Oral Cavity

Question 1

_____ _____ extends from the lateral corner of the nose to the angle of the mouth

Answer 1

nasolabial sulcus

clinically, a unilateral diminution or absence of the sulcus may indicate a neurological disorder

Question 2

______ is a shallow, midline sulcus b/w the nose and the upper lib

Answer 2

Philtrum

Question 3

___ _____ is the red portion of the lips and is due to the thin epithelium and extensive underlying capillary network

Answer 3

Red margin

Question 4

upper and lower ___ _____ are midline folds of mucosa which extend b/w the inside of the lips to the gingivae

Answer 4

labial frenulae

Question 5

What lymph nodes do the lips drain?

Answer 5

drain directly into the submental and submandubular (pericervical) lymph nodes, then into the deep cervical nodes

Question 6

The skin of the cheek is ______ __ ______ epithelium and is innervate by the __________ nerve.

Answer 6

keratinized stratified squamous

buccinator nerve V (long buccal nerve)

Question 7

Describe the buccal fat pad

Answer 7

the buccal fat pad is compartmentalized and encapsulated

in infants it provide leverage for sucking

Question 8

Immediately deep to the buccal fat pad is the _________ muscle

Answer 8

buccinator

Question 9

What pierces the buccinator muscle?

Answer 9

the parotid duct

the orifice of the parotid duct is located on the inner cheek opposite the crown of the 2nd upper molar

Question 10

what innervates the buccinator muscle?

Answer 10

facial nerve

Question 11

Describe the relationships of the sublingual region.

Answer 11

lingual n. spirals around the submandibular duct from superior-lateral to inferior-medial
the hypoglossal n. enters this region considerably more posterior and deeper and is adherent to the hypoglossus m.

Question 12

Where does the submandibular gland drain?

Answer 12

The sublingual caruncle or papilla located at the antero-medial end of the sublingual fold

Question 13

What is the position of the sublingual salivary gland?

Answer 13

flattened between the mandible and genioglossus/ geniohyoid m in the floor of the mouth and rest upon the superior surface of the mylohyoid
the submandibular duct crosses the medial side of the gland

Question 14

Describe the parasympathetic innervation to the Sublingual gland.

Answer 14

Preganglionic parasympathetic fibers from the superior salivatory nucleus exits the brainstem w/ Facial n. travel through the chorda tympani and join lingual then enter submandibular ganglion

Postganglionic parasympathetic fibers are short branches to the submandibular gland

Question 15

Describe the sympathetic innervation to the Sublingual gland.

Answer 15

Postganglion sympathetic fiber originate in the SCG then enter the external carotid plexus to the facial plexus then enter the sublingual plexus which course in the adventitia of the sublingual branch of the lingual artery.

Question 16

The epithelium on the anterior 2/3 of the tongue is innervate by the ______ and _____ nerves

Answer 16

trigeminal nerve (GSA fibers for pain, temperature, and touch) 
facial nerve (SVA taste fibers)

Question 17

The epithelium on the posterior 1/3 of the tongue is innervated by the _______ nerve.

Answer 17

glossopharyngeal nerve, which supplies both GSA and SVA fibers

Question 18

The intrinsic muscle of the tongue are derived from head myotomes and are innervated by ___ fiber from the _______ nerve.

Answer 18

GSE, hypoglossal nerve

Question 19

_________ ________ divides the tongue into the anterior 2/3 and posterior 1/3.

Answer 19

sulcus terminalis

the division reflects the different embryological origins of the tongue from the floor of the primitive pharynx

Question 20

What are the 5 muscles of the tongue?

Answer 20

hyoglossus muscle arises from the hyoid; retracts tongue
styloglossus muscle arises from the styloid process; retracts and elevate the tongue
genioglossus muscle arises from teh genial tubercle; protrudes tongue
Palatoglossus muscle arise from the posterolateral hard palate and is innervated by the vagus nerve via the pharyyngeal plexus

Question 21

Describe paralysis of the tongue.

Answer 21

unilateral hypoglossal palsy results in paralysis, atrophy and fasciculations of the intrinsic muscle of the tongue.

when protruded, the normal genioglossus deviated the tongue towards the affected side. bilateral paralysis may cause airway obstruction (dyspnea), dysarthria and dysphagia

Question 22

Where do the lymphatic of the tongue drain?

Answer 22

deep cervical lymph nodes

jugulo-digastric and juguloomohyoid

Question 23

Muscles of the Palate

Answer 23

Tensor Veli Palatini muscle: innervated by a small branch of the mandibular n (V). the tensor palati tenses the soft palate and opens the auditory tube
Levator Veli Palatini muscle: located inferior to the auditory tube on the lateral wall of the nasopharynx, innervated by the vagus from the pharyngeal plexus

Question 24

What is the clinical presentation of paralysis of the tensor or levator palate?

Answer 24

The paralysis allow the muscle on the non-paralyzed side to pull or deviate the uvula towards the normal side.

