Oral and Nasal Cavities/Paranasal Sinuses Flashcards
Describe the epithelium and innervation of the skin of the inner cheek.
Keratinized Stratified Squamous Epithelium
Innervation: Long Buccal Nerve (V)
Which structure will pierce the Buccinator Muscle?
What is the innervation?
Parotid Duct
Facial Nerve (VII)
Where is the orifice of the parotid duct located inside of the mouth?
Inner Cheek Opposite the crown of the SECOND MOLAR
Describe the relationship between the Submandibular Duct, Lingual Nerve, and the Hypoglossal Nerve in the Mouth.
Hypoglossal Nerve is DEEP to all the structures (Easy to see hypoglossal nerve in the neck)
*** Submandibular Duct is going to be SUPERIOR to Lingual Nerve in the mouth
Describe the location of the inferior alveolar neurovascular bundle.
Enters the Mandible @ the Mandibular Foramen!
Exits the Mental Foramen as the Mental Nerve
What is the smallest of the salivary glands?
Between which two muscles is it located?
What is another name for the Sublingual Duct?
What is the blood supply?
- Sublingual Salivary Gland!
- Genioglossus Muscle
- Geniohyoid Muscle
- Bartholin’s Duct
Sublingual Branch of the Lingual Artery (Off of External Carotid Artery)
Describe the Autonomic Innervation of the Sublingual Gland.
What is the name of the marker for the area that will have seperate innervation than the hard palate?
Incisive Foramen
Describe the Innervation of the Tongue.
Anterior 2/3 –> Trigeminal (GSA) and Facial (SVA)
Posterior 1/3 –> Glossopharyngeal (GSA and SVA)
Intrinsic Muscles of the Tongue –> Hypoglossal (GSE)
*** GSA: Pain, Temperature, and Touch
*** SVA: Taste Fibers
Describe the purpose of the Foramen Cecum and the Sulcus Terminalis on the tongue.
Foramen Cecum: Structure is for development of the Thyroid Gland
Sulcus Terminalis: Demarcates the Anterior 2/3 and Posterior 1/3 of the tongue! There will circumvallate papillae along this line.
Median Glossoepiglottic Fold is where you are going to place the BLADE for intubation.
Describe the embrological derivatives of the tongue.
Oral portion: Anterior 2/3 is derived from ECTODERM; GSA fibers are from the LINGUAL nerve (V); Taste Buds are derived from the SECOND arch and are innervated by SVA fibers from the Facial Nerve
Pharyngeal Portion: Posterior 1/3 is derived from ENDOERM; GVA and SVA fibers come from Glossopharyngeal Nerve
List the intrinsic muscles of the tongue along with their functions.
What is their innervation?
- Hyoglossus –> RETRACTS tongue
- Styloglossus –> RETRACTS and ELEVATES tongue
- Genioglosss –> PROTRUDES tongue
- Palatoglossus –> ELEVATES tongue and CLOSES Faucial Istmus during Deglutition (swallowing)
- Intrinsic Muscles of the tongue
**** All muscles are innervated by the HYPOGLOSSAL NERVE EXCEPT for Palatoglossus (Palatoglossal Nerve (X))
What happens when you have paralysis of the Mylohyoid Muscle?
Function: Supports the floor of the mouth to support the base of the tongue
*** Unilateral Paralysis causes food to pocket in the ANTERIOR FLOOR of the mouth
Differentiate between Unilateral and Bilateral paralysis of the tongue.
UNILATERAL –> When normally protruded, Genioglossus deviates towards the affects side
BILATERAL –> May cause airway obstruction (dyspnea), dysarthria (difficult or unclear speech) and dysphagia (difficulty swallowing)
What happens to the tongue muscles when you have ALS?
Hypertrophy of intrinsic tongue musculature!
Difficulty with speech (Dysarthria)
Which vessels will supply and take the blood from the tongue?
Which lymph nodes will they primarily drain to?
Lingual artery and its terminal branch (profunda lingual artery)
Lingual Vein –> IJV or Facial Vein
DEEP CERVICAL Lymph Nodes!
List the different muscles and functions and innervation for the Muscles of the Palate.
What happens if you have paralysis in these muscles?
- Muscularis Uvulae –> Intrinsic muscle of the Soft Palate; Innervated by X via the Pharyngeal Plexus
- Tensor Veli Palatini Muscle –> Tenses the soft Palate and Opens the Auditory Tube; Innervated by Small Branch of the Mandibular Nerve (V)
- Levator Veli Palatini Muscle –> Elevator of the Soft Palate; Innervated by X via the Pharyngeal Plexus
- Palatoglossus –> ELEVATES tongue and CLOSES Faucial Istmus during Deglutition (swallowing); Innervated by Pharyngeal branch of vagus nerve (X)
**** Paralysis of tensor or levator palate allows the muscles of the non-paralized side to pull or deviate the uvula towards the normal side.
What is the vascular supply and innervation to the Palatine Tonsils?
Which structure can easily be injured during a Tonsilectomy?
What is the lymphatic drainage from the Palatine Tonsil?
Arterial Supply: Tonsillar Artery of the Facial Artery and the Palatine Branch of the Ascending Pharyngeal;
Venous Drainage: Tonsillar (Paratonsillar) Vein –> Pharyngeal Plexus of Veins –> Facial Vein
*** Tonsillar Vein is a frequent bleeder during a tonsillectomy (Glossopharyngeal (CN IX) nerve is also located within close proximity)
*** Direct Drainage into the Jugulodigastric (Tonsillar) Nodes
A Tumor in the Internal Acoustic Meatus can present with which kind of symptoms?
Bells Palsey because of the Relationship with the Facial Nerve!
Route of the Facial Nerve: Pons –> Internal Acoustic Meatus –> Facial Canal –> Exits @ Stylomastoid Foramen
Differentiate between the Eustation Tube structure in a Child vs. an Adult.
Which structures will pass through the Sphenopalatine Foramen?
Sphenopalatine Arterty
What are the important structures on the Lateral Nasal Wall?
- Opening for the Sphnoidal Sinus
- Ethmoidal Bursa
- Hiatus Semilunaris (Opening for the Maxillary sinus)
- Ethmoidal Infundibulum (Opening for frontal sinus)
- Frontal Recess (Opening for frontal sinus) - Nasolacrimal Opening (under the Inferior Conchae)
- When you cry this is where the tear come out of the nose!
What are the different relationships of the Maxillary Sinus?
- Roof of Maxillary Sinus is the FLOOR of the orbit
- Posterior wall forms the ANTERIOR wall of the pterygopalatine fossa and infratemporal fossa!
- Inferior wall forms molar teeth of maxilla (if you have inflammation to the Sphnoid Sinus, everytime you heel strike while walking, your molars are going to hurt!)
What are the Relationships of the Sphenodial Sinus?
Posterior –> Pons and Basilar Artery
Superior –> Pituitary
Anterior –> Nasal Cavity
Inferior –> Nasopharynx
Lateral –> ICA, V1, Cavernous Sinus
Describe the different nerves that are related to the Pterygopalatine Ganglion.
San Diego (Sympathetics –> Deep Petrosal)
PG (Parasympathetics –> Great Petrosal)
