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HNS > Face and oral cavity > Flashcards

Face and oral cavity Flashcards

1
Q

Folds of tissue in roof of mouth

A

Palatopharangeal fold
Palatoglossal fold- anterior

In between palatine tonsil

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2
Q

Deviation in the uvula

A

Can be seen when soft palate rises
If deviates to the side- may be problem with one of the vagal nerves
Deviates to side opposite of vagal problem

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3
Q

What happens during swallowing to prevent going into airways

A

Larynx is raised

Epiglottis retroflects

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4
Q

Hole either side of larynx

A

Piriform fossa in the oesophagus

- very sensitive, food can get caught there

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5
Q

Relative position of trachea and oesophagus

A

Trachea anterior to oesophagus

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6
Q

Pharynx parts

A

Nasopharynx
Oropharynx
Larygopharynx

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7
Q

Muscles of the pharynx

Their innervation and what motion they aid

A

Superior, middle and inferior constrictor muscles
Motor activity is largely due to X innervation (XI as well)
Aid swallowing

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8
Q

Swallowing sequence

A

Lift and retract the tongue (controlled by the styloglossus and intrinsic muscles)

Bolus is moved into the oropharynx (contraction of palatoglossus muscle of tongue)

Elevate the soft palate (levator muscles) – this closes off the nasopharynx (stops food going into nose)

Raise the larynx, to close off the epiglottis – stops food going into the airway

Peristaltic wave of constrictor muscles (superior, middle and inferior constrictors) – moves bolus down

Relax cricopharyngeus -> this opens the oesophagus to allow passage for food

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9
Q

Salivary glands

A

Parotid- biggest, para from CN IX, anterior to ear, mainly thin serous saliva

Submandibular- CN VII, mainly serous, under mandible

Sublingual- CN VII, mainly mucous, on floor of mouth

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10
Q

Muscles of the tongue

And where they attach to

A

Extrinisic:
Styloglossus- help retract the tongue- form styloid process
Hyoglossus- attaches to hyoid bone
Genioglossus- protrudes tongue- attaches to the mandible
Palatoglossus- attaches to palate

Intrinsic muscles

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11
Q

Deviation of tongue

A

Dysfunction of the hypoglossal in same direction of deviation

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12
Q

Lingual nerve

A

Branch of the mandibular division of the trigeminal nerve (CN V3), which supplies general sensory and taste (chorda tympani) innervation to the anterior 2/3 of the tongue.

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13
Q

Innervation of anterior two thirds of tongue and where they go to

A

Normal sensation is the trigeminal nerve (V3) – however, taste fibres are from the facial nerve (chorda tympani).

All of the taste fibres go back to the nucleus solitaries in the brainstem – this is where taste perception is processed.

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14
Q

Innervation of posterior third of tongue

A

Both sensation and taste fibres are carried in the glossopharyngeal nerves. There is also little innervation from the vagus nerve

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15
Q

Muscles of mastication

A 
Masseter
Temporalis
Lateral pterygoid
Medial pterygoid
Buccinator muscle
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16
Q

Masseter muscle innervation, location and function

A

Mandibular division of trigeminal

From zygomatic arch to lateral surface of ramus and angle of mandible -superficial

Elevates mandible

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17
Q

Temporalis innervation, location and function

A

Mandibular division

Temporal fossa to coronoid process of mandible-superficial

Elevate and retract mandible

18
Q

Lateral pterygoid innervation, location and function

A

Mandibular

Sphenoid/ lateral pterygoid plate to neck of mandible-deep

Depresses and protracts mandible to open mouth

19
Q

Medial pterygoid innervation, location and function

A

Manidbular

Lateral pterygoid plate/maxilla/palate to angle to mandible-deep

Elevates, protracts and allows lateral movement of mandible for chewing

20
Q

Buccinator muscle innervation, location and function

A

Facial nerve

Cheek

Pushes food into middle of the mouth and aids chewing

21
Q

Temporalmandibular joint

A

Articular disc in-between

Open jaw slightly- hinge action
Open jaw widely- gliding movement

22
Q

Branches of the External carotid artery supplies

A
  • Superior thyroid arteries
  • Ascending pharyngeal arteries
  • Lingual arteries – go to the tongue
  • Facial artery – passes round inferior border of mandible, before going up to medial canthus of the eye
  • Occipital artery
  • Posterior auricular artery – goes behind the ear
  • Maxillary artery
  • Superficial temporal artery
23
Q

Route of facial nerve

A

The facial nerve exits the cranial cavity via the internal acoustic meatus (along with the vestibulocochlear nerve).

