Oral Cavity/Pharynx Flashcards by Kara Albright

Palate

skeletal muscle over hard (anterior 2/3) and soft (post 1/3) palates

uvula extends inferior to soft palate, helps elevate to close off oropharynx in swallowing

fauces--> opening b/t oral cavity and oropharynx
    bounded by paired 
    muscular folds:
             glossopalatine arch 
                  (anterior)
             pharyngopalatine arch 
                     (posterior)

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Where are palatine tonsils located?

Between glossopalatine arch and pharyngopalatine arch

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What are removed during tonsillectomy?

Palatine tonsils

Can damage CN IX or ICA if tortuous b/c both are lateral to tonsils

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Tongue Histo/Anatomy

skeletal muscle covered with lightly keritanized stratified squamous epithelium

compress partially digested food against palate–> bolus

inferior surface attached by lingual frenulum

papillae on superior surface

lingual tonsils on posterior surface

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Salivary Glands

produce and secrete saliva to digest

increased during mealtime (1-1.5L / day)

submandibular>parotid>sublingual

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Neural Control of Saliva

CN IX parasympathetic stimulate parotid

CN VII parasympathetic stimulate submandibular and sublingual

Sympathetic cervical ganglia–>mucus secretion in lungs (beta receptor)

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Parotid Gland

CN IX stimulation

Anterior inferior to ears

Largest salivary gland–> 25-30% saliva through parotid gland to oral cavity, opens into oral vestibule (space b/t cheek and gums) next to 2nd upper molar

–>serous secretion

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Submandibular Gland

inferior to body of mandible

most saliva (60-70%)

duct from each gland–> papilla in floor of mouth lateral to lingual frenulum

–> mucous and serous secretion

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Sublingual Gland

inferior to tongue, internal to oral cavity mucosa

multiple tiny glands that open to inferior surface of oral cavity (post to submandibular gland papilla)

–> mucous mainly, some serous secretion

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Saliva

moistens food, help turn into bolus

moistens and cleans oral cavity

1st step–> breakdown carbs via amylase

ABX (lysozyme) inhibits bacterial growth in oral cavity

–> dissolved material activate taste receptors

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Teeth- overview

mechanical digestion

exposed crown, constricted neck, 1+ roots anchored to jaw (dental alveoli) via periodontal ligaments–> gomphosis joint

alveoli (bone) in maxilla and mandible

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Teeth- infant vs adult

Infant: deciduous teeth b/t 6-30 months
lost, replaced by 32
permanent

Anterior appear 1st

3rd molars in late teens–> wisdom teeth, can be impacted (no space in alveoli)

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Teeth-types

Infant: upper teeth overview
 central incisor (2)- 7 to 9 mo.
 lateral incisor (2)- 9 to 11 mo.
 canine (2)- 18-20 mo.
 1st molar (2)- 14 to 16 mo.
 2nd molar (2)- 24 to 30 mo.

Adult: upper teeth overview
 central incisor 7-8 yrs
 lateral incisor 8-9 yrs
 canine 11-12 yrs
 1st premolar 10-11 yrs
 2nd premolar 10-12 yrs
 1st molar 607 yrs
 2nd molar 12-13 yrs
 3rd molar 17-25 yrs

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Describe the look of each tooth type

central: flat
lateral: pointed
canine: 2 roots, indented
molar: typical tooth, multiple
roots, deeply indented
premolar: bicuspids

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Anatomy of Swallowing

1: voluntary
    bolus compressed against 
     palate, pushed into 
     oropharynx by tongue and 
     soft palate muscles

2: involuntary and rapid
soft palate elevated to seal
off nasopharynx

pharyx widens and 
 shortens to receive bolus

suprahyoid muscles and 
 longitudinal pharyngeal 
 muscles contract to 
 elevate larynx

3: involuntary
    sequential contraction of 
     all 3 pharyngeal 
     constrictor muscles moves 
     bolus to esophagus

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Tensor veli palatini vs Levator veli palatini muscles

Tensor veli palatini: CN V3
  tenses soft palate, acts on 
  Eustachian tube 
  (pharyngotympanic tube) to 
  depressurize middle ear

Levator veli palatini: CN X-
pharyngeal plexus
elevates tensed palate, also
acts on Eustachian tube

PARALYSIS–> reflux of oral components into nasal cavity or Eustachian tube dysfunction

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N/A/L of teeth

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Superior (CN V2) and Inferior (CN V3) alveolar nerves create dental plexus that supply teeth

Superior and inferior alveolar arteries (maxillary A) supply teeth

Lymph–> submandibular lymph nodes

Sublingual gland innervation pathway

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Presynaptic parasympathetic secretomotor fibers on chorda tympani (CN VII) to lingual nerve (CN V3)–> synapse in submandibular ganglion–> go to gland along with postsynaptic sympathetic fibers from superior cervical ganglion

