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Head N Neck > Lecture 14 - Oral Cavity And Pharynx > Flashcards

Lecture 14 - Oral Cavity And Pharynx Flashcards

1
Q

How many teeth does a normal adult have?

A

32

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2
Q

What are the teeth each quadrant of the oral cavity contains?

A

Medial incisor
Lateral incisor
Canine
2 pre molars
3 molars with last one being the wisdom tooth

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3
Q

What is the vestibule?

A

Space between the lips/cheeks and gums/teeth

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4
Q

What are the roof, floor, posterior and the cheek boundaries of the oral cavity proper?

A

Roof = hard palate (anterior) then soft palate (posterior)

Floor = mylohyoid muscles, geniohyoid muscles, tongue, salivary glands + ducts

Cheek = Buccinator muscle

Posterior = uvula, palatine tonsil, roof of tongue and lingual tonsils

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5
Q

What arch forms part of teh posterior boundary of the oral cavity proper?

A

Palatoglossal arch

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6
Q

What is the arch found in the pharynx called?

A

Palatopharyngeal arch

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7
Q

What is the relative position of the Palatoglossal arch compared to the palatopharyngeal arch?

A

Palatoglossal arch anterior to the palatopharyngeal arch

Palatopharyngeal arch posterior

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8
Q

How many intrinsic muscles of the tongue are there?

A

4 pairs of intrinsic tongue muscles

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9
Q

What are the 4 pairs of intrinsic tongue muscles innervated by?

A

Hypoglossal nerve (XII)

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10
Q

What are the 4 extrinsic tongue muscles?

A

Genioglossus
Hyoglossus
Styloglossus
Palatoglossus

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11
Q

What is the main innervation to all the extrinsic tongue muscles?

A

Hypoglossal nerve (XII)

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12
Q

What is the extrinsic tongue muscle that is not innervated by the Hypoglossal nerve (XII)?

What is it innervated by?

A

Palatoglossus

Vagus nerve (X)

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13
Q

What are all of the extrinsic tongue muscles?

What are all their innervation?

A

Genioglossus = Hypoglossal (XII)

Hyoglossus = Hypoglossal (XII)

Styloglossus = Hypoglossal (XII)

Palatoglossus = Vagus (X)

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14
Q

Where does Genioglossus originate from?

A

Chin
Genio means chin
Inserts tongue

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15
Q

Where does the Styloglossus originate from?

A

Styloid process

Inserts on tongue

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16
Q

Where des Palatoglossus originated from?

A

Either side of palate

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17
Q

What nerve supplies sensation to the anterior 2/3 of the tongue?

What nerve supplies taste to the anterior 2/3 of the tongue?

A

Sensory = Trigeminal (Vc lingual branch of mandibular division)

Taste = Facial (VII Chorda tympani branch)

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18
Q

What nerve supplies sensation to the posterior 1/3 of the tongue?

What nerve supplies taste to the posterior 1/3 of the tongue?

A

Sensation and taste both from the GLOSSOPHARYNGEAL (IX)

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19
Q

Go to last slide and label the extrinsic tongue muscles on image 1:

A

Blue = genioglossus
Green = Hyoglossus
Purple = Styloglossus

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20
Q

Go to last slide and label the extrinsic tongue muscles on image 2:

A

1 = Styloglossus
2 = Hyoglossus
3 = genioglossus
4 = palatoglossus

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21
Q

What are the 3 different salivary glands?

A

Submandibular glands
Parotid glands
Sublingual glands

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22
Q

Which salivary gland are stones most likely to form in?

A

Submandibular salivary glands

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23
Q

What are the ducts called which allow the submandibular salivary glands to secrete saliva into the oral cavity?

A

Whartons duct

Remember South West (SW)
Submandibular Wharton’s ducts

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24
Q

Where are Whartons ducts located?

A

Base of lingual frenulum (under tongue)

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25
Q

What part of the neck is the submandibular salivary gland located in?

A

Submandibular triangle which is made by the digastric muscle

(In the anterior neck triangle)

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26
Q

Go to the last slide and label image 3:

A

1 = anterior belly of digastric muscle

2= posterior belly of digastric muscle

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27
Q

Go to the last slide and label image 4:

A

1 = parotid gland
2 = submandibular
3 = sublingual

Salivary glands

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28
Q

Go to the last slide and label image 5:

A

1 = whartons duct

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29
Q

What duct does the parotid gland secrete into the oral cavity proper through?

