Oral cavity and Esophagus Flashcards

1
Q

What is the extent of the oral cavity?

A

Lips to oropharyngeal isthmus

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2
Q

What is the structure of the lips?

A

Orbicularis oris muscle covered by skin and mucus membrane

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3
Q

What is the innervation of the lips?

A

Upper lip - CNV2
Lower lip - CNV3

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4
Q

What is the lymphatic drainage of the lips?

A

Upper and lateral lower to submandibular lymph nodes
Medial lower lip to submental lymph nodes

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5
Q

What are the parts that come together to form the hard palate?

A

Palatine processes of maxilla and the horizontal plates of palatine bones

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6
Q

What is the palatoglossal arch?

A

Where the soft palate continues with the tongue

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7
Q

What with the palatopharyngeal arch?

A

Where the soft palate continues with the pharynx

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8
Q

Where is the tonsillar fossa located?

A

Between the palatoglossal and palatopharyngeal arches

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9
Q

What are the 5 muscles of the soft palate?

A

Tensor veli palatini
Levator veli palatini
Palatoglossus
Palatopharyngeus
Musculus uvulae

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10
Q

What is the innervation of the tensor veli palatinin?

A

Nerve to medial pterygoid via otic ganglion - branch of CNV3

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11
Q

What is the majority of the soft palate muscles innervated by?

A

Pharyngeal branch of CNX via pharyngeal plexus

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12
Q

What is the arterial supply of the palate?

A

Greater and lesser palatine from descending palatine from maxillary artery
Ascending palatine from facial artery

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13
Q

What are the veins of the palate?

A

Corresponding to arteries
Tributaries to pterygoid venous plexus

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14
Q

What is the sensory innervation of the gingiva, mucous membrane and hard palate glands of the oral cavity?

A

Greater palatine nerve from CNV2

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15
Q

What is the sensory innervation of the soft palate?

A

Lesser palatine nerve from CNV2 that pass through pterygopalatine ganglion

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16
Q

What is the afferent and efferent limbs of the gag reflex?

A

Afferent - CNIX - glossopharyngeal
Efferent - CNX - Vagus

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17
Q

What way will the uvula deviate if the pharyngeal plexus is injured?

A

To the opposite side

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18
Q

What are the actions of the tongue?

A

Mastication
Taste
Deglutition
Articulation
Oral cleansing

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19
Q

What causes the cobblestone appearance of the root of the tongue?

A

Lingual tonsil

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20
Q

What are the 5 divisions of the tongue?

A

Root
Body
Apex
Inferior surface
Dorsal surface

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21
Q

What is the terminal sulcus?

A

V shaped groove separating anterior 2/3 of tongue from post 1/3

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22
Q

Where is the foramen cecum located?

A

Apex of the terminal sulcus

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23
Q

What is the foramen cecum?

A

Proximal part of thyroglossal duct

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24
Q

What are the 4 types of lingual papillae?

A

Vallate
Foliate
Filiform
Fungiform

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25
Q

Where do the submandibular ducts open?

A

Base of the lingual frenulum

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26
Q

What are the 4 extrinsic muscles of the tongue?

A

Palatoglossus
Genioglossus
Styloglossus
Hyoglossus

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27
Q

What are the 4 intrinsic muscles of the tongue?

A

Superior longitudinal
Inferior longitudinal
Transverse
Vertical

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28
Q

What are the actions of the genioglossus muscle?

A

Depresses tongue medially
protrusion and retraction
Deviates side to side

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29
Q

What are the actions of the hyoglossus muscle?

A

Depresses tongue laterally
Retrusion

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30
Q

What are the actions of the styloglossus?

A

Retrusion
Elevates sides

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31
Q

What are the actions of the palatoglossus?

A

Elevates posterior tongue
Depresses soft palate
Constrict isthmus of fauces a ligament of the throat

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32
Q

What are the actions of superior longitudinal muscle?

A

Curls tongue upward
Retrusion

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33
Q

What are the actions of the inferior longitudinal muscle?

A

Curls tongue downward
Retrusion

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34
Q

What is the action of the transverse muscle of the tongue?

A

Narrows and protudes

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35
Q

What is the action of the vertical muscle of the tongue?

A

Flattens and broadens

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36
Q

What is the motor innervation of the palatoglossus muscle?

A

CNX through pharyngeal plexus

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37
Q

What is the motor innervation for the majority of tongue muscles?

