Nasal and Oral Cavity Flashcards
what separates the nasal cavity from the anterior cranial fossa?
the perforated cribriform plate of the ethmoid bone
lateral to the upper half of the nasal cavity
ethmoidal air sinus and lateral to that is the MEDIAL wall of the orbit
lateral to the lower half of the nasal cavity
maxillary air sinus
below floor of nasal? what separates it
oral cavity and the hard palate forms a common partition separating the oral cavity from the nasal cavity below - they share an inferior and superior border
what is the nasal cavity continuous with posteriorly?
pharynx - nasopharynx
bones that make up the roof of the nasal cavity
cartilages - see better in anterior view
nasal bones
nasal spine of frontal bone
cribriform plate of the ethmoid bone
anterior and inferior aspects of the body of the sphenoid bone
bones making up floor of nasal cavity
palatine process of the maxilla
horizontal plates of palatine bone
bones making up the medial wall of the nasal cavity
formed by the nasal septum components of the nasal septum are: septal cartilage perpendicular (vertical) plate of ethmoid bone vomer
bones making up the lateral wall of the nasal cavity
maxilla
ethmoid bone - which provides the superio and middle conchae
inferior conchae
palatine bone
ethmoid bone contribution to the conchae
superior and middle conchae
T/F the inferior concha is its own bone
TRUE - the superior and middle are formed by the ethmoid bone
nasal conchae - general
superior middle and inferior and they divide the nasal cavity into four passages
four passages in the nasal cavity
sphenoethmoidal recess
superior meatus
middle meatus
inferior meatus
what is the lateral wall of the nasal cavity covered with?
with respiratory epithelium
drainage in the nasal cavity - GENERAL
secretions from the orbit and paranasal sinuses drain into the nasal cavity through openings in the lateral wall
tears produced by the lacrimal glands?
removed from the orbit by the nasolacrimal apparatus - the NASOLACRIMAL DUCT drain to the INFERIOR MEATUS
inferior meatus receives drainage from?
nasolacrimal duct - tears produced drain
hiatus semilunaris
curved depression found in the middle meatus - DRAINS the anterior ethmoidal sinus, frontal sinuses, and the maxillary sinus
bulla ethmoidalis
swelling on the superior border of the haitus semilunaris
DRAINS the middle ethmoidal sinuses
superior meatus drains?
posterior ethmoidal sinuses drain into the superior meatus
spenoethmoidal recess drains?
spenoid sinus
NG tube clinical correlation
since the nasal cavity is continuous posteriorly with the nasopharynx - it is ultimately connected to the esophagus and thus stomach - so passing a nasogastic tube from the nasal cavity to the stomach is a common procedure to provide nutrients to a pateint that is a critical condition
path that you should put an NG tube in
from the nasal cavity you want to go STRIAGHT BACK HORZONTALLY to reach the nasopharynx but want to stay MEDIAL in the nose - to avoid the less smooth lateral walls of the nasal cavities that have the conchae
ALONG FLOOR OF NOSE AND ADVANCE PARALLEL TO NASAL FLOOR –> nasopharynx will be met –>
complicatoins of an NG tube placement
perforation of the esophagus
misplacement in the airway (tracheobronchial placement)
cranial displacement - due to a potential fracture in the ethmoid bone of the skull - can go through the cribriform plate and into cranial cavity
paranasal sinuses - GENERAL
air filled extensions of the respiratory part of the nasal cavity into the following cranial bones
paranasal sinuses reach what bones
frontal, ethmoid, sphenoid, and maxilla
where do all paranasal sinuses drain to?
to the nasal cavity through openings on the LATERAL NASAL WALL
frontal sinuses location
are between the outer and inner tables of the frontal bone, posterior to the superciliary arches and the root of the nose
frontal nasal sinus drainage
each sinus drains through a frontonasal duct and into the semilunar hiatus of the middle nasal meatus
What does the frontonasal duct open up to?