A

Stensen duct

Think PS (Parotid drains through Stensen duct)

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30
Q

How does the Stensen duct from the parotid gland travel?

A

Passes through masseter
Pierces the Buccinator
Opens near upper 2nd molar

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31
Q

Go to the last slide and label the image 6:

A

Yellow = parotid gland + Stensen duct
Blue = Sternocleidomastoid
Red = masseter
Green = Buccinator

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32
Q

How do the sublingual slaivary glands drain into the oral cavity?

A

Via minor sublingual ducts

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33
Q

What is sialolithiasis?

A

Salivary gland stones/calculi

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34
Q

Why do the majority of salivary gland stones/calculi form in the submandibular glands?

A

Conc of Ca2+ in the saliva here the highest

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35
Q

What are the symptoms of Sialolithiasis?

A

Pain in gland
Swelling
Infection

All stimulated by eating

36
Q

How is Sialolithiasis diagnosed?

A

History
X-ray
Sialogram (radioopaque dye injected)

37
Q

What is tonsillitis?

A

Inflammation of the palatine tonsils

38
Q

Where do the palatine tonsils lie?

A

Between the 2 arches

Between the Palatoglossal and the Palatopharyngeal arches

39
Q

What are some signs/symptoms of tonsillitis?

A

Fever
Sore throat
Painful/difficulty swallowing
Cervical lymphadenopathy
Bad breath

40
Q

What is the most common cause of tonsillitis?

A

Viral

41
Q

What is the normal causative organism if a tonsillitis is a bacterial cause?
((Normally viral)

A

Beta haemolytic strep pyogenes

42
Q

What is the uvula and extension of?

A

Soft palate

43
Q

What can you see on examination of the oral cavity to indicate tonsillitis?

A

Uvula unaffected

Swollen palatine tonsils often with exudate

44
Q

What often causes peritonsilar abcesses?

A

Tonsillitis

45
Q

What is an alternate name for a peritonsillar abcesses?

A

Quinsy

46
Q

How does a peritonsillar abscess present?

A

Sevre throat pain
Fever
Bad breath
Drooling
Difficulty opening mouth

47
Q

What usually happens to the uvula in a peritonsilar abcesses?

A

Uvula deviates

48
Q

Where does the pharynx exist?

A

Behind the 3 other cavities

49
Q

What are the 3 pharyngeal cavities?

A

Nasopharynx
Oropharynx
Laryngopharynx

50
Q

What are the borders of the nasopharynx?

A

Anterior = nasal cavity
Posterior = C1 and C2 vertebra
Roof = base of skull + soft palate

51
Q

What are the contents of the nasopharynx?

A

Pharyngeal/adenoid tonsils
Opening of the Eustachian/pharyngotympanic tube

52
Q

What issues can enlarged pharyngeal/adenoid tonsils cause? (Nasopharynx)

A

Block Eustachian tube causing recurrent/persistent middle ear infections
Snoring/sleep apnoea
Sleeping with mouth open
Chronic sinusitis
Nasal tone to voice

53
Q

What are the boundaries of the oropharynx?

A

Anterior = oral cavity
Posterior = C2 and C3 vertebrae

54
Q

What are the contents of the oropharynx?

A

Palatine tonsils

55
Q

What structures are the palatine tonsils located between?

A

Palatoglossal and Palatopharyngeal arches

56
Q

Go to slide 7 and label the image:

A

1 = Palatoglossal arch
2 = palatopharyngeal arch
3 = enlarged uvula
4 = tonsilar (palatine) hypertrophy

57
Q

What are the boundaries of the Laryngopharynx?

A

Anterior = larynx ( from epiglottis to cricoid cartilage)
Posterior = C4,C5 and C6 vertebra

The Laryngopharynx is continous with the oesophagus

58
Q

What does the Laryngopharynx contain?

A

Piriform fossae

59
Q

What are the piriform fossae in the Laryngopharynx?

A

Holes that funnel food and water into the oesophagus when the epiglottis has closed of the trachea

60
Q

What are the 2 types of muscles in the pharynx?

A

3 outer longitudinal muscles
3 inner circular muscles

61
Q

What are the 3 longitudinal muscles of the laryngopharynx?

A

Stylopharyngeus
Palatopharyngeus
Salpingopharyngeus

62
Q

What is the function of the 3 longitudinal pharyngeal muscles?

