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Semester 3 - Head and neck > 15. Anatomy of the Oral Cavity, Tongue & Pharynx > Flashcards

15. Anatomy of the Oral Cavity, Tongue & Pharynx Flashcards

1
Q

What are the 2 arches in the oral cavity called and what is found between them?

A

Palatoglossal arch and palatopharyngeal arch

- Palatine tonsils between them

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2
Q

What is the fauces?

A

Opening between oral cavity and oropharynx

  • palatoglossal arch forms the anterior pillars
  • palatopharyngeal arch forms the posterior pillars
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3
Q

Which muscles form the arches in the oral cavity?

A
  • Palatoglossal arch by palatoglossus

- Palatopharyngeal arch by palatopharyngeal muscle

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4
Q

What is the uvula?

A

An end of the soft palate

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5
Q

What is the space between the teeth/gums and the lips called?

A

Vestibule

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6
Q

What is the lingual frenulum?

A

Small fold of mucous membrane extending from the floor of the mouth to the midline of the underside of the tongue

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7
Q

What are the 2 categories of the muscles of the tongue?

A

Intrinsic and extrinsic muscles

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8
Q

How many maximum teeth do we have?

A

32

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9
Q

What is the innervation of the intrinsic muscles of the tongue?

A

Hypoglossal nerve

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10
Q

What are the intrinsic muscles?

A 
4 paired muscles:
• sup longitudinal
• inf longitudinal
• transverse
• vertical
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11
Q

what does intrinsic and extrinsic mean in relation to tongue muscles?

A

intrinsic - not attached to any other structures apart from other intrinsic muscles

extrinsic - arise from other structures and inert into tongue

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12
Q

What are the extrinsic muscles of the tongue and what is their innervation?

A

Genioglossus, Hyoglossus, Styloglossus:
• Motor innervation (hypoglossal nerve)
Palatoglossus:
• Motor innervation (Vagus nerve)

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13
Q

Where do the extrinsic muscles of the tongue originate from?

A
  • Genioglossus from mental protuberance
  • Hypoglossus from the hyoid bone
  • Styloglosusu from the styloid process of temporal bone
  • Palatoglossus from the hard/soft palate
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14
Q

What is the general and special sensory innervation to the tongue?

A 
Anterior 2/3:
• Sensation -trigeminal (V3, lingual nerve)
• Taste -facial (chorda tympani)
Posterior 1/3:
• Sensation and taste- glossopharyngeal
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15
Q

What is the duct of the submandibular gland and where does it open in the oral cavity?

A

Whartons duct, opening at each side of the frenulum of the tongue at the base of the tongue

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16
Q

Where are the submandibular glands found?

A

in submandibular/digastric triangle - underneath mandible - between anterior and posterior belly of digastric

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17
Q

What are the boundaries of the parotid gland?

A
  • Superior: zygomatic arch
  • Posterior: SCM
  • Anterior: masseter
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18
Q

What is the duct of the parotid gland and where does it open into the oral cavity?

A

Stensen duct, in the vestibule, in the region of the pre-molars

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19
Q

What is the duct of the sublingual gland and where does it open into the oral cavity?

A

Has lots of entries into the oral cavity

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20
Q

Where is the sublingual gland found?

A

underneath the tongue

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21
Q

describe the sublingual gland

A
  • Smallest and most diffuse of the major salivary glands

* 8-20 excretory ducts per gland

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22
Q

How much of saliva is produced by each gland?

A

submandibular = 60%
parotid =
sublingual = 3-5%

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23
Q

What are salivary gland stones called and in which gland do they mostly occur in?

A

Sialolithiasis, submandibular gland

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24
Q

What are the symptoms of salivary gland stones?

A
  • Pain in gland
  • Swelling
  • Infection
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25
Q

What stimulates the symptoms of sialithiasis?

A

thinking of eating, smelling food, eating

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26
Q

How is a salivary gland stones diagnosed?

A

History, x-ray, sialogram

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27
Q

What causes salivary gland stones?

