Oral and Nasal Cavities and Pterygopalatine Fossa Flashcards
Differentiate locations of hard vs. soft palate
Hard palate: anterior 2/3 of palate; hard and bony
Soft palate: posterior 1/3 of palate; soft and muscular (primarily skeletal m.)
Extending inferiorly from the posterior part of the soft palate is the _______
Uvula
When swallowing, the ____ and _____ elevate to close off the opening of the nasopharynx
Soft palate; uvula
_______ represent the opening between the oral cavity and the oropharynx
Fauces
The fauces are bounded by what 2 paired muscular folds?
Glossopalatine arch (anterior fold)
Pharyngopalatine arch (posterior fold)
What structures are located between the glossopalatine arch and the pharyngopalatine arch?
Palatine tonsils
3 tonsils from superior to inferior
Pharyngeal tonsil (adenoid)
Palatine tonsils
Lingual tonsils
What complication may be caused by inflammation of the pharyngeal tonsil?
Eustachian tube drainage issues
The tongue is made up of _____ muscle and is covered with ______ epithelium
Skeletal; lightly keratinized stratified squamous epithelium
The inferior surface of the tongue attaches to the floor of the oral cavity by a thin vertical mucous membrane called the ____ ___
Lingual frenulum
Numerous small projections called ____ cover the superior surface of the tongue. The posterior surface contains the ______ tonsils.
Papillae; lingual
3 pairs of salivary glands
Parotid glands
Submandibular glands
Sublingual glands
Neural control of saliva secretion from parotid, submandibular, and sublingual glands
Parasympathetic axons in CN IX stimulate parotid salivary gland secretions
Parasympathetic axons in CN VII stimulate submandibular and sublingual salivary gland secretions
Sympathetic stimulation from cervical ganglia stimulates mucus secretion
Which salivary gland is the largest? Which makes the most saliva?
Largest = parotid
Makes the most = submandibular
Each parotid gland is located anterior and inferior to the ear, partially overlying the _____ m.
It produces about 25-30% of saliva, which is conducted through the ______ to the oral cavity. This structure opens into the oral vestibule next to the ______ (tooth)
Masseter m.
Parotid duct
Second upper molar
The submandibular glands are inferior to the body of the ______. They produce 60-70% of saliva. A duct opens from each gland through a papilla in the floor of the mouth on the lateral sides of the _______
Mandible; lingual frenulum
The ____ glands extend multiple tiny ducts that open onto inferior surface of oral cavity, posterior to submandibular duct papilla; they contribute 3-5% of total saliva (least amount)
Sublingual
Compare types of secretions from parotid vs. submandibular vs. sublingual gland
Parotid = serous secretions only
Submandibular and sublingual = both mucous and serous secretions
Antibacterial element in saliva
Lysozyme
3 parts of a tooth
Tooth has an exposed crown, constricted neck, and one or more roots that anchor it to the jaw
Roots of the teeth fit tightly into _____ ______, which are sockets within the alveolar processes of both the maxillae and the mandible
Dental alveoli
Collectively, the roots, the dental avleoli, and the periodontal ligament that binds roots to alveolar processes form a _____ joint
Gomphosis
What happens when there is not intermittent occlusion of the dentition?
Alveolar bone is lost
How many deciduous teeth are there vs. how many permanent teeth?