A

CNXII - hypoglossal

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38
Q

What innervates general sensation of the anterior 2/3 of the tongue?

A

Lingual nerve branch of CNV3

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39
Q

What innervates taste sensation of the anterior 2/3 of the tongue?

A

Chorda tympani branch of CNVII

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40
Q

What is the sensory innervation of the posterior 1/3 of the tongue?

A

CN IX

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41
Q

What is the sensory innervation for the small area in front of the epiglottis?

A

CN X - internal laryngeal nerve

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42
Q

What will the position of the tongue be with an injury to to the hypoglossal nerve (CNXII)?

A

It will deviate toward the paralyzed/injured side

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43
Q

What is the lymphatic drainage of the posterior 1/3 of the tongue?

A

Superior deep cervical nodes bilaterally

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44
Q

What is the lymphatic drainage of the medial anterior 2/3 of the tongue?

A

Inferior deep cervical nodes bilaterally

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45
Q

What is the lymphatic drainage of the lateral anterior 2/3 of the tongue?

A

Submandibular nodes

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46
Q

What is the lymphatic drainage of the apex and frenulum of the tongue?

A

Submental nodes

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47
Q

What are the salivary glands?

A

Parotid glands
Submandibular glands
Sublingual glands

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48
Q

What are the functions of saliva?

A

Keeps mouth mucous membrane moist
Lubricates food during mastication
Begins digestion of starches
Intrinsic mouth wash
Prevention of tooth decay
Ability to taste

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49
Q

What is the parotid sheath derived from?

A

Investing layer of deep cervical fascia

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50
Q

What structures pass through the parotid gland?

A

Facial nerve
Retromandibular vein
External carotid artery

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51
Q

What is the anatomical location of the parotid gland?

A

Between mandible, styloid process and mastoid process bilaterally

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52
Q

What is the locations of the submandibular gland?

A

Lies along body of mandible

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53
Q

What is the location of the sublingual gland?

A

Lies in floor of mouth between mandible and genioglossus muscle

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54
Q

What is the secretomotor nerve supply of the parotid gland starting from the pons?

A

Inferior salivatory nucleus in pons
Glossopharyngeal N
Tympanic nerve
Tympanic plexus
Lesser petrosal nerve
Otic ganglion
Auriculotemporal nerve
Parotid gland

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55
Q

What is the nerve supply of the submandibular and sublingual glands starting at the pons?

A

Superior salivary nucleus in pons
Facial nerve
Chorda tympani
Submandibular ganglion
To glands

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56
Q

With what viral disease can you see parotiditis?

A

Mumps

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57
Q

What is the extent of the pharynx?

A

Base of cranium to cricoid cartilage at C6 level

58
Q

What are the 3 subdivisions of the pharynx?

A

Nasopharynx
Oropharynx
Laryngopharynx/hypopharynx

59
Q

What are the boundaries of the oropharynx?

A

Soft palate
Base of tongue
Palatoglossal and palatopharyngeal arches

60
Q

What is the extent of the laryngopharynx?

A

Tip of epiglottis to cricoid cartilage

61
Q

What part of the pharynx is continuous with the epiglottis?

A

Laryngopharynx

62
Q

What is the piriform fossa?

A

Small depression on either side of laryngopharyngeal cavity

63
Q

What lies anterior to the layngopharynx?

A

Larynx

64
Q

What structure is related to the piriform fossa?

A

Branches of internal laryngeal and recurrent laryngeal nerves lie deep to the fossa

65
Q

What are the external layer of muscles of the phaynx?

A

Superior pharyngeal constrictor
Middle pharyngeal constrictor
Inferior pharyngeal constrictor

66
Q

What are the internal layer of muscles of the pharynx?

A

Palatopharyngeus
Salpingopharyngeus
Stylopharyngeus

67
Q

What is the innervation of the stylopharyngeus muscle?

A

CNIX - glossopharyngeal

68
Q

What are the majority of the pharynx muscles innervated by?

A

Pharyngeal branch of vagus nerve and pharyngeal plexus?

69
Q

What muscles of the pharynx are also innervated by the external and recurrent laryngeal nerves?

A

Middle pharyngeal constrictor
Inferior pharyngeal constrictor

70
Q

What is the sensory innervation of the pharynx?

A

Anterior and superior nasopharynx by CNV2
Rest is by pharyngeal plexus from glossopharyngeal nerve

71
Q

What makes up the pharyngeal tonsillar ring of Waldeyer?