A

Dehydration, reduced salivary flow

28
Q

What are the symptoms of tonsillitis?

A
  • Sore throat
  • Pain/difficulty swallowing
  • fever
  • Bad breath
29
Q

Which lymph nodes swell in tonsillitis?

A

Cervical lymph nodes

30
Q

What are the causes of tonsillitis?

A
  • Viral causes (most common)

* Bacterial causes (up to 40% of cases) - Strep pyogenes

31
Q

What is peritonsillar abscess and what is it also called?

A

Inflammation of tissue surrounding the tonsil

- also called Quinsy

32
Q

What are the symptoms of peritonsillar abscess?

A
  • Severe throat pain
  • Fever
  • Bad breath
  • Drooling
  • Difficulty opening mouth
33
Q

What causes peritonsillar abscess?

A
  • Can follow on from an untreated or partially treated tonsillitis
  • Can arise on its own - Aerobic and anaerobic bacteria
34
Q

What is the difference between position of the uvula in tonsilitis and peritonsillar abscess?

A
  • Usually central (not displaced) in tonsillitis

- Displaced in peritonsillar abscess

35
Q

What are the boundaries of the nasopharynx and what does it contain??

A

Base of skull to upper border of soft palate
• Posterior (C1, C2)
• Anterior (nasal cavity)
• inferior (tip of uvula)

  • Contains pharyngeal (adenoid) tonsil and opening of Eustachian tube
36
Q

What are the 3 parts of the pharynx?

A

nasopharynx
oropharynx
laryngopharynx

37
Q

What are the signs/symptoms of enlarged adenoids?

A
  • Block ET - Recurrent/persistent middle ear infections
  • Snoring/sleep apnoea
  • Sleeping with mouth open
  • Chronic sinusitis - Sore throat
  • Nasal tone to voice
38
Q

What are the boundaries of the oropharynx and what does it contain?

A 
Soft palate to epiglottis
• Anterior (oral cavity)
• Posterior (C2, C3)
• superior (tip of uvula)
• inferior (upper border of epiglottis)
  • contains the palatine tonsils
39
Q

What are the boundaries of the laryngopharynx and what does it contain?

A

Oropharynx to oesophagus
Epiglottis to cricoid cartilage
• Anterior (larynx)
• Posterior (C4,C5,C6)

  • Contains Piriform fossa
40
Q

What is the piriform fossa?

A

Recesses on either side of the of the laryngeal orifice.

41
Q

What happens to divert food away from trachea?

A

epiglottis comes over and covers respiratory tract, diverting food down piriform fossa and into oesophagus

42
Q

What are the 3 longitudinal muscles of the pharynx and what is their function?

A

elevate pharynx and larynx during swallowing:
• Stylopharyngeus
• Palatopharyngeus
• Salpingopharngeus

43
Q

What are the attachments and innervation of the palatopharyngeus?

A
  • originate from Hard palate
  • insert into posterior border of thyroid cartilage
  • Pharyngeal branch of vagus (CN X)
44
Q

What are the attachments and innervation of the salpingopharyngeus?

A
  • originates from Cartilaginous part of ET
  • merges with palatopharyngeus
  • Pharyngeal branch of vagus (CN X)
45
Q

What are the attachments and innervation of the stylopharyngeus?

A
  • originate from Styloid process
  • insert into posterior border of thyroid cartilage
  • Glossopharyngeal nerve (CN IX)
46
Q

What are the 3 circular muscles of the pharynx and what is their function?

A
  • Superior pharyngeal constrictor
  • Middle pharyngeal constrictor
  • Inferior pharyngeal constrictor,
47
Q

What are the origins of the circular muscles?

A

Superior pharyngeal constrictor
- Origin -Pterygomandibular raphe
Middle pharyngeal constrictor
- Origin- Hyoid bone
Inferior pharyngeal constrictor, Has 2 parts
- Thyropharyngeal (origin- thyroid cartilage)
- Cricopharyngeal (origin-cricoid cartilage)

48
Q

What is the insertion and innervation of the pharyngeal constrictor muscles?

