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ESA 3 - Head and Neck > The Oral Cavity And Pharynx > Flashcards

The Oral Cavity And Pharynx Flashcards

1
Q

What is the oral cavity proper?

A

The part of the mouth that is between the teeth

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2
Q

How many teeth should we have?

A

32

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3
Q

What are the muscles of the tongue?

A

Intrinsic muscles - 4 pairs of muscles - innervated by the hypoglossal nerve.

Extrinsic muscles - Genioglossus, Hypoglossus, Styloglossus (hypoglossal nerve), Palatoglossus (Vagus nerve).

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4
Q

What nerve innervate the sensation and taste of he tongue?

A

Anterior 2/3 - Sensation - Trigeminal (Vc - lingual)
Taste - Facial

Posterior 1/3
-Sensation and taste - glossopharyngeal.

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5
Q

Where are the submandibular salivary glands?

A

Between belly’s of digastric

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6
Q

Where is the parotid gland?

A

In front of ear. Posterior to master, superior to SCM and inferior to the zygomatic arch.

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7
Q

Where are sublingual glands?

A

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.

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8
Q

What us sialolithiasis?

A

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

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9
Q

What are the symptoms of tonsillitis?

A

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.
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10
Q

What are the symptoms fo a peritonsilar abscess?

A 
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

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11
Q

What are the three parts of the pharynx?

A

Nasopharynx
Oropharynx
Laryngopharynx

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12
Q

Where is the nasopharynx and what does it contain?

A

Boundaries: Base of skull to upper border of soft palate.

  • Posterior: C1,C2
  • Anterior: nasal cavity.

Contains the pharyngeal tonsil

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13
Q

Where is the oropharynx and what does it contain?

A

Boundaries: Soft palate to epiglottis.

  • Anterior: oral cavity
  • Posterior: C2,C3

Contains: Palatine tonsils

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14
Q

Where is the laryngopharynx and what does it contain?

A

Boundaries: Oropharynx to oesophagus, Epiglottis to cricoid cartilage.
Anterior: Larynx
Posterior: C4,C5,C6

Contains: Piriform fossa

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15
Q

What is the Piriform fossae?

A

It is a recess either side of the laryngeal orifice that diverts material so that it is not near the laryngeal inlet

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16
Q

What are the three longitudinal muscles that elevate the pharynx and larynx when swallowing?

A

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

17
Q

What are the three pharyngeal constrictors?

A

Circular muscles:

Superior pharyngeal constrictor
Middle pharyngeal constrictor
Inferior pharyngeal constrictor - 2 parts (Thyropharyngeal, cricopharyngeal.

All innervated by the vagus nerve

18
Q

What is the pharyngeal raphe?

A

An area of attachment for most of the pharyngeal constrictors. It is also an area where many fibres fuse.

19
Q

What is a pharyngeal pouch?

A 
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.

20
Q

What is the pharyngeal plexus?

A

Located mainly on surface of middle constrictor muscle

Vagus, glossopharyngeal and cervical sympathetics.

21
Q

What are the phases of swallowing?

A

Oral
Pharyngeal
Oesophagus

22
Q

What happens in the oral phase of swallowing?

A

Preparatory phase.
Voluntary - making a bolus, transit phase - bolus compressed against palate and pushed into oropharynx by tongue and soft palate.

23
Q

What happens in the pharyngeal phase of swallowing?

A

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.

24
Q

What happens in the oesophageal phase of swallowing?

A

Involuntary

Upper striated muscle of oesophagus (CN X)

Lower smooth muscle

25
Q

What is dysphagia?

A

Difficulty swallowing

26
Q

What are the signs and symptoms of dysphagia?

A 
Coughing and choking 
Sialorrhoea (drooling)
Recurrent pneumonia 
Change in voice / speech (wet voice)
Nasal regurgitation
27
Q

What cranial nerve problems (IX, X) could you get in this area?

A

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)

28
Q

What cranial nerve problems (XII) could you get in this area?

A

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)

ESA 3 - Head and Neck (20 decks)

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