Oral cavity Flashcards
what are the two parts of the OC
vestibule (region between the lips and teeth)
OC proper (bounded by the teeth anteriorly, cheeks laterally and pillar of fornices posteriorly)
what does the OC contain
ant 2/3 of tongue (moveable part): circumvallate papillae
sulcus terminalis
buccal mucosa: lining sitting infront of the pillar of fornices
floor of mouth
retromolar trigone - sitting behind molars
what is the sulcus terminalis
it is the border between the anterior and posterior part of the tongue
what does the roof of mouth contain
hard palate
palatine bones and maxilla
rigid
soft palate comprised of muscle, anchored by the palatoglossal and palatopharyngeal arches
what are the core muscles
obicularis oris
buccinator
work together to keep food between the teeth, when we chew forms the vestibule
what is the role of the tongue
helps with sound formation, manipulation of air
what does the intrinsic muscles of the tongue do
changes shape, not anchored
what does the extrinsic muscles do
alters tongue position
attachment muscles attach adjacent bony structures
what happens via mechanical processing
manipulation of food
sensory analysis
taste: papillae on surface, senses temperature, secrete lingual lipase
what is frenulum lingae
extension of tissue at the bottom, is the opening for sublingual salivary glands
epidemiology
increases with age
x2 common in males
50+
south asian and chinese population
aetiology
smoking x3
alcohol x6
betel quid chewing
leukoplakia: pre cancerous plaques which can progress to cancer
poor dental health + poorly fitted dentures
syphilis
what can impact teeth
necrosis, teeth might need to be removed before RT
what is the common type of cancer
SCC [90%] = well differentiated
what are the other types of cancer
adenocarcinomas [salivary glands]
malignant mixed [minor SG]
lymphomas
what does HPV do to the prognosis
greater prognosis, linked with the OC, oropharynx, nasopharynx
better response to chemo and RT
what is the presentation symptoms
persistent deep ulcers
infections = halitosis
leukoplakia
interference with swallowing, chewing, might impair on speech
pain radiating from ear
asymptomatic
what are the investigations
full medical history
clinical exam
indirect laryngoscopy: check opening and closing of vocal chords
haematological = rule out infection if enlarged LN
biopsy = primary and potential leukoplasia + enlarged LN, identifies differentiation
FNA
EUA [depth of invasion and extent]
dental assessment
nodal involvement
2 CTVs
+ nodes: primary dose
SIB = 54Gy in 30
what are the types of spread
direct
lymphatic
haematological [late stage: liver, lung, bone]
direct spread:
early
into adjacent tissues
invasion through bony structures
lymphatic spread
first involvement depends on the subsite
crosses midline - bilateral involvement is common
rich blood supply
what is the treatment given dependent on
location and PS
