9. Oral Cavity, Tongue And Pharynx

Question 1

Look at lectures for anatomy

Answer 1

Pls

Question 2

What are the intrinsic muscles of the tongue?

Answer 2

4 paired muscles - longitudinal, transverse, vertical

Motor innervation from hypoglossal nerve

Question 3

What are the extrinsic muscles of the tongue?

Answer 3

Arise form other structures and insert into tongue
Genioglossus (hypoglossal nerve)
Hyoglossus (hypoglossal nerve)
Styloglossus (hypoglossal nerve)
Palatoglossus (vagus nerve)

Question 4

What is the sensory of the tongue divided into?

Answer 4

Anterior 2/3 - sensation (Vc), taste (facial)

Posterior 1/3 - sensation and taste (glossopharyngeal)

Question 5

Describe the submandibular salivary glands

Answer 5

Produces 60% of saliva, located in submandibular triangle, exits at Wharton ducts under tongue

Question 6

What are the borders of the submandibular triangle?

Answer 6

Mandible
Anterior belly of digastric muscle
Posterior belly of digastric muscle

Question 7

Describe the parotid salivary glands

Answer 7

Lies posterior to masseter and inferior to zygomatic arch, anterior to sternocleidomastoid
Duct opens through Stensen duct

Question 8

Describe the sublingual salivary glands

Answer 8

Only produce 3-5% saliva

8-20 excretory ducts per gland

Question 9

What are sialolithiasis?

Answer 9

Salivary gland stones
Most located in submandibular glands
Most less than 1cm diameter

Question 10

What are the symptoms of salivary gland stones?

Answer 10

Pain in gland
Swelling
Infection
Eating stimulates symptoms

Question 11

How do you diagnose salivary gland stones?

Answer 11

History
X-ray
Sialogram

Question 12

What are the symptoms of tonsillitis?

Answer 12

Fever
Sore throat
Pain/difficulty swallowing
Swollen cervical lymph nodes
Bad breath

Question 13

If tonsillitis is bacterial, what organism is usually responsible?

Answer 13

Strep pyogenes

Question 14

What are the symptoms of peritonsillar abscess?

Answer 14

Severe throat pain
Fever
Drooling
Difficulty opening mouth
Can follow on from an untreated or partially treated tonsillitis
Deviated uvula

Question 15

What are the boundaries of the nasopharynx?

Answer 15

Base of skull to upper border of soft palate
Posterior - C1, C2
Anterior - nasal cavity

Question 16

What does the nasopharynx contain?

Answer 16

Pharyngeal tonsil

Question 17

What happens if the pharyngeal tonsil (adenoid) enlarges?

Answer 17

Blocks Eustachian tube - recurrent middle ear infections
Snoring/sleep apnoea
Sleeping with mouth open
Chronic sinusitis
Nasal tone to voice

Question 18

What are the boundaries of the oropharynx?

Answer 18

Soft palate to epiglottis
Anterior - oral cavity
Posterior - C2, C3

Question 19

What does the oropharynx contain?

Answer 19

Palatine tonsils

Question 20

What are the boundaries of the laryngopharynx?

Answer 20

Oropharynx to oesophagus
Epiglottis to cricoid cartilage
Anterior - larynx
Posterior - C4, C5, C6

Question 21

What does the laryngopharynx contain?

Answer 21

Piriform fossa

Question 22

What are the 3 longitudinal muscles that elevate the pharynx and larynx during swallowing?

Answer 22

Stylopharyngeus
Palatopharyngeus
Salpingopharyngeus

Question 23

Where does the stylopharyngeus originate and insert?

Answer 23

Originates from styloid process

Inserts onto posterior border of thyroid cartilage

Question 24

What is the innervation of the stylopharyngeus?

Answer 24

Glossopharyngeal nerve

Question 25

Where does the palatopharyngeus originate and insert?

Answer 25

Originates - hard palate | Inserts - posterior border of thyroid cartilage

Question 26

What is the innervation of the palatopharyngeus?

Answer 26

Pharyngeal branch of vagus

Question 27

Where does the salpingopharyngeus originate and insert?

Answer 27

Originates - cartilaginous part of Eustachian tube | Inserts - merges with palatopharyngeus

Question 28

What is the innervation of the salpingopharyngeus?

Answer 28

Pharyngeal branch of vagus

Question 29

What are the pharyngeal constrictors?

Answer 29

3 circular muscles that constrict walls of pharynx when swallowing Superior, middle and inferior pharyngeal constrictors All insert onto pharyngeal raphe

Question 30

What is the innervation of the pharyngeal constrictors?

Answer 30

Vagus

Question 31

What is a pharyngeal pouch?

Answer 31

A posteromedial false diverticulum | Arises in weakness between 2 parts o inferior constrictor - killian’s dehiscence

Question 32

What is a pharyngeal pouch usually due to?

Answer 32

Failure of UOS to relax | Abnormal timing of swallowing

Question 33

What is the motor innervation of the pharynx?

Answer 33

CNX except stylopharyngeus which is CNIX

Question 34

What is the sensory innervation to the nasopharynx?

Answer 34

CNVb

Question 35

What is the sensory innervation to the oropharynx?

Answer 35

CNIX

Question 36

What is the sensory innervation to the laryngopharynx?

Answer 36

CNX

Question 37

Give a summary of the oral phase of swallowing

Answer 37

Voluntary Preparatory phase - making bolus Transit phase - bolus compressed against palate, pushed into oropharynx by tongue and soft palate CNXII

Question 38

Give a summary of pharyngeal phase of swallowing

Answer 38

``` Involuntary Tongue positioned against hard palate Soft palate elevates Suprahyoid and longitudinal muscles shorten Epiglottis closes over larynx Bolus moves though pharynx Relaxation of UOS ```

Question 39

Give a summary of the oesophageal phase of swallowing

Answer 39

Involuntary Upper striated muscle of oesophagus and lower smooth muscle contract to move bolus down LOS relaxes

Question 40

What are the signs and symptoms of dysphagia?

Answer 40

``` Coughing and choking Sialorroea (drooling) Recurrent pneumonia Change in voice/speech Nasal regurgitation ```

Question 41

What problems can be caused with IX or X injuries?

Answer 41

``` Absent gag Uvula deviated away from lesion Dysphagia Taste impairment (posterior tongue) Loss fo sensation of oropharynx ```

Question 42

What can happen with CNXII nerve problems?

Answer 42

Wanted tongue Stick tongue out - tongue may deviate Fasciculations