Head And Neck Session 9 Flashcards
1
Q
What is the oral vestibule?
A
Slit-like space between the teeth, gingiviae, lips and cheeks
2
Q
What peri-oral muscles control the oral fissure?
A
Orbicularis oris, buccinator, risoris, depressors and elevators of the lips
3
Q
What is gingiva?
A
Fibrous tissue covered with mucous membrane that reflects in the alveolar sockets with the periosteum
4
Q
How does gingiva proper appear?
A
Pink, stippled and keratinized
5
Q
How does the alveolar mucosa appear?
A
Shiny, red and non-keratinised
6
Q
What do the lips contain?
A
Orbicularis oris, superior and inferior labial muscles, vessels and nerves
7
Q
What is the labial frenulum?
A
Free-edged fold of mucous membrane in the midline from the vestibular gingiva to mucosa of upper and lower lips
8
Q
Which labial frenulum is longer?
A
Superior
9
Q
What provides blood supply to the upper lip?
A
Facial and infra-orbital arteries
10
Q
What gives arterial supply to the lower lip?
A
Facial and mental arteries
11
Q
Where are buccal glands found?
A
Between buccinator and mucous membrane
12
Q
Where are the buccal fat pads?
A
Superficial to buccinator
13
Q
Why are the buccal fat pads larger in infants?
A
To prevent cheeks from collapsing during suckling
14
Q
What is the vermillion border?
A
Change in epithelium from highly to less keratinised to continue with labial mucosa
15
Q
How many generations of dentition do humans have?
A
2
16
Q
What are the primary/deciduous teeth?
A
20 small teeth that erupt from 6 months to 3 years
17
Q
At what age do the deciduous teeth exfoliate?
A
6 y.o.
18
Q
What replaces the deciduous teeth after exfoliation?
A
Secondary/permanent
19
Q
Describe the secondary/permanent teeth.
A
32, do not regenerate
20
Q
Where do permanent teeth remain dormant if the overlying primary tooth is not lost?
A
Alveolar bone
21
Q
What is the term used for the internal surface of maxillary teeth?
A
Palatal surface
22
Q
What is the term used for the internal surface of mandibular teeth?
A
Lingual surface
23
Q
What are the teeth anchored in?
A
Alveolar processes of maxilla and mandible
24
Q
How are the secondary/permanent teeth named?
A
Central incisor, lateral incisor, canine (cuspid), 1st and 2nd premolars (bicuspid), 1st, 2nd and 3rd molars
25
What is the colloquial name for the 3rd molars?
Wisdom teeth
26
What is the major structural difference between gingiva proper and alveolar mucosa?
Gingiva proper is firmly attached to the underlying structure, alveolar mucosa is free
27
What gives arterial supply to the teeth?
Superior and inferior alveolar arteries from maxillary
28
What gives venous drainage to the teeth?
Alveolar veins that follow arteries
29
Where does lymph from the teeth and gingiviae drain?
Submandibular lymph nodes
30
What is the oral cavity proper?
Space between upper and lower dental arcades, palate and oropharynx
31
What is the oral cavity occupied by when the mouth is closed and at rest?
Tongue
32
What anatomical feature marks the start of the oropharynx?
Junction of hard and soft palate
33
What are the components of the hard palate?
Palatine process of maxilla, lateral and medial pterygoid plates, pterygoid hamulus, vomer and choanae
34
What becomes the maxilla after ossification?
Lateral palatine process
35
What fuses in the foetus to form the palatine raphe?
Median and lateral palatine processes with nasal septum
36
What is found at the anterior end of the palatine raphe?
Incisive fossa
37
What muscles make up the soft palate?
M. levator palatini, m. uvulae, m. tensor veil palatini, m. palato glossus, m. palato pharyngeus
38
Which muscles forms the anterior/palatoglossal arch?
M. palato glossus
39
What muscles forms the posterior/palatopharyngeal arch?
M. palato pharyngeus
40
Where does the soft palate attach to the hard palate?
At the anterior border of the choanae, just posterior to the great and lesser palatine foramina
41
Where does m. tensor veli palatini attach?
