Oral and Nasal Cavities Flashcards
What separates the oral cavity from the nasal cavity?
Hard Palate
Nasal Cavity:
- Roof
- Floor
- Medial Wall
Roof:
- Frontal
- Sphenoid
- ETHMOID
Floor:
Hard palate
Medial:
- Nasal Septum
Nasal Cavity:
- Lateral Wall
Lateral:
- Ethmoidal Labyrinth
- Uncinate Process
- Perpendicular Plate (Palatine Bone)
- Pterygoid Process (Sphenoid)
- Lacrimal Bones
- Maxilla
- Inferior Concha
Nasal Cavity:
- Anterior aperture (fleshy, bony)
Bony (single):
- Piriform Aperture
Fleshy (paired):
- Nares
Nasal Cavity:
- Posterior Aperture
Choanae
What does the hard palate forming the floor of the nasal cavity consist of?
- Anterior
- Posterior
Posterior:
- Horizontal Plate (palatine bone)
Anterior:
- Palatine Process (maxilla)
What does the nasal septum forming the medial wall of the nasal cavity consist of?
- Nasal Cartilage
- Vomer
- Perpendicular plate (ethmoid)
What do the conchae on the lateral wall of the nasal cavity divide the space into?
4 meatuses:
- Superior
- Middle
- Inferior
- Common
What gateways are there for nerves are blood vessels to enter the nasal cavities?
- Cribiform Plate
- Sphenopalatine Foramen
- Incisive canal
- Small foramen in lateral wall and around margin of nares
What nerve supplies the special sensory to the nasal cavity?
- Olfactory N. (CN I)
What nerves supply GSA to the nasal cavity?
- Anterior Ethmoid N. (V1)
- Nasopalatine n. (V2)
- Lateral Nasal Branches (V2)
Nasal Cavity GSA:
- Anterior
- Posterior
Anterior:
- Anterior Ethmoid N. (V1)
Posterior:
- Nasopalatine (V2)
- Lateral Nasal Branches (V2)
**Note: this includes the lateral walls of the respective areas
What nerve courses along the long axis of the ethmoid bone to reach the incisive canal?
- Nasopalatine N. (V2)
What artery courses with the Anterior Ethmoid n.?
- Anterior Ethmoid artery
What artery courses with the nasopalatine n.?
- where does it originate?
- Sphenopalatine a. (=> maxillary a. => External Carotid => common carotid)
**This is a terminal Branch of the maxillary artery
What supplies GSA to the mucosa of the pharynx, nasal and oral cavities?
Pharynx:
- Maxillary n. (V2)
- Glossopharyngeal n. (IX)
- Vagus (X)
Nasal and Oral:
- Trigeminal (V)
What are the 2 important cartilages of the external nose?
- Septal and Alar Cartilages
What bones form the piriform APERTURE?
- R and L maxilla Inferiorly and Laterally
- 2 small nasal bones superiorly
What bone forms the medial wall of the orbit and is also a major bone of the nasal cavity?
- Oribital Plate of the Ethmoid Bone
What space lies superior to the nasal cavity?
Anterior Cranial Fossa
What is the destination of nerves and arteries in the pterygopalatine fossa?
- Nasal Cavity
- Roof of the Mouth
What forms the nasal septum:
Anteriorly
Posteriorly
Anteriorly:
-Septal Cartilage
Posteriorly:
- Perpendicular Plate of Ethmoid
- Vomer
How are the vessels of the nasal cavity and the superior sagittal sinus connected?
- a Vein that runs through FORAMEN CECUM
What space is located just inside the nostril in the nasal cavity?
- what lies posterior
- Vestibule
- Conchae lie posterior
T or F: the superior, middle and inferior nasal conchae are all derived from the ethmoid bone
False, the inferior concha is a separate bone
Where is the sphenoethmoidal Recess located?
Above the Superior Concha
What is the function of the mucous and choncha in the nasal cavity?