A
  • Insert onto the pharyngeal raphe

- innervated by the vagus nerve

49
Q

What abnormality can arise due to the 2 parts of the inferior contrictor muscle?

A

Pharyngeal pouch (Zenker’s diverticulum)

50
Q

What are the sings/symptoms of pharyngeal pouch?

A 
70 year old man presents with
• Bad breath
• Regurgitation of food
• Occasional choking on fluids
• General difficulty swallowing
51
Q

What is the area of the inferior constrictor where the pouch can form called?

A

Killian’s dehiscence

  • A posteromedial (false) diverticulum
  • Arises in weakness between the two parts of the inferior constrictor
52
Q

Why does a pharyngeal pouch form?

A

Essentially there is a higher pressure in laryngopharynx:
• Failure of the UOS to relax
• Abnormal timing of swallowing

• Weakness in Inferior constrictor muscle produces outpouching

53
Q

What are the symptoms in pharyngeal pouch related to?

A

Symptoms related to food material collecting in pouch or disruption of swallow

54
Q

What is the pharyngeal plexus?

A
  • Located mainly on surface of middle constrictor muscle

* Vagus, glossopharyngeal and cervical sympathetic nerves

55
Q

What is motor innervation to the pharynx?

A
  • CN X innervates all muscles

* Except stylopharyngeus (Glossopharygeal nerve (CN IX)

56
Q

What is sensory innervation to the pharynx?

A
  • Naospharynx (maxillary nerve CN V2)
  • Oropharynx (glossopharyngeal nerve CN IX)
  • Laryngopharynx (vagus nerve (CN X)
57
Q

What are the 3 phases of swallowing?

A

oral, pharyngeal, esophageal

58
Q

Describe the oral phase of swallowing

A
  • Voluntary
  • Preparatory phase - Making bolus
  • Transit phase - Bolus compressed against palate and pushed into oropharynx by tongue and soft palate
59
Q

Describe the pharyngeal phase of swallowing.

A

• Involuntary
• Tongue positioned against hard palate (food cannot re-enter mouth) (CN XII)
• Soft palate elevated sealing off nasopharynx (tensor palatini CN V3, levator palatini CN X)
- Opens ET tube
• Suprahyoid (CN V3, CN VII, CN XII) and longitudinal muscles shorten (CN IX, CN X)
- Pharynx widens and shortens to receive bolus
- Larynx elevated and sealed off by vocal folds
• Epiglottis closes over larynx (result of elevated hyoid)
• Bolus moves through pharynx by sequential contraction of constrictors
• Relaxation of UOS

60
Q

Describe the oesophageal phase of swallowing.

A 
• Involuntary
Peristalsis:
- Upper striated muscle of oesophagus (CN X)
- Lower smooth muscle
• LOS relaxes
61
Q

What are the sings/symptoms of dysphagia? (5)

A
  • Coughing & choking
  • Sialorrhoea (drooling)
  • Recurrent pneumonia
  • Change in voice/speech (wet voice)
  • Nasal regurgitation
62
Q

What are the signs/symptoms o f a IX/X lesion?

A

Obvious things
• Absent gag
• Uvula deviated away from lesion (LMN)

Bit more subtle
• Dysphagia
• Taste impairment (posterior tongue)
• Loss of sensation oropharynx

63
Q

What can cause a lesion in CN IX/X?

A

medullary infarct, jugular foramen issue (fracture)

64
Q

What are the signs/symptoms of a XII lesion?

A
  • Wasted tongue
  • Stick tongue out- tongue may deviate
  • Damage to nerve itself (LMN) -point to side of lesion
  • Muscle wasting
  • Fasiculations
65
Q

https://quizlet.com/gb/452646946/session-8-anatomy-of-the-oral-cavity-and-pharynx-flash-cards/

A

(aspiration) pneumonia due to issues with swallowing (dysphagia)

Semester 3 - Head and neck (17 decks)

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