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3 - HNN > The Oral Cavity and Pharynx > Flashcards

The Oral Cavity and Pharynx Flashcards

1
Q

State the organisation of the fauces

A
  • The fauces are arches formed by the palatoglossus, palatopharyngeal muscles and palatine tonsil
  • anterior to posterior - palatoglossus arch, palatine tonsil, palatopharyngeal arch
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2
Q

Describe the muscles of the tongue and their innervation

A
  • Has intrinsic muscles which are not attached to bone but alter the shape of the tongue
    • 4 paired muscles all innervated by hypoglossal nerve
  • 4 extrinsic muscles change position of tongue and anchor it
    • Genioglossus, hypoglossus, styloglossus, palatoglossus
      • All innervated by hypoglossal nerve except palatoglossus, which is innervated by the vagus nerve
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3
Q

Describe the sensory and special sensory nerves of the tongue

A
  • Anterior 2/3 sensation provided by mandibular branch of trigeminal
    - Taste provided by facial nerve
  • Posterior 1/3 sensation and taste from glossopharyngeal
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4
Q

Describe the location and drainage of the submandibular gland

A

Submandibular gland located below the mouth and secrete through Wharton ducts under the tongue medially

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5
Q

Describe the location and drainage of the parotid gland

A

Parotid gland secretes saliva through the Stensen duct, located within the cheek next to the 2nd pre-molar

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6
Q

Describe the location and drainage of the sublingual gland

A

Sublingual gland has multiple ducts to release saliva laterally to the submandibular ducts

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7
Q

State possible pathology within the oral cavity

A
  • Salivary gland stones (siololithiasis)
  • Tonsilitis
  • Peritonsilar abscess
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8
Q

Describe how salivary gland stones present

A
  • Siololithiasis
  • Most stones are located in the submandibular glands
  • Leads to dehydration and reduced salivary flow
  • Symptoms during eating include pain in gland, swelling or infection
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9
Q

Describe how tonsillitis presents

A
  • Inflammation of the palatine tonsils

- Present with fever, sore throat, pain during swelling, bad breath, cervical lymph nodes

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10
Q

Describe how peritonsillar abscesses present

A
  • Abscess of surrounding tissue around palatine tonsils
  • Symptoms include severe throat pain, fever, bad breath, drooling, difficulty opening mouth
  • Can follow on from tonsillitis or can arise on its own
  • Leads to a deviated uvula
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11
Q

Explain how CN XII is tested

A
  • Wasted tongue
  • Stock tongue out, and if affected it deviates to side of lesion
  • Protrusion of the tongue is through the genioglossus muscle (innervated by CN XII)
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12
Q

Explain how CN IX and CN X are tested

A
  • Absent gag reflex or uvula deviation
  • Gag reflex
    • Afferent limb - glossopharyngeal nerve which provides sensation to posterior tongue and oropharynx
    • Efferent limb - vagus nerve allows contraction of pharyngeal muscles
  • Uvula deviation
    • Deviation of the uvula to one side implies a motor lesion of the vagus nerve on the opposite side of the uvula deviating towards
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13
Q

Describe the boundaries and contents of the nasopharynx

A
  • Boundaries - base of skull to upper border of soft palate
    • Anterior border is the nasal cavity
    • Posterior border is C1, C2
  • Contains the pharyngeal tonsil - adenoids
    - Also contains the opening of Eustachian tube
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14
Q

Describe the boundaries and contents of the oropharynx

A
  • Boundaries - soft palate to epiglottis
    • Anterior border - oral cavity
    • Posterior - C2, C3
  • Contains the palatine tonsils
    • The depressed fossa between the palatoglossal and palatopharyngeal arches is where the palatine tonsils lie
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15
Q

Describe the boundaries and contents of the laryngopharynx

A
  • Boundaries - oropharynx to oesophagus or from epiglottis to cricoid cartilage
    • Anterior border - larynx
    • Posterior border - C4, C5, C6
  • Contains the piriform fossa
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16
Q

State the names and action of the longitudinal muscles of the pharynx

A
  • Stylopharyngeus
  • Palatopharyngeus
  • Salpingopharyngeus
  • Elevate pharynx and larynx during swallowing
17
Q

