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YR2: Head, Neck and Spine > Session 4: Oral Cavity and Upper GI Tract > Flashcards

Session 4: Oral Cavity and Upper GI Tract Flashcards

1
Q

List the 3 sets of tonsils found in the upper GI tract

A

Palatine
Pharyngeal
Lingual

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2
Q

Between which 2 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 + uvula + depresses the tongue
Tests motor function of the vagus nerve.
Uvula should be midline
Problem: uvula deviates away from lesion

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4
Q

Describe the borders of the pharynx.

A

Base of the skull + inferior border of cricoid cartilage

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5
Q

What are the 3 parts of the pharynx and what are their borders?

A

Nasopharynx: down to the soft palate (pharyngeal isthmus)
Oropharynx: between the soft palate + epiglottis
Laryngopharynx: between the epiglottis + 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 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

Depressions on either side of the laryngeal inlet where food (e.g. 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 + inferior pharyngeal constrictor muscles

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10
Q

Which nerves provide sensory innervation of the pharyngeal wall?

A

Glossopharyngeal + Vagus (pharyngeal plexus)

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11
Q

Which nerves provide motor innervation of the pharyngeal constrictor muscles?

A

Vagus (+ a bit of accessory)

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12
Q

Describe the changes that occur during swallowing.

A

Lift + retract tongue (styloglossus + 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 3 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 2nd 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  
Innervated by hypoglossal nerve
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16
Q

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

A

Palatoglossus – 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 + 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 + 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

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

23
Q

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

A 
Zygomatic Arch to Lateral surface of the ramus of the mandible + angle of the mandible  
Elevates 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 to Coronoid Process of mandible

Elevates + 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 (+ greater wing of sphenoid) TO neck of the mandible
Depresses + protracts mandible to open the mouth
Medial: lateral pterygoid plate, maxilla, palate TO angle of the mandible
Elevates, protracts + allows lateral movement of mandible for chewing

26
Q

Describe the structure of the temporomandibular joint.

A

= a capsular joint
Capsule has an articular plate splitting it in 2
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

Open mouth slightly= hinge action

Open further= the head of the mandible glides anteriorly on the articular tubercle of the temporal bone

28
Q

State the 8 branches of the external carotid artery.

A 
Superior Thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal
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 taut, opening the mouth would cause rupture

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 5 branches of the facial nerve

A 
Temporal 
Zygomatic 
Buccal 
Mandibular 
Cervical
34
Q

What are the 2 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 lower teeth (tooth ache)
Lingual: sensation (touch + taste) to anterior 2/3 of the tongue + secretomotor to sublingual + submandibular salivary glands

36
Q

What fibres join the lingual nerve?

A

Some fibres of the facial nerve via the Chorda Tympani (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 + 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

Temporalis: Mandibular (trigeminal)
Masseter: Mandibular (trigeminal)
Buccinator: Buccal (facial)
Medial + Lateral Pterygoids: Mandibular (trigeminal)
Pharyngeal Constrictors
Sensory = Glossopharyngeal (IX) + Vagus (X)
Motor = Vagus (X) (+ a bit of Accessory (XI))
Digastric
Anterior belly = Mandibular (trigeminal)
Posterior belly = Facial
Mylohyoid: branch of inferior alveolar nerve (branch of the mandibular)

43
Q

What are the branches coming off the inferior alveolar nerve?

A

Mental nerve: terminal branch (sensation to front of chin)

Nerve to mylohyoid

44
Q

What is the vallecula?

A

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

45
Q

Why are the tonsils clinically important?

A

Areas of lymphoid tissue so can get infected + inflamed

46
Q

What is the simplest test of the glossopharyngeal nerve?

A

Test gag reflex by sticking something down their throat

47
Q

How is the trigeminal nerve tested?

A

Sensory: touch jawline, cheek + forehead (to test the 3 divisions)
Motor: patient to clench teeth. Palpate bulge of the masseter + temporalis

48
Q

How is the facial nerve tested?

A

Patient to crease up their forehead by raising their eyebrows
Patient to keep their eyes closed against resistance

49
Q

How can dislocation occur at the temporomandibular joint?

A

If mouth opened far + over done, head of mandible glides past articular tubercle + dislocates into the temporal fossa

50
Q

Where does the facial nerve emerge?

A

From anterior border of parotid gland

YR2: Head, Neck and Spine (6 decks)

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