Week 8: Lymphatics, oral cavity, SG + submandibular region,

Question 1

where do lymph drain to from head and neck

Answer 1

deep cervical lymph nodes

Question 2

where do the deep cervical lymph nodes drain to and how

Answer 2

the R or L subclavian vein

through the thoracic or R lymphatic duct

Question 3

what are the 5 groups of paired of SUPERFICIAL lymph nodes of the HEAD

Answer 3

occipital
posterior auricular
anterior auricular
superficial parotid
facial

Question 4

what cerivical lymph node is unpaired

Answer 4

(midline) submental nodes

drain the tissue in the submental triangle bilaterally

Question 5

what are the four groups of SUPERFICIAL CERVICAL lymph nodes

Answer 5

submental
submandibular
external jugular
anterior jugular

Question 6

where do the DEEP CERVICAL lymph nodes lie

Answer 6

along the length of the internal jugular vein on each side of the neck, deep to the SCM muscle

Question 7

how are the superior and inferior deep lymph nodes divided

Answer 7

based on where the omohyoid crosses the jugular vein.

Question 8

what structures does the superior deep lymph nodes drain

Answer 8

posterior nasal cavity
posterior hard palate
soft palate]
base of the tongue
maxillary third molars with associated tissues
TMJ
esophagus
trachea
thyroid gland.

Question 9

what clinical significance does the lymphatic drainage have on the tongue

Answer 9

drainage of the back of the tongue is bilateral, so pathology may appear in the lymph nodes on either side rather than just on the affected side

Question 10

what is a prominent node in the neck (superior deep LN)

Answer 10

the jugulodigastric/tonsillar node - drains palatine tonsils

Question 11

what structures do the posterior deep cervical lymph nodes drain

Answer 11

the posterior part of the scalp and neck
the superficial pectoral region
a part of the arm

Question 12

what prominent palpable nodes is located in the posterior deep LN

Answer 12

thejugulo-omohyoid lymph node

This node receives the lymph from the tongue and the submental triangle

Question 13

what do enlarged lymph nodes indicate

Answer 13

current or past pathology, or area of immune activity

Question 14

boundaries of the oral cavity

Answer 14

roof - Hard and soft palates

floor - mainly soft tissues, including tongue

lateral walls - cheeks

Question 15

the oral cavity consists of what 2 parts and how is it separated

Answer 15

theoral vestibule and the oral cavity proper
separated by dental arches

Question 16

what forms the anterior boundary of the oral cavity

Answer 16

lips

Question 17

what is the sensory innervation of the lips

Answer 17

maxillary (CNV2) - upper lip
mandibular (CNV3) - lower lip

Question 18

what is the lymphatic drainage of the lips

Answer 18

primarily via the submandibular
except medial part of lower initially via submental

Question 19

features of the oral vestibule

Answer 19

this is the area b/w the teeth and the cheeks
labial and bucal frenum
papilla of parotid duct

Question 20

the floor of the mouth is formed by

Answer 20

muscular diaphragm created by the paired mylohyoid muscles. 2 muscles attach in midline by mylohyoid raphe

Question 21

what other muscle accompanies the mylohyoid in the floor of the mouth

Answer 21

The geniohyoid muscles sit superior to the mylohyoid attaching from the inferior mental spine of mandible to the body of the hyoid

Question 22

how is the tongue compartmentalised

Answer 22

The anterior and posterior parts of the tongue are separated by the terminal sulcus

posterior part = forms anterior wall of oropharynx

Question 23

how is the tongue compartmentalised

Answer 23

The anterior and posterior parts of the tongue are separated by the terminal sulcus

posterior part = forms anterior wall of oropharynx

Question 24

what are the lymphoid nodules found in the posterior tongue

Answer 24

lingual tonsil

Question 25

what features are found on the anterior part of the tongue

Answer 25

covered in numerous small lingual papillae (vallate, fungiform, filiform, foliate)

Question 26

what features are on the inferior surface of the tongue

Answer 26

frenulum sublingual caruncle (papilla) openings of submandibular and sublingual ducts

Question 27

what are the intrinsic muscles of the tongue

Answer 27

Superior longitudinal Vertical Transverse Inferior longitudinal

Question 28

what are the extrinsic muscles of the tongue

Answer 28

Palatoglossus Styloglossus Hyoglossus Genioglossus 

Question 29

where does the lingual artery enter the tongue

Answer 29

between the hyoglossus and genioglossus muscles

Question 30

where do the hypoglossal and lingual nerves enter the tongue

Answer 30

external surface of the hypoglossus

Question 31

motor innervation of the tongue

Answer 31

Hypoglossal nerve (CNXII) EXCEPT palatoglossus muscle which is supplied by the CN X vagus

