagus (involuntary)

82
Q

Deglutition

A

Mastication of food is positioned on the middle 3rd of the tongue—>elevation of both the tongue and soft palate forces the bolus into the oropharynx—>suprahyoid muscles contract, elevating the hyoid bone and larynx—>opening the hypopharynx and the piriform sinuses—>intrinsic laryngeal muscles contract in a sphincter-like fashion to prevent aspiration—>a strong motion of the tongue posteriorly plunges the food inferiorly through the oropharynx, a movement aided by the contraction of the superior and middle pharyngeal constrictors—>bolus is guided through the esophageal introitus when the inferior pharyngeal constrictor contracts and cricopharyngeus muscle relaxes—>peristalsis, assisted by gravity, moves the food down the esophagus and into the stomach

83
Q

Areas of loose connective tissue that may be the sites of abscess formation as well as pathways by which infection may spread

A

Fascial spaces of the head and neck

84
Q

Layers of thickened connective tissue enclosing the muscles and organs

A

Fascial sheath

85
Q

Functions of fascial sheath

A
  1. Protection

2. Allow the movement of the structures against one another

86
Q

Encircles the scalp, face and neck subcutaneously to enclose the muscles of facial expression and the platysma

A

Superficial cervical fascia

87
Q

Components of deep cervical fascia

A
  1. Superficial component: investing layer
  2. Middle component: pretracheal (visceral) layer
  3. Deep component: vertebral (prevertebral) layer
88
Q

Encircles the neck, attaching only to the nuchal ligament of the vertebrae posteriorly
Splits to enclose the trapezius and SCM but lies anteriorly to the strap muscles

A

Investing layer

89
Q

Limited to the anterior neck below the hyoid bone
Attaches to the superficial layer at the lateral border of the strap muscles on each sides, extends posterior to these muscles in front of the larynx and trachea
Encircles the thyroid gland

A

Pretracheal layer

90
Q

Attaches to the nuchal ligament and encircles the neck
Covers the vertebral bodies and the scalene muscles anteriorly and the paraspinous and deep neck muscles laterally
Splits to form 2 layers, an alar part anteriorly and a true prevertebral part posteriorly

A

Vertebral layer

91
Q

Space between alar part and true prevertebral part

Infection may spread downward to the chest

A

Danger space

92
Q

Between the prevertebral layer and the pretracheal layer on each side is a tube of fascia encircling the carotid artery, vagus nerve and jugular vein

A

Carotid sheath

93
Q

Becomes external to the suprahyoid musculature but then splits to enclose the mandible and muscles of mastication
Forms the capsules of the submandibular and parotid glands

A

Investing layer

94
Q

Extends above the hyoid bone posteriorly only as a layer encircling the pharyngeal muscles

A

Pretracheal layer

95
Q

Unchanged above the level of the hyoid

A

Vertebral layer

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