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ENT Anatomy > The Mouth and Pharynx > Flashcards

The Mouth and Pharynx Flashcards

1
Q

What are the borders of the oral cavity?

A

Upper and lower teeth
Floor of mouth/tongue
Oropharynx
Hard palate and soft palate

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2
Q

What is the oral vestibule?

A

The space between the lips and teeth

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3
Q

What structures are found in the floor of the mouth?

A

Deep lingual vein
Frenulum
Sublingual caruncle
Sublingual fold

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4
Q

What are the muscles of the floor of the mouth and what is their innervation?

A

Geniohyoid - C1 via hypoglossal nerve

Mylohyoid - CN V3

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5
Q

Which muscle of the floor of the mouth has a free border and why is this clinically significant?

A

Mylohyoid

Potential space for transfer of infection

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6
Q

What are the major salivary glands?

A

Bilateral pairs:
Parotid
Submandibular
Sublingual

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7
Q

What are the minor salivary glands and what is their function?

A

1000’s in oral mucosa

Basal secretion to keep mouth moist

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8
Q

What stimulates salivation?

A

Thought, site, smell of food or presence of food in the mouth
Painful oral conditions (teething or fracture)

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9
Q

What is the surface anatomy of the parotid duct?

A

Parotid duct crosses face and secretes into mouth by upper 2nd molar

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10
Q

What is the surface anatomy of the submandibular duct?

A

Submandibular duct enters floor of mouth and secretes via lingual caruncle

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11
Q

What is the surface anatomy of the sublingual gland?

A

Sits n floor of mouth and secretes via several ducts superiorly

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12
Q

What is the potential consequence of duct clogging/blockage?

A

Swelling due to a back up of secretions

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13
Q

What is the innervation of the submandibular and sublingual salivary glands?

A

Parasympathetic from CN VII

Chorda tympani connects to lingual nerve branch of CN V3

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14
Q

What is the innervation of the parotid gland?

A

Parasympathetic from CNIX

Hitches a ride on branches of CN V3 (auriculotemporal branch)

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15
Q

What is the basic histology of the tongue?

A

Made from skeletal muscle

Covered in mucosa

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16
Q

Where is the posterior 1/3 of the tongue and what is it’s innervation?

A

Vertical part - not in oral cavity

Taste and general sensory by CN IX

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17
Q

Where is the anterior 2/3 of the tongue and what is it’s innervation?

A

Horizontal part - in oral cavity
General sensory by CN V3
Taste by CN VII

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18
Q

What papillae are found in the tongue and what are their functions?

A

Foliate, vallate and fungiform = Taste buds

Filliform = Touch, temperature

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19
Q

What structure divides the tongue into its anterior and posterior portions?

A

Sulcus terminalis

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20
Q

What is found at the apex of the sulcus terminalis?

A

Foramen caecum

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21
Q

Where does the thyroid originate and how does it get to its final destination?

A

Originates in pharynx and descends through foramen caecum of tongue

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22
Q

What are the 4 pairs of extrinsic muscles of the tongue?

A

Palatoglossus
Styloglossus
Genioglossus
Hyoglossus

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23
Q

What is the function of the extrinsic muscles of the tongue?

A

Change the position of the tongue during mastication, swallowing and speech

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24
Q

How many intrinsic muscles of the tongue are there and where are they found?

A

4 pairs

Mainly dorsally/posteriorly

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25
Q

What is the function of the intrinsic muscles of the tongue?

A

Modify the shape of the tongue during function

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26
Q

What is the innervation of the tongue muscles?

A

All = hypoglossal nerve

Except palatoglossus = Vagus

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27
Q

What is the CNS connection of hypoglossal nerve?

A

Medulla oblongata

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28
Q

Through which foramina does the hypoglossal nerve exit the base of the skull?

A

Hypoglossal canal

found in anterior all of foramen magnum

29
Q

What is the extra cranial course of the hypoglossal nerve?

A

Descends in neck lateral to carotid sheath

At level of hyoid passes anteriorly to lateral aspect of tongue

30
Q

What is the clinical test for the hypoglossal nerve?

A

Ask the patient to stick their tongue straight out
NORMAL = Tip in midline
UNILATERAL CNXII DAMAGE = Tip of tongue points towards the side of the injured nerve

31
Q

What is the blood supply to the tongue?

A

Lingual artery

32
Q

Where are arteries and nerves found in relation to the tongue?

A

Arteries pass medial to hypoglossus

Nerves pass lateral to hypoglossus

33
Q

What is the gingivae?

A

Mucosa covering the alveolar bone

34
Q

What passes through the greater and lesser palatine foramina?

A

Branches of CN V2

Branches of maxillary a.

