Salivary glands, tongue and palate

Question 1

What is the frenulum of the tongue?

Answer 1

Connects the tongue to the gingivae of the lower incisor teeth

Question 2

Which major salivary gland is supplied by CN IX?

Answer 2

Parotid gland

Question 3

Which major salivary glands are supplied by CN VII?

Answer 3

Submandibular and sublingual glands

Question 4

Which branch of the facial nerve supplies the submandibular and the sublingual glands?

Answer 4

Chorda tympani

Question 5

Which salivary glands are shown in this image?

Answer 5

Parotid (anterior to the eat)

Submandibular

Question 6

What route does the parotid duct take to reach the oral cavity?

Answer 6

Crosses the masseter

Pierces through the buccinator medially

Opens on the parotid papilla of the buccal mucosa

Question 7

What is the name of the muscle of the floor of the mouth?

Answer 7

Mylohyoid

Question 8

Which foramen is being highlighted here?

Answer 8

Internal acoustic meatus

Question 9

What are the functions of the chorda tympani branch of the facial nerve?

Answer 9

Parasympathetic nerve supply to the submandibular and sublingual glands

Provides special sense of taste to the anterior 2/3rds of the tongue

Question 10

Which nerve does chorda tympani connect with later on its course?

Answer 10

Lingual nerve - a branch of CNV3

Question 11

What is the function of the lingual nerve?

Answer 11

It contains general sensory and special sensory axons from the anterior 2/3rds of the tongue

Question 12

What is the tongue made of?

Answer 12

Skeletal muscle covered in lingual mucosa

Question 13

What is the facial canal?

Answer 13

Between the internal acoustic meatus and the stylomastoid foramen, the facial nerve travels in the facial canal

Question 14

Which features are shown in this image? (top - bottom)

Answer 14

Question 15

Where is the styloid process of the temporal bone in this image?

Answer 15

Question 16

What are the structures indicated here and their function?

Answer 16

Top - vallate papillae, contain tastebuds

Bottom - surface texture papillae, for general sensation e.g. touch, temperature etc.

Question 17

What is the nerve supply of the anterior 2/3 of the tongue?

Answer 17

General - CNV3

Special sense of taste - CNVII

Question 18

What is the nerve supply of the posterior 1/3 of the tongue?

Answer 18

Both special sense and general - CN IX

Question 19

What is the foramen caecum and where is it located?

Answer 19

The embryological origin of the thyroid gland

Located at the apex of the ‘V’ separating the posterior from the anterior part of the tongue

Question 20

What happens to thyroid swellings when the patient swallows and why?

Answer 20

Moves superiorly then inferiorly due to attachment to the larynx

Question 21

What are the four extrinsic muscles of the tongue?

Answer 21

Palatoglossus

Genioglossus

Styloglossus

Hyoglossus

Question 22

Which nerve supplies most of the extrinsic muscles of the tongue and which muscle is the exception?

Answer 22

Hypoglossal nerve CNXII

Palatoglossus - supplied by the vagus nerve CNX

Question 23

The course of which nerve is shown here?

Answer 23

Hypoglossal CNXII

Passes anteriorly through the neck lateral to the “loop” of the lingual artery (not shown here)

Question 24

How can you test the function of CNXII clinically?

Answer 24

Ask patient to stick tongue straight out

If there is injury to the nerve, the tongue will deviate to the injured side

Question 25

What is the vermillon border?

Answer 25

The border between the lip and the “normal” skin of the face

This is the first transformation from “normal” skin to mucosa

Question 26

What do the arches of the soft palate consist of?

Answer 26

Skeletal muscle covered in mucosa

Question 27

Which kind of epithelium covers the hard palate and why?

Answer 27

Keratinised stratified squamous epithelium

Provides some protection against mechanical injury

Question 28

Which kind of epithelium covers the soft palate?

Answer 28

Non-keratinised stratified squamous epithelium

Question 29

What bones are being shown here?

Answer 29

Question 30

Which foramina is being indicated here and which nerve does it transmit?

Answer 30

Question 31

In what ways does the soft palate function as a trapdoor?

Answer 31

Stops food entering the nose during swallowing

Directs air into the nose or the mouth during speech, sneezing, coughing & vomiting

Helps to close off the entrance into the oropharynx during the gag reflex

Question 32

What are the five pairs of muscles of the soft palate?

Answer 32

Levator veli palantini

Tensor veli palantini

Palatoglossus

Palatopharyngeus

Musculis uvulae

Question 33

What is the function of the tensor veli palantini?

Answer 33

Tenses the soft palate by using the pterygoid hamulus as a pulley to pull each side of the palate laterally before elevating it

Question 34

What is the function of the levator veli palantini?

Answer 34

Elevates the soft palate

Question 35

What is the function of the palatoglossus?

Answer 35

Depresses the palate towards the tongue or vice versa

Question 36

What is the palatopharyngeus?

Answer 36

A longitudinal muscle of the pharynx that attaches between the palate and the larynx

Question 37

Which nerve supplies the skeletal muscles of the soft palate and which muscle is the exception?

Answer 37

Vagus nerve CN X

Exception - tensor veli palinitini, supplied by CNV3

Question 38

How can the function of CN X and CN V3 be tested clinically?

Answer 38

Ask the patient to say ‘ah’

Uvula should be pulled up towards the midline

If there is injury, the uvula will be pulled away from the injured side

Question 39

What are the regional lymph nodes for the tip of the tongue?

Answer 39

Submental nodes