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ENT > Anatomy- Salivary glands, Tongue, Palate and Pharynx > Flashcards

Anatomy- Salivary glands, Tongue, Palate and Pharynx Flashcards

1
Q

where is the oral vestibule

A

between the lips and the teeth

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2
Q

what is the order of the pharynxs from top to bottom

A

nasopharynx
oro
laryngo

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3
Q

where is the definitve choanae

A

between the nasopharynx and nasal cavity (infront of entrance to eustachian tube)

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4
Q

what divides the naso and oro pharynx

A

the low tip of the soft palate

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5
Q

what makes up the epiglottis

A

laryngeal cartilage

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6
Q

what is the boundary between the laryngopharynx and the oropharynx

A

tip of the epiglottis

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7
Q

what is the oral cavity

A

everything above the tongue and below the hard palate

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8
Q

what level is the hyoid bone at

A

C3, in line with inferior aspect (base) of the mandible

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9
Q

what is the frenulum

A

connects the tongue to the base of the oral cavity

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10
Q

what is the sublingual caruncle

A

bump in the fremulum- opening for the submandibular glands

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11
Q

what is the sublingual fold

A

where the sublingual glands secrete mucous into

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12
Q

what veins are on the floor of the night

A

deep lingual veins

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13
Q

what muscles make up the floor of the mouth

A

geniohyoid (genio=back of chin)

mylohyoid

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14
Q

what innervates the geniohyoid

A

C1 (cervical spine nerve) via hypoglossal nerve

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15
Q

what innervates the mylohyoid

A

CN V3

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16
Q

what is the purpose of the free edge of the mylohoid

A

allows the submandibular gland to curl up

can allow infections to spread down into the neck

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17
Q

what are the major salivary glands

A

3 bilateral pairs

  • parotid
  • submandibular
  • sublingual
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18
Q

what are the minor salivary glands

A

1000’s in oral mucosa

basal secretion to keep mouth moist

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19
Q

what stimulates salivation

A

thoughtm sight, smell of food/ food in mouth

painful oral conditions (teething, fractures mandible)

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20
Q

where does the parotid gland secrete into the mouth

A

by the upper 2nd molar

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21
Q

where are the parotid salivary glands

A

infront of/below ear

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22
Q

how does the submandibular gland secrete into the mouth

A

enters floor of mouth and secretes via the lingual caruncle

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23
Q

how does the sublingual gland secrete into the mouth

A

lays in floor of mouth, secretes via several ducts superiorly

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24
Q

what can salivary duct clogging/blockage cause

A

swelling due to back up of secretions

e.g in parotid transient swelling during meal times

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25
Q

what ‘pathetic’ innervates the salivary glands mostly

A

parasympathetics

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26
Q

what is the innervation of the submandibular and sublingual salivary glands

A

parasympathetics axons (secretorymotor) of chorda tympani branch of CN VII via the lingual branch of CN V3

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27
Q

what nerve supplies the muscles of facial expression

A

CN VII

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28
Q

what is the innervation of the partoid gland

A

parasympathetic innervation (secretomotor) from CN IX, hitches a ride of branches of CN V3 (otic ganglion)

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29
Q

what type of muscle is the tongue

A

skeletal

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30
Q

what is the tongue covered in

A

mucosa

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31
Q

what is the innervation of the posterior 1/3rd of the tongue (vertical part of tongue)

A

taste and general sensory by CN IX

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32
Q

what is the innervation of the anterior 2/3rds of the tongue (horizontal part of tongue)

A

general sensory CN V3

taste CN VII

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33
Q

what do filiform papillae sense

A

touch, temp

why there is a high conc of them at the tip of the tongue

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34
Q

what papillae have taste buds

A

foliate
vallate
fungiform

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35
Q

what separates the horizontal (posterior 1/3rd) and vertical (anterior 2/3rds) of the tongue

A

sulcus terminus

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36
Q

what is the path of the developing thyroid

A

originates in the pharynx

descends through the foramen caecum of the tongue

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37
Q

what can you get in the migratory path of the thryoid

A

thryoglossal cysts or ectopic thyroid tissue

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38
Q

what holds the tongue in place

A

4 pairs of skeletal muscles- palatoglossus, styloglossus, genioglossus, hyoglossus (name tells you where they’ve come from)

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39
Q

what is the role of the extrinsic muscles of the tongue

A

function to change the position of the tongue during mastication, swallowing and speech

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40
Q

where are and what is the role of the intrinsic muscle of the tongue

A

mainly dorsally/posteriorly

modify the shape of the tongue during function

41
Q

what is the innervation of the extrinsic muscles of the tongue

A

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

42
Q

how does CN XII attach to the CNS

A

rootlets that attach to the medulla oblongata

43
Q

how does CN XII leave the skull

A

hypoglossal canal (occipital bone) (anterior wall of foramen magnum)

44
Q

what is the extracranial course of CN XII

A

descends in neck lateral to carotid sheath
at level of hyoid bone passes anteriorly towards the lateral aspect of the tongue - supplies most of the muscles of the tongue
passes anteriorly through neck lateral to the loop of the lingual artery

45
Q

how do you clinically test CN XII

A

ask patient to stick tongue out
if both CN XII functional then tongue tip will remains in the midline
in unilateral CN XII damage tongue will point TOWARDS the injured side

