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M1 HAE Quiz 4 > Oral Cavity > Flashcards

Oral Cavity Flashcards

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1
Q

The oral fissure, between the lips, is the entry to the mouth. The oral cavity is bounded laterally by the cheeks and extends posteriorly to the oropharyngeal isthmus.

The oral cavity is subdivided into two regions:
Vestibule – space between the lips/cheeks and the upper and lower alveolar ridges/teeth
Oral cavity proper –area “medial” to the alveolar ridge/teeth

A

The oral fissure, between the lips, is the entry to the mouth. The oral cavity is bounded laterally by the cheeks and extends posteriorly to the oropharyngeal isthmus.

The oral cavity is subdivided into two regions:
Vestibule – space between the lips/cheeks and the upper and lower alveolar ridges/teeth
Oral cavity proper –area “medial” to the alveolar ridge/teeth

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2
Q

What is the vascular supply and innervation to the Cheeks?

A

Vascular supply - branch of the maxillary artery

Innervation (sensory) – zygomaticofacial & infraorbital nerves (CN V2); buccal nerve (CN V3)

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3
Q

What is the vascular supply and innervation to the lips?

A

Vascular supply – superior & inferior labial branches of the facial artery
Innervation - infraorbital nerve (CN V2) and mental nerve (CN V3)

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4
Q

What is the orbicularis oris? What is its innervation?

A

orbicularis oris - sphincteric-functioning muscle surrounding the oral fissure
muscle of facial expression and innervated by CN VII.

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5
Q

What is the buccinator? Where is its orgin? What is its function? What is its innervation?

A

muscle of the cheek
originates from the pterygomandibular raphe, attaches to the outer alveolar surfaces of the maxilla and mandible and interdigitates with the obicularis oris
prevents food from accumulating in the vestibule by compressing the check against the teeth and gums: together with the tongue, it keeps food between the teeth during mastication
innervation - buccal branch of CN VII (muscle of facial expression)

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6
Q

What is the VESTIBULE? What is the Parotid Papilla? What are the Upper and Lower Labial Frenulae?

A

slit like “U” shaped space bordered by the lips/cheeks on the outside and the teeth/alveolar ridge on the inside
communicates with the oral cavity posterior to the last molar when teeth are occluded
parotid papilla - parotid ducts piece the buccinators and drain opposite the maxillary (upper jaw) second molar tooth
upper and lower labial frenulae - folds of mucosa attaching the lips to the gingiva (gums) in the median plane

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7
Q

What is the lingual frenulum?

A

a midline fold of mucosa going from the floor of the mouth to the inferior surface of the tongue near its base

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8
Q

What is the sublingual papilla (caruncle)?

A

opening of the submandibular salivary duct on each side of the lingual frenulum

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9
Q

What are the sublingual folds?

A

mucosa overlying the sublingual glands and submandibular ducts
extends posterolaterally from the sublingual papilla

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10
Q

What are the upper and lower labial frenulae?

A

located in the vestibule, folds of mucosa attaching the lips to the gingiva (gums) in the median plane

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11
Q

What is the origin/insertion of the mylohoid muscles?
What is the innervation of the mylohoid muscles?
What is the action of the mylohyoid muscles?

A

Origin/insertion
triangular-shaped muscles originating from the mylohyoid lines of the mandible
posterior fibers pass medially and downwards to insert on the body of the hyoid bone
from there the muscles come together and interdigitate in a midine raphe that extends from hyoid bone to the symphysis menti
Innervation – mylohyoid branch of the inferior alveolar nerve (CN V3)
Action
primarily elevates the floor of the mouth at the initiation of deglutition
depending upon which bone is “fixed”, depresses mandible to open the oral fissure or elevates hyoid bone during swallowing

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12
Q

What is the origin and insertion of the geniohyoid muscles?
What is the innervation of the geniohyoid muscle?
What is the action of the geniohyoid muscle?

