Sievert: Oral Cavity

Question 1

Where are the openings of the sublingual ducts?

Answer 1

openings of these ducts lie on either side of the frenulum of the tongue (there are ~6 on each side)
**this is why the inferior teeth get the most plaque build up

Question 2

Where is the opening of the submandibular duct?

Answer 2

in the sublingual caruncle (on either side of the frenulum of the tongue)

Question 3

The submandibular duct runs right alongside what nerve?

Answer 3

lingual nerve

Question 4

What 2 components is the lingual nerve carrying in the oral cavity?

Answer 4

taste to the anterior 2/3 of the tongue

GSA

Question 5

Where is the opening of the parotid duct?

Answer 5

by the second upper molar

Question 6

How are teeth numbered?

Answer 6

Beginning up top on the right side (1-16)

From left to right on the bottom (17-32)

Question 7

What other structures can be found running along the inferior aspect of the tongue?

Answer 7

deep lingual artery and vein

Question 8

What structures can be seen upon inspection of the oral cavity?

Answer 8

soft palate
uvula
palatoglossal arch
palatopharyngeal arch
palatine tonsil
posterior wall of pharynx

Question 9

What two arches surround the palatine tonsil? Which is anterior? Which is posterior?

Answer 9

palatoglossal arch **anterior

palatopharyngeal arch **posterior

Question 10

What two muscles lie with the palatoglossal arch and palatopharyngeal arch? What are these muscles innervated by?

Answer 10

palatoglossus
palatopharygeal
*innervated by CN 10

Question 11

How many molars do we have?
How many premolars?
How many canines?
How many later incisors?
How many central incisors?

Answer 11

6
4
2
2
2

Question 12

Which papillae do NOT contain tastebuds?

Answer 12

filiform

*these are rough tastebuds that you feel on a cat’s tongue

Question 13

Which papillae lie along the sulcus terminalis?

Answer 13

vallate papillae

Question 14

What structures are sandwiched between the hyoglossus muscle and the mylohyoid muscle on the lateral side of the floor of the mouth?

Answer 14

lingual nerve
lingual artery
submandibular duct
hypoglossal nerve

Question 15

What nerve does the submandibular duct hook as it courses anteriorly?

Answer 15

lingual nerve as it enters the tongue

Question 16

All of the muscles of the tongue (extrinsic and intrinsic) are innervated by CN 12 except for which?

Answer 16

palatoglossus **CN 10

Question 17

4 tongue muscles

Answer 17

palatoglossus
hyoglossus
styloglossus
genioglossus

Question 18

What action does the styloglossus have?

Answer 18

retraction of tongue

Question 19

What action does the hyoglossus have?

Answer 19

depresses the tongue

helps elevate the hyoid bone

Question 20

Where do the fibers of the genioglossus come from? What does this muscle do?

Answer 20

genoid tubercle of the mandible;

sticks out tongue, moves it side to side

Question 21

When you ask a patient to stick out their tongue and move it from side to side, what CN are you testing? If there is damage to the nerve, what side will the tongue fall to?

Answer 21

CN 12; tongue will fall to weak side (strong side pulls)

Question 22

If you have a cut right hypoglossal nerve, what will you observe when you stick out your tongue?

Answer 22

atrophy of tongue

tongue will deviate to right

Question 23

How many different cranial nerves supply the tongue?

What are they?

Answer 23

5;

CN 5, 7, 9, 10, 12

Question 24

Which cranial nerves supply MOTOR innervation to the tongue?

Which cranial nerves supply SENSORY innervation to the tongue?

Answer 24

CN 10 to palatoglossus
CN 12 to all other muscles of tongue;

CN 10 (internal laryngeal nerve) taste to back of tongue
CN 9 taste and GSA to posterior 1/3
CN 7 (chorda tympani) taste to anterior 2/3
CN 5 (lingual nerve) GSA to anterior 2/3

Question 25

What are the elements of the tonsilar ring?