Stylopharyngeus AI

A
  • Styloid process to posterior border of thyroid cartilage

- Innervated by glossopharyngeal nerve

18
Q

Palatopharyngeus AI

A
  • Hard palate to posterior border of thyroid cartilage

- Innervated by pharyngeal branch of vagus nerve

19
Q

Salpingopharyngeus AI

A
  • Cartilaginous part of Eustachian tube and merges with palatopharyngeus
  • Swallowing opens Eustachian tube to equilibrate pressure
  • Innervated by pharyngeal branch of vagus
20
Q

State the names, innervation and action of the pharyngeal constrictors

A
  • 3 circular muscles which constrict walls of pharynx when swallowing
    • Superior pharyngeal constrictor
    • Middle pharyngeal constrictor
    • Inferior pharyngeal constrictor
      • Has thyropharyngeal and cricopharyngeal part
      • All innervated by vagus nerve
21
Q

Describe the motor and sensory innervation to the pharynx

A
  • Motor - vagus nerve innervates all muscles except stylopharyngeus
  • Sensory
    • Nasopharynx - maxillary nerve
    • Oropharynx - glossopharyngeal nerve
      • Laryngopharynx - vagus nerve
22
Q

Describe the pharyngeal pouch

A
  • Small area of weakness between the two parts of the inferior pharyngeal constrictor
  • Pharyngeal mucosa can herniate through the gap, forming a gap that can trap food
  • Leads to failure of the UOS to relax - raised pressure in the area
    • Abnormal timing of swallowing
23
Q

Describe enlarged adenoids and its presentation

A
  • May obstruct passage of air from nasal cavity into the nasopharynx
  • Pharyngotympanic tube can be blocked - cause middle ear infections such as otitis media with effusion
  • Present with mouth breathing and ‘nasal tone’ when speaking
24
Q

Describe the oral phase of swallowing including muscles and nerves involved

A
  • Voluntary
  • Preparatory phase - making bolus
  • Transit phase - bolus compressed against palate and pushed into oropharynx by tongue and soft palate
  • Done through muscles of tongue innervated by hypoglossal nerve
25
Q

Describe the pharyngeal phase of swallowing including muscles and nerves involved

A
  • Involuntary
  • Tongue positioned against hard palate - CN XII through intrinsic and extrinsic muscles of the tongue
  • Soft palate elevated to seal off nasopharynx - CN X
  • Suprahyoid and longitudinal muscles shorten - CN IX, CN X
    • Larynx elevated and sealed off by vocal cords
    • Pharynx widens and shortens to receive bolus
  • Epiglottis closes over larynx
  • Bolus moves through pharynx by sequential contraction of constrictors
  • Relaxation of UOS
26
Q

Describe the oesophageal phase of swallowing including muscles and nerves involved

A
  • Involuntary
  • Upper striated muscle of oesophagus - CN X
  • Lower smooth muscle
27
Q

Describe the articulations within the TMJ

A
  • TMJ joint formed from the articulation of the mandible and the temporal bone
  • Head of the mandible articulates with the articular disk
  • Mandibular fossa also articulates with the articular disk
    • Articulating surfaces are lined with fibrocartilage
28
Q

Describe the ligaments present at the TMJ

A
  • Lateral ligament - runs from articular tubercle to mandibular neck
    • Prevents posterior dislocation of the joint
  • Sphenomandibular ligament - sphenoid spine to mandible
  • Stylomandibular ligament - thickening of the parotid fascia
29
Q

Describe what muscles are involved in the movement at the TMJ

A
  • Protrusion and retraction through upper part of the jaw
    • Protrusion - lateral pterygoid
    • Retraction - geniohyoid, digastric
  • Elevation and depression through lower jaw - opens and closes mouth
    • Depression - normally through gravity, but if resistance then digastric, geniohyoid and mylohyoid
    • Elevation - temporalis, masseter, medial pterygoid
30
Q

Outline how dislocation of the TMJ can occur

A
  • Can occur from trauma, yawning or taking a large bite
  • Head of the mandible slips out of the mandibular fossa and is pulled anteriorly
  • Facial nerve can be damaged

3 - HNN (15 decks)

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