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Y2 HNS Anatomy (LCRS2) > Session 4: Oral Cavity and Upper GI Tract > Flashcards

Session 4: Oral Cavity and Upper GI Tract Flashcards

1
Q

List the three sets of tonsils found in the upper GI tract

A

Palatine, Pharyngeal, Lingual

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2
Q

Between which two folds do the palatine tonsils lie?

A

Palatopharyngeal Fold Palatoglossal Fold

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3
Q

Why does the GP gets you to say ‘aaaaaah’ when he inspects the inside of your mouth?

A

It raises the soft palate and uvula and depresses the tongue, which arevagus-mediated effects. So the GP is testing the motor function of the vagus nerve.

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4
Q

Describe the borders of the pharynx.

A

Base of the skull and the inferior border of the cricoid cartilage

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5
Q

What are the three parts of the pharynx and what are their borders?

A

Nasopharynx – down to the soft palate (pharyngeal isthmus) Oropharynx – between the soft palate and the epiglottis Laryngopharynx – between the epiglottis and the cricoid cartilage

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6
Q

What happens to the epiglottis when you swallow?

A

Retroflexion to cover the laryngeal inlet

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7
Q

What is the role of the soft palate in swallowing?

A

It elevates to close off the nasopharynx so that food doesn’t go into the nasal cavity

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8
Q

What is the Piriform Fossa and what is its clinical significance?

A

The piriform fossae are depressions on either side of the laryngeal inlet where food (commonly fish bones) get stuck

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9
Q

Which muscles aid the passage of a bolus of food down the oesophagus?

A

Superior, middle and inferior pharyngeal constrictor muscles

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10
Q

Which nerves provide sensory innervation of the pharyngeal wall?

A

Glossopharyngeal and Vagus (pharyngeal plexus)

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11
Q

Which nerves provide motor innervation of the pharyngeal constrictor muscles?

A

Vagus (and a bit of accessory)

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12
Q

Describe the changes that occur during swallowing.

A

Lift and retract the tongue (styloglossus and intrinsic muscles) Bolus into oropharynx (palatoglossus) Close off nasopharynx by raising soft palate Raise the larynx – closed off by the epiglottis Peristaltic wave of constrictor muscles Relax cricopharyngeus, open oesophagus

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13
Q

Name the three salivary glands, describe their secretions and state the nerves that provide secretomotor innervation to them.

A

Parotid – serous – glossopharyngeal Submandibular – serous – facial Sublingual – mucous – facial

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14
Q

Which muscle does the parotid duct pierce and where does it open into the buccal cavity?

A

Buccinator It opens next to the second upper molar

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15
Q

Name the main muscles of the tongue. Which nerve innervates all of this?

A

Genioglossus, Hyoglossus, Styloglossus Intrinsic Muscles These are all innervated by the hypoglossal nerve

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16
Q

What other muscle is associated with the tongue but isn’t innervated by this nerve?

A

Palatoglossus – it is innervated by the vagus

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17
Q

What tongue movements do the genioglossus and styloglossus perform?

A

Genioglossus – protracts the tongue Styloglossus – retracts and elevates the tongue

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18
Q

To which side would the tongue move if a patient with a unilateral lesion in the hypoglossal nerve was asked to stick their tongue out?

A

Towards the side of the lesion because the genioglossus is used in protracting the tongue

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19
Q

What movement is palatoglossus responsible for?

A

Elevates the soft palate and moves the back of the tongue upwards

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20
Q

Where is the lingual nerve relative to the hypoglossal nerve?

A

Lingual nerve is superior to the hypoglossal nerve

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21
Q

Describe the sensory innervation of the tongue

A

Anterior 2/3 sensation – mandibular branch of trigeminal Anterior 2/3 taste – facial Posterior 1/3 everything – glossopharyngeal

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22
Q

To which structure in the brainstem do the neurons of taste go? It is considered the main taste centre within the brainstem.

A

Nucleus Solitarius

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23
Q

State the origin and insertion of the masseter and the movement that it is responsible for.

A

Zygomatic Arch Lateral surface of the ramus of the mandible and the angle of the mandible Elevates the mandible (allows forced closure of the mouth)

24
Q

State the origin and insertion of temporalis and the movement that it is responsible for.

A

Temporal Fossa Coronoid Process Elevates and retracts mandible

25
Q

State the origin and insertion of the medial and lateral pterygoid muscles and the movements that they are responsible for.

A

Lateral – lateral pterygoid plate (and greater wing of sphenoid) TO neck of the mandible Medial – lateral pterygoid plate, maxilla, palate TO angle of the mandible Lateral – Movement – depresses and protracts mandible to open the mouth Medial – Movement – elevates, protracts and lateral movement of mandible for chewing

26
Q

Describe the structure of the temporomandibular joint.

A
  • it is a capsular joint
  • The capsule has an articular plate splitting it into two
  • The head of the mandible articulates with the articular tubercle of the temporal bone
27
Q

Describe the movements around the temporomandibular joint when opening the mouth.

