Submandibular Region

Question 1

describe the different regions below the tongue

Answer 1

Question 2

where does the submandibular duct open in the mouth?

Answer 2

at the sublingual papillae

Question 3

describe the inner side of the manidble

• find the mylohyoid line,
• lingula (where inferior alveolar nerve passes)
• sublingual fossa
• submandibular fossa

Answer 3

Question 4

where do the mental spines sit?

Answer 4

they sit above the mylohyoid line of the jaw

Question 5

what nerve innervates the strap msucles?

Answer 5

The Ansa Cervicalis

Question 6

Why are the strap muscles important?

Answer 6

they close off the neck and form the floor

Question 7

Describe the suprahyoid muscles from superior to inferior

Answer 7

•Geniohyoid (most superior) attached to the mental spine

–C1 via Hypoglossal

•Mylohyoid- attaches to the mylohyoid bone

–V3 inferior alveolar nerve

•Stylohyoid– inserts onto the hyoid bone from the styloprocess

–Facial

•Digastric- has an anterior belly and posterior belly - this muscle anterior belly comes from mandible and it has a sling on the hyoid bone that divides it from the posterior belly which goes back to the mastoid process

–Posterior belly; Facial VII

–Anterior belly; V3

Question 8

describe the layers of the muscles below the tongue

Answer 8

geniohyoid muscle

• mylohyoid
• digastric
• stylohyoid muscle

Question 9

where does mylohyoid get its innervation from?

Answer 9

from the inferior alveolar nerve

Question 10

what nerve innervates the tongue and the geniohyoid muscle?

Answer 10

the hypoglossal nerve

Question 11

describe the divisions of the tongue

Answer 11

Question 12

Waht are the extrinsic muscles of the tongue? What are their attachments?

Answer 12

they originate outside the tongue (glossus) and attach to it

–Genioglossus

•Remember Geniohyoid, genioglossus originates from the superior mental spines

–Hyoglossus

•Hyoid bone

–Styloglossus

•Styloid Process

–Palatoglossus

Palate

Question 13

what are the arches at the back of the mouth?

Answer 13

palatoglossus arch - which is where the palatoglossus muscle originates ( underlies the palatoglossus arch of mucosa)

Question 14

what nerve innervates all of the muscles of the tongue except the palatoglossus?

Answer 14

the 12th cranial nerve

= palatoglossus is innervated by the cranial root of the accessory nerve via the Vagus nerve - ((some people say it’s vagus, doesn’t matter clinically)

Question 15

describe the path of the hypoglossal nerve

Answer 15

Question 16

between which muscles of the floor of the mouth does the hypoglossal nerve ascend through?

Answer 16

enters between the mylohyoid and the hyoglossus

Question 17

if there is damage ot the 12th cranial nerve and you ask the patient to stick their tongue out - what will happen?

Answer 17

the tongue will deviate to the effected site- b/c the damaged side will waste away and the other muscles will push it towards that side

Question 18

the lingual nerve is a branch of what nerve?

Answer 18

the Mandibular nerve

Question 19

the lingual nerve and what branch of the facial nerve join together to access the tongue?

Answer 19

the chorda tympani joins the lingual nerve

Question 20

the lingual nerve carries what information?

Answer 20

it give general sensation to the anterior 2/3 of the tongue - note the chorda tympani brings taste sensation from the anterior 2/3 of the tongue back

Question 21

what nerve supplies the posterior 1/3 of the tongue?

Answer 21

both taste and general sensation are supplield by the Glossopharyngeal nerve (cranial nerve 9)

Question 22

what are the bumps on the tongue?

Answer 22

the various papillae

Question 23

where does the thyroid start its descent on the tongue?

Answer 23

at the foramen cecum= then it moves down on a duct

Question 24

what are the salivary glands of the mouth?

Answer 24

paotid, submandibular and sublingual

•Secrete Saliva

–Keeps mucous membranes moist

–Lubricates food during mastication

–Begins the digestion of starch

–Prevents decay

Question 25

the mylohyoid muscle is wrapped by what gland?

Answer 25

the submandibular gland

and the sublingual gland sits just above this muslce in the submandibular fossa

Question 26

what does the submandibular gland produce?

Answer 26

mixed serous/mucous

Question 27

what is the artery, vein and nerve suppy to the submandibular gland?

Answer 27

artery = submental branch of facial artery

vein = accompany arteries

nerve= chorda tympani

lymphatics = cervical lymph nodes

Question 28

What is ‘Wharton’s Duct’?

Answer 28

–salivary duct

– 5cm long, passes uphill

–Lingual nerve loops under it

–Opens in sublingual papillae

Question 29

the sublingual gland forms what fold?

Answer 29

forms the sublingual fold and it drains into numerous small ducts which lie on this fold

Question 30

Where does chorda tympani stem from?

Answer 30

it descends form the facial nerve and the superior salivatory nucleus ( which is the parasympathetic nucleus of the 7th cranial nerve)

Question 31

what nucleus is located in the pons and it stems the chorda tympani nerve?

Answer 31

the superior salivatory nucleus

Question 32

describe the branches of the external carotid

Answer 32

Some look forward, others are posterior

• superior thyroid
• lingual
• facial
• occipital
• ascending pharyngeal
• posterior auricular
• maxillary
• superficial temporal

Question 33

what are the terminal branches of the external carotid artery?

Answer 33

superficial temporal artery and the maxiallary artery (which gives off a branch to the inside of the skull = middle meningeal)

Question 34

what are the branches of the facial artery?

Answer 34

Question 35

what are the supratrochlear and supraorbital arteries branches of?

Answer 35

they are branches of the opthalmic artery ( not facial)

Question 36

underneath the tongue - we have a very vascular region - why is this region very useful?

Answer 36

it’s handy for quick absorption of drugs

Question 37

where does the facial vein bein?

Answer 37

angular vein

Question 38

where does the pterygoid plexus sit? what does it communicate with

Answer 38

sits in the infratemporal fossa - and it communicates with the cavernous sinus -

Question 39

where does the external jugular sit in surface anatomy?

Answer 39

from the angle of the mandible to 1cm above mid clavicle

Question 40

where do lymphatics from the mouth drain to?

Answer 40

they drain to the deep cervical nodes, submental and submandibular nodes

Question 41

where does the tip of the tongue drain?

Answer 41

drains to the submental lymph nodes

Question 42

where are stones more common in salivary ducts?

Answer 42

more common in submandibular gland b/c of the backward flow of the saliva - it has more mucoids as well uphill