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HAE term 2 quiz 4 > oral cavity > Flashcards

oral cavity Flashcards

1
Q

oral fissure

A

between lips - entry to the mouth

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2
Q

oral cavity

A

bounded laterally by cheeks and extends posteriorly to oropharyngeal isthmus

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3
Q

vestibule

A

space between lips/cheeks and upper and lower alveolar ridges/teeth
region of oral cavity

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4
Q

oral cavity proper

A

area medial to alveolar ridge

region of oral cavity

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5
Q

cutaneous innervation to cheeks

A 
zygomaticofacial and infraorbital nerves (V2)
buccal nerve (V3)
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6
Q

vascular supply to cheeks

A

branch of maxillary artery

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7
Q

vascular supply to lips

A

superior and inferior labial branches of facial artery

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8
Q

cutaneous innervation to lips

A 
infraorbital nerve (V2)
mental nerve (V3)
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9
Q

orbicularis oris

A

sphincteric-functioning muscle surrounding oral fissure
muscle of facial expression
CN VII

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10
Q

buccinator

A

muscle of the cheek
origin: pterygomandibular raphe
insertion: outer alveolar surfaces of maxilla and mandible
interdigitates with obicularis oris
prevents food from accumulating in vestibule
with tongue, keeps food between teeth during mastication
muscle of facial expression - CN VII

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11
Q

floor of mouth contents

A

lingual fenulum
sublingual papilla
sublingual folds
upper and lower labial frenulae

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12
Q

floor of mouth

A

horse-shoe shaped region between muscular diaphram and mobile portion of tongue

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13
Q

lingual frenulum

A

midline fold of mucosa going from the floor of the mouth to the interior surface of the tongue near its base
part of floor of mouth

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14
Q

sublingual papilla (caruncle)

A

opening of the submandibular salivary duct on each side of the lingual fernulum
part of floor of mouth

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15
Q

sublingual folds

A

mucosa overlying sublingual glands and submandibular ducts
extends posterolaterally from sublingual papilla
part of floor of mouth

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16
Q

upper and lower frenulae

A

part of floor of mouth
located in the vestibule
folds of mucosa attaching the lips to the gingiva in the median plane

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17
Q

muscles of floor of mouth

A

mylohyoid

geniohyoid

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18
Q

mylohyoid muscle

A

origin: mylohyoid lines of mandible
insertion: medially downwards on body of hyoid
interdigitate in midline raphe that extends from hyoid to symphysis menti
innervated by mylohyoid branch of inferior alveolar nerve
action: elevates floor of mouth at initiation of deglutination
depending on which bone if fixed, depresses mandible to open oral fissure or elevates hyoid during swallowing

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19
Q

geniohyoid muscles

A

deep to mylohyoid
medial and narrow
origin: inferior mental spines of mandible
insertion: body of hyoid
innervation: branch of C1 via hypoglossal nerve (XII)
action:
elevates and pulls hyoid bone anteriorly during swallowing

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20
Q

inferior mental spines

A

on mandible

insertion of geniohyoid muscle

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21
Q

midline raphe

A

where mylohyoid muscles intergiditate

extends from hyoid bone to symphysis menti

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22
Q

submandibular gland

A

located in digastric triangle superfuical to mylohyoid muscle

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23
Q

submandibular duct

A

loops around posterior free margin of mylohyoid muscle
continues anteriorly beneath mucosa of oral cavity proper
empties into sublingual papilla

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24
Q

sublingual papilla

A

small submucosal caruncle where submandibular duct empties into
drains into oral cavity proper

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25
Q

sublingual gland

A

on mylohyoid muscle
has numerous small excretory ducts that drain onto summit of sublingual fold
drain into oral cavity proper

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26
Q

autonomic innervation of head

A

all postganglionic parasympathetic fibers hitch a ride with one of the three branches of the trigeminal nerve
all postganglionic sympathetic fibers that go to specific targets hitch a ride on one of three branches of trigeminal nerve too

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27
Q

autonomic innervation to oral cavity

A

two preganglionic parasympathetic pathways

two preganglionic sympathetic pathways

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28
Q

parasympathetic innervation of head

A

III –> ciliary ganglion —> V1
VII —-> pterygopalatine ganglion —-> V2 (salivary glands sup to oral fissure)
VII —-> submandibular ganglion —-> V3 (salivary glands inf to oral fissure)
IX —–> otic ganglion —–> V3