35
Q

What is the pterygoid haulus?

A

Projection of the medial pterygoid plate of sphenoid bone

36
Q

What are the muscles of the soft palate?

A 
Tensor veli palatini 
Levator veli palatini 
Palatopharyngeus 
Palatoglossus 
Musculus uvulae
37
Q

What is the function of tensor veli palatini?

A

Tenses palatine apopneurosis

38
Q

What is the function of elevator veli palatini?

A

Lifts palatine apopneurosis

39
Q

What is the function of palatopharyngeus?

A

Lifts pharynx and thyroid cartilage

40
Q

What is the function of palatoglossus?

A

Brings tongue and soft palate together

41
Q

What is the function of muscles uvulae?

A

Shortens uvula

42
Q

What is the innervation of the skeletal muscles of the soft palate?

A 
CN X (vagus) 
Exception: Tensor veli palatini - CN V3
43
Q

What is the function of the soft palate?

A

Stops food entering nose while swallowing
Directs air into nose or mouth during speech, sneezing, coughing, vomiting
Helps close off entrance into oropharynx during gag reflex

44
Q

What is the clinical test for the vagus nerve?

A

Ask patient to say “aaah”
NORMAL = Uvula lifts straight in midline
UNILATERAL NERVE PATHOLOGY = Uvula pulled away from the non functioning side

45
Q

What is the function of the outer circular muscles of the pharynx?

A

During sequential contraction, push food bolus inferiorly towards oesophagus

46
Q

What is the function of the inner longitudinal muscles of the pharynx?

A

During contraction, pulls larynx superiorly shortening pharynx during swallowing

47
Q

What are the circular muscles of the pharynx?

A

Superior constrictor
Middle constrictor
Inferior constrictor

48
Q

What is the innervation of the muscles of the pharynx?

A

All = CNX

Exception: Stylopharyngeus = CN IX

49
Q

What is the “Gateway to mouth” ?

A

Formed by gaps between the circular muscles of the pharynx

CN IX, Lingual artery and stylopharyngeus muscle pass here

50
Q

What is the common insertion of the circular constrictors of the pharynx?

A

Midline raphe

51
Q

What are the longitudinal muscles of the pharynx?

A

Stylopharyngeus
Palatopharyngeus
Salpingopharyngeus

52
Q

What is the common insertion of the longitudinal muscles of the pharynx?

A

Posterior border of thyroid cartilage

53
Q

What is the origin of the superior constrictor of the pharynx?

A

Pterygoid hamulus
Pterygomandibular raphe
Mylohyoid line

54
Q

What is the origin of the middle constrictor of the pharynx?

A

Greater horn of hyoid

55
Q

What is the origin of the inferior constrictor of the pharynx?

A 
Thyroid cartilage (oblique line) 
Cricoid cartilage
56
Q

What is the origin of Stylopharyngeus?

A

Styloid process

57
Q

What is the origin of Palatopharyngeus?

A

Palate

58
Q

What is the origin of Salpingopharyngeus?

A

Cartilage of pharyngotympanic tube

59
Q

What are the components of Waldeyer’s Tonsillar Ring?

A

Pharyngeal tonsil (Adenoid)
Tubal tonsil
Palatine tonsil (The Tonsil)
Lingual tonsil

60
Q

What is the function of Waldeyer’s Tonsillar Ring?

A

Defence against invading pathogens

61
Q

Where is Waldeyer’s Tonsillar Ring located?

A

Within the mucosa of the nasopharynx and oropharynx

62
Q

What are the regional lymph nodes associated with the mouth/salivary glands/pharynx?

A 
Retropharyngeal nodes 
Jugulo-digastric node
Deep cervical nodes 
Submental nodes 
Submandibular nodes
63
Q

Which lymph nodes drain the tip of the tongue?

A

Submental

64
Q

Which lymph nodes drain the parotid gland?

A

Jugulo-digastric node

65
Q

What are some of the features of an infected lymph node?

A 
Swollen 
Painful 
Soft 
Smooth 
Not fixed to adjacent structures 
Improve rapidly with antibiotics etc.
66
Q

What are some of the features of a lymph node due to cancer?

A 
Swollen 
Not painful 
Hard 
Irregular 
Fixed to adjacent structures
Do not improve
67
Q

Why must examination of the head and neck lymph nodes be bilateral?

A

Midline structures often drain bilaterally

68
Q

What are the bilateral regional lymph nodes to be examined?

A 
Submental 
Submandibular 
Parotid (pre auricular) 
Mastoid (post auricular) 
Occipital 
Deep cervical (along IJV)
Superficial cervical (along EJV)

ENT Anatomy (4 decks)

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