A

Origin: inferior mental spines of mandible / insertion: body of hyoid
Innervation –branch of C 1 via hypoglossal nerve (CN XII)
Action
elevates and pulls the hyoid bone anteriorly during swallowing
when hyoid bone is fixed, depresses the mandible

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13
Q

What is the location of the Submandibular gland? What muscle does it loop around? What does its duct empy into and where?

A

The superficial part of the submandibular gland is located in the digastric triangle superficial to the mylohyoid muscle. Together with a small tongue of glandular tissue, the submandibular duct loops around the posterior free margin of the mylohyoid muscle. The duct continues anteriorly beneath the mucosa of the oral cavity proper to empty into a small submucosal caruncle, the sublingual papilla, just lateral to the frenulum of the tongue .

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14
Q

Where is the Sublingual gland?

A

The sublingual gland rests upon the mylohyoid muscle and numerous small excretory ducts drain on to the summit of the sublingual fold.

Whereas the parotid ducts drain into the vestibule, both the submandibular and sublingual glands drain into the oral cavity proper.

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15
Q

Salivary glands (parotid gland not included in this discussion; lacrimal gland is an exception)
parasympathetic innervation to the glands lying:
superior to the oral fissure arrives via the ______ ganglion
inferior to the fissure arrives via the ______ ganglion
sympathetic innervation
superior to the oral fissure follows pathway of ______ carotid vessels
inferior to the fissure follows pathway of ______ carotid vessels

A

parasympathetic innervation to the glands lying:
superior to the oral fissure arrives via the pterygopalatine ganglion
inferior to the fissure arrives via the submandibular ganglion
sympathetic innervation
superior to the oral fissure follows pathway of internal carotid vessels
inferior to the fissure follows pathway of external carotid vessels

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16
Q

See Slides 10 through 12 Oral Cavity SBQs for innervation and ganglion permutations of the oral cavity.

A

See Slides 10 through 12 Oral Cavity SBQs for innervation and ganglion permutations of the oral cavity.

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17
Q

Autonomic innervation
All postganglionic parasympathetic fibers of the head are distributed by hitching a ride on the pathways of one of the three main branches of the trigeminal nerve – V1, V2, V3.
All postganglionic sympathetic fibers of the head that go to specific targets (i.e. lacrimal gland) hitch a ride on the pathways of one of the three main branches of the trigeminal nerve – V1, V2, V3.

A

Autonomic innervation
All postganglionic parasympathetic fibers of the head are distributed by hitching a ride on the pathways of one of the three main branches of the trigeminal nerve – V1, V2, V3.
All postganglionic sympathetic fibers of the head that go to specific targets (i.e. lacrimal gland) hitch a ride on the pathways of one of the three main branches of the trigeminal nerve – V1, V2, V3.

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18
Q

Parasympathetic innervation
(secretomotor)
Whichtwo para nerve uses the

Pterygopalatine ganglion?

A

Parasympathetic innervation
(secretomotor)
Greater Petrosal Nerve (CN VII)
Nerve of the pterygoid canal

Pterygopalatine ganglion

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19
Q

Parasympathetic innervation
(secretomotor)
Which two para nerves use the

Submandibular ganglion?
A

Parasympathetic innervation
(secretomotor)
Chorda Tympani (CN VII)

Lingual nerve (CN V3)

Submandibular ganglion
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20
Q

What is the parasympathetic pathway superior to the orbital fissure (name 3 pre-nerves, ganglion, and 1 post-nerve)?

A

preganglionic - facial nerve (CN VII), greater petrosal nerve, nerve of the pterygoid canal
synapse in the pterygopalatine ganglion.
postganlionic fibers distributed with the branches of the maxillary nerve - V2.

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21
Q

What is the pathway of sympathetic nerves that pass through the pterygopalatine ganglion (name four nerves that pass through)?

A

Postganglionic sympathetic vasomotor innervation:
arrives from the superior cervical ganglion via the internal carotid nerve, internal carotid plexus, deep petrosal nerve, nerve of the pterygoid canal and passes through the pterygopalatine ganglion to distributed with the branches of the maxillary nerve - V2

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22
Q

What is the parasympathetic pathway inferior to the orbital fissure (name 2 pre-nerve, ganglion, and 1 post-nerve)?