What are the 3 longitudinal muscles?

A

Elevate pharynx and larynx during swallowing

Stylopharyngeus
Palatopharygeus
Salpingopharyngeus

63
Q

Where do all of the longitudinal pharyngeal muscles insert?
(Stylopharyngeus, palatopharyngeus and Salpingopharyngeus)

A

Posterior aspect of thyroid cartilage

64
Q

What is the innervation of the 3 longitudinal muscles of the pharynx?

A

All vagus (X) except Stylopharyngeus = Glossopharyngeal (IX)

Stylopharyngeus = Glossopharyngeal (IX)
Palatopharyngeus = Vagus (X)
Salpingopharyngeus = Vagus (X)

65
Q

What are the origins of all the 3 outer longitudinal muscles?

A

Stylopharyngeus = Styloid process of temporal bone
Palatopharyngeus = hard palate
Salpingopharyngeus = from opening of Eustachian tube

66
Q

What are the 3 inner circular pharyngeal muscles?

A

Superior pharyngeal constrictor
Middle pharyngeal constrictor
Inferior pharyngeal constrictor

67
Q

What is the function of the 3 circular muscles of the pharynx/pharyngeal constrictors?

A

Constrict walls of the pharynx when swallowing

68
Q

What is the origin of the superior pharyngeal constrictor?

A

Pterygomandibular raphe which is in the mouth

69
Q

What is the origin of the middle pharyngeal constrictor?

A

Hyoid bone

70
Q

What is the origin of the inferior pharyngeal constrictor?

A

Has 2 parts to it

Thyropharngeal = thyroid cartilage

Cricopharyngeal = cricoid cartilage

71
Q

What is the clinical significance of the inferior pharyngeal constrictor?

A

It has 2 parts to it, the thyropharyngeal part and the cricopharyngeal part

Between these is a point of weakness where herniation can occur called a pharyngeal pouch

72
Q

What is the innervation to all of the pharyngeal constrictors?

A

Vagus nerve (X)

73
Q

Go to the last slide and label image 8:

A

1 = superior constrictor
2 = middle constrictor
3 = inferior constrictor
4 = oesophagus

74
Q

Where does a pharyngeal pouch/ posteromedial (false) diverticulum form?

A

Weakness between the 2 parts f the inferior constrictor

75
Q

What are the symptoms of a pharyngeal pouch/posteromedial false diverticulum?

A

Bad breath
Regurgitation of food
Choking on fluids
Difficulty swallowing

76
Q

What usually causes the pharyngeal pouch?

A

Failure of the upper oesophageal sphincter to relax or abnormal timing of swallowing

So anything increasing the pressure in the Laryngopharynx

77
Q

What are the 3 phases of swallowing ?

A

Oral
Pharyngeal
Oesophageal

78
Q

What happens in stage 1 oral phase of swallowing?

A

Bolus made
Bolus compressed against plate and pushed into oropharynx by tongue and soft palate

79
Q

What happens in stage 2 pharyngeal phase of swallowing?

A

Tongue positioned against hard palate
Soft plate elevated sealing off nasopharynx
Longitudinal muscles shorten
Pharynx widens and shortens
Larynx elevates a sealed of by vocal cords
Epiglottis closes over larynx
UOS relaxes

80
Q

What happens in stage 3 oesophageal phase of swallowing?

A

Upper striated muscle of oesophagus and Lower smooth muscle contract

81
Q

How does the type of Dysphagia in stroke patients and patients with a mass in their oesophagus present differently?

A

Stroke = hard to swallow liquids (poor coordination)

Mass = solids harder to swallow

82
Q

What are some common symptoms of Dysphagia?

A

Coughing and choking
Sialorrhoea
Recurrent pneumonia
Chang invoice/speech
Nasal regurgitation (soft palate not raising)

83
Q

What is affected if Glossopharyngeal and vagus nerve damage occurs?

A

Absent gag
Uvula deviated away from the lesion (supposed to be central, healthy side lifts up but non healthy doesnt)

Dysphagia
Loss of toast on posterior tongue

84
Q

What can damage cranial nerves IX and X?

A

Medullary infarct
Jugular foramen issue

85
Q

What can happen with a Hypoglossal nerve (XII) damage?

A

Wasted tongue

Lick your wounds, tongue deviates to damaged side, since other muscle is functional

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