Palate and Lymphatics of the Head and Neck

Question 1

The hard palate is formed by the fusion of the ____ ____ of the maxillary and the _____ part of the palatine bones

Answer 1

palatine processes; horizontal

Question 2

What are the 3 things the mucosa of the hard palate possesses?

Answer 2

1. numerous transverse palatine folds
2. palatine raphe
3. incisive papilla

Question 3

What are the 3 foramina in the hard palate?

Answer 3

1. incisive canal
2. greater palatine foramen
3. lesser palatine foramen

Question 4

The soft palate’s posterior midline projection forms the ____

Answer 4

uvula

Question 5

The soft palate acts as a valve to close the oral cavity from the _____, and is elevated to separate the _____ from the _____ during swallowing

Answer 5

oropharynx; nasopharynx; oropharynx

Question 6

This muscle arises from the petrous part of the temporal bone and some fibers come from the cartilage of the pharyngotympanic tube to insert into the soft palate

Answer 6

levator veli palatini

Question 7

What innervates levator veli palatini? What is its action?

Answer 7

vagus; elevates the soft palate and aids in the opening of the auditory tube

Question 8

This muscle arises from the sphenoid and lateral side of the auditory tube. The tendon of the muscle makes a sharp turn around the pterygoid humans to course medially into the soft palate and forms its aponeurotic component

Answer 8

tensor veli palatini

Question 9

What is the innervation and action of tensor veil palatine?

Answer 9

innervation: mandibular nerve (V3)
action: tenses the palate and aids in the opening of the auditory tube

Question 10

This soft palate muscle originates in the palatine aponeurosis and courses inferiorly to insert in to the side of the tongue. It is covered in mucosa and forms the palatoglossal arch.

Answer 10

palatoglossus

Question 11

What is the innervation and action of palatoglossus?

Answer 11

innervation: vagus
action: aids in elevating the tongue, and depressing the soft palate

Question 12

This soft palate muscle originates in the palatine aponeurosis and courses inferiorly to insert into the fascia of the pharynx. It is covered in mucosa and forms the palatopharyngeal arch.

Answer 12

palatopharyngeus

Question 13

What is the innervation and action of palatopharyngeus?

Answer 13

innervation: vagus
action: functions mainly to elevate the pharynx, but can also depress soft palate

Question 14

This soft palate muscle is formed by a paired bundle of muscle fibers that originate from the posterior edge of the hard palate and aponeurosis, and forms the core of the uvula.

Answer 14

musculus uvulae

Question 15

What is the innervation and action of musculus uvulae?

Answer 15

innervation: vagus
action: elevates and retracts uvulae and thickens the soft palate

Question 16

Most of the blood supply to the soft palate is via the maxillary artery by its branch the ____ ____ artery

Answer 16

descending palatine

Question 17

This branch from the descending palatine artery enters the palate via the greater palatine foramen, turns anteriorly and supplies the hard palate. Its terminal branch sends a twig through the incisive canal into the nasal cavity

Answer 17

Greater palatine artery

Question 18

This branch from the descending palatine artery enters the palate via the lesser palatine foramen, turns posteriorly and supplies the soft palate.

Answer 18

lesser palatine artery

Question 19

This branch from the facial artery follows the levator veli palatini to the soft palate

Answer 19

ascending palatine artery

Question 20

Venous drainage of the palate is into tributaries of the _____ plexus

Answer 20

pterygoid

Question 21

The sensory nerve supply of the palate is mainly through branches of the ____ division of the trigeminal nerve.

