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Neuro Exam 3 > Oral cavity and submandibular regions > Flashcards

Oral cavity and submandibular regions Flashcards

1
Q

what makes up the oral region?

A 
A.	Oral cavity
B.	Cheeks and lips
C.	Teeth and gingivae
D.	Tongue
E.	Tonsils
F.	Salivary glands
G.	Palate
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2
Q

what is the oral cavity ?

what is it bounded by laterally, posteriorly and superiorly?

A

A. Consists of oral cavity proper and vestibule.

B. The oral cavity is the proximal-most portion of the GI tract.

C. It is the space bounded by the lips/cheeks and teeth; posteriorly by the oropharynx; superiorly by the palate.

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3
Q

what is the vestibule ?

what controls the size of the oral fissure

where does the parotid duct open in the vestibule?

A
  1. Space between the lips/cheeks and teeth.
  2. Opens externally at the oral fissure between lips.
  3. Muscles of facial expression control shape/size of oral fissure.
  4. Parotid duct opens into the vestibule opposite the upper 2nd molar.
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4
Q 
what are the boundaries of the oral cavity proper?
lateral/anterior
superior
inferior
posterior
A
  1. Lateral/anterior – teeth gums
  2. Superior – hard/soft palate
  3. Inferior – floor of mouth
  4. Posterior – fauces
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5
Q

what covers the lips externally? internally?

A

covered by thin skin externally

internally covered by mucus membrane

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6
Q

orbicularis oris does what to mouth?

A

a. Orbicularis oris – closes lips/mouth

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7
Q

levator labii superioris

A

elevates upper lip

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8
Q

levator anguli oris

A

elevates upper lip, widens mouth

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9
Q

zygomaticus major and minor

A

elevates upper lip, main smile muscles

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10
Q

risorius

A

stretches lips laterally

wide smile

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11
Q

levator labii superioris alaeque nasi

A

elevates upper lip, flares nostrils

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12
Q

depressor anguli oris

A

depresses lower lip, frown

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13
Q

depressor labii inferioris

A

depresses lower lip

frown, pout

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14
Q

mentalis

A

protrudes lower lip

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15
Q

innervation to upper lip?

innervation to lower lip?

A
  1. Upper lip – V2 via infraorbital branches

2. Lower lip – V3 via mental and buccal branches

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16
Q

what is the lymphatic drainage of the lips (2)

A
  1. Submental lymph nodes – medial part of lower lip

2. Submandibular lymph nodes – all other regions

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17
Q

what is the funciton of teeth

A

mastication, articulation

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18
Q

how many permanent teeth?

how many deciduous teeth

A

B. 32 permanent teeth; 16 deciduous (baby teeth)

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19
Q

how many incisors, canine, premolars, molars

A
  1. Incisors (4), canine (2), premolars (4), molars (6)

2. Typically appear around 6-8 years of age

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20
Q

what is the gingivae

A

mucus membrane and fibrous tissue attached to the alveolar processes of the mandible and and maxilla bones

also attached to neck of teeth

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21
Q

maxillary teeth are innervated by what?

mandibular teeth?

A
  1. Maxillary teeth – superior alveolar branches of V2

2. Mandibular teeth – inferior alveolar branches of V3

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22
Q

innervation of the maxillary gingivae

palatine portion
vestibular portion

A

a. Palatine portion
1. Nasopalatine n (V2)
2. Greater palatine n (V2)
b. Vestibular portion
1. Superior alveolar branches of V2

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23
Q

innervation of the mandibular gingivae

internal portion
external portion

A
  1. Mandibular teeth – inferior alveolar branches of V3

a. Internal portion
1. Lingual n (V3)

b. External portion
1. Buccal n (V3)
2. Inferior alveolar n, mental branch (V3)

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24
Q

where does most lymph from teeth and gingivae drain?

what are 2 exceptions to this?