semilunar hiatus of the middle nasal meatus
ethmoidal air cells
aka ethmoidal sinuses- but are small invaginations of the middle and superior nasal meatus into the ethmoid bone between the nasal cavity and the orbit
anterior ethmoidal cells drainage
into the middle nasal meatus through the frontonasal duct
middle ethmoidal cells drain…
into the middle nasal meatus where they FORM THE ETHMOIDAL BULLA
ethmoidal bulla describe
formed by a swelling of the middle ethmoidal cells when they drain into the middle meatus
it is a swelling on the superior border of the semilunar hiatus
posterior ethmoidal cells drain
open directly into the superior meatus
maxillary sinuses - general description and where they communicate
are the largest of the paranasal sinuses and they occupy the bodies of the maxillae and communicate with the middle nasal meatus
medial wall of maxillary sinus
INFERIOR PART of the lateral wall of the nasal cavity
roof of maxillary sinus..
formed by the FLOOR of the orbit
floor of maxillary sinus
formed by the alveolar part of the maxilla of the oral cavity
each maillary sinus drains..
each sinus drains by one or more openings, the maxillary ostium which open into the middle nasal meatus of the nasal cavity VIA the semilunar hiatus
maxillary ostium
each maxillary sinus drains by one or more openings termed this and go into the middle nasal meatus via the semilunar hiatus
three spaces adjacent to each maxillary sinus
nasal cavity (inferior wall) orbit (roof) oral cavity (floor)
clinical correlation regarding the maxillary sinus
displaced root fragment
for example - a palatal root tip was displaced and went into the maxillary sinus as the FLOOR of the the maxillary sinus is formed by the alveolar process of the maxilla of the oral cavity
the roots of maxillary teeth - more so the first two molars, often produce conical elevations in the floor of the sinus
vestibule
space between teeth and mucosal lining of the lips and cheeks (labial and buccal mucosa)
oral cavity proper
space between upper and lower dental arches
occupied by the tongue
position of drainage of the maxillary sinus
the drainage spot is in the superior region of the sinus - which makes it difficult for some drainage
lips are controlled by?
controlled by muscles of facial expression which are innervated by the facial nerve - cranial nerve VII
cheeks are controlled by? important in dental carries prevention?
buccinator muscle
- helps keep food between the occlusal surfaces of the teeth
does the biccinator pass deep to the mandible?
yes - passes deep to the mandible so more associated with the buccal mucosa than the skin of the face
attachments of buccinator and innervation
laterally to the alveolar process of the maxillae and mandible, opposite the molar teeth and to the pterygomandibular raphe - a tendinous thickening of the buccopharyngeal fascia (deep fascia of the neck)
innervated by the buccal branch of the facial nerve
active in smiling and keeping teeth taut - so keeping the food between the occlusal planes while chewing - preventing pocketing of the food
mobius syndrome
decreased development of CN 6 and 7 - thus this has dental implications as well - cn 7 is facail expression and innervates buccinator which helps keep food in right position during eating
- more sever tooth decay due to asymmetry of facial expresision
parotid gland
pierces buccinator muscle and enters the oral cavity opposite the crown of the second molar
air or infection in parotid gland?
occuring via route of the parotid duct
swelling on the left cheek ( or right)
palate - general
forms roof of oral cavity proper and floor of nasal cavity
has two distinct parts 1- hard palate 2- soft palate
hard palate formed by and functions as?
