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ENT anatomy > Salivary Glands, Tongue, Palate and Pharynx > Flashcards

Salivary Glands, Tongue, Palate and Pharynx Flashcards

1
Q

what is the superior border of oral cavity?

A

hard and soft palate

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2
Q

what makes up the anterior border of the oral cavity?

A

upper and lower teeth

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3
Q

what is the inferior border of the oral cavity?

A

floor of mouth/tongue

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4
Q

what is the posterior border of the oral cavity?

A

oropharynx

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5
Q

what gives rise to ‘tongue tie’?

A

the frenulum of the tongue is too short and and therefore binds the tongue to the gingivae of the lower incisor teeth

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6
Q

when the tip of the tongue is lifted to the roof of the mouth, what side of the tongue are we looking at?

A

the ventral (anterior) surface

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7
Q

where are the sublingual papillae located?

A

at the base of the frenulum

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8
Q

what do the sublingual papillae contain?

A

openings for the ducts of the submandibular salivary glands

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9
Q

what is the venous drainage of the floor of the mouth and ventral surface of tongue?

A

right and left lingual vein

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10
Q

which blood vessels are important for absorbing sublingual medications e.g GTN spray?

A

lingual veins

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11
Q

what are the 3 pairs of major salivary glands?

A

parotid, submandibular, sublingual

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12
Q

where do you find minor salivary glands?

A

oral mucosa, lips, cheeks, palate

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13
Q

what percentage of the average daily secretions of saliva does the major salivary glands make?

A

90%

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14
Q

which one of the major salivary glands contains many small ducts rather than just one opening?

A

the sublingual gland

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15
Q

which salivary gland is the largest?

A

parotid

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16
Q

over which muscle does the parotid gland lie?

A

masseter

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17
Q

how does the parotid gland supply saliva into the oral cavity?

A

pierces medially through buccinator then opens on the parotid papilla of the buccal mucosa

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18
Q

anatomically, where abouts is the opening of the parotid papilla of the buccal mucosa?

A

opposite upper 2nd molar

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19
Q

what does the submandibular duct open into?

A

sublingual papillae

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20
Q

where can the submandibular duct be found?

A

deep to the mucosa of the floor of the mouth

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21
Q

where can you find the sublingual gland?

A

deep to mucosa of floor of mouth

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22
Q

normally, should the parotid gland be palpable?

A

no, only palpable if there is pathology

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23
Q

what is the name given to the muscle of the floor of the mouth?

A

mylohyoid

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24
Q

what is the parasympathetic innervation to the submandibular salivary gland?

A

chorda tympani of CN VII (facial nerve)

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25
Q

what is the parasympathetic innervation of the sublingual salivary gland?

A

CN VII

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26
Q

the chorda tympani branch of facial nerve connects to what before supplying the sublingual gland?

A

the lingual nerve branch of CN V3

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27
Q

what is the parasympathetic innervation of the parotid salivary gland?

A

CN IX - glossopharyngeal nerve

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28
Q

where does CN IX leave the base of the skull?

A

jugular foramen

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29
Q

with which structure does CN IX ‘hitch a ride’ with to reach the parotid gland?

A

branches of CN V3

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30
Q

what type of muscle is in the tongue?

A

skeletal (voluntary) muscle

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31
Q

what is the general sensory supply to anterior 2/3rds of tongue?

A

CN V3

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32
Q

what is the special sensory supply to anterior 2/3rds of tongue?

A

CN VII. chorda tympani of facial nerve

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33
Q

which part of the tongue is not considered as being part of the oral cavity?

A

posterior 1/3rd. vertical part of tongue

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34
Q

what is the general and sensory supply to the posterior 1/3rd of the tongue?

A

CN IX - glossopharyngeal

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35
Q

what is the name of the landmark at the apex of terminal groove of the tongue?

A

foramen caecum

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36
Q

what is the foramen caecum a remnant of?

A

remnant of the thyroglossal duct as this is where the thyroid gland originated embrylogically

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37
Q

what is the function of the 4 paired extrinsic tongue muscles?

A

to change position of tongue during mastication, swallowing and speech

38
Q

name the 4 paired extrinsic tongue muscles?

A

palatoglossus, styloglossus, hyoglossus, genioglossus

39
Q

where does the palatoglossus attach?

A

the palate and the tongue

40
Q

where does the styloglossus attach?

A

tongue and styloid process

41
Q

where does the hyoglossus attach?

A

the tongue and the hyoid bone

42
Q

where does the genioglossus attach?

A

the tongue and the genio tubercles

43
Q

what is the motor supply to the extrinsic muscles of the tongue?

A

all supplied by the hypoglossal nerve (CN XII) except palatoglossus which is supplied by the vagus nerve (CN X)

44
Q

how are the hypoglossal nerves connected to the CNS?

A

via many rootlets that attach to the medulla oblangata

45
Q

what is the intracranial part of the course for the hypoglossal nerves?

A

passes anteriorly towards the hypoglossal canal in the posterior cranial fossa

46
Q

what is the base of the skull foramen part of the course of the hypoglossal nerve?