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29
Q

autonomic innervation of major salivary glands

A

(not parotid)
parasympathetic:
1: superior to oral fissure via pterygopalatine ganglion
2: inferior to fissure via submandibular gland
sympathetic innervation:
1: superior to oral fissure via internal carotid vessels
2: inferior via external carotid vessels

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30
Q

autonomic innervation of minor salivary glands

A

superior to oral fissure via pterygopalatine ganglion

inferior to oral fissure via submandibular ganglion

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31
Q

parasympathetic innervation through pterygopalatine ganglion

A

VII (greater petrosal and deep petrosal; nerve of pterygoid canal) —–> pterygopalatine ganglion ——> V2 (glands: lacrimal, nose, palate and pharynx; zygomatic: communicating, lacrimal nerve; greater and lesser palatine nerves; nasopalatine and medial and lateral posterior nasal branches; pharyngeal nerve)

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32
Q

parasympathetic innervation through the submandibular ganglion

A

VII (chodra tympani; lingual (V3)) —-> submandibular ganglion —–> V3 (submandibular gland; sublingual gland; minor salivary glands of mouth (labial, lingual, buccal))

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33
Q

postganglionic sympathetic vasomotor innervation through pterygopalatine ganglion

A

internal carotid nerve, internal carotid plexus, superior cervical ganglion —-> deep petrosal nerve, nerve of pterygoid canal —-> pterygopalatine ganglion —-> distributed with branches of V2

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34
Q

postganglionic sympathetic vasomotor innervation through submandibular gland

A

superior cervical ganglion —-> plexus on external carotid and facial arteries —-> through submandibular gland —-> distributed with lingual branch of V3

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35
Q

functions of tongue

A

1: taste
2: speech
3: mastication
4: deglutition
5: absorption of medications

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36
Q

deep lingual veins

A

visible near the tip of the tongue just beneath the mucous membrane
absorb certain sublingual medications directly into the venous system

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37
Q

median sulcus

A

line on dorsum of tongue that divides it into lateral halves

terminates in foramen cecum

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38
Q

foramen cecum

A

pit at back/posterior of tongue where median sulcus terminates
embryologic origin of thryoglossal duct
sulcus terminalis radiates from here

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39
Q

sulcus terminalis

A

radiates obliquely anterior from foramen cecum

v-shaped groove that separates anterior 2/3 of tongue from posterior 1/3

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40
Q

oral portion of tongue

A

anterior 2/3

anterior to sulcus terminalis

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41
Q

pharyngeal portion of tongue

A 
posterior 1/3 of tongue
posterior to sulcus terminalis
forms anterior wall of oropharynx
devoid of papillae
has submucosal lymphoid follicles = lingual tonsil
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42
Q

lingual tonsil

A

submucosal lymphoid follicles on pharyngeal portion of tongue

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43
Q

glossoepiglottic folds

A

mucosa of tongue is reflected onto epiglottis

44
Q

lingual papillae

A 
mucosal projections on dorsal surface of oral portion of tongue
increase surface area
4 types:
those that have taste buds:
1: fungiform
2: foliate
3: vallate
those that don't
4: filiform
45
Q

mucosal of inferior surface of tongue

A

stratified squamous epithelium without papillae or taste buds

46
Q

muscles of tongue

A 
all innervated by hypoglossal (XII) except palatoglossus (X)
intrinsic: inferior longitudinal
superior longitudinal
transverse
vertical
extrinsic: 
genioglossus
hyoglossus
styloglossus
palatoglossus
47
Q

intrinsic muscles of the tongue

A 
complex interlacing fasciculi allowing great mobility and alteration of shape
important in deglutition and speech
inferior longitudinal
superior longitudinal
transverse
vertical
48
Q

extrinsic muscles of tongue

A 
originate from mandible, hyoid bone, styloid process and soft palate
genioglossus
hyoglossus
styloglossus
palatoglossus
49
Q

genioglossus

A

extrinsic muscle of tongue
origin: superior mental tubercules of mandible: fans out superiorly and posteriorly
action: protrudes apex of the tongue
depresses central part of tongue - pulling mandible forward
prevents the tongue from sinking backwards and obstructing respiraton

50
Q

hyoglossus

A

extrinsic muscle of the tongue

origin: greater horn of hyoid
insertion: ascends vertically to lateral portion of tongue
action: depresses tongue