formed from 2 bones of the skull
horizontal plate of the palatine bone and palatine process of maxilla
functions as rigid surface for food during chewing
3 pairs of foramina present
3 pairs of foramina present on the hard palate
greater palatine foramen
lesser palatine foramen
incisive fossa
greater palatine foramen
lateral posterior aspect of the hard palate and transmits the greater palatine nerve and arteries
lesser palatine foramen
posterior to the greater paaltine foramen and transmits the lesser palatine nerve and arteries
incisive fossa
behind/posterior to the central incisors and transmits the nasopalatine nerves and sphenopalatine vessels
soft palate - general function
rises as a reflex to close off nasopharynx during swallowing
what are the sides of the soft palate attached to
sides are attached to pharyngeal walls
soft palate composed of what muscles
1 - levator veli palatini 2- tensor veli palatini 3- palatoglossus 4- palatopharyngeus 5- musculus uvulae
levator veli palatini
location /origin insertion and function
originates from the temporal bone and inserts into the paltine aponeurosis
functions to elevates the soft palate
palatine aponeurosis
interacting tendons of the soft palate - tendons of the tensor veli palatini muscles in the anterior two thirds of the soft palate
attached to the posterior border of the hard palate is a thin, firm fibrous lamella called the palatine aponeurosis which supports the muscles and gives strength to the soft palate
tensor veli palatini
location /origin insertion and function
Orginiates from the scaphoid fossa on the sphenoid bone, and the auditory tube and inserts into the palatine aponeurosis
acts to flatten and tense the soft palate
palatoglossus
originates / inserts
function
originates in the soft palate and inserts onto the lateral surface of the intrinsic muscles of the tongue
elevates the posterior 1/3 of the tongue and with its counterpart on other side
palatopharyngeus
arises from the soft palate and palatine aponeuorosis and inserts into the thyroid cartilage and the pharynx
functions to elevate the pharynx and larynx
musculus uvulae
originates on the palatine bone and from the palatine aponeurosis
acts to retract and elevate the uvula
list tonsils and give general description
aggregates of lymphoid tissue
palatine, pharyngeal, lingual
palatine tonsils
bilater, located at the boundary of oral cavity and pharynx - between the palatoglossus and the pharyngealglossus
pharyngeal tonsils
single, roof of the nasopharynx
lingual tonsils
dorsal surface of posterior tongue
surfaces of tongue
dorsal and ventral (sublingual) surface
functions of the tongue
mastication taste deglutition (swallowing) articulation (speech) oral cleansing
tongue is composed of?
intrinsic and extrinsic muscles
sulcus terminalis
V- shaped groove that divides anterior 2/3 of tongue from the posterior 1/3 of the tongue
- due to the developmental process of the tongue and we see this clinically
circumvallate papillae
8-10 rows of structures containing taste buds - more posterior
region of the sulcus terminalis
filiform and fungiform papillae
projections on the surface of the tongue
fungiform papillae contains taste buds
lingual frenulum
on sublingual surface of the tongue – which is a midline mucous membrane running from the lingual gingiva behind the mandibular central incisors posteriorly to the undersurface of the tongue
sublingual papilla
located on either side of the frenulum and is the opening of the duct of the submandibular gland
function of extrinsic tongue muscles - general
move tongue around -
function of instrinsic tongue muscles - general
change shape of tongue itself
genioglossus
attachments
action
innervation
extrinsic muscle of tongue
attachments - from mental spine and has superior middle and inferior portions
superior - into the tip of the tongue
middle - into the dorsum of the tongue
inferior- to the tip of the hyoid bone
action - depress and protrude the tongue
innervation - hypoglossus nerve CN XII
hyoglossus
attachments
action
innervation
extrinsic muscle of the tongue
attachments - from the upper surface of greater horn and lesser horn of hyoid bone to the lateral aspect of the tongue
action - depresses and retracts tongue
innervation - hypoglossal nerve
styloglossus
attachments
action
innervation
extrinsic muscle of the tongue
attachments - from the anterior part of the styloid process to the lateral aspect of the tongue
action - retracts the tongue
innervation - hypoglossal nerve
palatoglossus
attachments
action
innervation
extrinsic muscle of the tongue
attachments -
action - elevates posterior part of the tongue
innervation - PHARYNGEAL PLEXUS from CN X
intrinsic muscles of the tongue
superior longitudinal
inferior longitudinal
transver
vertical
all innervated by CN XII- hypoglossal
changing SHAPE OF THE TONGUE
blood supply to the tongue and floor of the mouth
LINGUAL ARTERY AND BRANCHES
- lingual artery is a branch of the external carotid artery
branches of the lingual artery in the oral cavity
dorsal lingual artery
deep lingual artery
sublingual brnach
dorsal lingual artery
from the lingual artery and provides blood supply to the root of the tongue
- it also sends a branch to the palatine tonsil - MORE POSTERIOR PART
deep lingual artery
branch of the lingual artery and supplies the body of the tongue - more ANTERIOR PART
sublingual branch of lingual artery
from lingual artery and provides the blood supply to the floor of the mouth, including the sublingual gland
venous drainage of the tongue
tongue is drained by two lingual veins that accompany the lingual arteries and receive the dorsal lingual veins
deep lingual vein
runs posteriorly under the mucuos membrane of the underside of the tongue at the side of the lingual frenulum (where it can be observed through the mucosa)
where does all of the venous drainage from the tongue eventually end up?
