15 Oral Cavity and Pharynx

Question 1

Fill in the missing labels:

Answer 1

Question 2

The tongue has intrinsic and extrinsic muscles. How many intrinsic muscles are there, how are they orientated and which nerve are they innervated by?

Answer 2

• 4 paired intrinsic muscles
• 3 axis of orientation
• Hypoglossal nerve innervation (CN XII)

Question 3

Identify the extrinsic muscles of the tongue on the following diagram:

Answer 3

Question 4

Which nerves supply the special sensory and general sensory innervation to the tongue?

Answer 4

Question 5

Via which ducts does saliva enter the oral cavity?

Answer 5

• Parotid: Stensen duct (medial and superior to second molar)
• Submandibular: Wharton duct (under tongue)
• Sublingual: multiple ducts- floor of oral cavity

Question 6

What is sialolithiasis? How is it caused? What are the symptoms? How is it diagnosed?

Answer 6

• What?
  
  • Salivary gland stones (most in submandibular glands)
• How is it caused?
  
  • Dehydration, reduced salivary flow
• Symptoms?
  
  • Pain in gland
  • Swelling
  • Infection
• Diagnosis?
  
  • X-ray, sialogram (dye)

Question 7

What causes tonislitis? What are the symptoms?

Answer 7

• Viral- most common
• Bacterial- up to 40%
  
  • Strep pyogenes

Symptoms:

• Fever
• Sore throat
• Dysphagia
• Bad breath

Question 8

How might a peritonsillar abscess be caused? What are the symptoms?

Answer 8

Question 9

What are the boundaries of the nasopahrynx?

Answer 9

Question 10

If a patient has enlarged adenoids (pharyngeal tonsils), what symptoms might they present with?

Answer 10

Question 11

What are the boundaries of the oropharynx and which tonsils are contained within it?

Answer 11

Question 12

What are the boundaries of the laryngopharynx?

Answer 12

Question 13

Name the 3 muscles that elevate the pharynx and larynx during swallowing and state their innervations. (2 are identifiable on this diagram)

Answer 13

Stylopharyngeus- CN IX

Palatopharyngeus- Pharyngeal branch of vagus, CN X

Salpingopharyngeus- Pharyngeal branch of vagus, CN X

Question 14

Name and identify the 3 circular muscles that constrict the walls of the pharynx during swallows and what nerve are they innervated by?

Answer 14

Question 15

What is a pharyngeal pouch?

Answer 15

Posteromedial diverticulum

• in weakness between 2 parts of inferior constrictor muscle (Killian’s dehiscence

Question 16

How is a pharyngeal pouch caused?

Answer 16

Question 17

Useful summary of nerve innervation to pharynx:

Answer 17

Question 18

What symptoms may be caused by damage to the hypoglossal nerve (XII) ?

Answer 18

Question 19

Give a possible cause of damage to the cranial nerves IX and X.

Answer 19

Medullary infarct

Jugular foramen issue (fracture)