Mucous:
Filter and Humidify Air
Concha:
Increase SA to aid in WARMING the air
What is the pupose of hairs and mucous in the nasal cavity?
- Remove Particles > 10 µm
What is the purpose of the cilia in the trachea?
To Move Material Up and Out
T or F: there is no mucous in healthy Alveoli?
True
What happens to particles that are
- Phagocytosed by Alveolar Macrophages (DUST CELLS)
Where does most air go during quiet breathing?
- Across Inferior Concha
- Through Middle meatus
When will air be forced up into the olfactory epithelium near the roof of the nasal cavity?
- Strongly Sniffing
Where does the Sphenoid Sinus Drain ?
Sphenoethmoidal Recess (ABOVE the superior Meatus)
Ethmoid Air Cell Drainage?
- Anterior
- Middle
- Posterior
Anterior/Middle:
- Bulla Ethmoidalis (beneath Middle concha)
Posterior:
- Directly into the superior Meatus
Where do the Frontal and Maxillary Sinuses Drain?
- Drainage Route
Frontal:
Frontal Sinus –> Frontonasal Duct –> Hiatus Semilunaris –> Middle Meatus
Maxillary:
Maxillary Sinus –> Hiatus Semilunaris –> Middle Meatus
What forms the Hiatus Semilunaris?
Anteriorly:
Uncinate Process
Posterioly:
Ethmoid Bulla
What is the drainage problem of the maxillary sinus and how is it solved?
- what about when your sick?
- to empty into the middle meatus, it must travel up
Normally:
Cilia beat and carry stuff up and out
Sick:
You blow your nose and use bernoulli’s principle to get stuff out
What does the Nasolacrimal duct drain and where does it empty?
- Drains tears from the surface of the eye
- Empties into Inferior Meatus
What sinuses empty into the Spenoethmoidal Recess, Superior Meatus, Middle Meatus, Inferior Meatus?
Spenoethmoidal Recess:
1. Sphenoid Sinus
Superior Meatus:
1. Posterior Ethmoid Air Cells
Middle Meatus:
- Anterior and Middle Ethmoid Air Cells
- Frontal Sinus
- Maxillary Sinus
Inferior Meatus:
1. Nasolacrimal Duct
T or F: Maxillary Teeth lie beneath the maxillary sinus
True, Severe infections in sinus can cause tooth rotting or visa versa
What opening lies just posterior to the middle concha?
- Bones joining here
Spenopalatine Foramen
- Palatine Bone Meets Sphenoid
What openings lie near the posterior end of the hard palate?
Greater and Lesser Palatine Foramina
- Where verticle and horizontal plates meet
What nerve(s) give(s) off branches that travel through the sphenopalatine foramen, foramin in the lateral wall, and greater and lesser palatine foramina?
- Fiber Type(s)
- Associated Ganglia
Maxillary N. (V2) - GSA fiber to mucosa of the nasal Cavity
- Trigeminal Ganglion
- CN VII has POSTganglionic GVE fibers traveling with maxillary branches
- Pterygopalatine Ganglion
What branches are given off by the maxillary a. has it comes through into the nasal cavity (via sphenopalatine foramen or formamen in the lateral wall)?
- Distribution
Lateral Nasal Branches:
- Disrtibute over Conchae
Greater and Lesser Palatine:
- Go through their respective foramina and distribute in the ROOF of the ORAL CAVITY
What does the nasociliary nerve (V1) innervate?
- Ethmoidal Air Cells
- Sphenoid Sinus
- Lateral Nasal Wall and Septum
Describe the course of the nasopalatine nerve.
Arches over the roof of the nasal cavity and descends on septum toward incisive canal
What does the nasopalatine n. innervate?
- Septum
- Small area of Hard Palate around Incisive Foramen
T or F: Olfactory nn. are present on the septum, Superior Concha, and Sphenoethmoidal Recess
True
Where do olfactory nerves synapse?
In the olfactory bulb
T or F: GSA innervation is supplied to the nasal cavity by CN I and V.
