Oral Cavity and Pharynx

Question 1

Parasympathetic innervation to the parotid gland originates from cranial nerve _____ at the inferior salivatory nucleus, giving off the ________ nerve that travels into the middle ear through the tympanic canaliculus, exiting as the ______ _______ nerve. This nerve synapses at the ________ ganglion, then postganglionic parasympathetic fibers piggyback on the _______ nerve to innervate the parotid gland. Simple!

Answer 1

CN IX at the inferior salivatory nucleus –> tympanic nerve (of Jacobson) nerve goes through tympanic canaliculus to the middle ear –> tympanic plexus –> exits middle ear as the lesser petrosal nerve –> synapses at the otic ganglion –> piggybacks the auriculotemporal nerve (V3 branch) to the parotid gland

Question 2

Parasympathetic innervation to the submandibular and sublingual glands originate from cranial nerve _____ at the superior salivatory nucleus, giving off the ______ ______ nerve that travels through the middle ear and out the petrotympanic fissure to the infratemporal fossa, where it joins with the _______ nerve to piggyback to its synapse at the _________ ganglion, giving off branches that innervate the submandibular and sublingual glands.

Answer 2

CN VII gives off chorda tympani nerve –> middle ear –> exit petrotympanic fissure –> piggyback on lingual nerve (V3) –> synapse at submandibular ganglion –> innervate submandibular and sublingual glands

Question 3

What is the anatomical term for the location where dip (tobacco - Skoal, Copenhagen, etc.) is put in the mouth?

Answer 3

Oral vestibule

Question 4

Where in the oral cavity do the parotid gland ducts empty into?

Answer 4

The ostia of the parotid ducts are opposite the upper 2nd molar bilaterally

Question 5

Through what structures do the submandibular gland ducts empty?

Answer 5

Sublingual caruncles (on the lateral aspects of the sublingual frenula)

Question 6

Through what structures do the sublingual gland ducts empty?

Answer 6

Sublingual folds

Question 7

All the muscles of the palate are innervated by cranial nerve _______ except for one muscle. What is this exception and what is its innervation?

Answer 7

Palatal muscles are innervated by CN X except for tensor veli palatini (V3)

Question 8

What is the epiglottic vallecula?

Answer 8

A space between the epiglottis and base of the tongue (where the probe is).

Question 9

What is the test for CN X nerve function in a physical exam?

Answer 9

Palatal rise to phonation

Question 10

Name this tonsil and name the arches it sits between.

Answer 10

Palatine tonsil, in between the palatoglossal and palatopharyngeal arches in the tonsillar fossa.

Question 11

The interior edge of the hyoid bone marks the division between the _______ and _______ pharyngeal constrictor muscles.

Answer 11

middle and inferior constrictors

Question 12

The foramen cecum is located at the tip of the terminal sulcus and is a vestige of the embryological ______ _______.

Answer 12

thyroglossal duct

Question 13

Drugs given sublingually are absorbed through which vessels?

Answer 13

Deep lingual artery and veins.

Question 14

Name the three types of tongue papillae and what each does.

Answer 14

Filliform - grip

Fungiform, circumvallate have taste buds

Question 15

All the intrinsic and extrinsic tongue muscles are innervated by CN ____ except for one muscle. Which muscle is this and what is its innervation?

Answer 15

CN XII except for palatoglossus (CN X)

Question 16

All the pharyngeal muscles are innervated by CN ____ except for one. What is this exception and what is its innervation?

Answer 16

CN X except for stylopharyngeus (CN IX)

Question 17

Describe the innervation of the tongue (general sensation and taste).

Answer 17

General sensation AND taste for posterior 1/3 is done by the glossopharyngeal nerve (CN IX)

Taste for anterior 2/3 is done by chorda tympani nerve (CN VII)

General sensation for anterior 2/3 is done by lingual nerve (CN V3)

Question 18

How many incisors, canines, premolars, and molars are there (normally)? How are teeth numbered?

Answer 18

2 incisors (central and lateral)

1 canine

2 premolars

3 molars

Numbering: right upper 3rd molar is #1, then count to the left on the upper teeth (left upper 3rd molar is #16), then go down to the left lower 3rd molar, and count towards the right lower 3rd molar.

Question 19

Which nerves innervate the upper and lower teeth, respectively? Explain why a maxillary sinus infection can give you tooth pain and vice-versa.

Answer 19

Upper: superior alveolar nerve (V2) sends branches to the maxillary sinus, so infection of either can refer pain.

Lower: inferior alveolar nerve (V3)

Question 20

The tensor veli palatini muscle wraps around the _______ _______ to insert on the palatine aponeurosis. It is innervated by…?

Answer 20

Wraps around the pterygoid hamulus, innervated by V3

Question 22

How far caudally does the retropharyngeal space extend? What about the danger space? What fascia separates these two spaces?

Answer 22

Retropharyngeal space goes down to the superior mediastinum. Danger space goes all the way to the diaphragm. Alar fascia separates the two spaces.

Question 23

What is the piriform recess/fossa?

Answer 23

A space on each side of the laryngeal inlet.

Question 24

Between what fascial layers is the retropharyngeal space? What about the danger space? How far inferiorly do each travel?

Answer 24

Retropharyngeal space is between alar and buccopharyngeal fascia; goes down to the superior mediastinum.

Danger space is between alar and prevertebral fascia; goes down to the diaphragm.