Oral Cavity and Larynx Flashcards
The oral cavity consists of two parts:
1 oral vestibule (space between cheeks and lateral edge of teeth)
2 oral cavity proper (space in between teeth, its filled by the tongue)
What is the first phase of deglutition? Voluntary or involuntary?
Food bolus put in the mouth and compressed against the palate. Voluntary
The alveolar arches are:
They contain the sockets of the teeth and are covered by gingivae (gums)
The lips are covered externally by skin and internally by?
Mucous membrane
The gingivae (gums) are composed of ___________ that is covered with mucous membrane
fibrous tissue
What are the pieces called that attach the lips to the gingivae?
Frenulum (thats singular)
What are the three layers of the cheeks?
Skin
Buccinator
Oral mucosa
What is the principle muscle of the cheek and what is it innervated by?
Buccinator
CN VII
What is the parotid papilla and where does it open into?
The parotid duct opens at the parotid papilla opposite the upper second molar
What provides somatosensory innervation to the cheek? What is the functional component?
Buccal nerve (branch of V3) SA
In context of the TOP tooth pulp, periodontal ligament, and alveolar processes, what innervates the incisors and canines?
Anterior superior alveolar nerve (V2 branch)
In context of TOP tooth pulp, periodontal ligament, and alveolar processes, what innervates the two premolars and half of the first molar?
Middle superior alveolar nerve (V2)
In context of TOP tooth pulp, periodontal ligament, and alveolar processes, what innervates the second half of the first molar plus the other two molars?
Posterior superior alveolar nerve (V2)
What innervates the superior lingual gingiva?
Nasopalatine (V2)
In context of the vestibular (buccal, labial) gingiva, what innervates the area above the incisors and canines?
Anterior superior alveolar nerve (V2) Infraorbital nerve (V2)
In context of the vestibular (buccal, labial) gingiva, what innervates the area above the premolars?
Middle superior alveolar nerve (V2) Infraorbital nerve (V2)
In the context of the vestibular (buccal, labial) gingiva, what innervates the area above the molars?
Posterior superior alveolar nerve (V2)
What are the two regions of the tongue and where are they located?
Anterior 2/3 is the body and is located in the oral cavity proper - has a dorsal and ventral surface
Posterior 1/3 is the root and is located in the oropharynx
Which papillae of the tongue contain taste buds?
Fungiform
Vallate
Foliate
Which papillae contain sensory nerve endings that are sensitive to touch?
Filiform
Which nerves does the anterior 2/3 of the tongue give special sensory (SS) and receive somatic sensory (SA) from?
The chorda tympani (CN VII) picks up the ss-taste fibers from the tongue via the lingual nerve. The lingual nerve picks up para/pre fibers from the chorda tympani
The lingual nerve (V3) delivers SA to the anterior 2/3 of tongue
Which nerve receives SS-taste fibers from the posterior 1/3 of the tongue and delivers SA fibers to the posterior 1/3 of the tongue?
Lingual branch of CN IX
What takes SS-taste fibers from the “anterior to the epiglottis” and supplies VA?
Internal laryngeal nerve (CN X)
All muscles of the tongue are innervated by _____ except for which muscle?
CN XII
Palatoglossus (CN X)
Which muscles alter the shape of the tongue
Intrinsic muscles
Which muscles alter the position of the tongue
Extrinsic muscles
The floor of the oral cavity proper contains what 6 structures?
Lower alveolar arch Mylohyoid muscle Geniohyoid muscle Submandibular gland and duct Sublingual gland Lingual nerve
What is the purpose of the lingual frenulum?
Attaches the tongue to the floor of the mouth while allowing free movement of the anterior 2/3 of the tongue
What is the sublingual caruncle?
Opening of the submandibular ducts
What is the sublingual fold? Whats on top of the fold?
Slight elevation of the mucosa due to the sublingual gland sitting underneath
8-20 holes that are the sublingual ducts
What are the vessels that can be seen on the ventral surface of the tongue?
Deep lingual vessels (from the lingual artery and vein)
What is more superior, the sublingual duct or lingual nerve?
Sublingual duct
The floor of the oral cavity proper is supplied by what vessels?
Lingual artery/vein and its branches (lingual vessels from external carotid)
What innervates the bottom incisors, canines, and half of the first premolar?
Incisive branch of inferior alveolar nerve (V3)
What innervates the bottom second half of the first premolar, the second premolar, and all of the molars?
Dental branches of inferior alveolar nerve (V3)
What innervates the bottom gums of the incisors, canines, and both premolars?
Mental branch of inferior alveolar nerve (V3)
What innervates the bottom gums of all of the molars?
Buccal branch of the inferior alveolar nerve (V3)
What nerve supplies general sensory innervation to the floor of the mouth?
Lingual nerve
What are the 2 suprahyoid muscles that help form the floor of the oral cavity proper?
Mylohyoid
Geniohyoid
What triangle is the larynx located in?
Muscular triangle
What vertebral levels does the larynx sit in and what does it do?
C3-C6
Phonating mechanism designed for voice production
What are the 3 laryngeal spaces and what are their boundaries?
Supraglottic - laryngeal inlet to the false vocal cords (vestibular folds)
Ventricle - between false and true vocal cords (vocal folds)
Infraglottic - between the true vocal cords and the lower border of the cricoid cartilage
What is the rima glottis?
Space between true vocal cords
What is the glottis?
Region that includes the true vocal cords AND the rima glottis
What are the 9 cartilages of the laryngeal skeleton?