A
  1. Most lymph drainage is to submandibular lymph nodes
  2. Exception: mandibular incisors drain to submental lymph nodes.
  3. Exception: 3rd maxillary molars drain directly to superior deep cervical lymph nodes.
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25
Q

what is the tongue?
what is it involved with in terms of function?
what are the parts of the tongue

A

B. Muscular, mobile organ involved in mastication, swallowing, articulation, and taste.

body
root
epiglottic portion

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26
Q

what is the body of the tongue?

root?

A
  1. Body
    a. Anterior 2/3rds of tongue; ends anteriorly at apex
    b. Mobile
  2. Root
    a. Posterior 1/3 of tongue
    b. Anchored to mandible, hyoid, and styloid process.
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27
Q

what is the terminal sulcus

what does it separate
what is its embryonic origin

A
  1. Terminal sulcus
    a. V-shaped groove on dorsum of tongue
    b. Separates root from body
    c. Represents embryonic site of oropharyngeal membrane.
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28
Q

what is the foramen cecum a remnant of

A

thyroglossal duct

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29
Q

what are 4 types of papillae

A

vallate, filiform (no taste buds) , fungiform, foliate

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30
Q

what is the frenulum of the tongue

A

attachments under tongue to lower lip and one under the upper lip

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31
Q

what are the three intrinsic muscles of the tongue?

what are the functions of each?

A

a. Longitudinal (shorten; retract tongue; also can curl tongue)

b. Vertical (flatten; broaden tongue)
c. Transverse (narrow; elongate tongue)

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32
Q

genioglossus attachments

A
  1. Origin – mental spines of mandible

2. Insertion – dorsum of tongue; from apex to hyoid

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33
Q

genioglossus innervation

action acting bilaterally and acting unilaterally

A
  1. Innervation – hypoglossal n.
  2. Function – acting bilaterally - protrudes tongue;

acting unilaterally – PUSHES tongue to opposite side

34
Q

hyoglossus attachments?

A
  1. Origin – Hyoid bone

2. Insertion – inferolateral side of tongue

35
Q

hyoglossus action and innervation

A
  1. Innervation – hypoglossal n.

4. Function – retracts; depresses tongue

36
Q

styloglossus muscle attachments

A
  1. Origin – styloid process

2. Insertion – superolateral side of tongue

37
Q

styloglossus innervation and function

A
  1. Innervation – hypoglossal n.

4. Function – retracts; elevates tongue

38
Q

palatoglossus attachments

innervation

function

A
  1. Origin – soft palate
  2. Insertion – tongue
  3. Innervation – vagus n***
  4. Function – pulls tongue and soft palate together during swallowing
39
Q

what is the motor innervation to the tongue?

A

hypoglossal nerve (GSE) to all muscles except palatoglossus ***

vagus nerve –> SVE to palatoglossus

40
Q

hypoglossal nerve lesion?

A

Hypoglossal Nerve Lesion. When patient is asked to protrude tongue, tongue will deviate toward affected (paralyzed) side because functioning genioglossus muscle pushes tongue contralaterally.

41
Q

sensory innervation of anterior 2/3 of tongue (2 components)

A 
GSA = lingual branch of V3 (NOT GVA) 
SVA = facial nerve via chorda tympani
42
Q

sensory innervation (2 components) to posterior 1/3 of tongue

A

GVA–> glossopharyngeal n.

SVA –> glossopharyngeal n.

43
Q

sensory innervation to eppiglottic region of tongue (2 components)

A

Hypoglossal Nerve Lesion. When patient is asked to protrude tongue, tongue will deviate toward affected (paralyzed) side because functioning genioglossus muscle pushes tongue contralaterally.

44
Q

what is the arterial supply to the tongue

A

lingual artery- branch off external carotid artery

branches:
dorsal lingual (posterior tongue, palatine tonsil)

sublingual (floor of mouth)

deep lingual (anterior tongue)

45
Q

what is the venous drainage of the tongue ?

where do they course to as their final ending /

A

lingual veins

drain tongue and floor of oral cavity to the internal jugular vein

46
Q

what are venae comitantes hypoglossi

A

drain floor of oral cavity and parallel course of hypoglossal nerve to end in the common facial vein.