A

Lingual tonsil
Palatine tonsils
Tubal tonsils
Pharyngeal tonsils

72
Q

What are the arteries that supply the palatine tonsils?

A

Branches of facial artery
-Tonsillar artery
-Ascending palatine
Descending palatine branch of maxillary artery
Lingual and ascending pharyngeal branches of external carotid

73
Q

What can be injured to cause bleeding during tonsillectomy?

A

External palatine vein that drains into facial vein

74
Q

What is the typical length of the esophagus?

A

25 cm

75
Q

At what level is the esophageal hiatus of the diaphragm?

A

T10

76
Q

Where does the thoracic part of the esophagus lie?

A

Between the two pleural cavities - called the mediastinum

77
Q

What is located anterior to the esophagus in the lower mediastinum?

A

Left atrium of heart

78
Q

What are the constrictions of the esophagus?

A

Cervical constriction/pharyngoesophageal sphincter
2 Thoracic/broncho-aortic constriction
Diaphragmatic constriction

79
Q

What causes the cervical constriction and what is its distance?

A

Cricopharyngeus muscle
15 cm from incisor teeth

80
Q

What causes the two thoracic constrictions and what are their distances?

A

Crossing of aorta - 22.5 cm
Crossing of left main bronchus - 27.5 cm

81
Q

At what distance does the esophagus pass through the diaphragm?

A

40 cm

82
Q

What is a tracheo-esophageal fistula?

A

Birth defect where partitioning of trachea and esophagus failed

83
Q

What is the most common type of tracheoesophageal fistula?

A

Upper part of esophagus ends in blind pouch and lower part connects to trachea

84
Q

What is the most common complaint seen in esophageal cancer?

A

Dysphagia

85
Q

What area of the esophagus is related to the portosystemic shunt?

A

Lower end

86
Q

What is the portosystemic shunt?

A

Abdominal part drains from portal venous system and thoracic part drains from systemic venous circulation

87
Q

What can form esophageal varices?

A

When the portosystemic shunt is dilated

88
Q

What are the three types of oral mucosa divided by location?

A

Masticatory mucosa
Specialized mucosa
Lining mucosa

89
Q

Where would you find the masticatory mucosa?

A

Gingiva and hard palate

90
Q

What is the epithelium of the masticatory mucosa?

A

Stratified squamous keratinized/parakeratinized

91
Q

Where would you find the specialized oral mucosa and what does it contain?

A

Dorsal surface of tongue
Lingual papillae

92
Q

Where would you find the lining oral mucosa?

A

Rest of oral cavity

93
Q

What is the epithelium of the lining oral mucosa?

A

Stratified squamous non-keratinized

94
Q

What are the three regions of the lip?

A

Cutaneous region
Vermillion region
Oral mucosa region/vestibular aspect

95
Q

What characterizes the cutaneous region of the lip?

A

Thin skin with hair follicles, sebaceous glands, and sweat glands
Stratified squamous epithelium

96
Q

What characterizes the vermillion region of the lip?

A

Stratified squamous epithelium
Supported by CT containing blood vessels that provide red color
No glands

97
Q

What characterizes the oral mucosa region of the lip?

A

Lining oral mucosa
Minor salivary glands

98
Q

What are the characteristics of filiform papillae?

A

Most numerous
Conical shape
No taste buds
Keratinized stratified squamous epithelium

99
Q

What are the characteristics of fungiform papillae?

A

More numerous near apex of tongue
Mushroom-shaped
Few taste buds on free surface
Nonkeratinized stratified squamous epithelium

100
Q

What are the characteristics of foliate papillae?

A

Posterolateral aspect of anterior 2/3 of tongue
Shallow furrows
Taste buds for first 2 years of life
Secretion of glands of von Ebner released into furrows

101
Q

What are the characteristics of Circumvallate papillae?

A

Just anterior to terminal sulcus
Numerous taste buds
Surrounded by deep furrow

102
Q

Where do the glands of von Ebner release their secretions?

A

Into furrow of foliate papillae
Into deep furrow surrounding circumvallate papillae

103
Q

What part of the tongue has lingual papillae?

A

Dorsal surface of tongue anterior to terminal sulcus

104
Q

How do taste buds appear in staining?

A

Oval, pale
Extend through epithelium

105
Q

The microvilli of what cells project through the taste pore?

A

Gustatory cells

106
Q

What is the basic secretory unit of the salivary glands?