A

preganglionic - facial nerve (CN VII), chorda tympani, lingual nerve - V3
synapse in the submandibular ganglion
postganglionic fibers distributed with the lingual branches of the mandibular nerve - V3

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23
Q

What is the pathway of sympathetic nerves that pass through the submandibular ganglion (what two arteries does it follow before the submandibular ganglion)?

A

Postganglionic sympathetic vasomotor innervation:
arrives from the superior cervical ganglion via a plexus on the external carotid and facial arteries and passes directly through the submandibular ganglion to be distributed with the lingual branch of the mandibular nerve - V3.

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24
Q

The dorsum of the tongue has a median sulcus that divides it into lateral halves.
This terminates posteriorly in a pit, the foramen cecum, (embryologic origin of the thyroglossal duct).
From the foramen cecum, a V-shaped groove, the sulcus terminalis, radiates obliquely anterior toward the palatoglossal arch at the periphery of the tongue.

A

The dorsum of the tongue has a median sulcus that divides it into lateral halves.
This terminates posteriorly in a pit, the foramen cecum, (embryologic origin of the thyroglossal duct).
From the foramen cecum, a V-shaped groove, the sulcus terminalis, radiates obliquely anterior toward the palatoglossal arch at the periphery of the tongue.

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25
Q

What separates the anterior two thirds of the tongue from the posterior third of the tongue?

A

It is the sulcus terminalis which separates:
anterior two-thirds (oral portion) of the tongue (apex & body)
from the
posterior one-third (pharyngeal portion) of the tongue (root)

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26
Q

What are the characteristics of the posterior third of the tongue?

A

forms the anterior wall the oropharynx.
is devoid of papillae but imbued with submucosal lymphoid follicles collectively known as the lingual tonsil
mucosa of the tongue is reflected onto the epiglottis as the:
median and lateral glossoepiglottic folds and the intervening valleculae.

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27
Q

Which three of the four types of lingual papillae have taste buds? Which does not?

A

fungiform
Foliate
vallate
filiform papillae do not.

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28
Q

There are 8 muscles which manipulate the tongue
all 8 muscles are innervated by the ____ nerve? Except the palatoglossus muscle which is innervated by ____? which can also be considered to be a muscle of the soft palate

A

all 8 muscles are innervated by the hypoglossal nerve (CN XII) except the palatoglossus (CN X) which can also be considered to be a muscle of the soft palate

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29
Q

intrinsic muscles (4): complex interlacing fasciculi allowing great mobility and alteration of shape that is important in deglutition and speech

What are the four instrinsic muscles of the tongue?

A

inferior longitudinal
superior longitudinal
transverse
vertical

30
Q

What are the four extrinsic muscles of the tongue?

A

Genioglossus
Hyoglossus
Styloglossus
Palatoglossus

31
Q

What is the origin insertion and action of the Genioglossus?

A

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

32
Q

What is the origin insertion and action of the Hyoglossus?

A

origin: the greater horn of the hyoid bone; ascends vertically and inserts in lateral portion of the tongue
action – depresses tongue

33
Q

What is the origin insertion and action of the Styloglossus?

A

origin: styloid process and passes forward and downward

action - draws the tongue upward and backward

34
Q

What is the origin, insertion, action and innervation of the Palatoglossus?

A

origin: palatine aponeurosis of the soft palate from which it descends in a forward and lateral direction
action – elevates the root of the tongue and approximates the palatoglossal arches shutting off the oral cavity from the oropharynx during degutition
CN X

35
Q

The tongue develops from what pharyngeal arches? Which nerves are with each respective arch?

A

The tongue develops from swellings in the floor of the pharynx and from pharyngeal arches 1 (CN V), 3 (CN IX) & 4 (CN X).

36
Q

The tongue develops from swellings in the floor of the pharynx and from pharyngeal arches 1 (CN V), 3 (CN IX) & 4 (CN X).

