ORAL CAVITY and NECK Flashcards
Lingual is tongue for latin, and frenulum is latin for little bridle, which is what helps controls a horse. So what is the lingual frenulum?
- a fold of oral mucosa
- connects the tongue to the floor of the mouth
What is the sublingual papilla also referred to as sublingual fold?
sub = below lingual = tongue
- small fold of soft tissue
- located on each side of the frenulum linguae
- binds the lips to the gums
What is the name of the main vein and artery that supplies the tongue and run, posterior on the tongue, either side of the lingual frenulum?
- lingual artery
- lingual vein
Vestibule means pouch or cavity. What is the vestibule in the oral cavity and its function?
- horseshoe-shape situated anteriorly
- space between the lips/cheeks, and the gums/teet
Vestibule means pouch or cavity. The vestibule in the oral cavity is a horseshoe-shape space situated anteriorly between the lips/cheeks, and the gums/teet. What is the most significant structure in this area and where is it located?
- parotid gland duct opens into this space
- located behind 2nd molar
The tongue is composed of skeletal muscle. It has 3 parts plus the tip. Label them in the image below using the labels below:
- tip
- root/base
- oral part (anterior 2/3s)
- pharyngeal part (posterior 1/3)
1 - oral part (anterior 2/3s)
2 - tip
3 - pharyngeal part (posterior 1/3)
4 - root/base
The tongue has 2 surfaces. The top and the bottom, what are the medical terms used to describe top and bottom?
- dorsal - faces palate
- ventral - faces underside of tongue
The tongue has intrinsic and extrinsic muscles. Are the muscles within the tongue, originate and attach to the tongue intrinsic or extrinsic?
- the tongue
- intrinsic means they are in the tongue
The tongue has intrinsic and extrinsic muscles. The intrinsic muscles are those within the tongue that originate and attach to the tongue hence the in part of intrinsic. The muscles of the tongue are names by the direction in which they travel. Label the 3 directions labelled in the image below?
- vertical
- longitudinal (from tip to root/base of tongue)
- transverse (horizontal)
1 = longitudinal (from tip to root/base of tongue) 2 = transverse (horizontal) 3 = vertical
The tongue has intrinsic and extrinsic muscles. The intrinsic muscles are within the tongue that originate and attach to the tongue hence the in part of intrinsic. The muscles of the tongue are names by the direction in which they travel, longitudinal (tip to root/base of tongue), transverse (horizontal) and vertical. What is the importance of these muscles and the direction in which they travel?
- help tongue take its shape
- contribute to talking
The extrinsic muscles of the tongue originate from outside of the tongue, but then insert into the tongue. There are 4 extrinsic muscles, label them on the image below using the labels below:
- palatoglossus (originates from palate bone)
- genioglossus (originates from genion, latin for chin)
- styloglossus (originates from styloid process of temporal bone)
- geniohyoidus (originates from hyoid bone)
- hyoglossus (originates from hyoid bone)
1 - geniohyoidus (originates from hyoid bone)
2 - genioglossus (originates from genion, latin for chin)
3 - hyoglossus (originates from hyoid bone)
4 - styloglossus (originates from styloid process of temporal bone)
5 - palatoglossus (originates from palate bone)
The extrinsic muscles of the tongue originate from outside of the tongue, but then insert into the tongue. There are 5 extrinsic muscles:
1 - geniohyoidus (originates from hyoid bone)
2 - genioglossus (originates from genion, latin for chin)
3 - hyoglossus (originates from hyoid bone)
4 - styloglossus (originates from styloid process of temporal bone)
5 - palatoglossus (originates from palate bone)
What is the main function of the extrinsic muscles?
- reposition the tongue
The intrinsic and extrinsic muscles primarily come under the control of which cranial nerve that provides entirely somatic motor function (voluntary movement)?
- hypoglossal nerve (cranial nerve XII (12))
- hypo = below
- glossal = greek for tongue
The intrinsic and extrinsic muscles primarily come under the control of the hypoglossal nerve (cranial nerve XII( 12), hypo = below and glossal = greek for tongue. There is one extrinsic muscle that does not come under the control of the hypoglossal nerve (cranial nerve XII (12), which muscle is this and which nerve innervates it?
- cranial nerve X (10) the vagus nerve
- innervates the palatoglossus
- important in swallowing
The intrinsic and extrinsic muscles primarily come under the control of the hypoglossal nerve (cranial nerve 12), hypo = below and glossal = greek for tongue. There is one extrinsic muscle that does not come under the control of the hypoglossal nerve (cranial nerve 12). Instead the palatoglossus (palat = palatine aponeurosis a fibrous sheet located at back of oral cavity) is innervated by cranial nerve X (10). What is the purpose of this?