Answer 21

Maxillary (V2)

Question 22

This branch of the maxillary nerve (V2) courses through the palatine canal, exists through the greater palatine foramen and supplies the hard palate and gingiva

Answer 22

greater palatine nerve

Question 23

This branch of the maxillary nerve (V2) exits through the lesser palatine foramen and supplies the mucosa of the soft palate

Answer 23

lesser palatine nerve

Question 24

This branch of the maxillary nerve (V2) enters the oral cavity via the incisor canal and supplies the mucosa behind the incisor teeth

Answer 24

nasopalatine nerve

Question 25

The palatine glands receive _____ fibers from the pterygopalatine ganglion in the palatine nerves

Answer 25

postganglionic

Question 26

In regards to cleft palate, the cleft may involve only the ____, giving it a fishtail appearance, or it may extend through the soft palate and hard regions of the palate. In severe cases associated with cleft lip, the cleft palate extends through the ____ processes of the maxillae and th lips on both sides

Answer 26

uvula; alveolar

Question 27

The embryological basis of cleft palate is failure of _____ masses in the _____ _____ processes to meet and fuse with each other, the nasal septum, and/or with the posterior margin of the median palatine process

Answer 27

mesenchymal; lateral palatine

Question 28

The nasopalatine nerves can be anesthetized by injecting anesthetic into the ____ fossa in the hard palate.

Answer 28

incisive

Question 29

The greater palatine nerve can be anesthetized by injecting anesthetic into the greater palatine foramen. The nerve emerges between the 2nd and 3rd molar teeth. This nerve block anesthetizes what structures/vessels?

Answer 29

all palatal mucosa, lingual gingivae posterior to maxillary canine teeth and the underlying bone of the palate

Question 30

What precautions should be taken when doing a greater palatine nerve block?

Answer 30

branches of the greater palatine arteries should be avoided and the anesthetic should be injected slowly to prevent stripping of the mucosa from the hard palate

Question 31

What nerves are responsible for the gag reflex?

Answer 31

Glossopharyngeal and Vagus

Question 32

Lymphatics from the entire body drain towards what area?

Answer 32

the root of the neck

Question 33

In regards to lymphatic drainage of the scalp, the occipital area drains mostly into occipital and deep cervical nodes. Often a large lymph channel follows the posterior border of the ______ to the deep cervical nodes

Answer 33

SCM

Question 34

In regards to lymphatic drainage of the scalp, the ____ and____ areas drain either in front of the ear or behind it, terminating in retroauricular, superficial parotid, superficial cervical and then deep cervical node.

Answer 34

temporal and parietal

Question 35

In regards to lymphatic drainage of the scalp, the frontal area drains into ____ ____ nodes

Answer 35

superficial parotid

Question 36

In regards to lymphatic drainage of the face, the lateral part of the eyelids drains into _____ ____ nodes

Answer 36

superficial parotid

Question 37

In regards to lymphatic drainage of the face, the middle part of the eyelids, most of external nose, upper lip, and lateral part of the lower lip drain into ____ and ____ nodes, then to _____ nodes

Answer 37

buccal; mandibular; submandibular

Question 38

In regards to lymphatic drainage of the face, the medial part of the lower lip drains into ____ nodes

Answer 38

submental

Question 39

In regards to lymphatic drainage of the face, most of the cheek drains into _____ and _____ nodes but the zygomatic and preauricular areas drain into the ____ ____ nodes

Answer 39

buccal; mandibular; superfical partoid

Question 40

The few scattered lymph nodes along the ____ artery are in two groups: the buccal and mandibular nodes

Answer 40

facial

Question 41

Superficial lymphatics are subdivided into submandibular, submittal, and superficial cervical channels and nodes. These drain into the deep cervical lymphatic chain related to the ____ _____ vein

Answer 41

internal jugular

Question 42

The deep cervical nodes are a collection of nodes along the internal jugular vein that are divided into two groups by the intermediate tendon of the _____ muscle

Answer 42

omohyoid

Question 43

The deep cervical nodes empty into ____ ____, that then drain into either the ____ duct on the left, or the ____ ____ duct on the right

Answer 43

jugular trunks; thoracic; right lymphatic

Question 44

Radial neck dissections are performed when cancer invades the cervical lymphatics. What is the goal of the procedure?

Answer 44

to remove all tissues that bear lymph nodes in one piece