Face and Oral Cavity Flashcards
what are the branches of the external carotids
Superior thyroid Ascending Pharyngeal Lingual Facial Occipital Posterior auricular Maxillary Superficial temporal
[Some Anatomists Like Fucking Over Poor Medical Students]
where does the middle meningeal artery arise from?
the maxillary artery
damage susceptibility of the facial artery
it meanders around the mandible
some parts are protected by the ramus of the mandible
some parts are superficial and can easily be damaged
what is the downward midline projection in the oral cavity called?
uvula
what are the two pillars/fauces?
what is their function?
pataloglossal folds (anterior) palatopharyngeal folds (posterior)
they depress the soft palate (anchored to the posterior aspect of the hard palate) against the tongue
seal off the nasopharynx from the oropharynx
purpose of the pharynx
Musculo-fascial passage which facilitates both food and air
what does the pharynx connect?
Connects nasal and oral cavities with larynx and oesophagus.
made of naso-, oro-, laryngopharynx
superior and inferior limit of the pharynx
superior: base of the skull
inferior: C6
sensory innervation of the pharynx
Glossopharyngeal and vagus (IX and X)
Via the “pharyngeal plexus”
EXCEPTION: Maxillary (V2) innervates small portion of nasopharynx
what type of muscles are contained in the pharynx?
circular and longitudinal
motor innervation to the muscles of the pharynx?
vagus
exception: Glossopharyngeal (IX) innervates stylopharyngeus
the circular muscles of the pharynx
Superior Constrictor
Middle Constrictor
Inferior Constrictor
all innervated by the vagus nerve
the longitudinal muscles of pharynx
Salpingopharyngeus* (innervated by X)
Palatopharyngeus (innervated by X)
- Important, as it is involved in closure of the oropharyngeal isthmus, part of the coughing reflex
Stylopharyngeus (innervated by IX)
what are the tonsils
Collections of lymphoid tissue:
1) Palatine tonsils (you can see them)
- Between palatoglossal and palatopharyngeal folds.
2) Tubal Tonsils
- Located posterior to the opening of the nasotympanic tube, lateral wall of nasopharynx
3) Lingual tonsil
- Posterior aspect of the tongue.
4) Pharyngeal tonsil (Adenoid Tonsil)
- Roof of the nasopharynx.
clinical significance of the tonsils
the tonsils can become infected/inflamed
what is the protective ring around the pharynx called?
Waldeyer’s tonsillar ring
what is the innervation to the anterior two thirds of the tongue?
lingual nerve
which branch of the lingual nerve provides general sensation to the anterior two thirds of the tongue?
V3
what innervation provided sensory information about taste in the anterior two thirds?
facial nerve (chordates tympani branch which joins the lingual nerve)
what is the innervation to the posterior third of the tongue?
glossopharyngeal (IX)
both used for general sensation and taste
where is the epiglottic vallecula and what is its function?
what innervates it?
depression located behind the root of the tongue between the folds in the throat
serves as spit traps, holding saliva temporarily before entering into the oesophagus to prevent the swallowing reflex being intiated
innervated by the vagus nerve
what sets of muscles are involved in the motor function of the tongue?
extrinsic and intrinsic muscles
what are the extrinsic muscles of the tongue?
- palatoglossus
- styloglossus
- hyoglossus
- genioglossus
[PSHG- people say hello+goodbye]
what nerve innervates the intrinsic and extrinsic muscles of the tongue?
hypoglossal (XII)
what is the exception in innervation to the tongues muscles?
the palatoglossus is innervated by the vagus rather than the hypoglossus like the other muscles
where is the hyoglossus and what is its function?
attached to hyoid bone hence hyo-
depresses the tongue
innervation: XII
where is the styloglossus and what is its function?
attached to styloid process
elevates and retracts tongue
innervation: XII
where is the genioglossus and what is its function?
attached to mandible and hyoid bone
protrudes the tongue
innervation: XII
where is the palatoglossus and what is its function?
aponeurosis of the palate
not much function related to the tongue, helps seal off oral cavity from the oropharynx
innervation: X
what is the result of damage to the hypoglossal nerve?
tongue deviates towards the lesion
with long standing injury there will be muscle wasting
what forms the temper-mandibular joint (TMJ)?
head of the mandible
into a socket formed by articular tubercle and mandibular fossa
articular disk located in between
where does the temporals insert itself on the mandible?
anterior border
where does the master insert itself on the mandible?
at the ramus, closer to the angle
where does the lateral pterygoid insert itself on the mandible?
interior mandible
at neck
where does the medial pterygoid insert itself on the mandible?
interior mandible at the angle
what are the two actions of the TMJ?