46
Q

what muscle pushes the tongue out of the mouth

A

genioglossal

47
Q

what is the blood supply to the tongue

A

lingual artery- comes off the external carotid artery

48
Q

what passes medial and lateral to the hypoglossus

A

arteries (lingual) pass medial

nerves (hypoglossal) pass lateral

49
Q

what pharyngeal arch forms the palatine tonsils

A

2nd pharyngeal arch

50
Q

what are the arches of the soft palate

A

skeletal muscles covered in mucosa

51
Q

what goes in the greater and lesser palatine foramina

A

branches of CN V2 and branches of the maxillary artery

52
Q

what lines the soft palate

A

non-keratinised stratified squamous epithelium

53
Q

what lines the hard palate

A

keratinised stratified squamous epithelium

54
Q

what bones form the hard palate

A

maxilla (anterior) and palatine (posterior aspect) bones

55
Q

where is the scaphoid fossa

A

the pterygoid plate

56
Q

what are palatal rugae

A

transverse mucosal ridges- assist in breaking down food

57
Q

where is the pterygoid hamulus

A

hook like structure on the sphenoid bone

58
Q

what are the five muscles of the soft palate

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

what is the innervation and role of tensor veli palatini

A

CN V3

tenses palatine aponeurosis

60
Q

what is the innervation and role of levator veli palatini

A

CN X

lifts palatine aponeurosis

61
Q

what is the innervation and role of palatopharyngeus

A

CN X

lifts pharynx and thyroid cartilage

62
Q

what is the innervation and role of palatoglossus

A

CN X

brings tongue and soft palate together

63
Q

what is the innervation and role of musculus uvulae

A

CN X

shortens uvula

64
Q

what is the innervation of the muscles of the soft palate

A

all supplied by CN X expect tensor veli palatini CN V3

65
Q

what is the role of the soft palate

A

stops food entering the nose during swallowing
directs air into the nose/ mouth during speech, sneezing, coughing and vomiting
closes off the entrance into the oropharynx during the gag reflex

66
Q

how can the soft palate be used to clinically test CN X

A

ask patient to say ahhh
if nerves normal uvula should lift in the midline
if unilateral pathology uvula will be pulled AWAY from the non functioning side

67
Q

what is the innervation of the muscles of the pharynx

A

all innervated by CN X except stylopharyngeus (IX)

68
Q

what are the two layers of pharynx muscles

A

outer circular layer (3 constrictor muscles, contracts pushing food inferiorly)

inner longitudinal layer (3 paired vertical muscles, contract and pull larynx superiorly shortening pharynx during swallowing)

69
Q

what types of muscles are in the pharynx

A

skeletal- voluntary

70
Q

what are the circular muscles of the pharynx

A

superior, middle and inferior constrictors

71
Q

what do the gaps in the circular pharynx muscles allow

A

‘gateway to the mouth’ for CN IX, lingual artery, stylopharyngeus muscle

72
Q

what pharynx muscles overlap each other

A

circular

73
Q

in what way do the circular muscles of the pharynx contract

A

sequentially- peristalsis action

74
Q

what innervates the circular muscles of the pharynx

A

CN X via the pharyngeal plexus

75
Q

where do all circular muscles of the pharynx insert

A

onto the midline raphe

76
Q

what is the only muscle in the pharynx to be innervated by CN IX

A

stylopharyngeus

77
Q

what nerve does stylopharyngeus pass through the gateway to the mouth with

A

CN IX

78
Q

what are the longitudinal muscles of the pharynx

A

stylopharyngeus
palatopharyngeus
salpingopharyngeus

79
Q

where do all the longitudinal muscles of the pharynx insert

A

onto posterior border of thyroid cartilage

80
Q

what is the role of the longitudinal muscles of the pharynx

A

elevate pharynx and larynx

81
Q

what innervates palatopharyngeus and salpingopharyngeus

A

CN X

82
Q

what is in the nasopharynx

A 
choanae 
torus tubarius (above opening of the eustachian tube) 
pharyngeal recess 
salpingopharyngeal fold 
opening to eustachian tube
83
Q

what is in the oropharynx

A

palatine tonsils palatoglossal arch palatopharyngeal arch

lingual tonsil

84
Q

what is in the laryngopharynx

A 
laryngeal aditus (inlet) 
piriform fossa (recess)
85
Q

what is the role and position of the waldeyers tonsillar ring

A

within mucosa of the naso and oropharynx

defence against invading pathogens

86
Q

how many pairs of tonsils do you have - name them

A 
4 
pharyngeal (adenoid)
tubal 
palatine 
lingual
87
Q

what are regional nodes

A

the group of lymph nodes that first receive the lymph that has drained from a given structure

88
Q

what are the regional nodes for the tip of the tongue

A

submental nodes

89
Q

where are the submental nodes

A

in the neck posterior to the mental process of the mandible

90
Q

where are submandibular nodes

A

superficial to the submandibular gland

91
Q

what nodes drain the palatine tonsils

A

jugulo-diagastric

92
Q

where are the deep cervical nodes

A

in the carotid sheath

93
Q

what are lymph nodes like in infection

A 
swollen 
painful
soft
smooth
not fixed (stuck to) adjacent structures
improve rapidly with antibiotics etc.
94
Q

what are lymph nodes like in cancer

A 
swollen
not painful
hard
irregular
fixed

do not improve

95
Q

where do midline structures usually drain

A

bilaterally (across the midline)

96
Q

where are the parotid nodes

A

pre auricular

97
Q

where are the mastoid nodes

A

post auricular

98
Q

where do you palpate the deep cervial nodes

A

along the internal jugular vein

99
Q

where do you palpate the superficial cervical nodes

A

along the external jugular vein

ENT (27 decks)

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