Oral and Nasal Cavities and Pterygopalatine Fossa

Question 1

Differentiate locations of hard vs. soft palate

Answer 1

Hard palate: anterior 2/3 of palate; hard and bony

Soft palate: posterior 1/3 of palate; soft and muscular (primarily skeletal m.)

Question 2

Extending inferiorly from the posterior part of the soft palate is the _______

Answer 2

Uvula

Question 3

When swallowing, the ____ and _____ elevate to close off the opening of the nasopharynx

Answer 3

Soft palate; uvula

Question 4

_______ represent the opening between the oral cavity and the oropharynx

Answer 4

Fauces

Question 5

The fauces are bounded by what 2 paired muscular folds?

Answer 5

Glossopalatine arch (anterior fold)

Pharyngopalatine arch (posterior fold)

Question 6

What structures are located between the glossopalatine arch and the pharyngopalatine arch?

Answer 6

Palatine tonsils

Question 7

3 tonsils from superior to inferior

Answer 7

Pharyngeal tonsil (adenoid)

Palatine tonsils
Lingual tonsils

Question 8

What complication may be caused by inflammation of the pharyngeal tonsil?

Answer 8

Eustachian tube drainage issues

Question 9

The tongue is made up of _____ muscle and is covered with ______ epithelium

Answer 9

Skeletal; lightly keratinized stratified squamous epithelium

Question 10

The inferior surface of the tongue attaches to the floor of the oral cavity by a thin vertical mucous membrane called the ____ ___

Answer 10

Lingual frenulum

Question 11

Numerous small projections called ____ cover the superior surface of the tongue. The posterior surface contains the ______ tonsils.

Answer 11

Papillae; lingual

Question 12

3 pairs of salivary glands

Answer 12

Parotid glands
Submandibular glands
Sublingual glands

Question 13

Neural control of saliva secretion from parotid, submandibular, and sublingual glands

Answer 13

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

Question 14

Which salivary gland is the largest? Which makes the most saliva?

Answer 14

Largest = parotid

Makes the most = submandibular

Question 15

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)

Answer 15

Masseter m.

Parotid duct

Second upper molar

Question 16

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 _______

Answer 16

Mandible; lingual frenulum

Question 17

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)

Answer 17

Sublingual

Question 18

Compare types of secretions from parotid vs. submandibular vs. sublingual gland

Answer 18

Parotid = serous secretions only

Submandibular and sublingual = both mucous and serous secretions

Question 19

Antibacterial element in saliva

Answer 19

Lysozyme

Question 20

3 parts of a tooth

Answer 20

Tooth has an exposed crown, constricted neck, and one or more roots that anchor it to the jaw

Question 21

Roots of the teeth fit tightly into _____ ______, which are sockets within the alveolar processes of both the maxillae and the mandible

Answer 21

Dental alveoli

Question 22

Collectively, the roots, the dental avleoli, and the periodontal ligament that binds roots to alveolar processes form a _____ joint

Answer 22

Gomphosis

Question 23

What happens when there is not intermittent occlusion of the dentition?

Answer 23

Alveolar bone is lost

Question 24

How many deciduous teeth are there vs. how many permanent teeth?

Answer 24

20 deciduous teeth

32 permanent teeth

Question 25

Last teeth to erupt

Answer 25

Third molars (wisdom teeth)

