Oral Cavity, TMJ And Tongue Flashcards
What forms the roof of the oral cavity?
Hard and soft palate
What forms the lateral wall of the oral cavity?
Cheek
Buccinator muscle
What is the anterior boundary of the oral cavity?
Oral fissure
What is the posterior boundary of the oral cavity?
Oropharyngeal isthmus
Opening to oropharynx
What is the floor of the oral cavity?
Tongue and other soft tissues
What is the oral vestibule?
Space between teeth and cheek/lips
Running tongue along outside of teeth
What are alternative names for the anterior and posterior arches of the oral cavity?
Anterior = palatoglossal Posterior = palatopharyngeal
What muscles form part of the soft palate and what is their function?
Palatoglossus
Palatopharyngeus
Tense and elevate the soft palate during yawning and swallowing
What nerve innervates the muscles of the soft palate?
Vagus nerve
What is the sign in the oral cavity if the vagus nerve is damaged?
Uvula pulled AWAY FROM side of affected nerve
Describe the limbs of the gag reflex
Afferent = glossopharyngeal - sensory to back of tongue and throat Efferent = vagus - motor to pharyngeal muscles of soft palate
Name the different types of teeth in the mouth from front to back
Central incisor Lateral incisor Canine First premolar Second premolar First molar Second molar Third molar/wisdom tooth
What is the sensory supply to the lower jaw?
Inferior alveolar nerve
Branch of V3
What are the extrinsic muscles of the tongue and give their action?
Styloglossus - elevate
Hyoglossus - depress and retract
Genioglossus - protrude
Name the intrinsic muscles of the tongue and their actions
Superior and inferior longitudinal - curl up or down
Vertical - flatten tongue
Transverse - pull in tongue, make smaller and rounder
Which nerve innervates the tongue muscles?
Hypoglossal
Describe the innervation to anterior 2/3 of tongue
General sensory = V3 (mandibular of trigeminal)
Special sensory = VII (chorda tympani of facial nerve)
Describe the innervation to posterior 1/3 of tongue
General and special sensory via glossopharyngeal nerve
Which is the only tongue muscle not innervated by hypoglossal and which nerve innervates it?
Palatoglossus
Vagus
If there is a lesion of hypoglossal nerve, how will it present in the tongue?
Tongue deviation TOWARDS the side of the lesion
Give the names of the ducts that the parotid and submandibular glands drain via
Parotid = Stenson's Submandibular = Wharton's
Which salivary gland has many ducts?
Sublingual
Salivary stones are usually …. based
Calcium
Which is the most common salivary gland to get a stone in and why?
Submandibular
Normal salvia is comparatively thicker from here
What are the Sx of a salivary stone?
Pain or swelling of a gland at meal times
What are the most common viral causes of tonsillitis?
Rhinovirus
Adenovirus
What are the most common bacterial causes of tonsillitis?
Beta haemolytic strep
How do we tell the difference between bacterial and viral tonsillitis?
Viral = Sx of URTI eg. Dry cough Bacterial = lymphadenopathy, fever and pus (often absence of cough)
What is a peritonsillar abscess?
Quinsy
Severe complication of bacterial tonsillitis
Which bacteria are most likely to cause quinsy?
Strep pyogenes
Staph aureus
H influenzae
Describe the signs and Sx of quinsy
Systemically unwell and trismus
Pain in mouth - cannot open much
Drooling due to dysphagia
Unilateral - uvula may deviate away
What is the Mx for quinsy?
Same day referral to ENT
Drainage and Abx
Describe the TMJ
Jaw joint Modified synovial hinge joint Between cranium (temporal bone) and mandible
Where does the condyle of the mandible sit?
In the mandibular fossa of the articular tubercle of the temporal bone
What are the 3 ligaments supporting the TMJ?
Lateral lig (TM lig) - main one
Stylomandibular lig
Sphenomandibular lig
Which muscles elevate the mandible?
Temporalis
Masseter
Medial pterygoid
Which muscles depress the mandible?
GRAVITY!
Lateral pterygoid, supra and infrahyoid
Which muscle protrudes the mandible?
Lateral pterygoid
Which muscle retrudes the mandible?
Temporalis
Which muscles cause lateral movements of mandible?
Temporalis (on same side)
Pterygoids (of opposite side)
Masseter
What are the muscles of mastication and what nerve innervates them?
Temporalis, masseter and pterygoids
Mandibular branch of trigeminal (V3)
What is the common mechanism of TMJ dislocation?
Blow to the side of chin when the mouth is open
Anterior dislocation
What is temporal arteritis?
A type of vasculitis
Causes TMJ pain
Must always think of because pt can lose eyesight
Rare
What is bruxism?
Grinding of teeth
What is the infratemporal fossa?
Irregularly shaped space deep and inferior to the zygomatic arch and deep to ramus of the mandible
What is the contents of the infratemporal fossa?
Inferior part of temporalis muscle Lateral and medial pterygoid Maxillary artery Pterygoid venous plexus Lots of nerves (V3 and branches of, chorda tympani and otic ganglion)
What is the otic ganglion?
PNS supply to parotid gland
Glossopharyngeal nerve
What is the clinical relevance of the infratemporal fossa?
Isolated infections can occur here (rare)
Infections can causes cavernous sinus thrombosis - connected via venous plexus
And fossa can be used as a site for mandibular nerve block
