Oral Cavity Flashcards
The dental arches subdivide oral cavity into ____
Vestibule and oral cavity proper
Vestibule contents
. U-shaped space located between lips/cheeks and teeth/gums
. Labial and buccal mucosa line lips/cheeks and teeth/gums
. Opening to parotid duct pierced buccinator m. And opens into vestibule opposite of M2 teeth
. Buccinator
. Orbicularis oris m.
. Gingivae
Oral cavity proper
. Space btw dental arched ant. And lat., palatoglossal folds post., palate sup., and muscular floor of mouth inf.
. Contains tongue, submandibular and sublingual glands and their ducts
Dental arches
Alveolar processes of maxilla and mandible
. House dentition
Deciduous dentition
. 1st teeth (lower central incisors) erupt at 6-8 mo
. Final teeth erupt 2024 mo
. Teeth and shed and replaced w. Adult teeth age 6-12
. 2 incisors, 1 canine, 2 molars per quadrant (20 teeth total)
. Molars important for maintaining spacing for adult dentition
. Deciduous molars replaced by adult premolars
Permanent dentition
. 1st tooth at 6 y/o
. Final teeth (3rd molars/wisdom teeth) at 1 y/o
. 2 incisors, 1 canine, 2 premolars (bicuspids), 3 molars (32 total)
Oral cavity cavity proper post. Boundary
. Palatoglossal folds border oropharyngeal isthmus
Oral cavity proper roof
. Palates covered by mucoperiosteum w/ mucous glands
. Hard palate: palatine processes of maxillary bones w/ incisive foramina ant. And horizontal plate of palatine bones w. Greater and lesser palatine foramina post.
. Soft palate: post. Extent of palate, has membranous aponeurosis, skeletal mm., and mucous membranes, continuous lat. w/ palatoglossal and palatopharyngeal arches
Oral cavity proper floor boundary
. Mylohyoid m.
. Geniohyoid m.
Mylohyoid OIAN
O: mylohyoid line
I: body of hyoid and fibers from opposite site to form median raphe
A: elevates hyoid and floor of mouth during swallowing
N: n. To mylohyoid
Geniohyoid m. OIAN
O: genial tubercle of mandible
I: body of hyoid bone
A: pulls hyoid sup.
N: Ca ventral ramus coursing w/ hypoglossal n.
Maxillary teeth and sinuses innervation
. Ant., and middle sup. Alveolar nn. Branch from infraorbital n. In infraorbital canal
. Post. Sup. Alveolar n. Splits from maxillary n. And enters infratemporal surface of maxilla
Maxillary labial and buccal gingivae and mucosa innervation
. Sup. Labial n.: branches from infraorbital n. At infraorbital foramen
. Post. Sup. Alveolar n.
Hard palate mucosa, palatal gingivae of maxillary dental arches innervation
. Nasopalatine n.: supplies ant. Palatal mucosa and gingivae, passes from nasal cavity through incisive
. Greater palatine n: supplies palatal mucosa gingivae, courses from greater palatine canal through greater palatine foramen
Soft palate mucosa innervation
. Lesser palatine n.: mucosa of soft palate, courses from greater palatine canal through greater foramen
. Branches of glossopharyngeal n.
Mandibular teeth innervation
. Inf. Alveolar n. Branches from mandibular n., courses inf. To lat. pterygoid m. And enters mandibular foramen
Lower lip, chin, labial gingivae and mucosa innervation
. Mental n.: ranches from inf. Alveolar n. W/in mandible and emerges from mental foramen
. Buccal n. (Long buccal n.)
Lingual gingivae and mucosa of Floor of mouth, plus mucous membranes of ant. 2/3rds of tongue innervation
. Lingual n. Courses lat. hyoglossus m.
Blood supply to maxillary teeth and sinuses
. Ant. And middle sup. Alveolar aa. Branch from the infraorbital a. In the infraorbital canal
. Post. Sup. Alveolar a.: splits from maxillary a. And enters infratemporal surface of maxilla
Hard palate, palatal gingivae, of maxillary dental arches blood supply
. Septal branches of sphenopalatine a. Pass from nasal cavity through incisive foramen
. Greater palatine a. Branches from descending palatine a. And courses from greater palatine canal through greater palatine foramen
Soft palate blood supply
. Lesser palatine a. Branches from descending palatine a. And courses from greater palatine canal through greater palatine foramen
Mandibular teeth blood supply
. Inf. Alveolar a. Branches from maxillary a. And courses inf. To the lat. pterygoid m. To enter mandibular foramen
Lower lip, chin, and labial gingivae and mucosa blood supply
. Mental a. Branches from inf. Alveolar a. W/in mandible and emerges from mental foramen
Lingual gingivae and floor of mouth and tongue blood supply
. Lingual a. Branches from ECA and courses deep to hyoglossus m. To give rise to several branches
Buccal gingivae and mucosa of vestibule blood supply
. Facial a. And labial branches supply check and lips, buccinator and orbicularis oris mm., and buccal and labial mucosa fo cheeks
Dorsal surface of tongue
. Sulcus terminalis: V-shaped groove dividing tongue into ant. Oral surface and post. Pharyngeal surface
. Oral surface w/ lingual papillae
. Pharyngeal surface w. Scatter taste buds and lingual tonsils
Oral surface papillae
. Filiform: general sensory but no taste buds, mechanical purpose to inc. SA of tongue, draw food to esophagus, and distribution saliva
. Fungiform: have taste buds, pink spots
. Vallate: large, flat, just ant. To sulcus terminalis, has taste buds
. Foliate: small lat. folds of lingual mucosa on tongue sides, has taste buds
Foramen caecum
. At apex of sulcus terminalis
. Site of origin of thyroid gland
. On pharyngeal surface of tongue
Ventral surface of tongue
. Frenulum
. Sublingual caruncle: where submandibular duct opens
. Sublingual fold: fold of mucous membrane containing opening of sublingual ducts
Intrinsic mm. Of tongue
. All arise from midline septum and intertwine each other
. Innervated by CN XII
. Change shape of tongue
. Divided into sup. And inf. Longitudinal, vertical, and transverse groups
Extrinsic muscles of tongue
. Intertwine w. Intrinsic mm.