to the internal jugular vein
what does the deep lingual vein drain into?
the sublingual vein
what does the sublingual vein receive?
dorsal vein
lymphatic drainage of posterior 1/3 of the tongue
jugulo-digastric and retropharyngeal –> jugulo-omohyoid group
anterior 2/3 of the tongue lymphatic drainage - general
the tip, the side of the tongue, and the central part of the tongue drain into respective areas
tip of the tongue lymphatic drainage
into submental group
side of the tongue lymphatic drainage
submandibular group
central part of the tongue lymphatic drainage
jugulo-omohyoid group
floor of oral cavity is formed mainly by?
muscular diaphragm which fills the U-shaped gap between the sides of the body of the mandible - which is composed of paired mylohyoid muscles
mylohyoid
paired muscles on floor of oral cavity
attachments: mylohyoid line of mandible to median raphe of the hyoid bone
innervation is nerve to mylohyoid which is a branch of he inferior alveolar nerve (from a branch of V3)
submandibular gland
duct passes between the mylohyoid, hyoglossus, and genioglossus
opens lateral to lingual freneulum with the lingual papillae
DOES NOT OPEN UP TO SMALL ORIFICES ON THE FLOOR OF THE ORAL CAVITY
sublingual gland
ducts open into oral cavity or may connect with the submandibular duct
- opens up into small orifices on the floor of the oral cavity
location of the lingual nerve in the oral cavity
emerges between the medial and lateral pterygoid muscles and is joined by the chorda tympani
continues anteriorly and downward, entering the floor of the mouth jsut MEDIAL to the root of the mandibular third molar
on the floor - the lingual nerve curves downward and then loops upward on the exterior and superior surface of the hyoglossus muscle - it will end more superiorly by supplying branches to the dorsum of the anterior 2/3 of the tongue
relationship between lingual nerve and submandibular duct in the floor of the mouth
LINGUAL NERVE WILL CROSS OVER THE DUCT - lingual nerve will take a more superior root over the submandibular duct
hypoglossal nerve route
CN XII
leaves teh skull through the hypoglossal canal and descends almost vertically in the neck to a level just below the angle of the mandible
angles forward and CROSSES the external carotid artery
continues forward and crosses the lingual artery to reach the hyoglossus muscle
hypoglossus nerve travels on the external surface of the hyoglossus muscle and deep to the mylohyoid muscle to reach the tongue
the hypoglossal nerve will travel under or over the external carotid artery?
OVER - it CROSSES THE EXTERNAL CAROTID ARTERY
general sensation of anterior 2/3 of the tongue?
via lingual nerve of cranial nerve 5 - which is a branch of V3 - mandibular
taste to the anterior 2/3 of the tongue
from fibers of Cn VII - chorda tympani that merge with CN V - the lingual nerve in the infratempporal fosaa
Taste to popsterior 1/3 of the tongue
cranial nerve IX
- glossopharyngeal
general sensation to the posterior 1/3 of the tongue
cranial nerve IX- glossopharyngeal
CN X contribution to SA fibers of tongue
Cn X - via internal laryngeal nerve carreis taste info from the epiglottis and the vallecula
CN X contribution to sensory of tongue
CN X - via internal laryngeal nerve
these are GVA fibers
- mucosa of the larynx to the level of the vocal folds, vellecula, epiglottis and priform recess