Question 26

Human dental formula

Answer 26

2123 (on each side) 2 incisors 1 canine 2 premolars 3 molars

Question 27

3 phases of swallowing

Answer 27

``` Voluntary phase Pharyngeal phase (involuntary) Esophageal phase (involuntary) ```

Question 28

Bones of external nose

Answer 28

Nasal bones Frontal process of maxilla Nasal part of frontal bone and nasal spine Bony part of nasal septum

Question 29

Important cartilages of the nose

Answer 29

2 lateral cartilages 2 alar cartilages Septal cartilage (nasal septum)

Question 30

Single, unpaired bone down center of nasal septum

Answer 30

Vomer

Question 31

Septal deviation causes problems with drainage of _____

Answer 31

Sinuses

Question 32

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

Answer 32

Nasal mucosa

Question 33

The areas of the nose lined with nasal mucosa constitute the _____ ____ (inferior 2/3) and the _____ _____ (superior 1/3)

Answer 33

Respiratory area; olfactory area

Question 34

Boundaries of nasal cavity including roof, floor, medial and lateral walls

Answer 34

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

Question 35

What is the difference in the bones in which the superior, middle, and inferior nasal chonchae are derived from?

Answer 35

Superior and middle conchae are part of ethmoid bone Inferior nasal conchae is an independent bone

Question 36

The nasal chonchae divide the nasal cavity into what 4 passages?

Answer 36

Spheno-ethmoidal recess Superior nasal meatus Middle nasal meatus Inferior nasal meatus

Question 37

The spheno-ethmoidal recess is the location for the opening of what structure?

Answer 37

Sphenoid sinus

Question 38

The superior nasal meatus is the location for the openings to what structure?

Answer 38

Posterior ethmoid sinus

Question 39

The middle nasal meatus is the location for the opening into what structures?

Answer 39

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)

Question 40

The inferior nasal meatus is the location for the opening of what structure?

Answer 40

Nasolacrimal duct

Question 41

6 arteries that supply the nasal cavity

Answer 41

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.)

Question 42

Venous drainage of nasal cavity (3 vv)

Answer 42

Sphenopalatine v. Facial v. Ophthalmic v.

Question 43

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

Answer 43

Kiesselbach area

Question 44

4 paired paranasal sinuses

Answer 44

Maxillary Ethmoid Sphenoid Frontal

Question 45

Which paranasal sinus is the largest?

Answer 45

Maxillary

Question 46

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.

Answer 46

Middle; maxillary; greater palatine; superior alveolar

Question 47

The ____ sinus consists of air cells located between orbits

Answer 47

Ethmoid

Question 48

The anterior and middle ethmoid cells drain into the _______ meatus; the posterior ethmoidal cells drain into the _____ meatus

Answer 48

Middle; superior

Question 49

Arterial supply and innervation of ethmoid sinus

Answer 49

Ethomoidal aa. (From ophthalmic a) Nasociliary n. (CN V1 branch)

Question 50

The _____ sinus is unevenly divided by bony part of nasal septum

Answer 50

Sphenoid sinus

Question 51

The sphenoid sinus drains via ________

Answer 51

Spheno-ethmoidal recess

Question 52

Arterial supply to sphenoid sinus

Answer 52

Posterior ethmoidal a.

Question 53

Innervation to sphenoid sinus

Answer 53

Posterior ethmoidal n.

Question 54

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

Answer 54

Superciliary; frontonasal; semilunar hiatus

Question 55

Arterial supply and innervation to frontal sinus

Answer 55

Supraorbital a. and anterior ethmoidal aa. Supraorbital nn (CN V1 branches)

Question 56

The salpingopharyngeal fold arises from the cartilage of what structure?

Answer 56

Eustachian tube

Question 57

What artery and nerve are found in the cervical viscera, deep to the palatine tonsil?

Answer 57

Tonsillary branch of facial a. | Glossopharyngeal n.

Question 58

What 2 arteries supply the palatine tonsil?

Answer 58

Tonsillar branch of ascending palatine a. Tonsillar branch of facial a.

Question 59

What small muscles are associated with cartilage of the eustachian tube and inserting on the soft palate?

Answer 59

Tensor veli palatini Levator veli palatini Salpingopharyngeus

Question 60

Innervation to tensor veli palatini

Answer 60

Trigeminal n., mandibular branch

Question 61

Innervation to levator veli palatini m.

Answer 61

CN X (pharyngeal plexus)

Question 62

Action of tensor veli palatini

Answer 62

Tenses soft palate and acts on pharyngotympanic tube for depressurizing middle ear

Question 63

Action of levator veli palatini m.

Answer 63

Elevates the tensed palate, and acts on pharyngotympanic tube

Question 64

Paralysis of tensor veli palatini and/or levator veli palatini leads to what complications?

Answer 64

Reflux of oral contents into nasal cavity, and pharyngotympanic tube dysfunction

Question 65

Small pyramid-shaped space found inferior to apex of orbit

Answer 65

Pterygopalatine fossa

Question 66

Borders of pterygopalatine fossa including anterior, posterior, medial, lateral, roof, and floor

Answer 66

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

Question 67

The superior part of pterygopalatine fossa opens into the _______ The inferior part of pterygopalatine fossa is closed except for the __________

Answer 67

Inferior orbital fissure Palatine foramen

Question 68

The pterygomaxillary fissure in the pterygopalatine fossa leads to the _____ fossa

Answer 68

Infratemporal

Question 69

Where does the spheno-palatine foramen in the pterygopalatine fossa lead?

Answer 69

To the nasal cavity

Question 70

What are the 7 openings in the pterygopalatine fossa?

Answer 70

Inferior orbital fissure Pterygomaxillary fissure Spheno-palatine foramen Foramen rotundum Pharyngeal canal Vidian canal (pterygoid canal) Pterygopalatine canal

Question 71

3 major contents of pterygopalatine fossa

Answer 71

Maxillary n. (CN V2) Pterygopalatine ganglion Third part of maxillary a.

Question 72

What 3 nerves pass from the orbit into the pterygopalatine fossa via the inferior orbital fissure?

Answer 72

Infraorbital n. Zygomatic n. Orbital branches (from CN V2)

Question 73

What 2 vessels pass from the orbit into the pterygopalatine fossa via the inferior orbital fissure?

Answer 73

Infraorbital a. | Inferior ophthalmic v.

Question 74

What nerve passes from the middle cranial fossa into the pterygopalatine fossa via foramen rotundum?

Answer 74

Maxillary n. (CN V2)

Question 75

Neurovascular structures from what region pass into the pterygopalatine fossa via the pterygopalatine canal (vidian)?

Answer 75

Base of skull

Question 76

What nerve and 2 vessels from the palate pass through the greater palatine canal to get to the pterygopalatine fossa?

Answer 76

Greater palatine n. Descending palatine a. Greater palatine a.

Question 77

Within the pterygopalatine fossa, the maxillary n. branches into the _____ and ______ nn

Answer 77

Zygomatic; pterygopalatine

Question 78

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.

Answer 78

Zygomaticofacial n.; zygomaticotemporal n.; lacrimal n. (CN V1)

Question 79

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.

Answer 79

Greater petrosal; deep petrosal

Question 80

The parasympathetic fibers from the greater petrosal n. supply the _____ ganglion

Answer 80

Pterygopalatine

Question 81

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

Answer 81

Deep petrosal; maxillary Superior cervical

Question 82

5 primary branches of pterygopalatine part of maxillary a.

Answer 82

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)