51
Q

styloglossus

A

extrinsic muscle of tongue
origin: styloid process
passes forward and downward
action: draws the tongue upward and backward

52
Q

palatoglossus

A

extrinsic muscle of tongue
origin: palatine aponeurosis of the soft palate
descends in forward and lateral direction
action: elevates root of tongue
approxiamtes patatoglossal arches => shutting off oral cavity from orophayrnx during deglutination

53
Q

embryological origin of tongue (arches)

A

1 (CN V)
3 (CN IX)
4 (CN X)

54
Q

swellings that develop in development of tongue

A

1: paired lateral lingual swellings occur in ventral regions of 1st arch
2: 2 median unpaired swellings also occur - separated from each other by foramen cecum = tuberculum impar and hypobranchial eminence

55
Q

tuberculum impar

A

swelling between 1st and 2nd arch

separated from hypotranchial eminence by foramen cecum

56
Q

hypobranchial eminence

A

swelling in development of tongue

merges with the ventral parts of the 3rd and 4th arches

57
Q

steps in development of tongue

A

4 weeks:
1: lateral lingual swellings develop from arch 1
tuberculum impar develops from arch 1 ust posterior to the lingual swellings
foramen cecum part of arch 2
hypobranchial eminence develops from arch iii
week 5:
2: lateral lingual swellings grow
copula = swelling in foramen cecum
merges with hypobranchial eminence
3: lingual swellings and tuberculum impar expand to form the anterior 2/3 of tongue
foramen cecum becomes really small and at cecum
sulcus terminalis = division between 1st and 3rd arch
3rd arch forms posterior 1/3 of tongue - overgrows 2nd arch and merges with 1st arch

58
Q

embryological origin of anterior 2/3 of tongue

A

formed by expansion of lateral swellings (arch 1) with a minor contribution by tuberculum impar

59
Q

embryological origin of posterior 1/3/root of tongue

A

formed by hypobranchial eminence with contributions from 3rd and 4th arches

60
Q

embryological origin of musculature of tongue

A

migrates from occiptial myotomes and brings hypoglossal never (CN XII) with it

61
Q

embryological origin of innervation of anterior tongue

A

general sensation: lingual nerve (branch of CN V3)

taste: chorda tympani (CN VII) is pretrematic - joins nerve of 1st arch (CN V3 - lingual branch)

62
Q

embryological origin of innervation of posterior tongue

A

general sensation: glossopharyngeal nerves (CN IX)

taste: glossopharyngeal nerve (CN IX)

63
Q

innervation of tongue (summary)

A

general sensation:

  - anterior = lingual branch of mandibular (V3)
  - posterior = lingual branch of glossopharyngeal (IX)

special sensation (taste buds)

   - anterior = VII - taste fibers travel back within lingual branch of mandibular nerve (V3) to chorda tympani to facial nerve (nervus intermedius
   - posterior = IX - lingual branch of glossopharyngeal

motor
- hypoglossal (XII) innervates all intrinsic and extrinsic muscles except palatoglossus (CN X)

64
Q

path of nerves into tongue

A

lingual and hypoglossal (CN XII) enter from posterior aspect
pass between mylohyoid and hyoglossus

glossopharyngeal travels with lingual artery
enters oral cavity between constrictor muscle and hyoglossus muscle

65
Q

path of lingual artery into tongue

A

enters oral cavity between deeper situated middle constrictor muscle and more superficial hyoglossus muscle
accompanied by glossopharyngeal nerve (CN IX)

66
Q

lingual artery

A

branch of external carotid

main blood supply to floor of tongue

67
Q

deep lingual veins

A

can absorb sublingual medication directlly into venous system
visible near tip of tongue just beneath mucous membrane

68
Q

teeth

A

crown of tooth projects above gingiva

crown separated from root by neck

69
Q

alveolus

A

bony socket into which the root of teeth are inserted

forms immovable gomphosis joint

70
Q

gomphosis joint

A

joint between alveolus and teeth

immovable

71
Q

labial/buccal surface

A

surface of teeth facing lip or cheek

72
Q

lingual surface

A

surface of teeth facing tongue

73
Q

periodontal ligaments

A

support teeth in alveolar socket

provide sensory info about tooth position and forces acting on teeth

74
Q

sets of teeth

A 
deciduous - 20: 2-1-2
     - 2 incisors
     - 1 canine
     - 2 molars
permanent - 32: 2-1-2-3
     - 2 incisors
     - 1 canine
     - 2 premolars
     - 3 molars
75
Q

nerve supply to teeth

A

braches of trigeminal nerve (CN V)