Thyroid Cricoid Epiglottic Arytenoid (2) Corniculate (2) Cuneiform (2)
Which cartilage is located in the aryepiglottic folds? Whats significant about this?
Cuneiform cartilages (2) They are lost if the mucosa has been pulled off
Thyrohyoid membrane?
Binds hyoid to superior portion of thyroid cartilage
Cricothyroid membrane
Made up of median and lateral cricothyroid ligaments
Binds cricoid and thyroid cartilages and helps form the conus elastus
Quadrangular membrane
Extends between epiglottic and arytenoid cartilages
Its inferior margin forms the vestibular ligament
What makes up the conus elastus? What does it do?
Median cricothyroid ligament
Lateral cricothyroid ligament
Vocal ligaments
Connects cricoid cartilage to the vocal ligaments and forms the roof of the infraglottic space
Lateral cricoarytenoid innervation and function
Recurrent laryngeal nerve (BM)
Adduction of vocal ligaments
Innervation and function of transverse and oblique arytenoid muscles
Recurrent laryngeal nerve (BM)
Adduction of vocal ligaments
Posterior cricoarytenoid innervation and function
Recurrent laryngeal nerve (BM)
Abduction of vocal ligaments
Vocalis and thyroarytenoid innervation and function
Recurrent laryngeal nerve (BM)
Relaxation of vocal ligaments
Cricothyroid innervation and function
External laryngeal nerve (BM)
Increase tension of vocal ligaments
What are the adductors of the intrinsic laryngeal muscles?
Lateral cricothyroid
Oblique Arytenoid
Transverse arytenoid
What are the abductors of the intrinsic laryngeal muscles
Posterior cricoarytenoid
Which of the intrinsic laryngeal muscles is a relaxer?
Vocalis
Thyroarytenoid
Which laryngeal constrictor muscle is a tensor?
Cricothyroid
Which nerve sends visceromotor (VE) and viscerosensory (VA) innervation to the mucosa and mucous glands of the larynx?
CN X
All of the muscles of the larynx are innervated by what? What are the functional components?
CN X (specifically recurrent laryngeal and superior laryngeal branches) BM
Which arteries supply blood to the larynx?
Superior/inferior laryngeal vessels
What does the internal laryngeal nerve supply and what are its functional components?
. VA and VE-para/pre to the laryngeal mucous membrane superior to the vocal cords
. VA and SS-taste to the anterior epiglottis
What does the external laryngeal nerve supply and what are the functional components?
BM and SA
Cricothyroid
The recurrent laryngeal nerves ascend toward the larynx in between the:
Trachea and Esophagus
What do the recurrent laryngeal nerves supply and what are the functional components?
. BM and SA to all laryngeal muscles except cricothyroid
. VE-para/pre and VA to mucosa and mucous glands below the true vocal cords
What vessels are paired with the internal laryngeal nerve after passing the thyrohyoid membrane?
Superior laryngeal artery/vein, which is a branch of the superior thyroid artery/vein
Which vessels accompany the recurrent laryngeal nerve in the pharyngeal gap #4
Inferior laryngeal artery/vein which is a branch of the inferior thyroid artery/vein
What is the neurovasculature above the vocal folds?
Innervation:
• Internal laryngeal nerve (VE-para/pre, VA, SS-taste of anterior epiglottis)
• Sym/post (via superior laryngeal artery)
Blood Supply:
• Superior laryngeal artery (branch of superior thyroid artery)
What is the neurovasculature below the vocal folds?
Innervation:
• Recurrent laryngeal nerve (BM-CN X, VE-para/pre, VA, SA- propriception of muscles)
• Sym/post (via inferior laryngeal artery)
Blood Supply:
• Inferior laryngeal artery (branch of inferior thyroid artery)
What four muscles comprise the intrinsic tongue muscles? What innervates them?
Superior longitudinal Vertical Transverse Inferior longitudinal CN XII
What do the superior longitudinal muscles do? Nerve?
Curls tongue longitudinally upward, elevating apex and sides, shortens tongue
CN XII
What do the vertical tongue muscles do? Nerve?
Flattens and broadens tongue
CN XII
What do the transverse tongue muscles do? Nerve?
Narrows and elongates tongue
What do the inferior longitudinal tongue muscles do? Nerve?
Curls tongue longitudinally downward, depressing apex, shortens tongue
CN XII
Genioglossus innervation and function
Protrudes tongue, bilaterally depresses tongue, unilaterally wags tongue
CN XII
Styloglossus innervation and function
Retract and elevate the tongue
CN XII
Hyoglossus innervation and function
Retract and depress tongue
Geniohyoid innervation and function
Pulls hyoid anterosuperiorly, shortens floor of mouth, widens pharynx
CN XII
Mylohyoid innervation and function
Elevates hyoid, floor of mouth, and tongue during speaking and swallowing Mylohyoid nerve (V3)
Describe the innervation of the submandibular and lingual glands, beginning with the superior salivatory nucleus
Para/pre fibers from the superior salivatory nucleus course through the chorda tympani (VII), then the lingual (V3), and synapse at the submandibular ganglion. The para/post fibers then directly innervate the submandibular gland or hop back on the lingual nerve to innervate the sublingual gland
Describe the parotid gland innervation, beginning with the inferior salivatory nucleus
Para/pre fibers originate from the inferior salivatory nucleus and course through the tympanic nerve of CN IX to the tympanic plexus. The para/pre fibers course through the lesser petrosal nerve and travel through the foramen ovale to synapse at the otic ganglion. Para/post fibers course through the auriculotemporal nerve (V3) to the parotid gland