20 deciduous teeth
32 permanent teeth
Last teeth to erupt
Third molars (wisdom teeth)
Human dental formula
2123 (on each side)
2 incisors
1 canine
2 premolars
3 molars
3 phases of swallowing
Voluntary phase Pharyngeal phase (involuntary) Esophageal phase (involuntary)
Bones of external nose
Nasal bones
Frontal process of maxilla
Nasal part of frontal bone and nasal spine
Bony part of nasal septum
Important cartilages of the nose
2 lateral cartilages
2 alar cartilages
Septal cartilage (nasal septum)
Single, unpaired bone down center of nasal septum
Vomer
Septal deviation causes problems with drainage of _____
Sinuses
Except for the vestibule of the nose (considered external portion), all of the nasal structures are lined with ____ _____, which is firmly connected to the periosteum of the bony parts of the nasal cavity and the perichondrium of the cartilaginous nasal components
Nasal mucosa
The areas of the nose lined with nasal mucosa constitute the _____ ____ (inferior 2/3) and the _____ _____ (superior 1/3)
Respiratory area; olfactory area
Boundaries of nasal cavity including roof, floor, medial and lateral walls
Roof = frontal bone, ethmoid bone, sphenoid bone
Floor = palatine process of maxilla, horizontal plate of palatine bone
Medial wall = nasal septum (perpendicular plate of ethmoid, vomer, septal cartilage, nasal crests of maxillary and palatine bones)
Lateral wall = superior, middle, and inferior nasal conchae
What is the difference in the bones in which the superior, middle, and inferior nasal chonchae are derived from?
Superior and middle conchae are part of ethmoid bone
Inferior nasal conchae is an independent bone
The nasal chonchae divide the nasal cavity into what 4 passages?
Spheno-ethmoidal recess
Superior nasal meatus
Middle nasal meatus
Inferior nasal meatus
The spheno-ethmoidal recess is the location for the opening of what structure?
Sphenoid sinus
The superior nasal meatus is the location for the openings to what structure?
Posterior ethmoid sinus
The middle nasal meatus is the location for the opening into what structures?
Anterior and middle ethmoid sinus
Frontal sinus
Maxillary sinus (opens into middle nasal meatus in posterior part of semilunar hiatus at the maxillary ostium — below the ethmoid bulla)
The inferior nasal meatus is the location for the opening of what structure?
Nasolacrimal duct
6 arteries that supply the nasal cavity
Anterior and posterior ethmoidal aa. (Branches of ophthalmic a.)
Sphenopalatine and greater palatine aa. (Branches of maxillary a.)
Superior labial a. and lateral nasal branches (branches of facial a.)
Venous drainage of nasal cavity (3 vv)
Sphenopalatine v.
Facial v.
Ophthalmic v.
Clinically important area where all 5-6 aa supplying nasal cavity come together in a capillary bed that can bleed profusely, becomes an issue with chronic epistaxis
Kiesselbach area
4 paired paranasal sinuses
Maxillary
Ethmoid
Sphenoid
Frontal
Which paranasal sinus is the largest?
Maxillary
The maxillary sinus drains via the maxillary ostium into the _______ meatus. Its arterial supply is from the alveolar branches of ________ a. and _________ a. Its sensory innervation comes from the branches of the _________ n.
Middle; maxillary; greater palatine; superior alveolar
The ____ sinus consists of air cells located between orbits
Ethmoid
The anterior and middle ethmoid cells drain into the _______ meatus; the posterior ethmoidal cells drain into the _____ meatus
Middle; superior
Arterial supply and innervation of ethmoid sinus
Ethomoidal aa. (From ophthalmic a)
Nasociliary n. (CN V1 branch)
The _____ sinus is unevenly divided by bony part of nasal septum
Sphenoid sinus
The sphenoid sinus drains via ________
Spheno-ethmoidal recess
Arterial supply to sphenoid sinus
Posterior ethmoidal a.
Innervation to sphenoid sinus
Posterior ethmoidal n.
The frontal sinus is located between outer and inner tables of frontal bone, posterior to the ______ arches. It drains via _______ duct into _________ of middle meatus
Superciliary; frontonasal; semilunar hiatus
Arterial supply and innervation to frontal sinus
Supraorbital a. and anterior ethmoidal aa.
Supraorbital nn (CN V1 branches)
The salpingopharyngeal fold arises from the cartilage of what structure?
Eustachian tube
What artery and nerve are found in the cervical viscera, deep to the palatine tonsil?
Tonsillary branch of facial a.
Glossopharyngeal n.
What 2 arteries supply the palatine tonsil?
Tonsillar branch of ascending palatine a.
Tonsillar branch of facial a.
What small muscles are associated with cartilage of the eustachian tube and inserting on the soft palate?
