Nasal and Oral Cavities Flashcards
What is the purpose of the nasal cavities?
warm and humidify air breathed in
provide for sense of smell
What are the 3 nasal cavities?
nasal vestibule- flared, hair follicles
respiratory region- largest art with conchae
olfactory region- superior with smell receptors
What are the boundaries of the nasal cavity?
lateral wall
medial wall = nasal septum
Floor- hard palate of oral cavity
Roof
What bones are in the lateral wall of the nasal cavity?
1 Nasal bone (lateral and alar cartilage)
2 maxilla
3 lacrimal bone
4 ethmoid (conchae)
5 inferior nasal concha
6 perpendicular plate of palatine one
7 medial pterygoid plate of sphenoid bone
What is the medial wall of the nasal cavity?
1 perpendicular plate of ethmoid bone
2 vomer
3 septal cartilage
What is the floor of the nasal cavity?
1 anterior 2/3r of maxilla
2. posterior 1/3 of palatine
What is the roof of the nasal cavity?
1 lateral nasal cartialge 2 nasal bone 3 frontal bone 4 cribiform plate of ethmoid bone 5 body of sphenoid bone
What are the 6 openings of the nasal cavity?
- orbit= nasolacrimal duct
- nasopharynx= choanae
- paranasal sinus = meatal openings
- anterior cranial fossa = cribifrorm plate and foramen cecum with olfactory
- trygopalatine fossa = sphenopalatine foramen
- oral cavity = incisive canal (4 front teeth)
What are the 4 paranasal sinuses?
- maxillary sinus = w/in body of maxilla beneath orbit
- ethnonidal sinus = w/in each ethmoid bone
- anterior ethnoidal air cells
- middle ethomidal air cells
- posterior ethmoidal air cells - frontal sinus = within frontal bone, bilaterally
- sphenoidal sinus = within sphenoid bone, separate into right and left halves by midline septum
What are the 4 openings into meati?
- sphenoethmoidal recess- above superior concha for sphenoidal sinus
- superior meatus- beneath superior concha for posterio ethmoidal air cells
- middle meatus- beneath middle concha with hiatus semilunaris and ethnoidak bulla
- inferior meatus- orifice of nasolacrimal duct
What is drains into the haitus semilunaris in the middle meatus?
1 frontal sinus- from frontonasal duct to infundibulum
2 anterior ethmoidal air cells
- maxillary sinus- very close to sinus roof
What drains into the ethmoidal bulla?
middle ethmoidal air cells
What is the blood supply of the lateral wall of the nasal cavity?
1 antiorior and posterior ethmoidal arteries ( branch of ophthalmic a)
2 lateral nasal branches (branch of facial a)
3 sphenopalatine artery (branch of maxillary)
What is the blood supply of the medial (septal) wall?
1 anterior and posterior ethmoidal artery
2 superior lavial artery (branch of facial)
3 sphenopalatine branches (with nasopalatine nerve through incivive canal)
What is the blood supply of kiesselbachs area?
anastomoses between anterior ethmoidal, sphenopalatine, superior labial branches of anteiror septum
What is the most common site for nosebleedsdue to trauma, infection, dry air, or hypertension?
Kiesselbach’s area
What is the nerve supply for the lateral wall of the nasal cavity?
1 Anterior ethmoidal nerve- from V1 sensory
2 branches from pterygopalatine ganglion
- sensory from V2
- parasympathetic (secretomotor) from CN 7 (from greater petrosal)
- sympathetic (vasoconstriction)
- olfacotry nerves
- smell CN1 - nerve of pterygoid canal
- greater petrosal (parasympathetics, CN7)
- deep petrosal (sympathetics, cartoid plexus)
- autonomic innervation to pterygopalatine ganglion) ONLY PARASMPATHICS synpase there
- autonomics innervate nasal and oral mucosa by following maxillary V2 from ganglion to glands
What nerves supply the medial septal wall?
1 Anterior ethmoidal nerve- anterior superior area of septum
2 olfactory nerve- smell, roof of nasal cavity)
3 nasopalatine n - accompanies sphenopalatine artery through incisive canal
What synapses at the pterygopalatine ganglion?
parasympathetics only
What nerve and artery travel together through the incisive canal?
nasopalatine n and sphenopalatine a
What causes a painful tooth ache?
maxillary sinus infection
What does the pterygopalatine ganglion hang off of?
maxillary V2
What is the roof of the pterygopalatine fossa?
foramen rotundum
- connects middle cranial fossa with PPF
- V2 runs through foramen
What is the left lateral wall of the PPF?
pterygomaxillary fissure
- lateral opening where maxillary artery enters from infratemporal fossa
- becomes sphenopalatine atery
What is the medial wall (right) of the PPF?
sphenopalatine foramen
- medial opening between PPF and nasal cavity
- sphenopalatine artery, lateral nasal n, nasopalatine n go through
What is the anterior (front) wall of the PPF?
inferior orbital fissure
- V2 becomes infraorbital nerve
- passes anteriorly from PPF to orbit
What is the posterior wall (behind) of the PPF?