Answer 25

pharyngeal tonsils = adenoids palatine tonsils lingual tonsils

Question 26

Which tonsil is associated with the opening of the auditory tube? Why is this significant?

Answer 26

pharyngeal tonsil; inflammation of this tonsil can close off the auditory tube and cause chronic ear infections

Question 27

Which tonsil lies at the back of the throat, and if inflammed for a long period of time, will make you feel like you have to clear your throat?

Answer 27

lingual tonsil

Question 28

What are the three subdivisions of the pharynx?

Answer 28

nasopharynx oropharynx laryngopharynx

Question 29

Area posterior to nasal cavity extending to the inferior aspect of the soft palate (respiratory)

Answer 29

nasopharynx

Question 30

Area posterior to oral cavity; from inferior border of soft palate down to epiglottis (digestive and respiratory)

Answer 30

Oropharynx

Question 31

Area posterior to larynx; from epiglottis down to cricopharyngeus muscle (digestive and respiratory)

Answer 31

laryngopharynx

Question 32

What are the superior and inferior borders of the pharynx?

Answer 32

extends from the base of the skull to the C6 vertebra (cricoid cartilage)

Question 33

In which division of the pharynx are the torum and ostium of the auditory tube located?

Answer 33

in the nasopharynx | **auditory tube can be closed off during inflammation of the pharyngeal tonsil

Question 34

3 structures associated with the nasopharynx/soft palate

Answer 34

cartilagenous end of the auditory tube (torus) levator veli palatini tensor veli palatini

Question 35

What innervates the levator veli palatini? What does this muscles do?

Answer 35

CN 10; elevates the soft palate

Question 36

What innervates the tensor veli palatini? What does this muscle do?

Answer 36

CN 5; tenses the soft palate and opens the auditory tube

Question 37

What is one way to clinically check for CN 10 damage?

Answer 37

Have your patient open their mouth and say ah, while you observe the uvula. If it is deviated to one side, there is CN 10 damage to that side.

Question 38

What are 3 components of the oropharynx?

Answer 38

posterior 1/3 of the tongue palatine tonsil between two arches (palatroflossal and palatopharyngeal) valleculae (recess at the back of the tongue)

Question 39

Why is the valleculae significant?

Answer 39

Food particles can get lodged here and may cause a gag reflex

Question 40

Components of the laryngopharynx?

Answer 40

epiglottis laryngeal inlet piriform fossa

Question 41

There are 3 pharyngeal constrictor muscles. What are they?

Answer 41

superior middle inferior

Question 42

What does the superior constrictor muscle attach to anteriorly?

Answer 42

the buccinator at the pterygomandibular raphe

Question 43

What does the middle constrictor muscle attach to?

Answer 43

the hyoid bone | *this muscle is wider posteriorly and narrows down at the front to attach to hyoid bone

Question 44

What does the inferior constrictor muscle attach to?

Answer 44

ends at the cricoid and thyroid cartilage | *continuous with the esophagus

Question 45

Where do the buccinator and superior pharyngeal constricter attach?

Answer 45

the pterygomandibular raphe

Question 46

How are the superior, middle, and inferior constrictor muscles arranged?

Answer 46

like a flower pot (they fall within the posterior muscle)

Question 47

What are the three extrinsic pharynx muscles?

Answer 47

stylopharyngeus *inserts between the superior and middle constrictor muscle palatopharyngeus salpingopharyngeus *tiny

Question 48

Only pharynx muscle innervated by CN 9

Answer 48

stylopharyngeus

Question 49

Where is the narrowest part of the pharynx?

Answer 49

at the esophageal junction | *cricopharyngeus muscle

Question 50

What is Zenker's diverticulum? Where does it most commonly occur?