Pterygoid hamulus
42
Why does the uvula deviate away from the side of lesion?
All except m. tensor veli palatini are innervated by the vagus nerve so a lesion causes unopposed muscle action away from affected side
43
What gives blood supply to the hard and soft palates?
Greater, lesser and ascending palatine arteries
44
What gives venous drainage to the hard and soft palates?
Pterygoid venous plexus
45
What gives sensory innervation to the gingiviae, mucous membranes and glands of the hard palate?
Greater palatine artery
46
What gives sensory innervation to the mucous membranes of the anterior hard palate?
Nasopalatine nerve
47
What gives sensory innervation to the soft palate?
Lesser palatine nerve
48
Where does the duct of the parotid gland open?
Buccal mucosa opposite 2nd molar
49
Where do the submandibular glands empty?
Papilla each side of the frenulum
50
How are the sublingual glands drained?
Via several ducts through lots of papillae
51
What vein is visible on the sublingual surface of the tongue?
Deep lingual
52
What divides the tongue into its root and body?
Terminal sulcus
53
What are the 4 types of lingual papillae?
Valate, foliate, filiform, fungiform
54
Which lingual papillae are sensitive to touch?
Filiform
55
What is the foramen cecum?
Non-functional embryological remnant of the thyroglossal duct marking the middle of the terminal sulcus
56
Is the pharyngeal part of the tongue visible on inspection?
Not without a mirror or tongue depressor
57
What lymphoid tissue is found in the root of the tongue?
Lymphoid nodules of lingual tonsil
58
What does the midline groove of the tongue overlie?
The lingual septum
59
What forms the anterior wall of the oropharynx?
Pharyngeal part of tongue
60
What gives motor innervation to the tongue?
CNXII
61
What gives general and special sensory innervation to the posterior 1/3 of the tongue?
CNIX
62
What gives general sensory innervation to the anterior 2/3 of tongue?
CNV
63
What gives special sensory innervation to the anterior 2/3 of the tongue?
CNVII
64
What are the extrinsic muscles of the tongue?
Styloglossus, hyoglossus and genioglossus
65
What are the intrinsic muscles of the tongue?
Superior longitudinal, vertical, transverse, inferior and longitudinal (named according to muscle fibre direction)
66
What action do the superior longitudinal fibres of the tongue have?
Pull the sides of the tongue up
67
What is the action of the longitudinal muscles fibres of the tongue?
Pull the sides of the tongue down
68
Why does the tongue deviate towards the side of lesion?
Unopposed push
69
Where should you look for uvula deviation?
At the base
70
What forms Waldeyer's ring?
Adenoid, tubal, palatine and lingual tonsils
71
Where does exudate accumulate in tonsilitis?
Crypts of palatine tonsils
72
Where are the tubal tonsils found?
End of the Eustachian tube
73
Where are the palatine tonsils located?
Between anterior and posterior arches
74
What can cause uvula deviation other than nerve lesion?
Peritonsillar abscess
75
What type of joint is the TMJ?
Modified hinge-type synovial
76
What forms the TMJ?
Mandibular fossa, articular tubercle and head of mandible all covered in fibro cartilage
77
What splits the TMJ joint into two cavities?
Articular disc
78
What lines the 2 cavities of the TMJ?
Superior and inferior synovial membranes
79
What forms the superior cavity of the TMJ?
Temporal bone and upper part of articular disc
80
What forms the inferior cavity of the TMJ?
Mandibular condyle and inferior aspect of articular disc
81
What shapes does the articular disc have?
Upper surface is concavo-convex and lower surface is concave. Thinner centrally than at edge
82
Why is the capsule surrounding the TMJ relatively thin and loose?
Allow for movement
83
What ligaments are found at the TMJ?
Lateral, 2 medial, sphenomandibular and stylomandibular
84
Which ligament of the TMJ is the strongest?
Lateral
85
Describe the structure of the lateral ligament of the TMJ.
Zygoma --> neck and ramus of mandible with deep fibres blending with the joint capsule
86
Describe the structure of the sphenomandibular ligament.