47
Q

what is the lymphatic drainage of the posterior 1/3 of the tongue

A

superior deep cervical lymph nodes (bilaterally)

48
Q

what is the lymphatic drainge of the anterior 2/3 of the tongue

A

lateral sides–> submandibular ipsilateral

middle –> inferior deep cervical nodes (bilateral)

apex–> submental (medial portion draining bilaterally)

49
Q

what are the 4 tonsils ?

what do they form>?

A

lingual
pharyngeal
palatine
tubal

B. These 4 groups form a defensive ring of lymphoid tissue referred to as the pharyngeal lymphoid ring or Waldeyer’s ring.

50
Q

lingual tonsil

A

located deep to mucosa of posterior 1/3 of tongue

51
Q

pharyngeal tonsils

A

located within pharyngeal recess of nasopharynx right under occiptial bone

52
Q

palatine tonsils

A

located at the openings of oropharynx,

between palatoglossal and palatopharyngeal arches

53
Q

tubal tonsils

A

located at the opening of auditory tube

54
Q

what are adenoids

A

when pharyngeal tonsils are inflamed

55
Q

what is the problem with enlarged lymph nodes

A

become englarged and occlude surrounding structures (fauces, opening to auditory tube; nasopharynx).

56
Q

what is the function of salivary glands?

A

A. Secrete salivary fluid into oral cavity which functions to: begin process of digestion, lubricate food, prevent tooth decay, moisten oral cavity.

57
Q

what are the three salivary glands

A

parotid
sublingual
submandibular glands

58
Q

sublingual glands

location
what do they form
open into what via what?

A
  1. Lie in floor of oral cavity; covered with oral mucosa.
  2. Forms sublingual fold on floor of mouth.
  3. Open into oral cavity via several small ducts on sublingual fold.
59
Q

submandibular glands

location (b/w what two muscles)
where does its duct course and open?

what nerve wraps around this gland as it courses forward

A

D. Submandibular glands
1. Superficial portion lies within submandibular triangle of neck; deep to mandible; superficial to mylohyoid muscle.

  1. Deep portion of gland wraps around the posterior border of the mylohyoid to pass between it and the hyoglossus muscle.
  2. Submandibular (Wharton’s) duct courses anteriorly from deep part of gland (between mylohyoid and hyoglossus) to open in floor of the mouth on the sublingual caruncle.
  3. NOTE: The lingual nerve wraps around the submandibular duct as they course forward.
60
Q

where is the submandibular ganglion

what nerve is it suspended from

what does it contain

what does it provide innervation to

A
  1. Submandibular ganglion
    a. Ganglion suspended from lingual nerve within posterior floor of oral cavity.
    b. Contains the cell bodies of postganglionic parasympathetic fibers.
    c. Provides innervation for the submandibular and sublingual glands
61
Q

what are the boundaries of the submandibular region?

inferior
superior
roof
floor

A
  1. Inferior – anterior and posterior bellies of digastric muscles
  2. Superior – mandible
  3. Roof – cervical investing fascia
  4. Floor – mylohyoid muscle
62
Q

what are the 4 main contents of the submandibular region

A

submandibular gland
facial artery
CN XII
Suprahyoid muscles

63
Q

what are the 4 suprahyoid muscles

A

digastric
stylohyoid
mylohyoid
geniohyoid

64
Q

digastric attachments

A
  1. Origin – anterior belly (digastric fossa of mandible)
    – posterior belly (mastoid notch of temporal bone)
  2. Insertion - hyoid
65
Q

innervation and function of the digastric

A
  1. Innervation – anterior belly (V3); posterior belly (CN VII)
  2. Function – depresses mandible; elevates hyoid
66
Q

what are the attachments, innervation and function of the stylohyoid

A
  1. Origin – styloid process
  2. Insertion – hyoid
  3. Innervation – CN VII
  4. Function – elevates and retracts hyoid
67
Q

attachments of the mylohyoid

A
  1. Origin – mylohyoid line of mandible

2. Insertion – midline raphe and hyoid

68
Q

innervation and function of the mylohyoid

A
  1. Innervation – mylohyoid branch of V3

4. Function – elevates hyoid and floor of mouth; assists with opening mouth

69
Q

what are the attachments, innervation and function of the geniohyoid

A
  1. Origin – mental spines of mandible
  2. Insertion – hyoid
  3. Innervation – C1 via hypoglossal
  4. Function – elevates hyoid; when hyoid fixed, opens mouth
70
Q

what is the paralingual space

A

posterior region of oral cavity between hyoglossus and mylohyoid mm.