Pterygoid canal
- nerve and artery of pterygoid canal come through
- carry secretomotor and sympathetic fibers
What is the floor of the PPF?
palatine canal
- greater and lesser palatine nn and descending palatine artery come through
- pharyngeal n sensory to nasopharynx
What makes up the nerve of the pterygoid canal?
1 greater pretrosal nerve (after foramen lacerum)
2- deep petrosal nerve
Where does the nerve of the pterygoid canal go?
1 through pterygoid canal
2 pterygopalatine fossa
3 pterygopalatine ganglion (ONLY parasymp fibers synapse)
- post ganglionic paraympsathetic fibers rejoin sympathetic fibers and branch to go to nasal cavity and hard palate of oral cavity
How do parasympathetic and sympathetic fibers affect secretion?
parasympathetic- increase secretion (thin and watery)
sympathetic- increase secretion of viscous mucus
Does maxillary nerve V2 synase at the pterygopalatine ganglion?
NO. ‘‘provides sensory innervation but pass through ganglion without synpasing
Does the deep petrosal sympathetic fibers synmpase at pterygopalatine ganglion?
NO. pass through carrying sympathetics
cause vasoconstrictuion of arteries for nasal mucosa and palate
What synapses at the pterygopalatine ganglion?
Parasympathetic fibers (greater petrosal CN 7)
NOT sympathetic fibers deep petrosal
NOT V2
What makes up the hard palate of the oral cavity?
palatine process of maxilla (ant 2/3)
horizontal plate of palatine bone (post 1/3)
What are the 3 foramen of the hard palate?
1 incisive fossa
- nasopalatine artery and nerve
2 greater palatine foramen (big)
- greater palatine artery and nerve
3 lesser palatine foramen (tiny)
- lesser palatine artery and nerve
What gland is in the hard palate and soft palate?
palatine glands (covered with mucus)
Does the hard palate contain muscles?
No
What nerve innervates all soft palate muscles but 1?
pharyngeal plexus via vagus X
EXCEPT tensor veli palatini (V3)
What is the only exception to vagus innervation in soft palate?
tensor vali palatini = V3
Tensor veli palatini
innervation - V3
function: tenses soft palate, prevents flipping upwards during swallowing
Levator veli palatini
Innervation: X
function: prime mover of palate (elevation)
Musculus uvulae
innervation: X
function: forms uvulae, shorten uvula
Palatoglosus
Innervation: X
Only glossus not 12
function: Forms palatoglossal arch, moves tongue and depresses arch
Palatopharyngeus
innervation: X
function: Forms palatopharyngeal arch, raises pharynx and depresses arch
What happens if there is a lesion to X in the soft palate?
roof of mouth should lift evenly
if pull up on one side, uvula will point AWAY from side with lesion
Which muscles originate above the soft palate?
Tensor veli palatini
levator veli palatini
Which muscles insert below the the soft palate?
Musculus uvulae
palatopharyngeus
How is food prevented from going up nose?
levators lift and tensors tighten
Why is the pterygoid hamulus significant?
tendon of tensor veli palatini muscle starts laterally and hooks around hamulus to tighten palate
What muscle helps equilize pressure in ears?
levator veli palatini
more posterior push on ends of eustacian tube when swallowing
forces open- equalize pressure in middle ear
Which muscle lifts the pharynx to narrow the tube to make sure food goes down?
palatopharyngeous
What is the blood supply to the hard palate>
greater palatine artery
-branch of descending palatine artery
enter through greater palatine foramen and anastomoses with septal artery after greater palatine artery passes through incisive cnal
What is the blood supply of the soft palate?
Lesser palatine artery
- enter throgh lesser palatine foramen
- ascending palatine artery (branch of facial)
What is the blood supply to upper dentition molars ?
posterior superior alveolar artery
- branch of V2
- anastomose with infraorvital artery branches
What is the blood supply to upper dentition premolars, incisors + canines?
middle and anterior superior alveolar arteries
-branches of infraorbital
middle = premolar anterior = canine and incisors
What nerve supplies the hard palate?
all nerve branches pass through PPG
- sensory fibers from V2
- post gang para from CN7
- post gang symp from superior cervical
What sensory nerves supply the hard palate>
- greater palatine
- greater palatine foramen - nasopalatine
- incisive canal
What nerves innervate the soft palate?
lesser palatine
-via lesser palatine foramen
pass through PPG so also has
- sensory fibers from V2
- post gang para from CN7
- post gang symp from superior cervical
also some glossopharyngeal IX
What nerve provides the sensory arc of the gag reflex?
glossopharyngeal IX
What nerve supplies the upper teeth?
maxillary V2
How is the tongue divided?
