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

1
Q

where do lymph drain to from head and neck

A

deep cervical lymph nodes

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2
Q

where do the deep cervical lymph nodes drain to and how

A

the R or L subclavian vein

through the thoracic or R lymphatic duct

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3
Q

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

A

occipital
posterior auricular
anterior auricular
superficial parotid
facial

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4
Q

what cerivical lymph node is unpaired

A

(midline) submental nodes

drain the tissue in the submental triangle bilaterally

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5
Q

what are the four groups of SUPERFICIAL CERVICAL lymph nodes

A

submental
submandibular
external jugular
anterior jugular

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6
Q

where do the DEEP CERVICAL lymph nodes lie

A

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

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7
Q

how are the superior and inferior deep lymph nodes divided

A

based on where the omohyoid crosses the jugular vein.

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8
Q

what structures does the superior deep lymph nodes drain

A

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

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9
Q

what clinical significance does the lymphatic drainage have on the tongue

A

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

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10
Q

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

A

the jugulodigastric/tonsillar node - drains palatine tonsils

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11
Q

what structures do the posterior deep cervical lymph nodes drain

A

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

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12
Q

what prominent palpable nodes is located in the posterior deep LN

A

thejugulo-omohyoid lymph node

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

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13
Q

what do enlarged lymph nodes indicate

A

current or past pathology, or area of immune activity

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14
Q

boundaries of the oral cavity

A

roof - Hard and soft palates

floor - mainly soft tissues, including tongue

lateral walls - cheeks

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15
Q

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

A

theoral vestibule and the oral cavity proper
separated by dental arches

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16
Q

what forms the anterior boundary of the oral cavity

A

lips

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17
Q

what is the sensory innervation of the lips

A

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

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18
Q

what is the lymphatic drainage of the lips

A

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

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19
Q

features of the oral vestibule

A

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

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20
Q

the floor of the mouth is formed by

A

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

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21
Q

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

A

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

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22
Q

how is the tongue compartmentalised

A

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

posterior part = forms anterior wall of oropharynx

23
Q

how is the tongue compartmentalised

A

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

posterior part = forms anterior wall of oropharynx

24
Q

what are the lymphoid nodules found in the posterior tongue

A

lingual tonsil

25
Q

what features are found on the anterior part of the tongue

A

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

26
Q

what features are on the inferior surface of the tongue

A

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

27
Q

what are the intrinsic muscles of the tongue

A

Superior longitudinal
Vertical
Transverse
Inferior longitudinal

28
Q

what are the extrinsic muscles of the tongue

A

Palatoglossus
Styloglossus
Hyoglossus
Genioglossus

29
Q

where does the lingual artery enter the tongue

A

between the hyoglossus and genioglossus muscles

30
Q

where do the hypoglossal and lingual nerves enter the tongue

A

external surface of the hypoglossus

31
Q

motor innervation of the tongue

A

Hypoglossal nerve (CNXII)

EXCEPT palatoglossus muscle which is supplied by the CN X vagus

32
Q

general sensation of tongue supplied by

A

ANT 2/3 - Mandibular (trigeminal CNV3)

POST 1/3 - glossopharyngeal (CN IX)

33
Q

special sensation (taste) of tongue supplied by

A

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

34
Q

arterial supply of the tongue

A

lingual artery (from ECA)

35
Q

venous drainage of the tongue

A

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

36
Q

where does the submandibular gland lie

A

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

37
Q

where are the submandibular ducts

A

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

38
Q

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

A

submental artery/vein

39
Q

where does the sublingual gland lie

A

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

40
Q

blood supply to sublingual gland

A

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

41
Q

venous drainage of sublingual gland

A

via submental veins (to lingual & facial veins)

42
Q

where are the sublingual ducts

A

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

43
Q

what is the PARASYMPATHETIC secretomotor innervation of the submandibular and sublingual

A

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

44
Q

what is the SYMPATHETIC innervation of the submandibular and sublingual

A

innervation from the superior cervical ganglia & the nerve plexus on the ECA

Vasoconstriction & reduction in volume of saliva that leads to dry mouth

45
Q

what are the minor salivary glands

A

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

46
Q

what is the innervation of minor salivary glands

A

CN VII & CN V

47
Q

what is the relationship b/w submandibular and sublingual

A

Thenerves of the sublingual glandsaccompany those of the submandibular gland

48
Q

Minor Salivary Gland Innervation (parasympathetic) ABOVE ORAL FISSURE

A

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

49
Q

Minor Salivary Gland Innervation (parasympathetic) BELOW ORAL FISSURE

A

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

50
Q

common pathologies associated with the salivary glands

A

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

51
Q

contents of the submandibular triangle

A

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

52
Q

contents of the submental triangle

A

submental lymph nodes & some small veins

53
Q

contents of the carotid triangle

A

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

54
Q

what is the arterial supply to the upper and lower lip

A

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