A

When opening the mouth slightly there is a hinge action When the mouth is opened further, the head of the mandible glidesanteriorly on the articular tubercle of the temporal bone

28
Q

State the eight branches of the external carotid artery.

A

Inferior to superior

  • Superior Thyroid
  • Ascending Pharyngeal
  • Lingual
  • Facial
  • Occipital
  • Posterior Auricular
  • Maxillary
  • Superficial

“Some Anatomists Like Freaking Out Poor Medical Students”

29
Q

At the level of what anatomical landmark does the common carotid artery bifurcate.

A

At the level of the laryngeal prominence

30
Q

Why does the facial artery have a wavy course across the mandible?

A

If it were taut, then when the mouth is opened the facial artery wouldrupture

31
Q

Which branch of the external carotid artery gives rise to the middle meningeal artery?

A

Maxillary

32
Q

Through which foramen does the middle meningeal artery enter the skull?

A

Foramen Spinosum

33
Q

State the five branches of the facial nerve

A

Temporal Zygomatic Buccal Mandibular Cervical

34
Q

What are the two main branches of the mandibular branch of the trigeminal nerve?

A

Lingual Nerve Inferior Alveolar Nerve

35
Q

What are the functions of the lingual and inferior alveolar nerve?

A

Inferior Alveolar – innervates the lower teeth (this is the one that is stimulated in tooth ache) Lingual – sensation (touch and taste) to the anterior 2/3 of the tongue AND secretomotor to the sublingual and submandibular salivary glands

36
Q

What fibres join the lingual nerve?

A

Some fibres of the facial nerve via the Chorda Tympani (this is why the lingual nerve is responsible for taste)

37
Q

Which cranial nerve provides all sensory innervation of the face?

A

Trigeminal Nerve

38
Q

How many arteries and veins does the thyroid gland have?

A

2 pairs of arteries 3 pairs of veins

39
Q

State where these arteries and veins originate from and drain to.

A

Superior thyroid artery – from the external carotid artery Inferior thyroid artery – from the thyrocervical trunk Superior thyroid vein – to the internal jugular vein Middle thyroid vein – to the internal jugular vein Inferior thyroid vein – to the brachiocephalic vein

40
Q

Which muscle protects the carotid sheath when the head is turned?

A

Sternocleidomastoid

41
Q

What is Bell’s Palsy and how may it present in a patient?

A

Facial nerve palsy Inability to contract muscles of facial expression and altered taste

42
Q

Which nerves innervate the following muscles: a. Temporalis b. Masseter c. Buccinator d. Medial and Lateral Pterygoids e. Pharyngeal Constrictors f. Digastric g. Mylohoid

A

a. Temporalis Mandibular (trigeminal) b. Masseter Mandibular (trigeminal) c. Buccinator Buccal (facial) d. Medial and Lateral Pterygoids Mandibular (trigeminal) e. Pharyngeal Constrictors Sensory = Glossopharyngeal (IX) + Vagus (X) Motor = Vagus (X) (and a bit of Accessory (XI)) f. Digastric Anterior belly = Mandibular (trigeminal) Posterior belly = Facial g. Mylohyoid Nerve to mylohyoid – branch of inferior alveolar nerve (which is a branch of the mandibular)

43
Q

What are the branches coming off the inferior alveolar nerve?

A

Mental nerve – terminal branch (provides sensation to the front of the chin) Nerve to mylohyoid

44
Q

What is the vallecula?

A

Depression just behind the root of the tongue – they serve as spit traps Saliva is temporarily held in the valleculae to prevent initiation of the swallowing reflex

45
Q

What are the full numbers in a typical permanent set of teeth?

A

32 16 upper and 16 lower 8 incisors, 4 canines, 8 premolars and 12 molars (including 4 wisdom teeth)

46
Q

How many deciduous (baby) teeth are there?

A

20

47
Q

Which teeth are missing in the deciduous set compared to the adult set?

A

No premolars or wisdom teeth

48
Q

When do the first deciduous teeth erupt?

A

Around 6 months

49
Q

When is the deciduous set usually complete?

A

Around 20-24 months

50
Q

What are the approximate starting and completion ages for the permanent set of teeth?

A

Starts around 7 years and usually completed by the age of 21

51
Q

Why are the tonsils clinically important?

A

They are areas of lymphoid tissue so they can get infected and inflamed

52
Q

What is the simplest test of the glossopharyngeal nerve?

A

Test the patient’s gag reflex by sticking something down their throat

53
Q

How is the hypoglossal nerve tested?

A

Ask the patient to stick their tongue out

54
Q

How is the trigeminal nerve tested?

A

Sensory – touch the patient around the jawline, on the cheek and on the forehead (to test the three divisions) Motor – ask the patient to clench their teeth and try to palpate the bulge of the masseter and temporalis

55
Q

How is the facial nerve tested?

A

Ask the patient to crease up their forehead by raising their eyebrows Ask the patient to keep their eyes closed against resistance

Y2 HNS Anatomy (LCRS2) (6 decks)

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