Palate and Lymphatics of the Head and Neck Flashcards
The hard palate is formed by the fusion of the ____ ____ of the maxillary and the _____ part of the palatine bones
palatine processes; horizontal
What are the 3 things the mucosa of the hard palate possesses?
- numerous transverse palatine folds
- palatine raphe
- incisive papilla
What are the 3 foramina in the hard palate?
- incisive canal
- greater palatine foramen
- lesser palatine foramen
The soft palate’s posterior midline projection forms the ____
uvula
The soft palate acts as a valve to close the oral cavity from the _____, and is elevated to separate the _____ from the _____ during swallowing
oropharynx; nasopharynx; oropharynx
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
levator veli palatini
What innervates levator veli palatini? What is its action?
vagus; elevates the soft palate and aids in the opening of the auditory tube
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
tensor veli palatini
What is the innervation and action of tensor veil palatine?
innervation: mandibular nerve (V3)
action: tenses the palate and aids in the opening of the auditory tube
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.
palatoglossus
What is the innervation and action of palatoglossus?
innervation: vagus
action: aids in elevating the tongue, and depressing the soft palate
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.
palatopharyngeus
What is the innervation and action of palatopharyngeus?
innervation: vagus
action: functions mainly to elevate the pharynx, but can also depress soft palate
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.
musculus uvulae
What is the innervation and action of musculus uvulae?
innervation: vagus
action: elevates and retracts uvulae and thickens the soft palate
Most of the blood supply to the soft palate is via the maxillary artery by its branch the ____ ____ artery
descending palatine
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
Greater palatine artery
This branch from the descending palatine artery enters the palate via the lesser palatine foramen, turns posteriorly and supplies the soft palate.
lesser palatine artery
This branch from the facial artery follows the levator veli palatini to the soft palate
ascending palatine artery
Venous drainage of the palate is into tributaries of the _____ plexus
pterygoid
The sensory nerve supply of the palate is mainly through branches of the ____ division of the trigeminal nerve.
Maxillary (V2)
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
greater palatine nerve
This branch of the maxillary nerve (V2) exits through the lesser palatine foramen and supplies the mucosa of the soft palate
lesser palatine nerve
This branch of the maxillary nerve (V2) enters the oral cavity via the incisor canal and supplies the mucosa behind the incisor teeth
nasopalatine nerve
The palatine glands receive _____ fibers from the pterygopalatine ganglion in the palatine nerves
postganglionic
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
uvula; alveolar
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
mesenchymal; lateral palatine
The nasopalatine nerves can be anesthetized by injecting anesthetic into the ____ fossa in the hard palate.
incisive
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?
all palatal mucosa, lingual gingivae posterior to maxillary canine teeth and the underlying bone of the palate
What precautions should be taken when doing a greater palatine nerve block?
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
What nerves are responsible for the gag reflex?
Glossopharyngeal and Vagus
Lymphatics from the entire body drain towards what area?
the root of the neck
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
SCM
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.
temporal and parietal
In regards to lymphatic drainage of the scalp, the frontal area drains into ____ ____ nodes
superficial parotid
In regards to lymphatic drainage of the face, the lateral part of the eyelids drains into _____ ____ nodes
superficial parotid
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
buccal; mandibular; submandibular
In regards to lymphatic drainage of the face, the medial part of the lower lip drains into ____ nodes
submental
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
buccal; mandibular; superfical partoid
The few scattered lymph nodes along the ____ artery are in two groups: the buccal and mandibular nodes
facial
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
internal jugular
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
omohyoid
The deep cervical nodes empty into ____ ____, that then drain into either the ____ duct on the left, or the ____ ____ duct on the right
jugular trunks; thoracic; right lymphatic
Radial neck dissections are performed when cancer invades the cervical lymphatics. What is the goal of the procedure?
to remove all tissues that bear lymph nodes in one piece