  - trigeminal 
        - maxillary (V2)
              - posterior superior alveolar nerve
              - infraorbital nerve
                    - middle superior alveolar nerve
                    - anterior superior alveolar nerve
        - mandibular nerve (V3)
              - inferior alveolar nerve
76
Q

arterial supply to teeth

A

maxillary artery

  - posterior superior alveolar artery (upper jaw)
  - infraorbital artery
        - anterior superior alveolar artery (upper jaw)
  - inferior alveolar arter (lower jaw)
77
Q

superior alveolar nerves

A

posterior, middle and anterior
nerve supply to superior teeth
posterior is direct branch of maxillary (V2)
middle and anterior are branch of infraorbital, which is branch of V2

78
Q

inferior alveolar nerve

A

nerve supply to lower teeth

branch of mandibular nerve (CN V3)

79
Q

posterior superior alveolar artery

A

blood supply to upper jaw

direct branch of maxillary artery

80
Q

anterior superior alveolar artery

A

blood supply to upper jaw

branch of infraorbital artery, which is branch of maxillary artery

81
Q

inferior alveolar artery

A

blood supply to lower mandible

branch of maxillary artery

82
Q

palate

A

partition between oral and nasal cavities

83
Q

hard palate

A

anterior 2/3 of palate
palatine process of maxillary bones and horizontal plates of palatine bones
has incisive foramen and greater and lesser palatine foramen
thick oral mucosa with abundance of minor salivary glands

84
Q

palatine process of maxillary bones

A

form anterior portions of hard palate

have incisive foramen and canal between the two lateral sides

85
Q

incisive foramen and canal

A

between two palatine processes of maxillary bone
passageway between nasal cavities and oral cavity
behind the incisor teeth

86
Q

horizontal plates of palatine bone

A

forms posterior portion of hard palate

contains greater and lesser palatine foramen

87
Q

greater and lesser palatine canals and foramina

A

passageway between pterygopalatine fossa and hard and soft palates
in horizontal plate of palatine bone/hard palate
travel though perpendicular plate of palatine bone
pathway for pterygopalatine fossa to posterior portion of oral cavity proper and orophayrnx

88
Q

perpendicular plate of palatine bone

A

makes up portion of posterior wall of lateral nasal cavity

greater and lesser palatine canals travel though

89
Q

greater palatine canal

A

transmits descending palatine artery (origin of greater and lesser palatine arteries) and greater palatine nerve

90
Q

descending palatine artery

A

origin of greater and lesser palatine arteries

travels through greater palatine canal to oral cavity proper and oropharynx

91
Q

path of greater palatine nerve

A

travels through greater palatine canal

92
Q

lesser palatine canal

A

transmits lesser palatine artery and lesser palatine nerve to soft palate

93
Q

sphenopalatine foramen

A

medial exit from pterygopalatine fossa

transmits nerves and vessels from pterygopalatine fossa going to nasal cavity

94
Q

greater palatine artery

A

branch of descending palatine artery
from greater palatine canal, travels anterior toward incisive canal
enters nasal cavity via incisive canal
anastamoses with branches of sphenopalatine artery
suplies blood to hard palate gums, mucosa, and glands

95
Q

A dentist needs to extract an impacted third molar tooth in the right lower jaw. Where will he inject local anesthetic and which nerve will he hope to anesthetize?

A

In the area of the mandibular foramen and lingula on the medial side of the mandibular ramus.
The inferior alveolar nerve innervates the mandibular teeth.

96
Q

If the anesthetic to the 3rd molar is effective, which muscle(s) may be paralyzed?

A

The mylohyoid and anterior belly of the digastric are both innervated by the nerve to the mylohyoid which branches off the inferior alveolar nerve just proximal to the mandibular foramen and creates the mylohyoid groove.

97
Q

The patient notices that his right lower lip and chin have become numb after numbing of his third molar. How do you explain this?

A

These areas are innervated by the mental nerve, a terminal branch of the inferior alveolar nerve.

98
Q

The patient also notices that the floor of his mouth has become numb after numbing of his third molar. His tongue feels “funny” and when he gently bit it to test it, it was also numb. Why?

A

The lingual nerve travels just slightly anteromedial to the inferior alveolar nerve in this area and is often also anesthetized by the diffusion of the anesthetic agent.