A

travels in occipital bone and into hypoglossal canal

47
Q

where is the hypoglossal canal in the skull?

A

anterior wall of foramen magnum

48
Q

the hypoglossal nerve descends in the neck lateral to what?

A

carotid sheath

49
Q

at the level of the hyoid bone, the hypoglossal nerve passes in which direction?

A

anteriorly towards the tongue

50
Q

how do you clinically test the function of the left and right hypoglossal nerves?

A

ask patient to stick out tongue

51
Q

if both hypoglossal nerves are functioning normally, how would you expect the tongue to look?

A

tongue tip remains in midline

52
Q

if there is a unilateral CN XII damage what way would you expect the tongue tip to point?

A

tongue tip points towards the side of the injured nerve

53
Q

what is the blood supply to the tongue?

A

lingual artery

54
Q

as the hypoglossal nerve passes anteriorly through the neck, what structure is it lateral to?

A

the ‘loop’ of the lingual artery

55
Q

what is the name for the junction between the lip border and the skin?

A

the vermillion border

56
Q

what passes through the palatine foraminae of the hard palate?

A

nerves- branches of CN V2 and vessels

57
Q

how many pairs of muscles are there in the soft palate?

A

5

58
Q

name the 5 pairs of soft palate muscles?

A
  • levator veli palatini
  • tensor veli palatini
  • palatoglossus
  • palatopharyngeus
  • musculus uvulae
59
Q

what is the function of the levator veli palatini?

A

lifts the soft palate towards the base of the skull

60
Q

function of the tensor veli palatini?

A

tenses the soft palate

61
Q

function of palatoglossus?

A

depresses the palate towards the tongue and vice versa

62
Q

where does the palatopharyngeus muscle attach between?

A

the palate and the larynx

63
Q

what nerve(s) are the skeletal muscles of the soft palate supplied by?

A

all supplied by the vagus nerve except tensor veli palatini which is supplied by CN V3

64
Q

what are the 3 functions of the soft palate?

A
  1. stops food entering the nose during swallowing
  2. directs air into the nose or the mouth during speech, coughing and vomiting
  3. helps to close off the entrance into the oropharynx during the gag reflex
65
Q

what do you ask the patient to do when assessing CN X and V3?

A

say ‘aaaah’

66
Q

if the nerves are functioning normally, what should happen to the uvula when patient says ‘aaaah’?

A

should lift straight up into midline

67
Q

if there is unilateral nerve damage, what would you expect to happen to the uvula when patient says ‘aaah’?

A

the uvula will be pulled away from the non-functioning side by the normal side

68
Q

where do all the constrictor muscles of the pharynx all insert?

A

midline raphe

69
Q

are the circular (constrictor) muscles of the larynx voluntary of involuntary?

A

voluntary

70
Q

what are the circular muscles of the pharynx innervated by?

A

CN X

71
Q

what is the only muscle in the pharynx supplied by CN IX?

A

stylopharyngeus

72
Q

what are the 3 longitudinal muscles of the pharynx?

A

stylopharyngeus, palatopharyngeus, salpingopharyngeus

73
Q

where do all 3 longitudinal muscles of the pharynx insert onto?

A

posterior border of thyroid cartilage

74
Q

what is the function of the longitudinal muscles of the pharynx?

A

elevate pharynx and larynx

75
Q

which recess is closely associated with the laryngeal inlet?

A

pisiform fossa (recess)

76
Q

what makes up Waldeyer’s (defensive) ring of lymphoid tissue?

A
  • palatine tonsils
  • pharyngeal tonsils “adenoids”
  • tubal tonsils
  • lingual tonsils
  • palate associated lymphoid tissue
77
Q

where do you find the pharyngeal tonsils “adenoids”?

A

in the mucosa of the roof of the nasopharynx

78
Q

where do you find the tubal tonsils?

A

in the mucosa of the eustachian tube opening

79
Q

where do you find the lingual tonsil?

A

in mucosa of the posterior 1/3rd of the tongue

80
Q

where do you find palate associated lymphoid tissue?

A

in the mucosa of the soft palate

81
Q

what is meant by the regional nodes?

A

regional nodes are the group of lymph nodes that FIRST receive the lymph that has drained from a given structure.

82
Q

where are the retropharyngeal nodes?

A

in the retropharyngeal space

83
Q

what are the regional nodes for the type of the tongue?

A

submental nodes

84
Q

where do you find the submental nodes?

A

in the neck posterior to the mental process of the mandible

85
Q

where do you find the submandibular nodes?

A

in the neck superficial to the submandibular gland

86
Q

where are the deep cervical nodes?

A

in the carotid sheath

87
Q

where does all lymph from the palatine tonsil drain to?

A

the jugulo-digastric node

88
Q

where do the submandibular nodes receive lymph from?

A

nasal cavity, oral cavity, tongue, lips etc

89
Q

what are the expected features of a lymph node that is swollen due to infection?

A

painful, soft, smooth, not fixed to adjacent structures, improves rapidly with antibiotics

90
Q

features of a lymph node that is swollen due to cancer?

A

not painful, hard, irregular, fixed, does not improve with antibiotics

ENT anatomy (4 decks)

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