Head and Neck: Anatomy of the Oral Cavity

Question 1

What make up the boundaries of the oral cavity?

Answer 1

The roof is the hard palate and soft palate (palatine and maxilla bones and muscle)
The floor is the tongue and soft tissues, lateral walls are the cheeks
The anterior wall is the oral fissure and the posterior wall is the oropharyngeal isthmus

Question 2

What is the oral vestibule?

What is the oral cavity proper?

Answer 2

The oral vestibule is the space between the teeth and cheeks
The oral cavity proper is from the teeth to the ring made by the palatopharyngeal arch, uvula and tip of epiglottis

Question 3

What is the innervation of the soft palate?

Answer 3

The pharyngeal branch of the vagus nerve

Question 4

What is the afferent and efferent limb of the gag reflex?

Answer 4

Afferent limb is the glossopharyngeal nerve (sensory to throat, uvula, tonsillar area)
Efferent limb is the vagus nerve (motor to the soft palate)

Question 5

Look at a photo and name the teeth

Answer 5

Starting from centre and working around one side
Incisor 
Lateral incisor
Canine 
1st premolar 
2nd premolar 
1st molar 
2nd molar 
(3rd molar is wisdom tooth)

Question 6

What is the sensory supply to the lower jaw?

Answer 6

The inferior alveolar nerve (branch of V3)

Has close relation to the lingual nerve so can sometimes get a numb tongue when used for anaesthesia in dental surgery

Question 7

What are the extrinsic muscles of the tongue?

Answer 7

–All help the tongue to change POSITION–
Styloglossus: attaches ventral surface of tongue to the styloid process, pulls tongue in and up
Hyoglossus: attaches ventral surface of tongue to hyoid bone, pulls tongue in and down
Genioglossus: attaches ventral surface of tongue to the mandible. Sticks the tongue out
Palatoglossus: attaches dorsal surface to the palatine region of the soft palate, elevates the posterior tongue

Question 8

What are the intrinsic muscles of the tongue?

Answer 8

–All help the tongue to change SHAPE–
Superior longitudinal: located dorsally and along the length of the tongue, curls the sides
Vertical: run down the depth of the tongue, flatten it
Transverse: round the tongue
Inferior longitudinal: located ventrally and run the length of the tongue, curls sides down

Question 9

What is the innervation of the tongue?

Answer 9

Motor: hypoglossal nerve
Sensory: anterior 2/3rds is V3 for GS and chorda tympani for SS
Posterior 1/3rd is glossophayngeal nerve for both GS and SS

Question 10

How do salivary gland stones present?

Answer 10

Pain and swelling of the affected gland at meal times - gland is stimulated at meals and cant drain. They commonly need removing

Most commonly affects submandibular duct as it produces the thickest saliva, stones are usually calcium based

Question 11

How can you differentiate between tosillitis and a peritonsillar abscess (quinsy)?

Answer 11

Peritonsillar abscess is a severe complication of bacterial tonsillits (often strep pyogenes)

Pts will appears systemically unwell with a hot potato voice and can be drroling due to dysphagia, The uvula may be deviated

They need same day referral to ENT to draina dn give antibiotics