It emerges from the stylomastoid foramen at the base of the skull and passes underneath the parotid

24
Q

5 branches of facial nerve

A 
Temporal 
Zygomatic
Buccal
Mandibular
Cervical
25
Q

Branches of mandibular nerve

A

Inferior alveolar- passes into back of mandible, mediates toothache

Mental nerve- inferior branch of inferior alveolar nerve

Lingual nerve- anterior 2/3 of tongue sensation (also revives innervation from facial nerve- chords tympani)

26
Q

Chorda tympani

A

Emerges in the temporal bone and branches off main facial nerve
Comes from the petrotympanic fissure and joins the lingual nerve

27
Q

Dermatomes of the head

A

V1- forehead
V2- cheek
V3- side of face, chin

28
Q

Ophthalmic sensory function

A

Supplies skin from top of head to upper eyelid and down median line of nose

And supplies conjunctiva covering inner surface of eyelid and much of the nasal mucosa and frontal sinus

29
Q

Maxillary sensory function

A

Supplies the skin of the anterior temple and the middle part of the face as far down as the corners of the mouth.
In addition it supplies the upper teeth, lip, gums and the roof of the mouth

30
Q

Mandibular sensory function

A

Supplies a strip of skin running from the middle part of the temple then anterior to the ear and down to the chin.

In addition it supplies the lower teeth, gums and lip, the lining of the cheeks, the floor of the mouth and the buccal part (anterior two-thirds) of the tongue.

31
Q

Facial nerve function

A

The main motor nerve supplying the muscles of facial expression and, via the chorda tympani, is the nerve that supplies the parasympathetic innervation to the submandibular and sublingual salivary glands.

32
Q

Glossopharyngeal nerve function

A

The main sensory nerve of the posterior 1/3 of the tongue and the oropharynx.

33
Q

Hypoglossal nerve function

A

Only motor nerve of the tongue

34
Q

Teeth set in permanent and deciduous set

A

Permanent-36- 8 incisors, 4 canines, 8 premolars, 12 molars

Deciduous- 20- 8 incisors, 4 canines, 4 premolars, 4 molars

35
Q

Maxillary artery

A

One of the terminal branches of the external carotid artery

Middle meningeal is a branch off the maxillary

36
Q

Phases of swallowing

A

Oral preparatory phase- food chewed into bolus. Lip, jaw, tongue and palate sensory &motor function needed- voluntary V, VII, IX, X, XII

Oral transit phase- bolus propelled to back of mouth. Palate seals entrance to nasal cavity. Same voluntary as previous.

Pharyngeal phase 1- triggered when bolus reaches faucial arch. Palate stays elevated and tongue retracts to push bolus to pharynx. Tongue, palate& laryngeal sensory and motor function needed- reflex control- IX, X, XII

Pharyngeal phase 2- bolus propelled thought pharynx. Tongue, palate, laryngeal sensory and motor function needed- reflex control IX, X, XII.

Oesophageal phase- oesophagus opens, airway closed, breath held. Bolus propelled through oesophagus. Reflex control of IX and X

37
Q

Cerebellar haematoma- ataxic swallowing

A

Uncoordinated tongue retraction to propel food
Delayed airway closure- food enters airway
Delayed and ineffective cough to clear airway- goof aspirated to lungs

38
Q

Excised acoustic neuroma

A

Ipsilateral paresis of pharynx, larynx and tongue
Weak bolus propulsion- pharyngeal & oral residue
Failed airway closure-aspiration

39
Q

Parkinson’s disease

A

Difficulty initiating swallowing
Typical repetitive tongue movement
Linked with muscle rigidity, unable to lower back of the tongue

40
Q

Sensory innervation of the pharynx

A

Highly sensitive: sensory IX, X supply to the pharyngeal plexus

HNS (6 decks)

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