Clinical Anatomy of the Salivary Glands, Tongue, Palate and Pharynx Flashcards
What is the space between the lips and the teeth known as?
Vestibule
List the muscles of the floor of the mouth
Mylohyoid
Geniohyoid (above mylohyoid)
Anterior belly of digastric
What vein is visible in the floor of the mouth?
Lingual vein
Which structure is involved in tongue-tie?
Frenulum
Too short and binds to gingivae of lower incisor teeth
Which major salivary gland is usually palpable?
Submandibular gland
Where does the parotid gland release secretions into the mouth?
Opposite right 2nd upper molar
Where does the submandibular gland release secretions into the mouth?
Sublingual papilla
Where does the sublingual gland release secretions into the mouth?
Ducts on sublingual fold
Outline the parasympathetic innervation for the three major salivary glands of the mouth
SUBLINGUAL: CNVII chorda tympani
SUBMANDIBULAR CNVII chorda tympani
PAROTID: CNIX (hitches ride on branches of CNV3)
What supplies innervation to the anterior 2/3s of the mouth?
General sensory: CNV3
Special sensory: CNVII
What supplies innervation to the posterior 1/3 of the mouth?
General and special sensory : CNIX
What is the foramen caecum?
Origin of thyroid at apex of terminal groove
How do you know neck pathology is in the thyroid gland?
Moves superior to inferior on swallowing
What is the function of the extrinsic tongue muscles?
Change position of tongue in mastication/ swallowing
List the extrinsic muscles of the tongue
Palatoglossus
Styloglossus
Hyoglossus
Genioglossus
Where do the intrinsic muscles of the tongue originate from?
4 paired muscles from tip of genioglossus
What is the function of the intrinsic tongue muscles?
Modify tongue shape during function
What is the CNS connection of CNXII?
Medulla oblongata
What is the intracranial course of CNXII?
Anterior to hypoglossal canal in PCF
What is the extracranial course of CNXII?
Reduce in neck lateral to carotid sheath at hyoid
What is the base of skull foramen for CNXII?
Hypoglossal canal
How do you test CNXII?
Ask patient to stick tongue straight out - tip should be in midline, if abnormal it will point to side of injured nerve
Outline blood supply of the tongue
External carotid artery –> Lingual artery (forms a loop) –> Under tongue to supply muscles
Which CN courses lateral to the lingual artery?
CNXII
Where is the palatine tonsil located?
In tonsillar fossa/ sinus between the arches
Which structure forms from the connection of the two arches of soft palate?
Uvula
What structures are formed from the hook at the bottom of the sphenoid behind the palatine bone?
Medial and lateral pterygoid plates
List the muscles of the soft palate
5 PAIRS Levator veli palatini Tensor veli palatini Musculus uvulae Palatoglossus Palatopharyngeus
Outline the innervation of the muscles of the soft palate
CNX (except levator veli palatini: CNV3)
Which muscle lifts the soft palate?
Levator veli palatini
Which muscle tenses soft palate?
Tensor veli palatini
What is the function of the muscles of the soft palate?
Trapdoor to prevent food passing into the nose
Allow air to pass through the nose for speech, sneezing and coughing
Close off oropharynx in gag reflex
How do you test CNX/V3?
Ask the patient to say ‘aaah’
Uvula should stay in midline - pulled away from non-functioning side by normal
List the extrinsic muscles of the pharynx
CIRCULAR CONSTRICTOR MUSCLES
Superior, middle and inferior pharyngeal muscles
Outline the innervation of the extrinsic muscles of the pharynx
CNX
List the intrinsic muscles in the pharynx
INNER LONGITUDINAL MUSCLES
Stylopharyngeus
Palatopharyngeus
Salphingopharyngeus
Outline the innervation of the intrinsic muscles of the pharynx
Stylopharyngeus = CNIX Palatopharyngeus = CNX Salphingopharyngeus = CNX
What is the action of the intrinsic muscles of the pharynx?
Connect to the posterior border of the thyroid and elevate the pharynx and larynx
Which structure appears as a pear-shaped recess in the pharynx?
Piriform fossa
What is the clinical term for the openings of the nasal cavity in the pharynx?
Choana
List the components of Waldeyer’s ring of lymphoid tissue and their location
Palatine tonsil in tonsillar fossa
Pharyngeal tonsil ‘adenoid’ in nasopharynx roof
Tubal tonsils in eustachian tube opening
Lingual tonsil in posterior 1/3 of tongue
Palate associated lymphoid tissue
What is the function of Waldeyer’s ring?
Defensive ring around pharynx and larynx opening
Outline the regional lymph nodes that supply lymphatic drainage for the pharynx and larynx
Tip of tongue - submental nodes
Other - submandibular nodes
Where do the regional lymph nodes for the pharynx and larynx drain into?
Deep cervical nodes in carotid sheath: retropharyngeal nodes and jugulodigastric nodes
Which group of lymph nodes drains the palatine tonsil?
Jugulodigastric nodes
A painful, soft, unfixed lymph node is suggestive of cancer. True/ False?
False
It is suggestive of illness
A hard, non-painful, fixed lymph node is suggestive of cancer