99
Q

A patient had sensation to his 3rd molar numbed for a dental operation. Would his taste sensation on the right side of his tongue be affected? if so, where and why?

A

Yes, because special sense taste fibers from the taste buds on the anterior 2/3 of the tongue travel with the lingual nerve before transitioning to the chorda tympani on their way back to the facial nerve. Their cell bodies are located in the geniculate ganglion of the facial nerve. (Both taste and general sensation in the posterior 1/3 of the tongue travel in the glossopharyngeal nerve.)
The chorda tympani is not a branch of V3 but its fibers travel with the lingual nerve for the distal part of their course.

100
Q

The patient has a tumor growing in his middle ear just anterior to the malleus. A CT scan shows it involving bone in that area. The floor of his mouth feels a little “gritty” on that side. What do you think is going on?

A

This is the area of the petrotympanic fissure where the chorda tympani exits the middle ear and enters the infratemporal fossa. This nerve carries preganglionic parasympathetic nerve fibers to the submandibular ganglion. The resulting decrease in saliva from submandibular, sublingual and microscopic salivary glands in the mucosa of the lower mouth might cause the “gritty” feeling.

101
Q

he patient has a tumor growing in his middle ear just anterior to the malleus.
If you gave him a delicious lemon flavored hard candy to enjoy, where in his mouth would he suck on it?

A

On the left side where the taste fibers would not be affected.

102
Q 
To drain an abscess (a closed collection of pus) in the cheek area, an emergency room physician used local anesthesia for the surgery. Cutaneous branches of which nerve must be anesthetized to block pain sensation from the cheek area? 
buccal (V3)
buccal (VII)
inferior alveolar
lingual
mental
A

1
The buccal branch of CN V3 is sensory to the mucosa and skin in the area of the cheek.
The buccal branch of CN VII is motor to the buccinator muscle and other muscles of facial expression in that area.

103
Q

A patient who experienced bilateral dislocation of the jaw (temporomandibular joints) could not swallow nor talk since the jaw would not elevate. Where are the condyles of the mandible located as a result of the dislocation?
1. against the external acoustic meatus2. against the anterior slope of the articular tubercle3. against the posterior slope of the articular tubercle4. in the mandibular fossa5. in the pterygoid fossa

A

2
To reduce the dislocation one needs to press the mandible posteroinferiorly so that the condyles can relocate posterior to the articular tubercles and move into the mandibular fossae.

104
Q

Your patient has developed painful arthritis in her left TMJ. She is addicted to peanut M&M’s. Where in her mouth do you think she would chew them and why?
Right

Center

Left

I’ll stick with milkshakes

A

3
When chewing on the left side, the mandibular condyle would not be in the mandibular fossa. There would be less pressure in the joint and therefore less pain. Most of the pressure would be on the right TMJ, so she would choose the left side for chewing. In other words, if she chewed on the right side, there would be more pressure and pain on the left, so she would avoid that.

105
Q

Inability to protrude the mandible indicates a dysfunction of which muscle?
Masseter

Lateral pterygoid

Medial pterygoid

Mylohyoid

A

2

106
Q

Parasympathetic preganglionic nerve
fibers to the parotid gland travel in:
CN X

lesser petrosal nerve

CN VII

chorda tympani nerve

auriculotemporal nerve

A

2
Preganglionic parasympathetic efferent fibers branch from CN IX via the tympanic and then the lesser petrosal nerves to synapse in the otic ganglion. The postganglionic fibers then “hitch-hike a ride” on the auriculotemporal nerve to reach the parotid gland where they control glandular secretion.

107
Q 
The medial pterygoid muscle originates from:
 Parietal bone
 Occipital bone
 Sphenoid bone - lateral pterygoid plate
 Sphenoid bone - medial pterygoid plate
 Temporal bone
A

3
One of the functions of the medial and lateral pterygoid muscles is to produce the grinding action of the teeth when chewing. The muscles originate mainly from medial and lateral sides of the lateral pterygoid plate of the sphenoid bone respectively. From this picture you can appreciate that the medial pterygoids, acting independently can move the mandible from side-to-side laterally.
The sphenoid is bilaterally symmetrical and is a midline structure of the cranium. The anterior surface of the greater wing is in the orbit; the posterior surface is in the middle cranial fossa. The surface colored in yellow is essentially the posterior wall of the pterygopalatine fossa.

HAE term 2 quiz 4 (6 decks)

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