Wednesday, 4-6-Oral Cavity (Stephens) Flashcards by Kelley Perry

Initially, the lips drain directly into the submental and submandibular (pericervical) LN’s, then into the ___ LNs

Deep cervical

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The skin of the cheek is __ epithelium and innervated by the __ nerve

Keratinized stratified squamous epithelium

Buccinator n. (V)

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The __ is compartmentalized and encapsulated and provides leverage for sucking in infants

Buccal fat pad

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Immediately deep to the buccal fat pad is the buccinator muscle which is innervated by the __ nerve. The __ duct pierces the buccinator muscle

Facial

Parotid

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The mucosa of the cheek is __ epithelium and innervated by the ___ nerve

Non-keratinized stratified squamous

Buccinator (long buccal)

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__ are formed by mucosa which is firmly attached to the underlying alveolar portion of the maxilla and mandible by dense fibrous CT

Gingivae (gums)

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Regarding the relationships of the sublingual region:

The __ nerve spirals around the submandibular duct (Wharton’s duct) from superior-lateral to inferior-medial. Therefore, in the dissection of the floor of the mouth the duct will be ABOVE the nerve, and sublingual gland will be lateral. The __ nerve enters this region considerably more posterior and deeper, and is closely adherent to the hyoglossus muscle

Lingual

Hypoglossal

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__ is the smallest of the salivary glands. It is flattened between the mandible and genioglossus/geniohyoid muscles in the floor of the mouth, and rests upon the superior surface of the mylohyoid

Sublingual gland

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The blood supply of the sublingual gland is by way of the __

List the nucleus that sends preganglionic parasympathetic fibers to the sublingual gland, as well as the ganglion where the preganglionic fibers synapse and the CN that the preganglionic fibers travel

Sublingual branch of the lingual a.

Nucleus=superior salivatory nucleus
Ganglion=submandibular ganglion
Travels on Facial n.

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Regarding sympathetic innervation to the sublingual gland:

Postganglionic sympathetic fibers originate in the __ ganglion, and reach the gland by coursing the in ___ plexuses in the adventitia of the respective arteries

Superior cervical

External carotid and facial

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The epithelium on the anterior 2/3 of the tongue is innervated by __ nerve (GSA fibers for pain, temp, and touch) and the __ nerve (SVA taste fibers)

Trigeminal

- Facial

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The epithelium on the posterior 1/3 of the tongue is innervated by the __ nerve, which supplies both GVA and SVA fibers.

The intrinsic muscles of the tongue are derived from head myotomes, and are innervated by GSE fibers from the ___ nerve

Glossopharyngeal

Hypoglossal

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The ___ is a V-shaped furrow which extends from the foramen cecum (at the midline apex) to the palatoglossal folds (laterally). Circumvallate papillae are distributed along its length, and contain taste buds which are innervated by VII and IX

Sulcus terminalis

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The __ of the tongue is the anterior 2/3 of the tongue. Its epithelium is derived from ectoderm.

The __ of the tongue is the posterior 1/3 of the tongue. Its epithelium is derived from endoderm

oral portion

- pharyngeal portion

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All of the extrinsic and intrinsic muscles of the tongue, except the palatoglossus, are innervated by the __ nerve

Hypoglossal

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The palatoglossus m. Is innervated by ___

Vagus via the pharyngeal plexus

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Unilateral hypoglossal palsy results in paralysis, atrophy, and fasiculations of the intrinsic muscles of the tongue. When protruded, the normal genioglossus deviates the tongue toward the ___ side

Bilateral paralysis may cause: ___

affected

Airway obstruction (dyspnea), dysarthria, and dysphagia

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The tongue gets its blood supply from the __ artery and its terminal branch, the ___ artery

Lymphatics of the tongue drain primarily into __ LNs

Lingual

Profunda lingual

Deep cervical

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The ___ comprises the anterior 2/3 of the palates and is formed by the palatine processes of the maxillae and the horizonatal plates of the palatine bones.

The ___ is a movable fibromuscular partition which forms the posterior 1/3 of the palate. During deglutition, it closes the pharyngeal isthmus and prevents reflux of material into the nasopharynx

Hard palate

Soft palate

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__ is the intrinsic muscle of the soft palate and forms part of the midline uvula. It is innervated by the X via the pharyngeal plexus

___ is located anterolateral to the levator palati muscle and the auditory tube. It is innervated by a small branch of the mandibular n. (V) and tenses the soft palate and opens the auditory tube

Musculari uvulae muscle

Tensor veli palatinin muscle

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__ muscle is innervated by the vaus via the pharyngeal plexus and elevates the soft palate

Levator veli palatini

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What happens when there is paralysis of the tensor or levator palate?

It allows the muscles on the non-paralyzed side to pull or deviate the uvula towards the normal side

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What is the neurovasculature for the hard palate?

What is the neurovasculature for the soft palate?

Greater palatine vessels and nerve

lesser palatine vessels and nerve

___ is an oval-shaped lymphatic gland that is located between the palatoglossal and palatopharyngeal folds in the tonsillar fossa. It is supplied by the tonsilar artery of the facial and the palatine branch of the ascending pharyngeal.

Palatine tonsil

The venous drainage of the palatine tonsil is principally the __ vein

Tonsillar

Clinically, the __ vein is a frequent bleeder during tonsillectomy. Lymphatic drainage from the palatine tonsil is directly into the __ nodes

Tonsillar v. Jugulodigastric (tonsillar) nodes

The ___ extends from the lateral corner of the nose to the angle of the mouth. Clinically, a diminution or absence of this sulcus may indicate a neuro disorder. ___ is a shallow, midline sulcus between the nose and upper lip. ___ is the red portion of the lips and is due to the thin epithelium and extensive underlying capillary network.

