Oral Cavity Flashcards
The tongue papillae is discussed in details in the histology of the oral cavity.
The oral cavity (commonly called mouth) represents the first part of the digestive tube, serving as the entrance of the alimentary canal and initiating the digestive process by salivation and propulsion of the alimentary bolus into the pharynx. State other functions of the oral cavity.
- Secondary respiratory conduit.
- Site of sound modification for the production of sound.
- A chemosensory organ.
- [Diagram: Anatomy of Oral Cavity]
State the extents of the oral cavity.
Anteriorly: at the lips (through the oral fissure to the face)
Posteriorly: oropharyngeal isthmus/isthmus of the fauces
[Diagram]
The oral cavity is divided into 2 parts by the upper and lower dental arches (formed by the teeth and their bony scaffolding). Name them.
☞ Vestibule of the mouth
☞ Oral cavity proper
What forms the:
(a) roof of the oral cavity?
(b) lateral walls of the oral cavity?
(c) floor of the oral cavity?
(a) palate
(b) cheeks
(c) diaphragma oris
The vestibule is bound externally by the lips and the cheeks, and internally by the gums and teeth. The entire vestibule is lined by mucous membrane except the teeth. When the mouth is closed, the vestibule communicates on each side with the oral cavity proper through a small gap behind the 3rd molar tooth and ramus of mandible called ______________________.
What is the clinical significance of the gap located in the back of the lower vestibule [retromolar space]?
instrumentation during dental procedures
Lips
They are musculofibrous folds that surround the oral fissure (aperture). There are the external (skin) and internal (mucous membrane) surfaces of the lips. Click on the image in the Answer section to appreciate some of the parts of the lips.
[Image]
Further notes:
☞ The red hue on the vermillion zone is due to rich vascular bed visible through the thin moist epithelium.
☞ The internal aspect of each lip is connected to the corresponding gum by a median fold of the mucous membrane called frenulum of the lip.
List the structures in the lip from superficial to deep.
- Skin.
- Superficial fascia.
- Orbicularis oris muscle.
- Submucosa containing mucous glands.
- Mucous membrane.
Describe the blood supply and lymphatic drainage of the lips.
Blood Supply
Each lip is supplied by labial branches of facial artery. Each lip has an arterial arch formed by the end-on anastomosis between labial branches of the facial arteries. When this arterial arch is cut, blood spurts from both ends with equal force. The veins correspond to the arteries and drain into the facial vein.
Lymphatics
☞ The lymphatics from the central part of the lower lip drain into submental lymph nodes.
☞ The lymphatics from lateral parts of lower lip and whole of upper lip drain into submandibular lymph nodes.
Describe the nerve supply of the lips.
☞ The lips have rich sensory supply from trigeminal nerve.
☞ The upper lip is supplied by labial branches of the infraorbital nerve (a branch of the maxillary division) and lower lip by the mental nerve (a branch of the inferior alveolar nerve, which is a branch of the posterior division of the mandibular division).
☞ The red portions of lip are highly sensitive and represented by a large area in the sensory cortex of cerebral hemisphere.
List the 7 layers of the cheek from superficial to deep.
- Skin.
- Superficial fascia containing some muscles of facial expression, viz. zygomaticus major, risorius.
- Buccal pad of fat.
- Buccopharyngeal fascia.
- Buccinator muscle between the alveolar processes of both jaws.
- Submucosa containing buccal (mucus) glands.
- Mucus membrane.
Further notes:
☞ The last five layers of the cheek are pierced by the parotid duct.
☞ The lymphatics from the cheek drain into the submandibular and preauricular lymph nodes.
The gums are composed of fibrous tissue covered with a smooth vascular mucous membrane. They envelop the alveolar processes of the jaws and the necks of the teeth. At the necks of the teeth, the fibrous tissue of gum becomes continuous with the periodontal membrane, which attaches the teeth to their sockets. The gum/gingiva has 3 parts. Name them.