–> SAME AS SUBMANDIBULAR

Submandibular gland innervation pathway

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–> SAME AS SUBLINGUAL

Submandibular-Nerve relationships

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Lingual N goes beneath submandibular duct and terminates as several medial branches
Hypoglossal N deep to gland–> digastric muscle
Facial N (marginal mandibular branch) exits anterior-inferior parotid gland @ angle of jaw and runs inferior to submandibular gland

Lymph drainage of tongue

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1) root of tongue drains BL to superior deep cervical LNs
2) medial part of body drains BL to inferior deep cervical LNs
3) BL lateral parts of body drain to submandibular LN on ipsilateral side
4) apex and frenulum (tip and front underside) drain to submental LNs

–> ultimately to deep cervical LN to venous system via jugular venous trunks

Palatine tonsil relationships/drainage

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Located between palatoglossal and palatopharyngeal arches

CN IX lateral and posterior to tonsil

Inneravtion via CN V2 and CN IX

Lymph drain into jugulo-digastric (upper) deep cervical lymph nodes

Removed in tonsillectomy d/t tonsillitis

Complication of bacterial tonsillitis is peritonsillar abscess that requires drainage

Lymph drainage of tongue

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–> ultimately to deep cervical LN to venous system via jugular venous trunks

Tensor veli palatini M

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M of soft palate

scaphoid fossa of medial pterygoid plate, sphenoid bone and cartilage of Eustachian tube–> palatine aponeurosis

CN V3- medial pterygoid nerve via otic ganglion

Tenses soft palate, opens Eustachian tube during swallowing and yawning

Levator veli palatini M

cartilage of Eustachian tube and temporal bone--> palatine aponeurosis Pharyngeal branch of CN X Elevates tensed soft palate during swallowing and yawning

Palatoglossus M

palatine aponeurosis-->side of tongue Pharyngeal branch of CN X Elevates posterior part of tongue and draws soft palate onto tongue Extrinsic muscle of tongue

Genioglossus M

Extrinsic muscle of tongue bulk of tongue: spine of mandible-->dorsum of tongue and hyoid bone Depress tongue, pull anteriorly for protrusion, retracts tip of tongue, deviate to contralateral side

Styloglossus M

Extrinsic muscle of tongue styloid process--> posterior sides of tongue Retrude tongue, curls sides w/ genioglossus to form central canal for swallowing

Hyoglossus M

Extrinsic muscle of tongue hyoid-->inferior lateral tongue Depress tongue, pull sides inferiorly, retrude tongue

Genioglossus M

Extrinsic muscle of tongue CN X bulk of tongue: spine of mandible-->dorsum of tongue and hyoid bone Depress tongue, pull anteriorly for protrusion, retracts tip of tongue, deviate to contralateral side

Styloglossus M

Extrinsic muscle of tongue CN X styloid process--> posterior sides of tongue Retrude tongue, curls sides w/ genioglossus to form central canal for swallowing

Hyoglossus M

Extrinsic muscle of tongue CN X hyoid-->inferior lateral tongue Depress tongue, pull sides inferiorly, retrude tongue

Intrinsic Ms of tongue

CN X superior longitudinal inferior longitudinal transverse vertical curls tongue, protrudes tongue, flattens and broadens tongue

Superior Pharyngeal Constrictor M

External pterygoid, mylohyoid, mandible, tongue--> occipital bone Pharygneal branch of CN X Constrict walls of pharynx during swallowing

Middle Pharyngeal Constrictor M

External Stylohyoid L, hyoid--> pharyngeal raphe Pharyngeal branch of CN X, recurrent laryngeal nerves Constrict walls of pharynx during swallowing

Inferior Pharyngeal Constrictor M

External Thyroid cartilage, cricocartilage--> encircles pharyngo-esophageal junction without forming a raphe Constrict walls of pharynx during swallowing

Salpingopharyngeus M

Internal Pharyngeal branch of CN X cartilage of Eustachian tube--->blends with palatopharyngeus on thyroid cartilage, pharynx and espophagus Elevate larynx, shorten pharynx during swallowing and speaking

Stylopharyngeus M

Internal CN IX Styloid process--> thyroid cartilage with palatopharyngeus Elevate larynx, shorten pharynx during swallowing and speaking

Waldeyer's lymphatic ring

Palatine tonsils Pharyngeal (adenoid) tonsils Lingual tonsils --> all drain to deep cervical LNs

Pharyngeal plexus

Sensory of oropharynx (CN IX) and laryngopharynx (CN X) Nasopharynx above Eustachian tube (CN V2)

Gag reflex

More superior--> CN IX More inferior--> CN X

Inferior Alveolar Nerve Block

branch of CN V3 inject around mandibular foramen teeth of median plane, skin and mucous of lower lip, gums, skin of chin (d/t supplied by mental N) -->pterygoid trismus if poorly injected into parotid gland or medial pterygoid M

Oral Cavity/Pharynx Flashcards

(42 cards)