. Change position of tongue
. All innervated by CN XII except palatoglossus that is innervated by vagus n. And pharyngeal plexus
Palatoglossus mm. OIA
O: Palatine aponeurosis of soft
palate
I: Side of tongue
A: Elevates the tongue and
narrows the oropharyngeal isthmus
Styloglossus OIA
O: Styloid process and stylohyoid
ligament
I: Side of the tongue
A: Retracts the tongue and draws the sides up
Hyoglossus m. OIA
O: Body and greater horn of hyoid
bone
I: Side of the tongue
A: Depresses and retracts the tongue; it also acts on hyoid bone
Genioglossus m. OIA
O: Genial tubercle
I: Along the length of the dorsum of the tongue and hyoid bone
A: Depresses tongue; posterior part pulls tongue anteriorly
General sensory innervation to tongue
. Lingual n. To ant. 2/3
. Glossopharyngeal n. To post. 1/3
. Internal laryngeal n. To root of tongue
Special sensory to tongue innervation
. Chordatympani (facial n.) from ant. 2/3
. Glossopharyngeal from post. 1/3
. Vagus n. Branches from root of tongue, epiglottis, and palate
Blood supply to tongue
. Lingual a. Courses deep to hyoglossus m.
Palatal mucous glands innervation
. Parasympathetic: pre-ganglionic fibers from greater petrosal n. Synapse in pterygopalatine ganglion, postganglionic follow V2 branches to mucous glands
. SNS: postganglionic fibers from sup. Cervical ganglion and travel w/ blood vessels to oral cavity
Parotid gland location and innervation
. Largest salivary gland
. Ant. To external eat and superficial to masseter
. PNS: preganglionic w/ lesser petrosal n. And synapse at otic ganglion, postganglionic fibers then travel w/ auriculotemporal n.
. SNS: postganglionic fibers from sup. Cervical ganglion and course w/ blood vessels to reach gland
Parotid duct
. Courses across ant. Border of masseter m. And pierces buccinator
. Opens into vestibule of mouth near upper M2
Submandibular gland location and innervation
. Submandibular triangle along post. Edge of mylohyoid m. Superficial to hyoglossus m., partially wraps around mylohyoid.
. PNS: preganglionic from chorda tympani course w/ lingual n., synapse in submandibular ganglion, the postganglionic fibers w/ distal lingual n. To gland
. SNS: postganglionic from sup. Cervical ganglionic course on lingual a. To gland
Submandibular/Wharton’s duct
. On medial deep surface of gland between mylohyoid m. Lat. and hyoglossus and genioglossus mm. Med.
. Crosses lingual n. Sup. Before opening into mouth at sublingual caruncle
Sublingual gland
. Almond-shaped, located just inf. To sublingual fold deep to mucous lining of mouth
. Sublingual ducts: open into mouth along sublingual fold
. Visceral motor innervation is same as submandibular gland
What nodes drain the area supplied by facial and lingual aa.?
. Superficial cervical
. Submandibular
. Submental
Deep cervical lymph nodes
. Located along internal jugular v.
. Run from clavicle to base of skull
. Receive lymph from superficial nodes and tongue
Tongue lymphatics
. Post. 1/3 drains bilaterally to sup. Deep cervical lymph nodes
. Tip and central regions of tongue drain bilaterally but to lesser extent, drain into submandibular, submental, and inf. Deep cervical lymph nodes
Lymphatic spread fo intraoral carcinoma
. Involves first uppermost, then middle, then lower deep dervical nodes
. Cross drainage btw R and L sides is common
. Tumor size and extent of metastatic spread are best indicators of patient prognosis
HPV 16
. Leading cause of oropharyngeal cancers
. Also assoc. w/ cancers of cervix penis and anus
What week does palate form by?
. Week 10
. Separates nasal and oral cavities
Development of primary palate
. Derives from intermaxillary segment (arch 1) along w/ upper lip and maxillary incisors
. Intermaxillary segment forms median palatal process projection that becomes primary palate
. Segment is continuos w/ rostral part of nasal septum that arises from frontonasal prominence
Development of secondary palate
. Derived from paired maxillary prominences (arch 1)
. Week 6: prominences develop med. projecting palatine shelves that grow into primitive nasal/oral cavity on either elide of tongue
. Week 7: mandible grows down and out and pulls tongue w/ it permitting palatine shelve to rotate into horizontal plane and grow to one another to fuse at midline
. Also fuse to nasal septum sup. That arises from frontonasal prominence and cartilages of basicranium
Cleft palate prevalence
1/700 births
. Most common in native Americans and people of East Asian ancestry
Anterior cleft lip and palate anomalies
. Involve upper lip and primary palate
. If severe is can extend from lip into nostril
. May result from mesenchyme deficiency in maxillary prominences and intermaxillary segment
Posterior cleft palate anomalies
. Involves secondary hard palate and/or soft palate
. May result from defective development of secondary palate and growth distortions in last. Palatine processes
