Oral Cavity And Pharynges Flashcards
Function of saliva?
Fluid that assists in initial activites of digestion
Moistens ingested food turning it into a semisolid bolus
Moistens and cleanses oral cavity
Contains antibodies and lysozyme
Water dissolves food so taste receptors can be stimulated
What are the three salivary glands? In order of production
Submandibular (60-70%)
Parotid (25-30%)
Sublingual (3-5%)
What is saliva mostly composed of?
Water (99%)
How much saliva do we secrete per day and when?
B/w 1-1.5 L
Mostly during meal time
What type of secretion does parotid gland give off?
Submandibular?
Sublingual?
Parotid: only serous
Submandibular: Both mucous and serous
Sublingual: Both mucous and serous
Besides water, what else is contained in saliva?
Electrolytes, immunoglobulin A, lysozyme, salivary amylase
How is saliva conducted to the oral cavity from the parotid gland
Thru the parotid duct
What is the largest salivary gland?
Parotid
What is the parotid gland stimulated by?
Inferior salivatory nucleus —> CN 9, lesser petrosal n. —> otic ganglion + auriculotemporal n (V3) —> parotid gland
What runs thru the parotid gland?
Facial n.
How is saliva conducted to the oral cavity from the submandibular glands?
Duct from gland will open thru papilla in the floor of the mouth on the lateral sides of the lingual frenulum
How is saliva conducted to the oral cavity from the sublingual glands?
Each gland extends multiple tiny sublingual ducts that open onto the inferior surface of the oral cavity posterior to submandibular duct papilla
How are the submandibular and sublingual salivary glands innervated?
Superior salivatory nucleus —> CN 7
CN 7 —> chorda tympani
Submandibular ganglion + Lingual N. (V3)
—> sublingual and submandibular glands
What is the oral vestibule?
How does it communicate?
Slit like space b/w teeth and gums and lips and cheek
Thru oral fissure
What is the oral cavity proper?
What is the roof?
What does it communicate with?
Where mastication and lingual manipulation of food occur
Palate
Oropharynx
What makes up the oral cavity?
Oral vestibule
Oral cavity proper
What makes up a tooth?
What kind of joint is it?
Exposed crown
Constricted neck
One or more roots anchoring it to jaw, fitting into dental alveoli
Gomphosis joint
What is a gomphosis joint made of?
Roots
Dental alveoli
Periodontal L.
How many teeth do infants have? When do they erupt?
20 deciduous teeth
Erupt b/w 6-30 months
Which teeth erupt first?
Anterior mandibular teeth
Why do third molar only partially emerge?
What can happen because of this?
Jaw lacks space to a ccomodate final molars
Wisdom teeth may become impacted and do not properly erupt
Order of teeth from “front teeth” back?
Incisors
Canines
Pre molars
Molar
What is the function of the uvula?
Assists soft palate in closing off entryway to nasopharynx when swallowing
What is the function of tonsils?
What are they composed of?
Detect antigens in swallowed food and drink and initiate immune response if necessary
Aggregates of partially encapsulated lymphatic tissue
How do you anesthetize the:
Nasopalatine N.?
Into incisive fossa in hard palate
Affects palatial mucosa, lingual gingival, alveolar bone of six anterior maxillary teeth, hard palate
How do you perform a
Greater palatine block?
Anesthetic into greater palatine foramen
N. Emerges b/w 2 and 3 molars
How do you perform an
inferior alveolar n. Block?
Anesthetic into mandibular foramen lateral to pterygomandibular raphe
How is the tongue attached to the floor of the oral cavity?
Lingual frenulum (a thin vertical mucous membrane)
What covers the superior surface of tongue?
Numerous small projections, or papillae
What does the posterior surface contain?
Lingual tonsils
What is the anterior portion of the tongue
Apex to terminal sulcus
What is the posterior surface of the tongue?
From terminal sulcus/foramen cecum to root
What is the formaen cecum?
Remnant of the proximal part of embryonic thyroglossal duct
What lingual papillae can we find on the anterior part of tongue?
Fungiform
Filiform (does not taste)
Gallate
Foliate
What do we find on the posterior part of the tongue?
Palatoglossus
Palatine tonsil
Terminal sulcus
What innervates stylopharyngeus?
CN 9 (3 pa)
Where does the superior constrictor attach?
To the buccinator
What innervates the pharyngeal constrictors?
Vagus N.
What is the function of
Extrinsic tongue Ms.
intrinsic tongue Ms?
Extrinsic: alter position of tongue
Intrinsic: alter shape of tongue
What are the 4 extrinsic tongue Ms and what innervates them?
Genioglossus
Hyoglossus
Styloglossus
^^ all CN 12
Palatoglossus - CN 10
What are the 4 intrinsic tongue muscles?
Functions?
Superior longitudinal
Inferior longitudinal
—make tongue short thick and retracted
Transverse
Vertical
—-make tongue long and narrow
What provides general sensation (touch, temp.) to anterior 2/3 of tongue?
Lingual N. (CN V3) does mucosa for ant. 2/3 of tongue
What does special sensation (taste) for ant. 2/3 of tongue?
Chorda tympani (CN 7)
What does general sensation for posterior 1/3 of tongue?
Glossopharyngeal N. (Lingual branch)
What does special sensation (taste) to the posterior 1/3 of the tongue?
Glossopharyngeal N. (Lingual branch)
What is the blood supply to the tongue?
Lingual artery
Dorsal lingual As.
