The Oral Cavity And Pharynx Flashcards
What is the oral cavity proper?
The part of the mouth that is between the teeth
How many teeth should we have?
32
What are the muscles of the tongue?
Intrinsic muscles - 4 pairs of muscles - innervated by the hypoglossal nerve.
Extrinsic muscles - Genioglossus, Hypoglossus, Styloglossus (hypoglossal nerve), Palatoglossus (Vagus nerve).
What nerve innervate the sensation and taste of he tongue?
Anterior 2/3 - Sensation - Trigeminal (Vc - lingual)
Taste - Facial
Posterior 1/3
-Sensation and taste - glossopharyngeal.
Where are the submandibular salivary glands?
Between belly’s of digastric
Where is the parotid gland?
In front of ear. Posterior to master, superior to SCM and inferior to the zygomatic arch.
Where are sublingual glands?
Inferior to tongue.
These are the smallest and most diffuse major salivary glands and only produce 3-5% of saliva. They only have 8-20 excretory ducts per gland.
What us sialolithiasis?
Salivary gland stones
Most stones are located in submandibular glands
Small - less than 1 cm
Caused by dehydration and reduced salivary flow.
Symptoms:
- Pain in gland
- Swelling
- Infection
Diagnosis: history, x-ray, sialogram
What are the symptoms of tonsillitis?
This is inflammation of the pharyngeal tonsils
Fever Sore throat Pain / difficulty swallowing Cervical lymph nodes Bad breath
Viral causes (Common) Bacterial causes (40%) - Strep pyogenes.
What are the symptoms fo a peritonsilar abscess?
Severe throat pain Fever Bad breath Drooling Difficulty opening mouth Uvula deviates from midline
Can follow from an untreated or partially treated tonsillitis
Can arise on its own
What are the three parts of the pharynx?
Nasopharynx
Oropharynx
Laryngopharynx
Where is the nasopharynx and what does it contain?
Boundaries: Base of skull to upper border of soft palate.
- Posterior: C1,C2
- Anterior: nasal cavity.
Contains the pharyngeal tonsil
Where is the oropharynx and what does it contain?
Boundaries: Soft palate to epiglottis.
- Anterior: oral cavity
- Posterior: C2,C3
Contains: Palatine tonsils
Where is the laryngopharynx and what does it contain?
Boundaries: Oropharynx to oesophagus, Epiglottis to cricoid cartilage.
Anterior: Larynx
Posterior: C4,C5,C6
Contains: Piriform fossa
What is the Piriform fossae?
It is a recess either side of the laryngeal orifice that diverts material so that it is not near the laryngeal inlet
What are the three longitudinal muscles that elevate the pharynx and larynx when swallowing?
Stylopharyngeus - styloid process - posterior border of thyroid cartilage and innervated by the glossopharyngeal nerve.
Palatopharyngeal - hard palate - posterior border of thyroid cartilage. Innervated by the pharyngeal branch of the vagus.
Salpingopharyngeus - Cartilagenous part of eustation tube - merges with palatopharyngeus. Innervated by the pharyngeal branch of CN X
What are the three pharyngeal constrictors?
Circular muscles:
Superior pharyngeal constrictor
Middle pharyngeal constrictor
Inferior pharyngeal constrictor - 2 parts (Thyropharyngeal, cricopharyngeal.
All innervated by the vagus nerve
What is the pharyngeal raphe?
An area of attachment for most of the pharyngeal constrictors. It is also an area where many fibres fuse.
What is a pharyngeal pouch?
A posteromedial (false) diverticula Probably due to: -Failure of the UOS to relax -Abnormal timing of swallowing -So higher pressure in laryngopharynx -Weakness in inferior constrictor muscle produces outpouching.
A pharyngeal pouch is bulge or pocket that develops in the top of your oesophagus. It usually occurs in older patients. Symptoms of a pharyngeal pouch can include a feeling of a lump in your throat, difficulty swallowing (dysphagia), bringing up food after a meal and bad breath.
What is the pharyngeal plexus?
Located mainly on surface of middle constrictor muscle
Vagus, glossopharyngeal and cervical sympathetics.
What are the phases of swallowing?
Oral
Pharyngeal
Oesophagus
What happens in the oral phase of swallowing?
Preparatory phase.
Voluntary - making a bolus, transit phase - bolus compressed against palate and pushed into oropharynx by tongue and soft palate.
What happens in the pharyngeal phase of swallowing?
This is involuntary.
Tongue positioned against hard palate (food cannot re-enter mouth CNXII)
Soft palate elevated sealing off nasopharynx - opens ET tube.
Suprahyoid and longitudinal muscles shorted - pharynx widens and shortens to receive bolus and larynx is elevated and sealed off by vocal folds.
Epiglottis closes over larynx.
Bolus moves through pharynx by sequential contraction of constrictors.
Relaxation of UOS.
What happens in the oesophageal phase of swallowing?
Involuntary
Upper striated muscle of oesophagus (CN X)
Lower smooth muscle
What is dysphagia?
Difficulty swallowing
What are the signs and symptoms of dysphagia?
Coughing and choking Sialorrhoea (drooling) Recurrent pneumonia Change in voice / speech (wet voice) Nasal regurgitation
What cranial nerve problems (IX, X) could you get in this area?
Absent gag
Uvula deviated away from lesion (lower motor neurone lesion)
Dysphagia
Taste impairment
Loss of sensation to oropharynx
Caused by:
Medullary infarct, jugular foramen issue (fracture)
What cranial nerve problems (XII) could you get in this area?
Wasted tongue
Stick tongue out - tongue may deviate to side of lesion
Damage to nerve itself
Muscle wasting
fasciculation (brief contraction of small number of muscle fibres)