Spine of sphenoid --> lingula
87
How does the sphenomandibular ligament prevent inferior dislocation of the TMJ?
Keeps a constant length and tension at all mandibular positions
88
Describe the structure of the stylomandibular ligament.
Styloid process --> posterior ramus of mandible as an extension of the deep parotid fascia
89
Which two structures does the stylomandibular ligament separate?
Parotid and submandibular glands
90
Does the stylomandibular ligament contribute significantly to the strength of the TMJ?
No
91
What does movement of the TMJ require?
Displacement of the mandible
92
What movements can the TMJ carry out?
Translation (gliding), rotation (pivoting), elevation, depression, retraction and protrusion
93
Which cavity of the TMJ is responsible for translational movement?
Superior cavity
94
Which cavity of the TMJ facilitates rotation of the joint?
Inferior
95
What stabilises the jaw when closed?
Mandibular condyle into mandibular fossa and action of teeth
96
Where does the majority of force pass through during chewing?
Teeth
97
What prevents posterior dislocation of the jaw?
Posterior glenoid tubercle
98
What prevents anterior dislocation of the jaw?
Articular tubercle
99
What prevents inferior dislocation of the jaw?
Spheno- and stylomandibular ligaments
100
What muscles are involved in closing the mouth?
Temporalis acting at the superior cavity and temporalis, masseter and medial pterygoid acting at the inferior cavity
101
What allows protrusion of the mandible?
Lateral pterygoid acting the superior cavity
102
What allows depression of the mandible?
Digastric acting at the inferior cavity
103
Is digastric a prime mover of the mandible?
No
104
What is the infratemporal fossa?
Irregularly shaped space deep and inferior to the zygomatic arch, below middle cranial fossa, deep to the ramus of the mandible and posterior to the maxilla
105
How does the infratemporal fossa communicate with the temporal fossa?
Through interval between zygomatic arch and cranial bones
106
What forms the roof of the infratemporal fossa?
Greater wing of sphenoid
107
What forms the medial border of the infratemporal fossa?
Lateral pterygoid and plate of sphenoid
108
What forms the posterior border of the infratemporal fossa?
Carotid sheath
109
What forms the lateral border of the infratemporal fossa?
Ramus of mandible
110
What forms the floor of the infratemporal fossa?
Medial pterygoid muscle
111
What forms the anterior border of the infratemporal fossa?
Psterior surface of maxilla
112
What are the muscular contents of the infratemporal fossa?
Inferior temporalis, inferior parts of medial and lateral pterygoid
113
What is the venous contents of the infratemporal fossa?
Pterygoid venous plexus, maxillary vein and MMV
114
What are the arterial contents of the infratemporal fossa?
Maxillary artery becoming MMA
115
How does the MMA exit the infratemporal fossa?
Foramen spinosum
116
Which artery runs next to the infratemporal fossa to supply the scalp?
Superficial temporal
117
What are the nerve contents of the infratemporal fossa?
Mandibular nerve and its branches, chorda tympani and parasympathetic fibres from Otic ganglion
118
How does the mandibular nerve exit the infratemporal fossa?
Through foramen ovale
119
What are the branches of the mandibular nerve found in the infratemporal fossa?
Auriculotemporal, buccal, lingual and inferior alveolar
120
Which two fissures are found in the infratemporal fossa?
Inferior orbital and pterygomaxillary
121
What canal is found in the infratemporal fossa?
Alveolar
122
How does a mandibular nerve block give a wide area of regional anaesthesia in the oral region?
Anaesthetic infiltrates mandibular nerve upon entry to the infratemporal fossa causing anaesthesia of its branches
123
How can either side of the mandibular teeth and lower lip be anaesthetised?
Inferior alveolar nerve block where anaesthetic is injected into the mandibular foramen
124
Which branch of the mandibular nerve does the chorda tympani travel with?
Lingual
125
Which branch of the mandibular nerve do the parasympathetic fibres supplying the parotid gland travel in association with?
Auriculotemporal
