Oral Cavity & Pharynx Flashcards
What are the borders of the oral cavity?
Lateral: Muscles of Buccinator
Roof: Soft and Hard Pallette
Floor: 2 Myohyoid muscles, tongue and other soft tissues
Name the features of the oral cavity
What is sialolithiasis?
Stones of the salivary glands causing significant painand swelling particularly after eating
What are the different types of muscle in the tongue?
Intrinsic and Extrinsinc Muscles
What is the motor innervation of the muscles of the tongue?
Hypoglossal (CN XII)
Name the extrinsic muscles of the togue and give their motor innervation
- Genioglossal - Hypoglossal
- Hypoglossus - Hypoglossal
- Styloglossus - Hypoglossal
- Palatoglossus - Vagus Nerve
How do you test the function of the hypoglossal nerve? Which muscle is responsible for this action?
- Ask the patient to stick out their tongue
- Genioglossus muscle, innervated by hypoglossal nerve protrudes the tongue
Describe the sensory innervation of the tongue
What are the the 3 pairs of salivary glands?
- Parotid
- Submandibular
- Sublingual
What is Warton’s Duct?
Duct connecting the submandibular salivary gland to the oral cavity for release of saliva
What is the Stenson Duct?
The duct of the parotid gland that releases saliva into the oral cavity
What are some of the symptoms of tonsilitis?
- Fever
- Pain/ difficulty swalling
- Cervical lymph nodes
- Bad Breath
How does the uvula appear in tonsilitis?
Remains central
How does the uvula appear in a peritonsilar abcess?
Uvula can deviate to one side
What are some of the symptoms of a peritonsillar abscess?
- Severe throat pain
- Fever
- Bad Breath
- Drooling
- Difficulty opening mouth
What are the boundaries of the Nasopharynx?
- Base of skull
- Posteriorally- C1 and C2
- Anteriorally - nasal cavity
What is an adenoid?
An enlarged pharyngeal tonsil
What are some of the effects of adenoids?
- Blocked Eustacian Tube → reccurrent middle ear infections
- Snoring / sleep apnoea
- Sleeping with mouth open
- Chronic Sinusitis
- Nasal tone to voice
What are the boundaries of the oropharynx?
Anterior: oral cavity
Posterior: C2, C3
Runs from the soft palate to the epiglottis
What are the contents fo the orophraynx?
The Palatine Tonsils
What are the boundaries of the laryngopharynx?
Runs from the oropharynx to the oesophagus
Anterior: larynx
Posterior: C4, C5, C6
What is the piriform fossa of the laryngopharynx?
Recesses either side of the laryngeal inlet that fluid can drain to if the epiglottis doesn’t close
What are the 3 longitudinal muscles that elevate the pharynx and larynx during swallowing? What is the nerve innervation of each?
- Stylopharyngeus - Glossopharyngeal nerve CN IX
- Palatopharyngeus - Vagus Nerve CN X
- Salpingopharngeus - Vagus Nerve CN X
What are the constrictors of the pharynx and what nerve innervates them?
- Superior pharyngeal constrictor
- Middle pharyngeal constrictor
-
Inferior pharyngeal constrictor
- Has 2 Parts: Thyropharyngeal
- Cricopharyngeal
- All innervated by the Vagus Nerve
What is Killian’s Dehiscence?
An area of weakness between thyropharyngeus and cricopharyngeus
Pharyngeal mucosa can herniate through here during swalling causing a pharyngeal pouch (diverticulum)
What is the pharyngeal raphe?
Line at the back of the pharynx where all the pharyngeal constrictors meet
What is Zenker’s Diverticulum?
Herniation of pharynx mucosa between the 2 inferior pharynx constrictors
What things can cause a rise in pressure in the pharynx which could cause Zenker’s Diverticulum
- Failure of UOS to relax
- Abnormal timing of smallowing
- Weakness in Killian’s Dehiscence
Describe the sensory nerve innnervation of the pharynx
Nasopharynx - Maxillary branch of Trigeminal Vb
Oropharynx - Glossopharyngeal CN IX
Laryngopharynx - Vagus Nerve CN X
What obvious signs suggest a problem with cranial nerves IX and X?
Absent gag reflex
Which nerve is being tested when the patient is asked to say ‘Ahhh’?
Vagus Nerve
Ulva deviates Away from the lesion
How would you test for a lesion in hypoglossal nerve CN XII?
Stick Tongue out - muscle wasting and may deviate towards the side of the lesion