- involved in the swallowing process
Cranial nerve V (5) is called the trigeminal nerve and has 3 sections, label them in the image below numbered 1, 2 and 3, using the labels below:
- mandibular
- opthalmic
- maxillary
1 = opthalmic 2 = maxillary 3 = mandibular
Cranial nerve V (5) is called the trigeminal nerve and has 3 branches, ophthalmic, maxillary and mandibular. The mandibular branch is unique in that it possess the ability to do what 2 things?
1 - sensory
2 - motor function
The lingual nerve is one of 4 branches of the mandibular branch of cranial nerve V (5), the trigeminal nerve. What does this nerve innervate in the oral cavity?
- anterior 2/3s of the tongue
- sensory fibres such as touch and proprioception
The chorda tympani provides taste sensations for the anterior 2/3 of the tongue. What cranial nerve is the chorda tympani a branch of?
- cranial nerve VII (7)
- facial nerve
The tongue is divided into the anterior 2/3s and the posterior 1/3. What is the v shaped margin where these 2 regions can be identified?
- a depression called a sulcus
- sulcus terminalis
The anterior 2/3 of the tongue are supplied by sensory and motor nerves. Which 3 cranial nerves provides the sensory and motor innervation?
- sensory = lingual (branch of mandibular nerve from cranial nerve V (trigeminal)
- sensory (taste) = chorda tympani (branch of facial nerve CN VII)
- motor = hypoglossus (cranial nerve XII (12)
The posterior 1/3 of the tongue are supplied by sensory and motor nerves. Which cranial nerves provides the sensory and motor innervation?
- sensory = cranial nerve IX (9) glossopharyngeal
- motor = cranial nerve X (10) vagus nerve
The chorda tympani is a branch of the cranial nerve VII (7) the facial nerve. It uses the cranial nerve V (5) mandibular branch, specifically the lingual nerve to innervate the anterior 2/3s of the tongue. What information does this provide to the body from the tongue?
- sensory fibres
- specifically taste
When the wisdom tooth (molar 2) has to be removed there is a risk that a nerve that runs close to this can be damaged. What nerve is this?
- lingual nerve
When the wisdom tooth (molar 2) has to be removed there is a risk that the lingual nerve could be damaged. If this occurs, what would patients present with?
- lack of sensation on anterior 2/3 of tongue
- touch, proprioception etc..
When the wisdom tooth (molar 2) has to be removed there is a risk that the lingual nerve could be damaged, which could present with a lack of sensory feeling in the anterior 2/3 of the tongue. What other nerve could be damaged that runs with the lingual nerve and how could this present?
- chorda tympani, branch of the facial nerve (CN VII)
- lack of taste on anterior 2/3 of tongue
What is the main artery supplying the tongue and which artery does this branch off?
- lingual artery (lingual means tongue)
- branches of the external carotid artery
What is the main vein draining the tongue and which vein does this drain into?
- lingual vein
- internal jugular vein
What are the 3 major glands of the oral cavity? Label them 1-3 in the image below using the labels below:
- parotid gland
- sublingual gland
- submandibular gland
1 = parotid gland 2 = submandibular gland 3 = sublingual gland
What are the 2 palates in the mouth called?
1 - hard palate (anterior aspect of oral cavity)
2 - soft palate (posterior aspect of oral cavity)
The hard palate as the name suggests is hard and made of bones. Which 2 bones is it composed of?
- palatine processes of the maxilla
- horizontal plates of the palatine bones
The hard palate as the name suggests is hard and made of bones. It is composed of the palatine processes of the maxilla and the horizontal plates of the palatine bones. It does not appear as a bone because it has an aponeurotic covering that is covered in a mucous membrane. What else is contained within the hard palate?
- nerves
- blood vessels
- glands
- lymphoid tissue
- muscles
What is the purpose of the hard palate?
- provides space for the tongue to move freely
- supplies a rigid floor to the nasal cavity so that pressures within the mouth do not close off the nasal passage
What are the major nerves of the palate?
- maxillary nerve
- a branch of CN V (5) trigeminal nerve
The major nerves of the palate come from the maxillary nerve, which is a branch of the CN V (5) trigeminal nerve. What are the 3 main nerves of the maxillary nerve that innervate the palate?
1 - nasopalatine
2 - greater palatine
3 - lesser palatine
The pharynx is essentially a fibro muscular tube. Where does it begin and end in relation to the skull and spinal vertebrae?