False, CN I provides SA fibers while GSA fibers are provided by CN V
What does the anterior ethmoid n. branch FROM and what nn. does it give rise TO?
Branch FROM:
Nasocilliary n.
Branches of Ant. Ethmoid n.:
- Internal, Extenal, and Lateral nasal branches
What does the Internal Nasal Branch of the Infraorbital n. do?
- Innervates the nasal vestibule
What nerves provide GSA innervation to the nasal Cavity?
Anteriorly:
- Internal, External, Lateral Nasal branches of Antertior Ethmoidal n. => Nasociliary n. => V1
- Internal Nasal Branch of Infraorbital n. => V2
Posteriorly:
- Superior and Inferior Posterior Lateral Nasal nn. => V2
T or F: Sympathetic and Parasympathetic nn. accompany distribution of CN V in the nasal Cavity
True
Explain what nerve have overlapping GSA function in the Nasopharynx.
Glosspharyngeal (IX)
- innervates the posterior aspect of the nasopharynx
Maxillary n. (V2)
- innervates the superior part of the nasopharynx
What 2 arteries anastomose in the incisive foramen?
- Greater Palatine a.
- Sphenopalatine a.
What 3 nerves supply the nasal septum?
- Anterior Ethmoid N.
- Nasopalatine N.
- Olefactory n.
What arteries give rise to the anterior and posterior septal arterial branches?
Anterior:
- Anterior Ethmoidal a.
Posterior:
- Sphenopalatine a.
What two foramen must the sphenopalatine a. pass through before entering the nasal cavity?
- Pterygopalatine Foramen
- Sphenopalatine Foramen
What is Kiesselbach’s Plexus?
- what arteries make it up?
- Point were 90% of Nosebleeds start
Arteries Involved:
- Anterior Ethmoid
- Alar brs., Lateral Nasal
- Sphenopalatine brs.
- Greater Palatine
Where do veins in the anterior superior aspect of the lateral wall drain to?
- all others?
- Through Foramen Cecum to SUPERIOR SAGITTAL SINUS
- Opthalmic Vein to Cavernous sinus
**Others drain to PTERYGOID PLEXUS to DURAL SINUSES
T or F: an infection in ANY area of the nasal cavity could quickly spread to the dural sinuses
True
What forms the hard palate?
- Palatine Processes of the MAXILLA
- Horizonal Plate of the PALATINE bone
What bone do the incisive canals penetrate?
- Maxilla
**Note: these unite in the middle for form the incisive forame
What is conducted through the incisive foramen?
- Nasopalatine n. Branches
- Anastomotic connections between greater palatine and sphenopalatine aa.
What bone do the greater and lesser palatine foramen pass through?
- Palatine
Where does the greater palatine CANAL start and end?
Start:
Pterygopalatine Fossa
End:
- Greater and Lesser Palatine Canals
What is found in the greater and lesser palatine canals?
- Greater/lesser Palatine a. => descending palatine a.
- Veins of same name accompany the aa.
- Greater/lesser palatine n.
What is the function of the lesser palatine n.?
Serves Soft Palate
What innervates the lingual gingiva of the Maxilla?
- Greater Palatine n.
2. nasopalatine n.
What closes off nasal-oral communication during swallowing or sucking?
Soft palate
**Note its Velum normally hangs down across the entrance to the oropharynx
Where do the muculus uvulae, palatopharyngeus, and palatoglossus muscles arise from?
- Posterior Palatine Spine
- Palatine Aponeurosis
T or F: the musculus uvulae can contract shortening the uvula changing the contour of the palate to help close off the nasopharynx.
True
See muscle table for info. on muscles of the palate
See muscle table for info. on muscles of the palate
Where does the vasculature of the palate come from?
- Lesser Palatine
- Ascending Palatine
- Tonsilar Branches of Facial a.
What is the palatine aponeurosis attached to?
Horizontal Plate of Palatine Bone
T or F: the Tendon of the Tensor Veli Palatini Muscle stengthens the palatine aponeurosis.
True
What is the primary support of the nasopharynx?