A

The tongue develops from swellings in the floor of the pharynx and from pharyngeal arches 1 (CN V), 3 (CN IX) & 4 (CN X).

37
Q

tuberculum impar originates between the which arches?

A

1st and 2nd arch

38
Q

hypobranchial eminence merges with the ventral parts of the which arches?

A

3nd and 4th arches

39
Q

3rd arch overgrows the 2nd arch and merges with the 1st arch. The sulcus terminalis represents the line of fusion between the lingual derivatives of which arches?

A

arch 1 & arch 3

40
Q

Anterior 2/3rds of the tongue formed by expansion of the lateral swellings Which Arch? with a minor contribution by the _____ _____.

A

Arch1 and the tuberculum impar

41
Q

Posterior 1/3 or root of the tongue formed by the ____ _____ with contributions from the which arches?

A

hypobranchial eminence and the 3rd and 4th arches

42
Q

Musculature of the tongue migrates in from the occipital myotomes and brings the which nerve with it?

A

hypoglossal nerve (CN XII)

43
Q

anterior to sulcus terminalis, the tongue is derived from which arch?

A

1st arch

44
Q

Posterior to the sulcus terminalis, the tongue is derived from which arches?

A

3rd and 4th arches

45
Q

anterior to sulcus terminalis, general sensation is from which nerve?

A

lingual nerve, a branch of CN V3

46
Q

anterior to sulcus terminalis, Taste is from which nerve?

A

chorda typani (CN VII), being pretrematic, joins the nerve of the 1st arch (CN V3 – lingual branch) and is distributed to the anterior 2/3’s of the tongue

47
Q

posterior to the sulcus terminalis, general sensation is from which nerve?

A

the glossopharyngeal nerve (CN IX)

48
Q

posterior to the sulcus terminalis, Taste is from what nerve

A

glossopharyngeal nerve (CN IX)

49
Q

Summary:
anterior to sulcus terminalis, the tongue is derived from which arch?
Posterior to the sulcus terminalis, the tongue is derived from which arches?

A

1st arch

3rd and 4th arches

50
Q

Summary:

1) anterior to sulcus terminalis, general sensation is from which nerve?
2) anterior to sulcus terminalis, Taste is from which nerve?
3) posterior to the sulcus terminalis, general sensation is from which nerve?
4) posterior to the sulcus terminalis, Taste is from what nerve?

A

1) lingual nerve, a branch of CN V3
2) chorda typani (CN VII), being pretrematic, joins the nerve of the 1st arch (CN V3 – lingual branch) and is distributed to the anterior 2/3’s of the tongue
3) the glossopharyngeal nerve (CN IX)
4) glossopharyngeal nerve (CN IX)

51
Q

What is the course of the lingual and hypglossal nerve as it enters the tongue? What muscles do they pass?

A

To reach the tongue, the lingual and hypoglossal (CN XII) nerves enter the oral cavity from its posterior aspect.
They pass between two muscles originating from the hyoid bone: the more superficially placed mylohyoid (floor of the mouth) and the more deeply placed hyoglossus (tongue) muscle.

52
Q

What is the main blood supply of the floor of the mouth and tongue?

A

The lingual artery, a branch of the external carotid artery, is the main blood supply to the floor of the mouth and the tongue.

53
Q

What is the course of the lingual artery? What nerve accompanies it?

A

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

54
Q

What are the deep lingual veins? Where are they visible?

A

Deep lingual veins can be utilized to absorb sublingual medication directly into the venous system. They are visible near the tip of the tongue just beneath the mucous membrane.

55
Q

TEETH
The crown of a tooth projects above the gingiva and is separated from the root by a constricting neck. The root is inserted into the bony socket (alveolus) of the alveolar ridge of either the maxilla or mandible by an immovable gomphosis joint. Teeth have a labial/buccal surface facing the lip or cheek and a lingual surface facing the tongue. Periodontal ligaments support the teeth in the alveolar socket and provide sensory information about tooth position and the forces acting on the teeth.