- base of skull
- to C6
Label the 3 regions of the pharynx?
1 - nasopharynx
2 - oralpharynx
3 - laryngopharynx
The 3 regions of the pharynx are the nasopharynx, oralpharynx and laryngopharynx. The whole pharynx has 4 layers, what are these from deepest first?
1 - mucosa
2 - sub-mucosa
3 - muscle
4 - specialised fascia
What is Waldeyer’s ring?
- ring of lymphoid tissue found in the throat
- made up of the tonsils, adenoids, and other lymphoid tissue
- contains lymphocytes
Waldeyer’s ring is a ring of lymphoid tissue found in the throat. It is composed of the tonsils, adenoids, and other lymphoid tissue and contains lymphocytes. Label the tonsils in Waldeyer’s ring numbered 1-4 in the image below, using the labels below?
- pharyngeal tonsils
- lingual tonsils
- tubal tonsils
- palatine tonsils
1 - pharyngeal tonsils
2 - tubal tonsils
3 - palatine tonsils
4 - lingual tonsils
The pyriform fossa is an area around the laryngopharynx, aka the voicebox. What is the purpose of this site?
- involved in speech
- allows sounds to echo up the pharynx
The oropharynx is an important first line immune response as part of the upper GI. What contributes towards immunity here?
- immunity
- contains 4 sets of tonsils
The pharynx contains 6 major muscles, label them in the image below 1-6 using the labels below:
- inferior constrictor
- stylopharyngeus (styloid process to the pharynx)
- middle constrictor
- superior constrictor
- palatopharyngeus
- salpingopharyngeus (eustachian tube, to the pharynx)
1 - stylopharyngeus (styloid process to the pharynx)
2 - superior constrictor
3 - middle constrictor
4 - inferior constrictor
5 - salpingopharyngeus (eustachian tube, to the pharynx)
6 - palatopharyngeus
There are 6 major muscles of the pharynx, which can be subdivided into intrinsic and extrinsic muscles. The intrinsic muscles begin and end in the pharynx. Which 3 muscles are intrinsic?
1 - superior constrictor
2 - middle constrictor
3 - inferior constrictor
There are 6 major muscles of the pharynx, which can be subdivided into intrinsic and extrinsic muscles. The extrinsic muscles begin outside of the the pharynx and fill the gaps in the pharynx where the intrinsic muscles do not overlap. Which 3 muscles are extrinsic?
1 - palatopharyngeus (originates from the palate)
2 - salpingopharyngeus (originates from the cartilage around ear)
3 - stylopharyngeus (originates from styloid process)
There is a triangular shaped area of weakness in the muscular wall of the pharynx, between the transverse and oblique bundles of the inferior pharyngeal constrictor. What is this site called?
- killian dehiscence
- can form an outpouching called pharyngeal diverticulum
All the intrinsic and extrinsic muscles, except the stylopharyngeus of the pharynx are innervated by which plexus?
- pharyngeal plexus
- network of nerve fibers innervating most of the palate and pharynx
Label the features of the larynx, also called the voice box using the labels below:
- epiglottis
- corniculate cartilage
- cricoid cartilage
- thyroid cartilage
- arytenoid cartilage
1 - epiglottis 2 - thyroid cartilage 3 - arytenoid cartilage 4 - cricoid cartilage 5 - corniculate cartilage
Which bone, that is part of the axial skeleton sits above the largest cartilage of the larynx, the thyroid cartilage?
- hyoid bone
What part of the vertebral cord does the hyoid bone correspond with?
- C3
The hyoid bone suspends from which bone by the hyoid muscles ?
- temporal bone
- specifically the styloid process and the mastoid process
The sternocleidomastoid muscle is an important muscle in the neck. What bony features does it attach to?
- sterno = sternum (manubrium)
- cleido - clavicle
- mastoid = mastoid
The sternocleidomastoid muscle is an important muscle of the neck that divides the neck into 2 halves. What are these halves called?
- anterior triangle
- posterior triangle
What are the borders of the anterior triangle of the neck?
- anterior border of the sternocleidomastoid muscle
- inferior border of the mandible
- sagittal midline of the neck
What are the borders of the posterior triangle of the neck?
- posterior border of the sternocleidomastoid muscle
- anterior border of trapezius
- middle 1/3 of the clavicle
Why is the anterior triangle of the neck important?
- contain all the neck structures, including glands, nerves, vessels and lymph nodes running between head and thorax
Why is the posterior triangle of the neck important?
