H&N 9.1 Oral cavity and tongue. Flashcards
What are the boundaries of the oral cavity?
- roof- hard and soft palate
- lateral- cheeks, buccinator muscles within
- floor- tongue and soft tissues
- posterior-oropharyngeal isthmus
- anterior- oral fissure
What is meant by the oropharyngeal isthmus?
a short space which is the connection between the oropharynx and the nasopharynx.
anteriorly bound by the palatoglossal arch, and posteriorly by the pallatopharyngeal arch.
What is the oral fissure?
the opening to the mouth
What is the oral vestibule?
the space between the teeth and the cheeks/lips.
you can runs you’re tongue in it
What is the oral cavity proper?
From the teeth to the ring made by the palatopharyngeal arch, uvula, and tip of epiglottis.
(together with the oral vestibule makes up the oral cavity)
What 2 arches are found within the mouth?
- pallatoglossal arch (Anterior)
- pallatopharyngeal arch (posterior)
What makes up the hard pallate within the mouth?
- The same as is found on the floor of the nasal cavity.
- pallatine process of maxilla and the pallatine bones.
What holes are found within the hard pallate?
- incisor foreamen
- greater palatine foramen.
What runs through the incisor foramen?
- nasopalatine nerves (from the maxillary branch of the trigeminal nerve)
- sphenopalatine artery.
What runs through the greater palatine foramina?
descending palatine artery and greater palatine nerve.
What is the soft palate of the oral cavity made from?
-the palatoglossus and the palatopharyngeus muscles (the same muscles that make up the arches)
What is the function of the palatoglossus and palatopharyngeus?
They act to elevate the soft palate during swallowing and yawning.
What is the innervation of the pallatoglossus and pallatopharyngeus muscles?
Vagus nerve.
pharyngeal branch
What would happen to the uvula if the right vagus nerve was damaged?
It would deviate away from the affected side, because the unnaffected side will be unopposed, leading to deviation to the left.
What is the function of the gag reflex?
To prevent choking, acts by involuntarily lifting the soft palate muscles.
What are the limbs of the gag reflex?
Afferent limb- glossopharyngeal nerve (sensory to the back of the tongue, uvula, tonsillar area)
Efferent limb- vagus nerve (motor to the pharyngeal muscles of the soft palate)
Why is the gag reflex not usually formally tested?
it’s unpleasant.
What are the order of the teeth found in an adult, from front to back?
Incisor (central) Incisor (lateral) Canine Premolar 1st molar 2nd molar 3rd molar (wisdom tooth)
What is the sensory supply to the teeth?
- lower jaw via the inferior alveolar nerve (from the mandibular nerve)
- upper jaw via the superior alveolar nerves (from the maxillary nerve)
What might cause loss of sensation to the lower jaw?
A fracture of the mandible, the inferior alveolar nerve runs through the bone of the mandible, so is likely to get damaged.
What are the extrinsic muscles of the tongue?
- styloglossus
- hyoglossus
- genioglossus
- palatoglossus
what is the general function of the extrinsic muscles of the tongue?
to move the position of the tongue.
What are the functions of:
1) styloglossus
2) Hyoglossus
3) genioglossus
1) to elevate and retract the tongue
2) to depress and retract the tongue
3) to protrude the tongue
What are the intrinsic muscles of the tongue?
- superior longitudinal
- vertical
- transverse
- inferior longitudinal
What is the general function of the intrinsic muscles of the tongue?
To change the shape of the tongue.
What are the specific actions of the following tongue muscles:
1) superior longitudinal
2) vertical muscle
3) transverse muscle
4) inferior longitudinal
1) to curl the tongue up
2) to make the tongue flatter
3) to make the tongue rounder in shape, drawing in the sides
4) to curl the tongue down.
What nerve supplies the tongue muscles?
Hypoglossus
What would happen if there was damage to the right hypoglossus nerve?
You’d get deviation towards the affected side, so youd get deviation to the right.
What nerve supplies sensory innervation to the tongue?
-General sensory via the lingual nerve, a branch of V3.
Special sensory- anterior 2/3 via the chorda tympani, posterior 1/3 via the glossopharyngeal nerve.
How does the parotid gland secrete into the oral cavity?
Via stensons duct, which overlies the second maxillary molar
How does the submandibular gland secrete into the oral cavity?
Via Whartons duct, which opens underneath the tongue.
How does the sublingual gland secrete into the oral cavity?
Via many different ducts into the base of the mouth
Which salivary glands are most likely to form stones and why?
Submandibular, because they produce thicker saliva (serous and mucus, as opposed to parotid whihc produces only serous saliva)
How would a salivary stone present?
pain and/or swelling at meal times (When saliva gets produced more)
May be able to see a whartons duct stone
How are salivary stones treated?
- small ones may resolve on their own
- larger ones will need surgical removal
What tissues make up Waldeyer’s ring?
adenoid
palatine tonsil
lingual tonsil
All made of lymphoid tissue
What is tonsilitis?
Inflammation of the palatine tonsil
known by lay people simply as ‘tonsil’
What signs/symptoms are associated with tonsilits?
- enlarged tonsils
- erythematous
- oodynophagia (pain)
- dysphagia (difficulty)
- exudate
- fever
- dry cough
- lymphadenopathy
What commonly causes tonsillitis?
usually due to infection:
Viral- rhinovirus, adenovirus
Bacterial- beta-haemolytic strep.
What are some features of viral tonsilitis?
- a dry cough
- symptoms of URTI (rhinnorrhoea, congestion, sore throat, headache)
What are some features of bacterial tonsilitis?
- exudate on tonsils
- cervical lymphadenopathy
- fever
- absence of a cough
What is a severe complication of tonsilitis?
What causes this?
Peritonsilar abscess- Quinsy.
Usually strep pyrogens.
What are some signs/symptoms of a quinsy?
- deviated uvula (because unilateral)
- loss of palatoglossal arch
- systemically unwell
- hot potato voice
- drooling
What actions do you take if you discover someone with quinsy?
Immediate same day referral to ENT.
Need drainage of the absess immediately by a specialist (lots of nerves running close by)