A

Salivon

107
Q

What does the salivon consist of?

A

Acinus
Intercalated duct
Excretory duct

108
Q

What are the characteristics of acini?

A

Spherical
Myoepithelial cells present at base

109
Q

What are the types of secretion in acini?

A

Serous - protein secreting
Mucous - mucin secreting
Mixed

110
Q

What is the drainage of the secretion from acinus?

A

Into intercalated duct which merges with striated duct and then into excretory duct

111
Q

What is the epithelium of the intercalated duct of the salivary gland?

A

Simple cuboidal

112
Q

What is the epithelium of the excretory duct of the salivary gland?

A

Stratified cuboidal/columnar epithelium

surrounded by CT

113
Q

What gives the striated duct of the salivary gland its striated appearance?

A

Numerous basal membrane infoldings containing mitochondria

114
Q

What type of acini is found in the parotid glands?

A

Only serous acini

115
Q

What are the histological characteristics of the parotid glands?

A

Dark serous acini
White adipose tissue

116
Q

What are the histological characteristics of the submandibular glands?

A

Predominantly dark serous acini with some lighter mucous acini mixed in
Evident striated ducts

117
Q

What type of acini is found in the submandibular glands?

A

Mixed, but predominantly serous

118
Q

What type of acini is found in the sublingual glands?

A

Mixed, but primarily mucous

119
Q

What are the histological characteristics of the sublingual glands?

A

Predominantly lighter mucous acini with some dark serous acini
Whitish ducts

120
Q

What are the 4 general layers of the GI tract?

A

Mucosa
Submucosa
Muscularis Propria
Serosa or adventitia

121
Q

What are the three divisions of the GI tract’s mucosa layer?

A

Epithelium
Lamina propria
Muscularis mucosa

122
Q

In what layer of the GI tract is the Meissner’s plexus found?

A

Submucosa

123
Q

In what layer of the GI tract is the Auerbach’s/Meyenteric plexus found?

A

Muscularis propria between the circular and longitudinal muscle

124
Q

What are the two types of muscle in the muscularis propria layer of the GI tract?

A

Circular
Longitudinal

125
Q

What are the characteristics of the lamina propria of the GI tract?

A

Loose CT
Rich in blood vessels, lymphatics, lymphocytes, and smooth muscle cells
Often contains small glands

126
Q

What are the characteristics of the muscularis mucosa of the GI tract?

A

Thin layer of smooth muscle
Separates mucosa from submucosa
Allows local movements of mucosa

127
Q

What are the characteristics of the submucosa of the GI tract?

A

CT with larger blood and lymph vessels
Contain submucoal/Meissner plexus
May contain glands and lymphoid tissue

128
Q

What type of nerves make up the Meissner plexus?

A

Autonomic

129
Q

What are the actions of the musclaris propria layer of the GI tract?

A

Contraction that mixes and propels luminal contents forward through the GI tract

130
Q

What are the characteristics of the adventitia?

A

Thin sheet of loose CT
Rich in blood vessels, lymphatics, and adipose tissue
Continuous with surrounding tissues

131
Q

What are the characteristics of the serosa?

A

Thin sheet of loose CT
Rich in blood vessels, lymphatics, and adipose tissue
Covered with simple squamous epithelium called mesothelium
Not continuous with surrounding tissues

132
Q

What makes up the ENS?

A

Meissner’s plexus
Myenteric plexus

133
Q

How is the ENS affected in Hirchsprung disease?

A

Part or all of the plexuses are absent or injured

134
Q

What type of epithelium is the mucosa of the esophagus?

A

Nonkeratinized stratified squamous

135
Q

Where are the esophageal glands located and what is their function?

A

Submucosa
Secrete mucus to lubricate and protect the mucosa

136
Q

What part of the esophagus has only striated muscle?

A

Superior 1/3

137
Q

What part of the esophagus has mixed striated and smooth muscle?

A

Middle 1/3

138
Q

What part of the esophagus has only smooth muscle?

A

Inferior 1/3

139
Q

What forms the outer layer of the esophagus?

A

Adventitia in thoracic cavity
Serosa in abdominal cavity

140
Q

What happens to the epithelium at the esophagogastric junction?

A

Abrupt change from nonkeratinized stratified squamous to simple columnar

141
Q

Where are the esophageal cardiac glands located and what is their function?

A

In mucosa of the esophagus near the stomach
Secrete additional neutral mucus to protect esophagus from regurgitated gastric contents