Nasolabial sulcus Philtrum Red margin

The upper portion of the nose is formed by these bones: The lower portion of the nose is formed by these cartilages:

Frontal, maxillae, and nasal bones Septal and alar cartilages

Fractures of the nose frequently occur at the junction between the __ cartilage and the __ bones. ___ is commonly used to view and surgically approach structures in the nasal cavity

Septal cartilage and the ethmoid and vomer bones anterior rhinoscopy

The lateral nasal wall is characterized by an irregular surface with 3 overhanging, scroll-like projections called ___, which form underlying gutters called meatuses

Conchae (turbinates)

The superior and middle conchae are part of the __ bone, and the inferior concha is a separate bone

Ethmoid

What are the functions of the conchae?

Increase the surface area of the nasal cavity, and humidify and warm inspired air

___ is located postero-superior to superior concha and the sphenoidal sinus drains into this.

Sphenoethmoidal recess

The ___ forms a bony eminence overlying the middle ethmoidal air cells, which have multiple openings onto it. The ___ is a crescent-shaped trough located anterior and inferior to the ethmoidal bulla

Ethmoidal bulla Hiatus semilunaris

The opening for the maxillary sinus is located in the __ of the hiatus semilunaris

Posterior 1/3

The frontal and anterior ethmoidal sinuses drain into the ___, which is located in the anterosuperior portion of the hiatus semilunaris. If these sinuses drain through a separate opening located anterior to the hiatus, then the opening is called a __ recess

Ethmoidal infundibulum Frontal

The opening for the nasolacrimal duct is located in the ___, 1 cm posterior to the anterior edge of the concha

Inferior meatus

The __ artery supplies the septum and lateral wall of the posterior 1/2 of the nasal cavity. It then branches into the posterior lateral and posterior septal arteries

Sphenopalatine: terminal branch of the maxillary artery

Branches of the __ arteries supply the anterior 1/2 of the nasal walls/septum

Anterior and posterior ethmoidal: branches of the opthalmic (off of the ICA)

The majority of nasal hemorrhages occurs at the junction of the septal branches of the superior labial and sphenopalatine arteries. Clinically, this region is referred to as ___

Kiesselbach's area

Most of the lymphatic drainage of the nasal cavity is via the __ nodes

Jugulodigastric

The __ nerve is a branch of the nasociliary n. (V1) that innervates the mucosa of the anterior 1/3 of the nasal cavity. Branches of the ___ supply the posterior 2/3. Coursing diagonally beneath the septal mucosa is the __ nerve, which is also a branch of the sphenopalatine ganglion and innervates the mucosa of the gingiva and hard palate in the area of the upper incisors

Anterior ethmoidal Pterygopalatine ganglion Nasopalatine

List the innervation for the following muscles: Levator veli palatini: ___ Tensor veli palatini: ___

Vagus via the pharyngeal plexus Branch of V3

The ___ sinus drains by ciliary action, gravity, and negative pressure into 1 or more openings into the hiatus semilunaris

Maxillary

__ may be associated with a toothache of the 1st or 2nd molars due to their close anatomical relationship with the sinus. Because of their intimate relationships with each other, maxillary infections may spread among the frontal, anterior ethmoidal cells, nasal cavity, teeth, and maxillary sinus With transmaxillary surgery, the __ sinus is frequently used as a surgical approach to its surrounds structures

Maxillary sinusitis Maxillary

List where the following ethmoidal cells open into: Anterior ethmoidal cells: ___ Middle ethmoidal cells: ___ Posterior ethmoidal cells: ___

Anterior part of the hiatus semilunaris Surface of the bulla ethmoidalis Superior meatus

The __ sinus is regarded as displaced anterior ethmoidal air cells

Frontal

What are 2 important milestones in face development?

- Development of paranasal sinuses | - Development of dentition

The sphenoidal sinus drains into the ___ recess

Sphenoethmoidal

List the anatomical relationship of the sphenoidal sinus: Posteriorly: ___ Superiorly: ___ Anteriorly: ___ Inferiorly: ___ Laterally: ___

Pons, basilar a. Pituitary Nasal cavity Nasopharynx ICA, V1, cavernous sinus

__ is a narrow, slit-like fossa located posterior to the maxillary sinus and is located between the pterygoid portion of the sphenoid bone and the palatine bone. The short maxillary n. (V2) enters the fossa via the foramen rotundum, courses along the roof of the fossa and exits via the inferior orbital fissure

Sphenopalatine (or pterygopalatine) fossa and ganglion

The pterygopalatine (sphenopalatine) ganglion is attached to the __ nerve in the fossa and has a number of branches

Maxillary (V2)

The __ nerve (or nerve of pterygoid canal) is formed by the merging of the deep petrosal and great petrosal nerves. It conveys postganglionic sympathetic, GVE parasympathetic, and GVA fibers to the pterygopalatine ganglion where it ends.

Vidian

The __ nerves are the largest branches of the pterygopalatine ganglion. They convey GSA (V2), GVA (V2), GVE parasympathetic, postganglionic sympathetic fibers to the mucosa of the inferior of the surface of the soft and hard palate, respectively.

Lesser and greater palatine

___ is where the laryngoscope blade needs to be placed for intubation

Valleculae epiglottica