Ant 2/3 = oral part
post 1/3 = pharyngeal part
separated by V shaped groove = sulcus terminalis
Where is the lingual tonsil?
pharyngeal part of tonue
What is the foramen cecum?
deep depression at apex of sulcus terminalis separating oral and pharyngeal aspect of tongue
reminant of thyroid empbrylogical development
What are the three folds of the tongue that attch it to the epiglottis?
2 lateral glossoepiglottic folds
1 median glossoepliglotti fold
What is the vallecula?
depression between lateral and median glossoepiglottic folds
where food slides to push down epiglottis
What innervates the intrinsic muslces of the tongue?
hypoglossal XII
change shape of tongue
all WITHIN tongue
1 vertical- flatten and broaden
2 transverse- narrows and increase height
3 superior longitudinal- curls apex up, pushes toward palate, turns protruded apex up to nose
4 inferior longitudinal- curls apex inferiorly (retract)
What is the lingual artery always deep to?
hyoglossus muscle
Why cant you swallow your tongue>
attached to geniotubricle
What happens the genioglossus is broken?
side working will point to lesioned side when stick out tongue
What are the extrinsic muscles of the tongue?
1 genioglossus
2 hyoglossus
3 styloglossus
4 palatoglossus
Genioglossus
XII
raises floor of oral cavity
pulls tongue forward (protrude)
wag
fan out
attached to genial tubrical on mandible
Hyoglossus
XII
depresses and retracts tongue; tilts unilaterally
broad flat sheet- roll tongue- lingual atery
styloglossus
XII
retracts tongue, pulls posteriorly and superiorurly (swallowing)
last swallow step
Palatoglossus
X
narrows oropharynx during swallowing
“constricts isthmus of fauces”
What 5 structures are on the inferior surface of the tongue?
1 lingual frenulum
-midline attach of tongue to floor of oral cavity
- fimbriated folds
- serpentine folds lateral to lingual frenulum
3 sublingual folds
-floor of oral cavity with glands and duct
- sublingual papilla
- elevation on side of lingual frenulum opening of submandibular ducts
5 root of tongue
-back of tongue with arteries and veins enter and leave
Where do you measure temperature>
Sublingual vein and artery
Where is 70% of secretion?
submanidbular gland through submandicular coruncle (1 on either side)
fluid under tongue
Where does the submandibular duct run?
start deep surface of gland
forward between mylohyoid, myoglossus, genioglossus
between sublingual gland and genioglossus
open at sublingual caruncle next to frenulu,
Where does lingual nerve CN7 go?
wraps around submandibular duct
starts lateral and goes medial under duct to more medial
sensory to ant 2/3 tongue
carries taste fibers from chorda tympani CN&
Where do hypoglossal nerve go?
inerfior to lingual nerve
What supplies blood to the tongue>
Lingual artery
branch of external carotid
comes off more posterior superficial to hyoglossus (behind)
What are the 3 major branches of lingual artery?
dorsal lingual artery- posterior dorsum of tongue
deep lingual artery - ant portion tongue
sublingual - sublingual salivary gland
What is the venous drainage of the tongue?
lingual veins
common facial vein
internal juglar vein
What structures run lateral to hyoglossus muscle?
lingual nerve
hypoglossal n
submandibular duct
What structure runs medial to hyoglossus msucle>
lingual artery
What supplies motor innervation to the tongue?
All hypoglossal XII
except palatoglossus X
What supplies sensory to ant 2/3 tongue?
General sensory: lingual V3
Taste: chorda tympany CN 7
What supplies sensory to post 2/3 tongue?
General and taste: glossalpharyngeal IX
What supplies taste to the base of the tongue?
X vagus
What innervates submandibular and sublingual glands?
motor CN7 chorda tympany
synapses in submandibular ganglion
post gang continue in lingual nerve
symp post gang fro superior cervical gang travel with lingual artery
How is parotid gland innervated?
GLOOAP
Glossopharyngeal nerve via Lesser petrosal neve through foramen ovale synapses at Otic ganglion post gang follow Auriculotemporal nerve into parotid
Sympathetic innervation of parotid gland?
symp post gang originate in superior cervical gang
travel with maxillary and superficial temporal artery to partotid