Question 32

general sensation of tongue supplied by

Answer 32

ANT 2/3 - Mandibular (trigeminal CNV3) POST 1/3 - glossopharyngeal (CN IX)

Question 33

special sensation (taste) of tongue supplied by

Answer 33

ANT 2/3 – Facial nerve via chordae tympani POST 1/3 – Glossopharyngeal nerve

Question 34

arterial supply of the tongue

Answer 34

lingual artery (from ECA)

Question 35

venous drainage of the tongue

Answer 35

The deep lingual and dorsal lingual veins drain (into IJV)

Question 36

where does the submandibular gland lie

Answer 36

along the mandible wraps around the mylohyoid Deep part lies in the floor of the oral cavity, lateral to the root of the tongue

Question 37

where are the submandibular ducts

Answer 37

5cm long open into 3 orifices in oral cavity - sublingual caruncles/papilla

Question 38

what is the arterial supply/venous drainage to the submandibular gland

Answer 38

submental artery/vein

Question 39

where does the sublingual gland lie

Answer 39

Sits in sublingual fossa of mandible, superior to anterior part of the mylohyoid line

Question 40

blood supply to sublingual gland

Answer 40

via submental & sublingual arteries (branch of facial & lingual arteries)

Question 41

venous drainage of sublingual gland

Answer 41

via submental veins (to lingual & facial veins)

Question 42

where are the sublingual ducts

Answer 42

there are many and they open at the crest of sublingual folds in oral cavity

Question 43

what is the PARASYMPATHETIC secretomotor innervation of the submandibular and sublingual

Answer 43

Parasympathetic (to produce saliva) 1. Preganglionic -fibres travel to the submandibular ganglion from the chorda tympani via the lingual nerve (CN V3) 2. postganglionic - fibres travel in the lingual nerve (CN V3) to the sublingual gland OR travel directly to the sublingual & submandibular glands

Question 44

what is the SYMPATHETIC innervation of the submandibular and sublingual

Answer 44

innervation from the superior cervical ganglia & the nerve plexus on the ECA Vasoconstriction & reduction in volume of saliva that leads to dry mouth

Question 45

what are the minor salivary glands

Answer 45

Buccal (cheek) Palatine (palate) Lingual (tongue) Labial (lip) (embedded in submucosa in oral cavity)

Question 46

what is the innervation of minor salivary glands

Answer 46

CN VII & CN V

Question 47

what is the relationship b/w submandibular and sublingual

Answer 47

The nerves of the sublingual glands accompany those of the submandibular gland

Question 48

Minor Salivary Gland Innervation (parasympathetic) ABOVE ORAL FISSURE

Answer 48

PARASYMPATHETIC innervation Preganglionic - fibres travel to the pterygopalatine ganglion in the greater petrosal nerve (CN VII nervus intermedius) Postganglionic -mfibres travel to the palate via the palatine nerves

Question 49

Minor Salivary Gland Innervation (parasympathetic) BELOW ORAL FISSURE

Answer 49

PARASYMPATHETIC Preganglionic - fibres travel to the submandibular ganglion from the chorda tympani (CN VII nervus intermedius) & via the lingual nerve (CN V3) Postganglionic - fibres then travel in the lingual nerve (CN V3) to the glands OR travel directly to the glands not in a nerve

Question 50

common pathologies associated with the salivary glands

Answer 50

mumps - viral infection - swellings salivary stones (sialolithiasis) - pain, swelling & lack of salivation - Excessive salivation (ptyalism) - Commonly occurs prior to vomiting - assoc/ with several disease processes

Question 51

contents of the submandibular triangle

Answer 51

submandibular gland lymph nodes (parts of) hypoglossal nerve mylohyoid nerve & parts of the facial artery & vein part of digastric

Question 52

contents of the submental triangle

Answer 52

submental lymph nodes & some small veins

Question 53

contents of the carotid triangle

Answer 53

(among other structures) carotid sheath and contents; external carotid and some branches; parts of accessory & hypoglossal nerves; deep cervical lymph nodes

Question 54

what is the arterial supply to the upper and lower lip

Answer 54

ECA via facial artery superior (upper) and inferior (lower) labial arteries