Question 25

_____ vessels and nerves supply the post-incisive?

Answer 25

nasopalatine

Question 26

_____ vessels and nerves supply the hard palate?

Answer 26

greater palatine

Question 27

______ vessels and nerves supply the soft palate?

Answer 27

less palatine

Question 28

Describe the relationships of the palatine tonsil.

Answer 28

blood supply: tonsillar branch of facial a. and palatine branch of the ascending pharyngeal innervation: glossopharyngeal nerve is closely related to the floor of the tonsillar fossa

Question 29

What vein is a frequent bleeder during tonsillectomy?

Answer 29

tonsillar vein

Question 30

What lymph nodes drains the palatine tonsil?

Answer 30

jugulodigastric nodes

Question 31

What is the upper portion of the nose formed by?

Answer 31

forntal, maxillae, and nasal bone

Question 32

What is the lower portion of the nose formed by?

Answer 32

septal and alar cartilage the septal cartilage is a large, midline,triangular-shaped cartilage that has lateral extensions, and the alar cartilages support the lateral aspect of the nostrils

Question 33

Where do fractures of the nose occur?

Answer 33

frequently occur at the junction between the septal cartilage and the ethmoid and vomer bones. Cartilaginous fragments may telescope posteriorly. Anterior rhinoscopy is commonly used to view and surgically approach structures in the nasal cavity.

Question 34

What are the relationships of the medial wall or nasal septum?

Answer 34

medial wall or nasal septum is formed by the alar and septal cartilages anteriorly; the perpendicular plate of the ethmoid posterosuperiorly; and the vomer posteroinferiorly.

Question 35

___________ ________ is located postero-superior to superior concha.

Answer 35

Sphenoethmoidal Recess is located postero-superior to superior concha. The sphenoidal sinus drains into the sphenoethmoidal recess. A highest concha and meatus may be present in this recess.

Question 36

The middle meatus contains what 5 structures?

Answer 36

It contains the ethmoidal bulla, hiatus semilunaris and | openings for the maxillary, ethmoidal and frontal sinuses.

Question 37

The opening for the ________ _____ is located in the inferior meatus, 1 cm posterior to the anterior edge of the concha

Answer 37

nasolacrimal duct

Question 38

The ____________ artery, the terminal branch of the maxillary artery, supplies the septum and lateral wall of the posterior one-half of the nasal cavity.

Answer 38

sphenopalatine artery The sphenopalatine artery branches into the posterior lateral and posterior septal arteries

Question 39

_________ and _________ _______ arteries, which are branches of the ophthalmic artery, supply the anterior one-half of the walls/septum.

Answer 39

anterior and posterior ethmoidal

Question 40

Describe the Kiesselbach's area.

Answer 40

A small region of near the vestibule is supplied by septal branches of the superior labial artery. The majority of nasal hemorrhages or (epistaxis) occurs at the junction of the septal branches of the superior labial and sphenopalatine arteries. Clinically, this region is referred to as Kiesselbach's area

Question 41

Describe the Maxillary Sinus.

Answer 41

pyramidal cavity with its base directly medially and the apex is directed towards the zygomatic process of the maxilla. The medial wall forms the lateral wall of the nasal cavity, and its roof forms the floor of the orbit. The maxillary floor is part of the alveolar portion of the maxilla. The posterior maxillary wall forms the anterior wall of the pterygopalatine fossa and infratemporal fossa. The maxillary sinus drains by ciliary action, gravity and negative pressure into one or more openings into the hiatus semilunaris.

Question 42

Describe the relationships of the ethmoidal sinus

Answer 42

Anterior ethmoidal cells open into the anterior part of the hiatus semilunaris. middle Ethmoidal cells open onto the surface of the bulla ethmoidalis. Posterior Ethmoidal cells open into the superior meatus

Question 43

Describe the relationship of the Sphenoidal Sinus.

Answer 43

a. posterior: pons, basilar artery b. superior: pituitary c. anterior: nasal cavity d. Inferior: nasopharynx e. lateral: internal carotid, cavernous sinus

Question 44

Pterygopalatine (Sphenopalatine) Ganglion is attached to the nerve in the fossa.

Answer 44

maxillary (V2) nerve

Question 45

Vidian nerve or nerve of the pterygoid canal is formed by the merging of the ______ _______ and _______ ______nerves.

Answer 45

Vidian nerve or nerve of the pterygoid canal is formed by the merging of the deep petrosal and great petrosal nerves. It conveys postganglionic sympathetic, GVE parasympathetic, and GVA fibers to the pterygopalatine ganglion where it ends.

Question 46

Lesser and Greater Palatine nerves are the largest branches of the pterygopalatine ganglion. What fibers do they carry?

Answer 46

They convey GSA (V2), GVA (VII), GVE parasympathetic, postganglionic sympathetic fibers to the mucosa of the inferior surface of the soft and hard palate, respectively

Question 47

_______ nerve distributes the same components as the palatine nerves to the mucosa of the posterior nasal septum and lateral nasal cavity

Answer 47

Nasopalatine nerve