Oral Cavity and Pharynx Anatomy Flashcards
What is a potential complication of tonsilitis?
A peritonsilar abscess
Presents as a painful soft tissue swelling - normally during or just after the tonsilitis
Requires drainage and administration of antibiotics directly with a needle
What structures enters the pharnyx between the superior and middle constrictor?
What is its role?
The glossopharyngeal nerve
Sensory innervation to the oropharnyx
What nerve enters between the middle and inferior constrictor of the pharnyx?
What is its function?
The vagus nerve
Including the internal laryngeal nerve
Sensory innervation to the laryngeal cavity superior to the vocal cords
What structures enter the pharynx inferior to the inferior constrictor of the pharynx?
Recurrent laryngeal nerve and vessels
Innervate intrinsic muscles of the larynx including control over the vocal cords - speech
Summarise the sensory innervation of the pharynx
Nasopharynx = CNV2
Oropharnyx = CNIX
Laryngopharynx = CNX
Summarise the motor innervation of the pharynx
All vagus nerve CNX
Except stylopharyngeus which is CNIX
What is the blood supply to the pharynx?
Superior constrictor = facial artery, ascending pharyngeal artery
Middle constrictor - superior thyroid artery
Inferior constrictor = inferior thyroid artery (thyrocervical trunk)
What is the blood supply to the tonsils?
Rich blood supply
Including the lingual artery, facial artery, ascending pharyngeal artery and descending palatine artery.
What is the venous drainage of the pharnyx?
Pharyngeal plexus - on posterior aspect of the pharynx
Blood drains from here to the internal jugular vein
What is the lymphatic drainage of the pharynx?
To the retropharyngeal and deep cervical nodes
What is the venous drainage of the tonsils?
Via the peritonsillar plexus into the lingual and pharyngeal veins then into the internal jugular vein
What is dysphagia?
How may it present?
Difficulty swallowing
Coughing assocaited with swallowing food, liquid or saliva.
Feeling food sticking in your throat
Oropharyngeal pooling of illiquid - can cause aspiration of food and fluids leading to pneumonia
What are the common causes of dysphagia?
Anatomical/funcation deficits from oral cavity to stamoch
Failure of neural control (congenital, trauma, stroke, neurodegenerative disease in CNS)
What is oropharyngeal dysphasia?
Swallowing porblems occuring in the mouth and/or throat
Loss of tongue strength to propel bolus posteriorly
Loss of control of pharyngeal phase of swallowing
What investigation should be done for a swallowing problem?
Video fluoroscopic swallowing examination/modified barium study to evaluate.
Define Zenkers diverticulum
Mucosal herniation posteriroly between the cricopharyngeus muscle and the inferior pharyngeal constrictor muscle
How does zenkers diverticulum tend to present?
Dysphagia to solids and liquids
Regurgitation of undigested food
Sensation of globus or fullness in the neck
Cough
Halitosis
Aspiration pneumonia
Weight loss
Voice changes
Sialorrhea (excessive drooling)
Describe the parasympathetic innervation of the parotid gland
Via the glassopharyngeal nerve - pre/post synapse in the otic ganglion - post carried by auriculotemporal branch of CNV3.
Describe the sympathetic innervation of the parotid gland
Vasomotor innervation (may reduce secretion) by the nerve plexus uvrlying the external carotid artery, originateing from apre/post synapse in the superior cervical ganglion of the sympathetic chain
What muscle does the submandibular gland warp around?
Mylohyoid
What nerve is the submandibular gland close to?
Superior to the lingual nerve
What is the parasympathetic innervation of the sublingual/submandibular gland?
From chorda tympania (CNVII),
Pre/post synapse in the submandibular ganglion with post synaptic nerve fibres travelling with the lingual nerve.
What is the sympathetic innervation of the sublingual/submandibular gland?
Vasomotor innervation (may reduce secretion)
Pre-post synapse in the superior cervical ganglion of the sympathetic chain, supply glands via the plexus overlying the external carotid artery.
What is sialolthiasis?
Hardened mineral deposits in the salivary gland - causing salivary gland swelling.
What are the different types of teeth found in humans?
16 teeth maximum on the top and bottom = 32 teeth
Made of t - central incisor, lateral incisor, canine, two premolar, 3 molars (third of which is the wisdom tooth)
What are some important features tbe able to identify on the bony hard palate?
THe incisive fossa
The palatine process of the maxilla
The horizontal plate of the palatine bone.
How can the gingiva be split anatomically
The lingual gingiva - facing the tongue
The vestibular gingiva - face the cheeks/buccal/labial)
Maxillary - top row
Mandibular - floor of mouth
Describe the innervation to the maxillary teeth
CNV2
-> superior alveolar branch which has three segments
-> anterior = incisor and part of canine
-> middle =
-> posterior = 3 molar
Describe the innervation the maxillary gingiva
All branches of CNV2
The lingual gingiva = incisor and canin by nasoplatine nerve
The remaining lingual gingiva by the greater palatine nerve
The vestibular gingica are supplied by the post/mid/ant inferior alveolar nerve, with contribution from the infra-orbital nerve for canine and pre-molar.
Describe the innervation of the mandibular teeth?
Supplies by branches of the CNV3
Inferior alveolar nerve - incisor branch to incisor and canine, the dental pranches to premolar and molars
What branches of the CNV3 are important to know in the oral cavity?
CNV3 splits into the buccal nerve, lingual nerve and the inferior alveolar nerve.
Inferior alveolar nerve continues giving off dental and incisive branches, final branch is the mental nerve.
Describe the innervation of the mandibular gingiva
The lingual gingiva are supplied by the lingual nerve
The vestibular gingica are supplied by the mental branch of inf alveolar and the buccal branch (3 molars)
Where does each salivary gland oepn into the mouth?
Parotid - pierces buccinator, enters near the 2nd maxillary molar
Sublingual - numerous small ducts onto the sublingual folds.
Submandibular - papilla (sublingual caruncle) beside the frenulum of the tongue
Within the subtance of the tongue the hypoglossal nerve runs between which two muscles?
The hyoglossus
The mylohyoid
What structure seperates the anterior 2/3 and the posterior 1/3 of the tongue
The sulcus terminalis
The floor of the mouth if formed by which muscle
The mylohyoid