There are two sets of teeth
Deciduous - 20 teeth
Permanent 32 teeth: 2 incisors, 1 canine, 2 premolars, 3 molars

A

TEETH
The crown of a tooth projects above the gingiva and is separated from the root by a constricting neck. The root is inserted into the bony socket (alveolus) of the alveolar ridge of either the maxilla or mandible by an immovable gomphosis joint. Teeth have a labial/buccal surface facing the lip or cheek and a lingual surface facing the tongue. Periodontal ligaments support the teeth in the alveolar socket and provide sensory information about tooth position and the forces acting on the teeth.

There are two sets of teeth
Deciduous - 20 teeth
Permanent 32 teeth: 2 incisors, 1 canine, 2 premolars, 3 molars

56
Q

Explain the nerve supply to the teeth.
What nerve becomes the superior alveolar nerves (posterior, middle, and anterior)?
What nerve becomes the inferior alveolar nerve?

A

Nerve supply to the teeth comes from branches of the trigeminal (CN V) nerve:
maxillary (CN V2) nerve gives the superior alveolar nerves (posterior, middle and anterior). The latter two branches come from the infraorbital nerve.
mandibular nerve (CN V3) gives the inferior alveolar nerve

57
Q

Explain the blood supply of the teeth.
Upper jaw?
Lower jaw?

A

Blood supply to the teeth is via the maxillary artery.
upper jaw (maxilla)
posterior superior alveolar artery directly off the maxillary artery
anterior superior alveolar artery a branch of the infraorbital artery.
lower jaw (mandible)
inferior alveolar artery

58
Q

posterior superior alveolar artery braches from?

A

directly off the maxillary artery

59
Q

anterior superior alveolar artery branches from?

A

infraorbital artery.

60
Q

The hard palate is composed of What two bones?

A

palatine processes of the maxillary bones

horizontal plates of the palatine bones

61
Q

What is the incisive foramen & canal?

A

a passageway between the nasal cavities and the oral cavity located behind the incisor teeth in the palatine process of the maxilla.

62
Q

What is the greater & lesser palatine canals and foramina?

A

a passageway between the pterygopalatine fossa and the hard and soft palates

63
Q

What is the association between the perpendicular plate of the palatine bone and the nasal cavity?

A

The perpendicular plate of the palatine bone makes up a portion of the posterior wall of the lateral nasal cavity.

64
Q

What are the greater and lesser palatine canals?

A

travel through the perpendicular plate of the palantine and open as foramina on the lateral aspect of the horizontal plate of the palatine bone.
This provides a pathway from the pterygopalatine fossa to the posterior portion of the oral cavity proper and the oropharynx.

65
Q

The greater palatine canal transmits which artery and which nerve?

A

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

66
Q

The lesser palatine canal transmits the which artery and which nerve?

A

lesser palatine artery

the lesser palatine nerve that supply the soft palate.

67
Q

Nerves and vessels from the pterygopalatine fossa destined for the nasal cavity do so by going medially through the what foramen?

A

sphenopalatine foramen.

68
Q

The greater palatine canal transmits the descending palatine artery (origin of greater and lesser palatine arteries) and the greater palatine nerve.

A

The greater palatine canal transmits the descending palatine artery (origin of greater and lesser palatine arteries) and the greater palatine nerve.

69
Q

What is the course of the greater palatine artery?

A

Out of the greater palatine canal, travels anterior toward the incisive canal where it enters the nasal cavity to anastamose with branches of the sphenopalatine artery.

70
Q

What is the course of the greater palatine nerve? What does it innervate?

A

Out of the greater palatine canal travels anteriorly.

They provide blood and innervation to the gums, mucosa and glands of the hard palate.

71
Q

What artery and nerve supplies the soft palate? What palantine canal do they travel through?

A

The lesser palatine canal transmits the lesser palatine artery and the lesser palatine nerve that supply the soft palate.

M1 HAE Quiz 4 (7 decks)

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