- Free part (free gingiva), which surrounds the neck of tooth like a collar.
- Attached part (attached gingiva), which is firmly attached to the alveolar process.
- Interdental part (interdental gingiva), which is the extension of the attached gingiva between the teeth.
- [Image]
The oral cavity proper has a roof and a floor. Posteriorly the oral cavity communicates with the oropharynx through oropharyngeal isthmus (also called isthmus of fauces). Boundaries of the oropharyngeal isthmus?
Superiorly: Soft palate
Inferiorly: Dorsal surface of the pharyngeal part of tongue
Laterally (on each side): Palatoglossal arches
[Diagram]
Necessities of the palatoglossal arches?
The approximation of these arches shuts off the mouth from oropharynx and is essential to deglutition.
Click on Answer to view a diagram showing the floor of the oral cavity. Appreciate the lingual frenulum, sublingual papilla and sublingual fold.
Further notes:
☞ The sublingual papilla is the opening of the submandibular duct. Where is the parotid papilla located?
☞ Many structures in the oral cavity are termed by their relationship to the tongue, palate, cheeks, and lips. The structures closest to the tongue are termed ‘lingual’. Those closest to the palate are termed ‘palatal’. Those closest to the cheeks are termed ‘buccal’. And those closest to the lips are termed ‘labial’.
What is Ludwig’s angina?
Ludwig’s angina is a cellulitis of the floor of the mouth, usually due to infection from a carious molar tooth, causing inflammatory edema of the floor of the mouth. It spreads to the submandibular and submental regions producing diffuse swelling in these regions also. The tongue is pushed upwards due to edema of the floor of the mouth, resulting in difficulty in swallowing.
[Diagram]
The paralingual space is found in the floor of the mouth. State its boundaries.
mylohyoid muscle, lateral margin of the tongue, hyoid bone, and oral mucosa
State the contents of the paralingual space. What is its clinical significance?
- Sublingual gland.
- Lingual nerve.
- Submandibular duct.
- Deep lingual vein.
- Lingual artery.
- Lymph nodes.
The mylohyoid line divides the floor of the mouth into a submandibular space below and a paralingual space above the line.
[11 minute video: Dissection of Paralingual Space]
Clinical significance: spread of infections to other spaces that it communicates with, tumours affecting structures there, etc.
(a) The posterior part of the tongue forms the ________________ wall of the oropharynx.
(b) The tongue is separated from the teeth by a deep ________________ sulcus, which is filled by palatoglossal fold/arch posterior to the last molar tooth.
(a) anterior
(b) alveololingual
Features on the oral part of tongue?
Features on the pharyngeal part of tongue?
Features on the oral part of tongue:
1. A median furrow, representing the bilateral origin of the tongue.
2. Large number of papillae.
Features on the pharyngeal part of tongue:
1. A large number of lymphoid follicles, which together constitute the lingual tonsil.
2. A large number of mucus and serous glands.
Note:
The furring or coating of tongue bears no relation to digestive disturbances as generally thought, but is usually due to smoking, respiratory tract infection, fever, or oral infection.
Click on Answer to view linked images and diagrams the of topography of the tongue.
The musculature of tongue consists of intrinsic and extrinsic muscles.
List the intrinsic muscles of the tongue, stating the locations and actions.
- Superior longitudinal
Location: Beneath the mucous membrane.
Actions:
☞ Shortens the tongue
☞ Makes the dorsum concave - Inferior longitudinal
Location: Close to inferior surface between genioglossus and hyoglossus
Actions:
☞ Shortens the tongue
☞ Makes the dorsum convex - Transverse
Location: Extends from median septum to the margin
Action: Makes the tongue narrow and elongated - Vertical
Location: At the border of the anterior part of the tongue
Action: Make the tongue broad and flattened. - [Diagram] [Diagram 2]
- [3-minute Video]