- hinge: elevation and depression of the mandible
- glide: protraction and retraction of the mandible
what muscles are involved in protrusion?
lateral pterygoid assisted by medial pterygoid
what muscles are involved in retraction?
posterior fibres of temporalis
deep part of masseter
geniohyoid and digastric
what muscles are involved in elevation?
temporalis
masseter
medial pterygoid
what muscles are involved in depression?
gravity aided by digastric, geniohyoid and mylohyoid muscles
what are the two superficial muscles of mastication?
what movement are they involved in?
masseter and temporalis
masseter: elevation
temporalis: elevation and retraction
what are the deep muscles of mastication?
lateral pterygoid and medial pterygoid
lateral: depression and protrusion/protraction
medial: elevation and protraction and lateral movement of mandible
what are the attachments of the temporalis?
function
temporal fossa
coronoid processor the mandible
elevation and retraction
what are the attachments of the masseter?
function
zygomatic arch
lateral surface of the ramus of the mandible
elevation
attachments of the lateral pterygoid?
function
lateral pterygoid plate and sphenoid
neck of mandible
protraction and depression
attachments of the medial pterygoid?
function
lateral pterygoid plate and maxilla
angle of mandible
elevation, protection, lateral movement
muscles at TMJ and function
all muscles elevate the mandible
except LPterygoids protract
temporalis retract
deep muscles protract
nerves
- V2
- V3
- VII
- IX
- V2: maxillary division of trigeminal
- V3: mandibular division of trigeminal
- VII: facial
- IX: glossopharyngeal
the branches of trigeminal
V1- sensory only
V2- sensory only
V3- sensory and motor (special efferent)
3 main branches of V3 (mandibular division)
- long buccal (anterior)
- lingual (posterior)
- inferior alveolar-nerve to mylohyoid (posterior)
what dermatome do V1, V2, and V3 supply
V1- forehead skin and upper eyelids
V2- anterior temple skin, middle of lateral aspect of the face and upper jaw
V3- middle part of the temple, cheeks, floor of the mouth
V1 sensory innervation
forehead skin and upper eyelids via frontal nerve
The conjunctiva, sclera, corneal epithelium and inner eyelids via the lacrimal nerve
The nasal mucosa and frontal sinus via the nasociliary
V3 sensory innervation
middle part of the temple, cheeks, floor of mouth by buccal nerve
Lower teeth, gums and lip by inferior alveolar
Anterior two thirds of tongue by lingual
what does V3, the motor component, supply
Innervation to the masseter, temporalis and pterygoids is mostly by the anterior division of the V3
Innervation to the anterior suprahyoid muscles (mylohyoid and ant. digastric) is through the mylohyoid nerve which is a branch of the inferior alveolar nerve
how can V3 motor component be tested on patient?
clench jaw (tests masseter and temporalis)
open mouth (lateral pterygoids)
move side to side (medial pterygoids)
stimulating the posterior third of the tongue
innervation by glossopharyngeal
intense stimulation can cause gag reflex
injury will result on no gag reflex on the respective side
what are the 5 special efferent branches of the CNVII motor component
Temporal branches Zygomatic branches Buccal branches Mandibular branch Cervical branch
[To Zanzibar By Motor Car]
branches of the parotid plexus
parotid plexus and the parotid gland
the parotid plexus is made of the facial nerve
the facial nerve itself does not innervate the parotid gland
how can the facial nerve?
expressions: Close eyes Raise eyebrows Smile Blow out checks Purse lips
what is the condition due to the damage to the facial nerve?
Bell’s palsy
what innervates the parotid?
innervated by glossopharyngeal via the otic ganglion
drainage of parotid serous secretions
Parotid gland drains via parotid duct, which opens into the oral cavity lateral and superior to the second upper premolar
what are the 3 main salivary glands
- parotid (XI)
- submandibular (VII)
- sublingual (VII)
innervation of submandibular gland?
secretion type?
facial nerve via the submandibular ganglion
serous
innervation of sublingual gland?
secretion type?
facial nerve via the submandibular ganglion[?]
mucous
where does the chordates tympani branch of VII come from?
from middle ear when it had entered the internal acoustic meatus
which fossa does the chordates tympani exit?
petrotympanic fissure
different to the main VII nerve- motor branches exit through stylomastoid foramen
where does the chordates tympani join the lingual nerve?
infra temporal fossa
containing GVE and SVA fibres
where does the chordates tympani that had now joined the lingual nerve go to?
submandibular ganglion
which motor fibres innervate the submandibular and sublingual glands?
parasympathetic GVE fibres that synapse the submandibular ganglion
where do the taste fibres of CNVII go
they SVA bypass the ganglion and go to the anterior two thirds of the tongue
(taste in this part of the tongue is facial nerve)
