Oral Cavity Flashcards
What are the two parts of the mouth?
Vestibule
Oral Cavity (proper)
What is the Vestibule?
Slit like space between lips and teeth as well as between the cheek and the lips
What are the boundaries of the vestibule?
Laterally
Lips and Cheeks
Medially
Teeth
The oral cavity proper and the vestibule communicate throught what?
The retromolar space
When the jaw is wired shut, a feeding tube may be inserted into the oral cavity through this space
Which muscles makes up the lips and cheeks, respectively.
The orbicularis oris (lips) and the buccinator (cheeks)
These muscles originate from the 2nd brachial arch. Innervated by the facial n.
In the image
Green = mucous membrane
Yellow = salivary glands (buccal and labial)
The very thin part of the skin coveritng the lips is known as the?
Vermilion Border
This is a way to observe blood circulation. Blue lips indicate a lack of proper circulation.
The muscle fibers of the bucinator originate from the __________ ________, run anterioly and blend with the orbularis oris.
pterygomandibular raphe
Which three muscles come togather to form a large muscular spinchter around the entrance of the oral tube?
Superior pharyngeal constrictor
Buccinator
Orbicularis oris
During chewing, food is kept between the occlusal surfaces (teeth) by which two structures?
buccinator and tongue
If there is a lesion in CN VII, what occurs during chewing?
Food accumulates in the vestibule and may dribble out of the corner of the mouth.
Buccinator in non-functional
What gives babies/newborns “fat cheeks” and what purpose does it serve?
Buccal Fat pad
(outside of the buccinator)
1. Provides rigidity to the cheek which is important in suckling
2. Source of food and energy during starvation
Starvation, Anorexia nervosa, and chronic disease (such as cancer) can all have what characterisitc?
“Sunken Cheeks”
Buccal fat pad is broken down and utilize as a source of energy
This structure enters into the vestibule opposite to the 2nd maxillary molar.
The Parotid Duct
The Gingivae cover the alveolar bone surrounding the teeth. There are two types, what are they?
attached (true)
loose (free-alveolar mucosa)
Which ligament holds attached gingivae in place?
Pariodontial ligament
What is Givivitis? and what are the two types?
it is inflammation of the gingivae
1. Chronic marginal gigivitis - chronic state of infection and inflammation
2. Acute necrotizing ulcerative gingivitis (ANUG) - also known as trench mouth.
How does Periodontial disease differetiate from gingivitis?
Infection now involves the alveolar bone and you get receding of the gums
This can lead to lost of a teeth “MAJOR CAUSE”
What is enclosed in the yellow circle?
Oral Cavity Proper
Anterior and lateral boundaries are the teeth
Posterior boundary is the Palatoglossal Arch (fold)
What is the Palatoglossal Arch?
Seperates the oral cavity from oropharynx, the region of the gag reflex
At which point in this image is the gag reflex initiated? Which cranial nerve is involved with the gag reflex?
Once you pass the linea terminalis CN IX initiates the gag reflex. This is also where the second phase of swallowinf occurs (oropharynx)
What is A, B, and C and what are there functions?
(hard palate)
A. Rugae - longitudinal ridge so that when you bite it allows you to swallow
B. Incisive papilla - location where the nasal palatine nerve, artery, and vein enter the oral cavity
C. Median raphe - seperate hard palate into left and right
What forms the floor of the oral cavity proper?
Mylohyoid m.
What are the two spaces that are inferior to the mylohyoid?
The submandibular and submental spaces
This muscle seperates the sublingual from the submandibular and submental spaces?
The Mylohyoid
The sublingual is above the muscle and the other two are below the tongue
Why is the mylohyoid line important during oral infections
It is the insertion of the mylohyoid muscle and allows the spread of infection (watershed) between the sublingual and the submandibular spaces.
Incisor teeth dont extend beyond the mylohyoid line (infection spreads to the sublingual space)
Roots of the molar teeth extend past the mylohyoid line (infection spreads into submandibular space)
Bilateral infection in sublingual, submandibular, and submental spaces is known as?
Ludwig’s Angina
May resul in an embarrased airway that leads to asphyxiation and death
What is so special about the floor of the mouth?
Excellent site for drug absorbtion
Identify the parts of the floor of the mouth
A. Tongue
B. Lingual frenulum - from the tongue to the floor of the mouth
C. Sublingual papilla - where the submandibular duct releases saliva into the oral cavity
D. Sublingua ridge - sublingual gland sits below the ridge
When the lingual frenulum is short, what is it called? How is this treated?
Ankyloglossia
(tongue tied)
Patient has difficult talking and stumbles over words. Tongue cant get pushed up to palate so it can become narrow.
Treatment: Frenulectomy (just cut it)
A salivary stone is know as?
Sialolithiasis
Patient experience pain during eating. Swelling and tenderness of gland. Stone is in the sublingual papilla
What are the contents of the floor of the mouth?
Salivary Glands
Sublingual gland (A) - underneath ridge
Submandibular duct (B) - terminate in teh subligual coruncle
Submandibular gland (deep part) (C)
Lingual Nerve
What is the path of the lingual nerve?
