Oral Cavity + Pharynx Flashcards
Extrinsic muscles of the tongue
Genioglossus
Hypoglossus
Styloglossus
Palatoglossus
Sensory innervation + taste to the tongue
- anterior 2/3: sensation from lingual branch from trigeminal nerve V | taste from facial VII (chorda tympani)
- posterior 1/3: sensation + taste from glossopharyngeal IX
Motor innervation to the extrinsic muscles of the tongue
- Hypoglossal nerve XII: genioglossus, hypoglossus, styloglossus
- Vagus nerve X: palatoglossus
Boundaries of the oral cavity
- superior: hard + soft palate
- inferior: muscular floor
- lateral + anterior: lip, cheek + body of tongue
- posterior: uvula, palatine + lingual tonsils, root of tongue
What is Sialolithiasis?
Condition where a calcified mass (sialolith) forms within a salivary gland,
Most common in the submandibular gland
What is the nerve of the tongue?
Hypoglossal nerve XII
What are the salivary glands?
Submandibular
Parotid
Sublingual
Symptoms of sialolithiasis
Eating stimulates:
- pain in gland
- swelling
- infection
What salivary gland is most likely to have stones?
Submandibular
Where is Wharton’s duct?
At base of tongue
Either side of lingual frenulum
What are parotid glands secretions transported by?
Stensen duct
Location of Stensen duct opening
In buccinator near the second upper molar
Pathway of stensen duct
- originates from parotid gland
- passes through masster muscle
- pierces buccinator
- opens into oral cavity near second upper molar
What duct is associated with the submandibular duct?
Wharton duct
What duct is associated with parotid gland?
Stensen duct
Investigation of sialolithiasis
Sialogram
Presentation of tonsillitis
Fever
Sore throat
Pain/difficult swallowing
Bad breath
Most common cause of tonsillitis
Virus
Most common bacterial cause of tonsillitis
Streptococcus pyogenes
Define tonsillitis
Inflammation of palatine tonsils
What is quinsy?
peritonsillar abscess
Presentation of peritonsillar abscess
- Severe throat pain
- Fever
- Bad breath
- Drooling
- Difficulty opening mouth
- Deviated uvula
How can a peritonsillar abscess arise?
- follow on from untreated tonsillitis
- can arise on its own: aerobic or anaerobic bacteria
Treatment of peritonsillar abscess/quinsy
- analgesia
- fluids
- antibiotics benzylpenicillin + metrondiazole
- surgery for drainage
Boundaries of the nasopharynx
Lines behind nasal cavity
- roof: base of skull
- floor: upper border of soft palate
- anterior: nasal cavity
- posterior: C1, C2
Contents of the nasopharynx
- pharyngeal tonsils (adenoids)
- pharyngeal ostium of auditory tube
Presentation of enlarged pharyngeal tonsils
- nasal tone to voice
- chronic sinusitis
- sore throat
- snoring/sleep apnoea
- sleeping with mouth open
- recurrent middle ear infections (blocks phayngotympanic tube)
Boundaries of oropharynx
Behind oral cavity
- roof: soft palate
- floor: epiglottis
- anterior: oral cavity
- posterior: C2, C3
Contents of oropharynx
Palatine tonsils
Which lie between the palatoglossal arch + palatopharyngeal arches
Boundaries of the laryngopharynx
Behind the larynx
- roof: epiglottis
- floor: ‘line from’ cricoid cartilage
- anterior: larynx
- posterior C4-6
Contents of laryngopharynx
Pisiform fossa
What is the piriform fossa?
- Potential space on either side of the larynx
- two pyramidal shapes with apex below
What are the three longitudinal muscles of the mouth?
What are their innervations?
What is their action
- Stylopharyngeus - glossopharyngeal
- Palatopharyngeus - vagus
- Salpingopharyngeus - vagus
Elevate pharynx + larynx during swallowing
What are the three pharyngeal constrictors (circular muscles)?
What are their origins?
What is their innervation?
What is their action?
- superior: ptergomandibular raphe
- middle: hyoid bone
- inferior: thyropharyngeal: thyroid cartilage | cricopharyngeal: cricoid cartilage
- vagus nerve X
- constrict wall of pharynx when swallowing
Innervation of the pharyngeal constrictors
Vagus nerve X
What is a pharyngeal pouch?
- Outpouching of pharynx at level of larynx
- Arises in weakness between two parts of inferior constrictor muscle
Motor innervation of the pharynx
Vagus nerve
Except Stylopharyngeus: CN IX
Sensory innervation of the nasopharynx
Maxillary nerve Vb
Sensory innervation of oropharynx
Glossopharyngeal nerve IX
Sensory innervation of laryngopharynx
Vagus nerve X
Presentation of dysphagia
- coughing + choking
- drooling
- recurrent pneumonia
- changes in speech/voice
- nasal regurgitation
Role of supra + infrahyoid muscles during swallowing
- suprahyoid: elevates + pushes forwards hyoid bone + larynx > prevents asphyxiation
- infrahyoid: opposite action > stabilises larynx
What are the arches in the oral cavity?
Palatoglossal arch
Palatopharyngeal arch
Name the longitudinal muscles of the mouth
Stylopharyngeus
Palatopharyngeus
Salpingopharyngeus
Action of the longitudinal muscles of the mouth
Elevate pharynx + larynx during swallowing
Name the pharyngeal constrictors
Superior, middle + inferior pharyngeal constrictors
What nerve innervates the soft palate?
Vagus nerve X