Pharyngobasilar Fascia
Define the following spaces of the Oral Cavity:
- Vestibule
- Oral Cavity Proper
Vestibule
- narrow area between lips and cheeks and teeth and gums
Oral Cavity Proper:
- Between alveolar arches and teeth
What muscles lie under the skin of the lips and cheek?
Lips:
Orbicularis Oris
Cheeks:
Buccinator
What is the dense fibrous tissue of the gingivae connected to?
- Alveolar Arches of the Maxilla and Mandible
How many teeth are there?
- what part is seen
- which is embedded in bone
- 32 (16 in each jaw)
- Crown is seen
- Root is embedded in bone
What do the following directions mean as they refer to teeth?
- Labial
- Buccal
- Lingual
Labial = anterior Buccal = Lateral Lingual = internal surfaces
Innervation of Lingual Gingiva
- mandibular
- maxillar
Mandibular:
- Lingual n.
Maxillary:
- Greater Palatine
- Nasopalatine nn.
What is the oropharyngeal isthmus?
- Narrowed Space between oral cavity and pharynx
What makes up the tonsilar pillars?
- Palatopharyngeal fold
- Palatoglossal fold
- *This one marks boundary between pharynx and oral cavity
What connects the base of the tongue to the epiglottis?
- what structures lie between?
- Median and Lateral Glossoepiglottic Folds
- Valleculae Lie Between
***note: things can accumulate in valleculae
What lies BETWEEN the palatopharyngeal and palatoglossal folds?
- Palatine Tonsils
Anterior 2/3 of tongue.
- Pharyngeal arch
- GSA
- SA
1st Pharyngeal Arch
GSA:
- Lingual branch of V3 (mandibular division of trigeminal)
SA:
- CN VII fibers that have joined the lingual branch of V3
What is the sulcus terminalis?
- what lies at the midpoint?
Marks the division between the anterior 2/3 of the tongue and the posterior 1/3.
- Foramen secum lies at the midpoint
What duct connected into the foramen cecum during development?
Thyroglossal duct
**Foramen Cecum = where the thyroid began to develope, Thyroglossal duct = how it migrated down
What papillae form the v-shape dividing anterior and posterior parts of the tongue?
Circumvallate / Vallate Papillae (8-12)
Besides circumvallate papillae, what other papillae lie on the anterior 2/3 of the tongue?
- Filliform
- Fungiform
What arches does the posterior 1/3 of the tongue develop from?
- which is dominant
- how do you know
- 2nd, 3rd, 4th arches
- Arch 3 = dominant, indicated by CN IX being the innervation here
What tonsil lies just posterior to the sulcus terminalis?
- Lingual Tonsil
**Often hard to distinguish from lower aspect of palatine tonsil
What parts make up the epiglottic region of the tongue?
- Valleculae
- Median Glossoepiglottic Fold
- Epiglottis
What supplies GSA and SA fibers to the epiglottic region of the tongue?
CN X via INTERNAL branch of SUPERIOR layrngeal n.
HOW DOES CN IX get to the TONGUE?
- Goes around LATERAL edge of stylopharygeus into the Tongue (posterior 1/3)
**Note: it must pass between the superior and middle constictors to do this
What suppies GSA and SA innervation to the posterior 1/3 of the tongue?
- Cell body location
- CN IX
- Cell Bodies = Superior and/or inferior ganglia
T or F: as you proceed past the nasal vestibule, hair stops and the walls are smooth and mucous coated
True
A patient present with swollen uvula and tonsils and is drooling, and is respiratory distress. What should you suspect?
Epiglottitis
***Note: this condition progresses fairly quickly
Why is the threshold for suspicion of epiglottitis low?
Because its fairly common and deadly if undiagnosed
What is the key for suspecting epiglottitis?
Severity of sore throat is out of proportion to the findings
What are some symptoms of epiglottitis?
- Tripod Position
- Anxiety
- Sore Throat
- Stridor
- Drooling
- Dysphagia
- Respiratory Distress