Answer 50

Mucosal linings of the inside of the pharynx can be pushed out between two layers of the constrictors; can fill with food, which will rot and present as bad breath; most common between inferior constrictor and cricopharyngeus

Question 51

Innervation of the pharynx? *there are three sources which converge on the posterior lateral wall as the pharyngeal plexus

Answer 51

sensory from CN 9 motor from CN 10 (except stylopharyngeus) sympathetics from sympathetic chain *parasympathetics from 10

Question 52

What does the "gag reflex" go IN and OUT on?

Answer 52

in on 9, out on 10

Question 53

Components of pharyngeal plexus?

Answer 53

CN 9 - sensory CN 10 - motor to all pharynx muscles (except stylopharyngeus) Sympathetics Parasympathetics from 10

Question 54

Which branch of 10 supplies motor to the muscles of the pharynx?

Answer 54

pharyngeal branch

Question 55

Where are the contributing fibers of the pharyngeal plexus imbedded?

Answer 55

in the buccopharyngeal fascia on the posterior wall of the pharynx

Question 56

What are two other notable motor branches of CN 10?

Answer 56

superior laryngeal *internal and external branch | recurrent laryngeal

Question 57

5 components of CN 9

Answer 57

``` GSA general visceral efferent (visceromotor) special visceral afferent (taste) general visceral afferent (viscerosense) branchiomotor ```

Question 58

If you place food on the anterior tongue and it causes salivation, what reflex is this? In on ? Out on ?

Answer 58

In on 7 (for anterior tongue); out on 7 or 9 for submandibular/sublingual and parotid glands, respectively

Question 59

What does the superior laryngeal nerve off of the Vagus supply?

Answer 59

taste to the epiglottis *internal branch) somatosensory to the lining of the larynx (above vocal cords) *internal branch motor to cricothyroid muscle *external branch

Question 60

What does the recurrent laryngeal nerve off of the Vagus supply?

Answer 60

somatosensory to lining of larynx (below vocal cords) | motor to all laryngeal muscles except cricothyorid

Question 61

After exiting the jugular foramen, CN 10 gives of a small sensory branch to the (blank). It also gives of motor innervation to the muscles of the (blank) and (blank)

Answer 61

``` external ear (auricular branch); pharynx and soft palate *except stylopharyngeus (CN 9) and tensor veli palatini (CN V1) ```

Question 62

The motor nucleus of 10 sends preganglionic parasympathetics to what?

Answer 62

ganglia in heart, thorax, abdomen

Question 63

What notable things lie around nucleus ambiguus?

Answer 63

anterolateral tract *ascending all the way up inferior salivatory nucleus descending input to preganglionic parasympathetics

Question 64

Where does info coming in on CN 10 for taste from epiglottis and GVA from thorax and abdomen enter?

Answer 64

nucleus solitarius *rostral and caudal respectively

Question 65

Where does info coming in on CN 10 for GSA from the ear and lower pharynx enter?

Answer 65

spinal nucleus of 5

Question 66

Has no body just a large neural arch and is the widest because of articulation with skull

Answer 66

atlas

Question 67

The body of the axis extends superiorly into the atlas | This extension is called the (blank) or odontoid process

Answer 67

dens

Question 68

Is there rotation at the atlanto-occipital joint?

Answer 68

no; only flexion and extension

Question 69

The transverse portion of the cruciform ligament holds the dens tightly against the (blank) arch of the atlas

Answer 69

anterior

Question 70

What can happen if you tear the transverse cruciform ligament?

Answer 70

the dens can move posteriorly and damage the cervical spinal cord

Question 71

Does the atlanto-axial joint allow for rotation?

Answer 71

yes; but no flexion or extension

Question 72

What innervates the prevertebral muscles? | What innervates the true back muscles?

Answer 72

ventral rami of spinal nerves; | dorsal rami of spinal nerves

Question 73

What does the SCM attach to? | What action does it have?

Answer 73

mastoid process and clavicle; | flexes neck from C1 to C7, but extends at the atlanto-occipital joint *think of a lineman