Deep lingual As.
Sublingual As.
What is the lymphatic drainage of the root of the tongue?
Drains bilaterally into the
Superior deep cervical lymph nodes (Jugulodigastric to IJV)
What is the lymphatic draininage of the medial part of the body of the tongue?
Drains bilaterally and directly to the
Inferior deep cervical lymph nodes (jugulo-omohyoid to IJV)
What is the lymphatic drainage of the R and L lateral part of body of tongue?
Drains to
Submandibular lymph nodes
(To deep cervical to IJV)
What is the lymphatic drainage of the apex and frenulum of tongue?
Submental lymph nodes
To deep cervical to IJV
Where and what are the palatine tonsils?
“The tonsils” as we classically think of them
Masses of lymphoid tissue
One on each side of the oropharynx
What is each tonsil bounded by?
Palatoglossal arch
Palatopharyngeal arch
Tongue
What does each tonsil form?
Lateral part of waldeyer’s ring
What is the lymphatic drainage of the tonsils?
Jugulodigastric (superior deep cervical l.n. To IJV)
What is the blood supply of the tonsils?
Facial a. (Tonsillar branch)
Asc. Palatine a. (Tonsillar branch)
What are the tonsils innervated by?
Glossopharyngeal n.
Maxillar n.
What is tonsillitis?
Caused by?
Presents as?
Inflammation of the palatine tonsils
Usually caused by viral infection
Difficult or painful swallowing w/ red and swollen tonsils w/ evident of purulent exudate
What is a tonsillectomy?
What is a common complication?
What is vulnerable to injury?
Removal of tonsils and urorunding conenctive tissue done by dissective the palatine tonsil from the tonsillar sinus
Bleeding common bc of rich blood supply
CN 9 vulnerable bc it accomplices Tonsillar a.
(ICA also vulnerable bc it is directly lateral to the tonsils0
What is Waldeyer’s Ring?
Lymphatic ring composed of palatine, pharyngeal, and lingual tonsils
Drains to deep cervical lymph nodes (to IJV)
What closes off the opening of the nasopharynx when swallowing?
Soft palate
Uvula
What are fauces?
What are they bounded by?
Opening for oropharynx
By paired muscular folds and superiorly by soft palate
Palatoglossus arch
Palatopharyngeal arch
What is the innervation of the palate?
Nasopalatine n. (Mucous membr. Of anger. Part of hard palate)
Greater palatine n. (Hard palate)
Lesser palatine N. (Soft palate)
Also V2 giving sensory
What is the blood supply to the palate?
Greater palatine a. (Chief blood supply) (hard palate)
Lesser palatine a. (Anastomoses with ascending palatine a.)
What does Asc. Palatine a. Anastomoses with?
Lesser palatine a.
What are the veins of the palate?
Tributaries of the pterygoid venous plexus
What is the O and I of the Tensor Veli Palatini M.?
O: spine of sphenoid bone/pharyngotympanic tube
I: palatine aponeurosis
What is the O and I of the Levator Veli Palatini?
O: Petrous part of temporal bone/ pharyngotympanic tube
I: palatine aponeurosis
What is the O and I of Palatoglossus M.?
O: palatine aponeurosis
I: Side of tongue
What is the O and I of the palatopharyngeal m.?
O: hard palate/palatine aponeurosis
I: lateral wall of pharynx
Innervation of Tensor Veli Palatini?
CN V3
Medial pterygoid n.
Innervation of Levator Veli Palatini?
CN 10
Pharyngeal branch
Innervation of Palatoglossus M.?
CN 10
Pharyngeal branch
Innervation of Palatopharyngeus m.?
CN 10
Pharyngeal branch
Action of:
Tensor veli palatini?
Tenses soft palate
Opens Pharyngotympanic tube during swallowing and yawning
Action of:
Levator Veli Palatini
Elevates soft palate during swallowing
action of:
Palatoglossus M.?
Elevator posterior tongue and draws soft palate onto tongue
Action of:
Palatopharyngeus M.?
Tenses soft palate
Pulls pharynx superiorly, anteriorly, and medially during swallowing
What innervates the pharyngeal constrictors?
CN 10
What innervates stylopharyngeus ?
CN 9
What depressurizing the middle ear?
Tensor Veli Palatini
What would be the result of paralysis of tensor and levator veli palatini Ms.?
Paralysis leads to reflux of oral contents into nasal cavity
(Pharyngotympanic tube dysfunction)
Tensor - V3
Levator - X
What muscles raise the floor of the oral cavity?
Mylohyoid (n. To mylohyoid - V3)
Palatoglossus M. (CN 10)
Ms. Of tongue
Gag reflex in the upper portion of the mouth is induced by what nerve?
CN 9
Gag reflex int he lower part of the mouth is induced by?
CN 10
What are the steps to swallowing?
Step 1: voluntary;
bolus compressed against palate, pushed form mouth into oropharynx via Ms. of tongue and soft palate
step 2: involuntary;
Soft palate is elevates sealing off nasopharynx from oropharynx and laryngopharynx
Pharynx widens and shorten and suprahyoid Ms. contract, longitudinal pharyngeal Ms. elevate larynx
Step 3: involuntary;
Sequential contraction of all 3 pharyngeal constrictor Ms. forcing food bolus back
What innervates the nasopharynx, oropharynx, and laryngopharynx?
Naso: V2
Oro: CN 9
Laryngopharynx: CN 10
(Accounts for differences in gag reflex)