71
Q

what is the major artery in the submandibular region?

A
  1. Lingual artery – branch of external carotid artery
    a. Dorsal lingual a. (posterior tongue)
    b. Sublingual a. (floor of mouth)
    c. Deep lingual a. (anterior tongue)
72
Q

what veins are in the submandibular region

A

lingual vein –> drains to internal jugular vein

venae comitantes hypoglossi –> veins which parllel course of hypoglossal nerve and end in the common facial vein

73
Q

sublingual absorption of drugs?

A

Sublingual Absorption of Drugs – certain drugs (such as nitroglycerin) need rapid absorption. Because the lingual veins drain directly to the IJV, drugs can be placed in the sublingual region (below the tongue on floor of mouth) and rapidly absorbed into the bloodstream.

74
Q

what are the four major nerves to the oral cavity

A

lingual nerve (V3)
hypoglossal n.
glossopharyngeal
vagus nerve

75
Q 
lingual nerve to oral cavity
branch of what?
enters oral cavity where?
courses in what space?
wraps around what structure 
what does it pierce?
A

a. Branch of V3
b. Enters oral cavity posteriorly from infratemporal fossa.
c. Courses through paralingual space (between hyoglossus and mylohyoid mm.)
d. Wraps around submandibular duct in course.
e. Pierces tongue laterally.

76
Q

what component does the lingual nerve provide

A

GSA to the floor of the mouth and anterior 2/3 of tongue

77
Q

what does the lingual nerve distribute ?

A

SVA
GVE-P
both via chorda tympani

78
Q

chorda tympani

branch of what nerve?
where does it exit the middle ear?
what does it merge with to travel to the oral cavity
what does it carry?

A

a. Chorda tympani is a branch of CN VII given of within middle ear.
b. Chorda tympani n exits middle ear via petrotympanic fissure to enter infratemporal fossa.
c. Here, it merges with the lingual n (V3) to travel to the oral cavity.
d. Carries
1. SVA to anterior 2/3rds of tongue
2. GVE-P (parasympathetic fibers) to submandibular ganglion to be distributed to the submandibular and sublingual glands.

79
Q

hypoglossal nerve to the oral cavity

enters oral cavity where
what artery does it pass over and what space does it enter
what does it provide and to what structures ?

A
  1. Enters oral cavity from submandibular region.
  2. After passing lateral to the occipital artery, the hypoglossal nerve then enters the paralingual space.
  3. Provides:
    a. GSE – extrinsic tongue muscles (except palatoglossus)
    b. GSE – intrinsic tongue muscles
80
Q

glossopharyngeal nerve in oral cavity

enters oral cavity where?
what muscles does it pass between
where does it pierce the tongue
what components does it provide

A
  1. Enters oral cavity posteriorly from pharyngeal region.
  2. After passing in between the superior and middle constrictor muscles, CN IX travels forward to pierce the tongue posteriorly.
  3. Provides:
    a. GVA – posterior 1/3 of tongue
    b. SVA – posterior 1/3 of tongue
81
Q

vagus nerve in the oral cavity

what branch off vagus will enter the oral cavity

between what muscles does it pass on its way to oral cavity

what components does it provide?

A
  1. Internal branch of superior laryngeal nerve will enters oral cavity posteriorly from pharyngeal region.
  2. After passing in between the middle and inferior constrictors muscles, the internal laryngeal nerve will ascend to supply the epiglottic region of the tongue
  3. Provides:
    a. GVA – epiglottic region of tongue
    b. SVA – epiglottic region of tongue

Neuro Exam 3 (12 decks)

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