Comes from the infratemporal fossa and goes to the tongue. While heading to the tongue it crosses over the submandibular duct
Provides general sensory informations, fibers from chorda tympani provide salivation and taste
Another muscle in the floor of the mouth is the hyoglossus (square shape muscle). What is the relationship of the nerves, arteries, and ducts in relation to this muscle?
Lateral to the hyoglossus you have:
Lingual n. (1) - goes to the body of tongue
CN IX (2) - tonsilar bed. Goes to back of tongue
CN XII (3) - loop around the hyoid bone. Motor innervation to tongue musceles
Submandibular duct (4)
Medial to the Hyoglossus you have
Sublingual artery
Where is the Submandibular ganglion located?
Underneath the lingual nerve at the crossing with the submandibular duct.
Parasympathetic, secremotor, visceromotor innervation to glands of the mouth
The dorsum of the mouth has severeal structures. What are they?
A. Vallecula - filed with saliva. Where things get stuck before swallowed
B. Foramen Cecum - where thyroid gland develps. If it still exist, the thyroglossal duct will open here
C. Sulcus (linea) terminalis - separates the oral cavity from the oral pharynx
D. Circumvallate papillae (8-12) - taste budds.
E. Median Sulcus
The Circumvallate papillae is innervated by which cranial nerve?
CN IX
The root of the tongue (oropharynx/posterior 1/3) and the body of the tongue (oral cavity/anterior 2/3) are seperated by what?
Sulcus Terminal
The body of the tongue (anterior 2/3) recieves sensory innervation which two nerves?
GSA (pain, temp, and touch) - CN V3
SVA (taste) - CN VII
The root of the tongue (posterior 1/3) recieves sensory innervation from which two nerves?
SVA (taste) - CN IX
GSA (pain, temp, and touch) - CN IX
The Epiglottis recieves sensory innervation from which nerves?
GSA (pain, temp, and touch) - CN X
SVA (taste) - CN X
The GVA and SVA fibers run in the _______ ________ and terminate in the _______ __________.
Solitary tract
Solitary Nucleus
(image of open medula/solitary tract identified)
What are the extrinsic muscles of the tongue? (what’s the exception to the rule)
Genioglossus
Styloglossus
Hyoglossus
Exception: Palatoglossus is sometimes considered one even though it is really a muscle of the palate (also has a different innervation)
The three main intrinsic muscles are innervated by what?
CN XII
Genioglossus
Function: depresses (verticle fibers) and protrudes the tongue (horizantal fibers)
“Allows the tongue to stick out”
Origin: Superior Mental Spine (Right and left muscle attach here)
Paralysis of the genioglossus muscle can cause what?
Tongue will fall into the back of the throat and produce choking
this is relieved by moving the mandible anterioly
Styloglossus
Funciton: retracts and elevates the tongue
Hyoglossus
Retracts and depresses the tongue
There are four groups of intrinsic muscles for the tongue. They originate and insert in the tongue are volunatarily controlled. What are the 4 groups, innervation, and group function?
Verical group
transverse group
longitudinal superficial gorup
longitudinal deep group
CN XII
Change size and shape of the tongue
Which is the only muscle of the tongue that is not innervated by CN XII? What is the actual inneration of this muscle?
The Palatoglossus muscle is the only muscle not innervated by CN XII. It is actually inntervated CN X.
Paralysis of CN XII leads to what?
Deviation of the tongue toward the side of the lesion
Lower motor neuron lesion
will also see fasciculation and wasting on the affected side
What are the major salivary glands of the oral cavity?
Parotid Gland
Sumbmandibular Gland
Sublingual gland
Parotid Gland
- Secretes Serous fluids
- Secremotor innervation controlled by CN IX (lesser petrosal n.) - preganglionic fibers
- Parasympathetic fibers to otic ganglion
- post ganglionic fibers carried on the auriculotemporal nerve -> parotid gland
Located in a retromandibular position, between mandible and ear.
Largest
Submandibular gland
- Secretion: serous (superficial) and mucous (deep)
- Parasympathetic fibers from CN VII (chorda tympani)
- Innervation: lingual nerve
- Sumandibular ganglion (Where preganglionic fibers from lingual nerve synapse). Post ganglionic fibers innervate submandibular and sublingual gland
Found in neck and floor of the mouth
Sublingual Gland
- Secretion: mucous
- CN VII (chorda tympanin) - Preganglionic parasympathetic fibers
- Lingual n.
- Submandibular ganglion (where preganglionic fibers synapse)
Floor of mouth
This is an image of?
Squamous Cell Carcinoma
Note: precancerous leukoplakia
Cancers in the tongues metastazie contalaterally, ipsilateral, or bilateral?
Bilaterally
Due to crossing of drainainge from the deep cervical nodes
The root of the tongue is drained by?
Retropharyngeal lymph nodes
The center of the anterior 2/3 of the tongue is drained by?
Deep cervical Lymph nodes
Cross (bilateral)
Also drain the mandibular teeth
The lateral part of the anteriro 2/3 of the tongue is drained by?
Submandibular lymph nodes
also drains the palate, maxillary teeth, upper lip, vestibular gingivae, floor of mouth, cheek
The tip of the tongue is drained by?
Submental lymph nodes
ipsilateral and bilateral/contralateral
The tip of the chin, lower lip, anterior floor of the mouth and tip of the tongue from the central part of the lower 1/2 of the oral cavity are drained by?
Submental lymph nodes