- contain all the neck structures, including glands, nerves, vessels and lymph nodes running between neck, thorax and upper limb
The anterior triangle of the neck is important as it all the neck structures, including glands, nerves, vessels and lymph nodes running between head and thorax. This triangle can be subdivided into 4 smaller sub divisions and named based on their locations. Using the labels below, label the image showing these 4 sub-divisions called:
- Carotid
- Muscular
- Submandibular
- Mental
1 = Submandibular 2 = Mental 3 = Carotid 4 = Muscular
The anterior triangle of the neck is important as it all the neck structures, including glands, nerves, vessels and lymph nodes running between neck, thorax and upper limbs. This triangle can be subdivided into 2 smaller sub divisions and named based on their locations. What are these 2 sub-divisions called:
1 - Occipital triangle
2 - Supraclavicular triangle
When we look at the neck we can split it into 4 compartments, what are these compartments?
1 - visceral compartment
2 and 3 - vascular compartments
4 - vertebral compartments
What is contained within the visceral compartment of the neck?
- thyroid gland
- trachea
- esophagus
The vascular compartment of the neck contains the carotid sheath. What is the carotid sheath?
- fibrous connective tissue
- surrounds the vascular compartment of the neck
There are 4 deep fascial layers of connective tissue of the neck. Fascia is a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place. What is the fascia layer that is closest to the skin?
- investing fascial layer
- surrounds all neck structures
There are 4 deep fascial layers of connective tissue of the neck. Fascia is a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place. What is the second least deep fascia layer after the investing fascial layer?
- pre-vertebral fascial layer
- surrounds the vertebral column and all associated muscles
There are 4 deep fascial layers of connective tissue of the neck. Fascia is a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place. What is the fascia layer that surrounds the visceral compartment of the neck called and what does it contain?
- pre-tracheal fascial layer
- has 2 parts:
1 = Muscular part – encloses the infrahyoid muscles
2 = Visceral part - encloses the thyroid gland, trachea and oesophagus
There are 4 deep fascial layers of connective tissue of the neck. Fascia is a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place. What is the fascia layer that surrounds the blood vessels of the neck called?
- carotid sheath
- part of the anterior triangle
The superficial fascial layer of the neck is predominantly composed of fat, but also contains nerves, blood vessels and lymphatics. Anteriorly there is a thin muscle that is part of the facial expression muscles. It begins on the mandible and covers the anterior lateral portion of the neck. What is this muscle called and which cranial nerve provides innervation?
- platysma muscle
- greek for flat piece
- innervated by the cervical branch of the facial nerve (CN VII).
Which cranial nerve controls facial expression muscles?
- cranial nerve VII (7) the facial nerve
The carotid sheath is a deep fascial layer within the neck. What are the 4 main structures contained within this?
1 - internal carotid artery
2 - internal jugular vein
3 - common carotid artery
3 - cranial nerve X (10) vagus nerve
Between the compartments of the neck are potential spaces. The retropharyngeal space, is the largest of these spaces. Where is this space located and what is the purpose of this space?
- means behind the pharynx
- allows contents of the visceral compartment to move freely during swallowing
Between the compartments of the neck are potential spaces. The retropharyngeal space, is the largest of these spaces. It is located behind the pharynx and allows the contents of the visceral compartment to move freely during swallowing. What is the clinical significance of this space though?
- infections from the oral cavity, nose, ear can spread here
- lymph nodes become affected
- increases risk of abscess (collection of pus and infection)
The danger space in the neck is in the retropharyngeal space, which a space that allows movement of pharynx and epiglottis. Why is this termed the danger space though?
- susceptible to infection
- infection can spread directly to the thorax and to both sides of the throat
Cranial nerve XI (11) the accessory nerve runs through the anterior or posterior triangle?
- posterior triangle
The cranial nerve XI (11) the accessory nerve runs through the posterior triangle. What does it innervate that forms part of the posterior border?
- trapezius muscle
Originating in the medualla oblongata, cranial nerve XII (12), the hypoglossal nerve innervates what in the mouth?
- the tongue
The anterior muscles of neck can be subdivided into the above and below the hyoid bone. What are these 2 groups called?
1 - infrahyoid muscles (inferior to hyoid)
2 - suprahyoid muscles (superior to hyoid)
The thyroid gland is contained within the neck. What level of the vertebral column can this be located?
- C5, C6 and C7
- down to T1
What is the function of the thyroid gland contained within the neck?
- releases hormones that control metabolism
The eustachian tube leaves the middle ear and merges with which part of the pharynx?
- nasopharynx
