Oral Cavity and Pharynx Anatomy

Question 1

What is a potential complication of tonsilitis?

Answer 1

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

Question 2

What structures enters the pharnyx between the superior and middle constrictor?
What is its role?

Answer 2

The glossopharyngeal nerve
Sensory innervation to the oropharnyx

Question 3

What nerve enters between the middle and inferior constrictor of the pharnyx?
What is its function?

Answer 3

The vagus nerve
Including the internal laryngeal nerve
Sensory innervation to the laryngeal cavity superior to the vocal cords

Question 4

What structures enter the pharynx inferior to the inferior constrictor of the pharynx?

Answer 4

Recurrent laryngeal nerve and vessels
Innervate intrinsic muscles of the larynx including control over the vocal cords - speech

Question 5

Summarise the sensory innervation of the pharynx

Answer 5

Nasopharynx = CNV2
Oropharnyx = CNIX
Laryngopharynx = CNX

Question 6

Summarise the motor innervation of the pharynx

Answer 6

All vagus nerve CNX
Except stylopharyngeus which is CNIX

Question 7

What is the blood supply to the pharynx?

Answer 7

Superior constrictor = facial artery, ascending pharyngeal artery
Middle constrictor - superior thyroid artery
Inferior constrictor = inferior thyroid artery (thyrocervical trunk)

Question 8

What is the blood supply to the tonsils?

Answer 8

Rich blood supply
Including the lingual artery, facial artery, ascending pharyngeal artery and descending palatine artery.

Question 9

What is the venous drainage of the pharnyx?

Answer 9

Pharyngeal plexus - on posterior aspect of the pharynx
Blood drains from here to the internal jugular vein

Question 10

What is the lymphatic drainage of the pharynx?

Answer 10

To the retropharyngeal and deep cervical nodes

Question 11

What is the venous drainage of the tonsils?

Answer 11

Via the peritonsillar plexus into the lingual and pharyngeal veins then into the internal jugular vein

Question 12

What is dysphagia?
How may it present?

Answer 12

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

Question 13

What are the common causes of dysphagia?

Answer 13

Anatomical/funcation deficits from oral cavity to stamoch
Failure of neural control (congenital, trauma, stroke, neurodegenerative disease in CNS)

Question 14

What is oropharyngeal dysphasia?

Answer 14

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

Question 15

What investigation should be done for a swallowing problem?

Answer 15

Video fluoroscopic swallowing examination/modified barium study to evaluate.

Question 16

Define Zenkers diverticulum

Answer 16

Mucosal herniation posteriroly between the cricopharyngeus muscle and the inferior pharyngeal constrictor muscle

Question 17

How does zenkers diverticulum tend to present?

Answer 17

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)

Question 18

Describe the parasympathetic innervation of the parotid gland

Answer 18

Via the glassopharyngeal nerve - pre/post synapse in the otic ganglion - post carried by auriculotemporal branch of CNV3.

Question 19

Describe the sympathetic innervation of the parotid gland

Answer 19

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

Question 20

What muscle does the submandibular gland warp around?

Answer 20

Mylohyoid

Question 21

What nerve is the submandibular gland close to?

Answer 21

Superior to the lingual nerve

Question 22

What is the parasympathetic innervation of the sublingual/submandibular gland?

Answer 22

From chorda tympania (CNVII),
Pre/post synapse in the submandibular ganglion with post synaptic nerve fibres travelling with the lingual nerve.

Question 23

What is the sympathetic innervation of the sublingual/submandibular gland?

Answer 23

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.

Question 24

What is sialolthiasis?

Answer 24

Hardened mineral deposits in the salivary gland - causing salivary gland swelling.

Question 25

What are the different types of teeth found in humans?

Answer 25

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)

Question 26

What are some important features tbe able to identify on the bony hard palate?

Answer 26

THe incisive fossa The palatine process of the maxilla The horizontal plate of the palatine bone.

Question 27

How can the gingiva be split anatomically

Answer 27

The lingual gingiva - facing the tongue The vestibular gingiva - face the cheeks/buccal/labial) Maxillary - top row Mandibular - floor of mouth

Question 28

Describe the innervation to the maxillary teeth

Answer 28

CNV2 -> superior alveolar branch which has three segments -> anterior = incisor and part of canine -> middle = -> posterior = 3 molar

Question 29

Describe the innervation the maxillary gingiva

Answer 29

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.

Question 30

Describe the innervation of the mandibular teeth?

Answer 30

Supplies by branches of the CNV3 Inferior alveolar nerve - incisor branch to incisor and canine, the dental pranches to premolar and molars

Question 31

What branches of the CNV3 are important to know in the oral cavity?

Answer 31

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.

Question 32

Describe the innervation of the mandibular gingiva

Answer 32

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)

Question 33

Where does each salivary gland oepn into the mouth?

Answer 33

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

Question 34

Within the subtance of the tongue the hypoglossal nerve runs between which two muscles?

Answer 34

The hyoglossus The mylohyoid

Question 35

What structure seperates the anterior 2/3 and the posterior 1/3 of the tongue

Answer 35

The sulcus terminalis

Question 36

The floor of the mouth if formed by which muscle

Answer 36

The mylohyoid