Tensor veli palatini
Levator veli palatini
Salpingopharyngeus
Innervation to tensor veli palatini
Trigeminal n., mandibular branch
Innervation to levator veli palatini m.
CN X (pharyngeal plexus)
Action of tensor veli palatini
Tenses soft palate and acts on pharyngotympanic tube for depressurizing middle ear
Action of levator veli palatini m.
Elevates the tensed palate, and acts on pharyngotympanic tube
Paralysis of tensor veli palatini and/or levator veli palatini leads to what complications?
Reflux of oral contents into nasal cavity, and pharyngotympanic tube dysfunction
Small pyramid-shaped space found inferior to apex of orbit
Pterygopalatine fossa
Borders of pterygopalatine fossa including anterior, posterior, medial, lateral, roof, and floor
Anterior = maxillary tuberosity
Posterior = pterygoid process of sphenoid (lateral plate)
Medial = perpendicular plate of palatine bone
Lateral = opens into infratemporal fossa via pterygomaxillary fissure
Roof = (incomplete) greater wing of sphenoid
Floor = pyramidal process of palatine bone
The superior part of pterygopalatine fossa opens into the _______
The inferior part of pterygopalatine fossa is closed except for the __________
Inferior orbital fissure
Palatine foramen
The pterygomaxillary fissure in the pterygopalatine fossa leads to the _____ fossa
Infratemporal
Where does the spheno-palatine foramen in the pterygopalatine fossa lead?
To the nasal cavity
What are the 7 openings in the pterygopalatine fossa?
Inferior orbital fissure
Pterygomaxillary fissure
Spheno-palatine foramen
Foramen rotundum
Pharyngeal canal
Vidian canal (pterygoid canal)
Pterygopalatine canal
3 major contents of pterygopalatine fossa
Maxillary n. (CN V2)
Pterygopalatine ganglion
Third part of maxillary a.
What 3 nerves pass from the orbit into the pterygopalatine fossa via the inferior orbital fissure?
Infraorbital n.
Zygomatic n.
Orbital branches (from CN V2)
What 2 vessels pass from the orbit into the pterygopalatine fossa via the inferior orbital fissure?
Infraorbital a.
Inferior ophthalmic v.
What nerve passes from the middle cranial fossa into the pterygopalatine fossa via foramen rotundum?
Maxillary n. (CN V2)
Neurovascular structures from what region pass into the pterygopalatine fossa via the pterygopalatine canal (vidian)?
Base of skull
What nerve and 2 vessels from the palate pass through the greater palatine canal to get to the pterygopalatine fossa?
Greater palatine n.
Descending palatine a.
Greater palatine a.
Within the pterygopalatine fossa, the maxillary n. branches into the _____ and ______ nn
Zygomatic; pterygopalatine
Within the pterygopalatine fossa, the zygomatic n. (branch of CN V2) branches into sensory branches _____ and ________, the latter has a communicating branch which conveys parasympathetic fibers to the ______ n.
Zygomaticofacial n.; zygomaticotemporal n.; lacrimal n. (CN V1)
Parasympathetic fibers to pterygopalatine ganglion are from the facial n. via the ________ n., which joins the ________ n. to form the nerve of the pterygoid canal.
Greater petrosal; deep petrosal
The parasympathetic fibers from the greater petrosal n. supply the _____ ganglion
Pterygopalatine
The ______ n. arises from the internal carotid plexus and conveys postsynaptic fibers which join branches of the _______ n. via the pterygopalatine ganglion (but do not synapse there)
Postsynaptic sympathetic fibers are from the ______ ganglion
Deep petrosal; maxillary
Superior cervical
5 primary branches of pterygopalatine part of maxillary a.
Descending palatine a. (supplies palate)
Posterosuperior alveolar a. (supplies maxillary molars, maxillary sinus, gingiva)
Infraorbital a. (supplies maxillary alveoli)
artery of pterygoid canal
Sphenopalatine a. (supplies nasal cavity, choanae, and septum)
