Oral Cavity & Pharynx

Question 1

What are the borders of the oral cavity?

Answer 1

Lateral: Muscles of Buccinator

Roof: Soft and Hard Pallette

Floor: 2 Myohyoid muscles, tongue and other soft tissues

Question 2

Name the features of the oral cavity

Answer 2

Question 3

What is sialolithiasis?

Answer 3

Stones of the salivary glands causing significant painand swelling particularly after eating

Question 4

What are the different types of muscle in the tongue?

Answer 4

Intrinsic and Extrinsinc Muscles

Question 5

What is the motor innervation of the muscles of the tongue?

Answer 5

Hypoglossal (CN XII)

Question 6

Name the extrinsic muscles of the togue and give their motor innervation

Answer 6

• Genioglossal - Hypoglossal
• Hypoglossus - Hypoglossal
• Styloglossus - Hypoglossal
• Palatoglossus - Vagus Nerve

Question 7

How do you test the function of the hypoglossal nerve? Which muscle is responsible for this action?

Answer 7

• Ask the patient to stick out their tongue
• Genioglossus muscle, innervated by hypoglossal nerve protrudes the tongue

Question 8

Describe the sensory innervation of the tongue

Answer 8

Question 9

What are the the 3 pairs of salivary glands?

Answer 9

• Parotid
• Submandibular
• Sublingual

Question 10

What is Warton’s Duct?

Answer 10

Duct connecting the submandibular salivary gland to the oral cavity for release of saliva

Question 11

What is the Stenson Duct?

Answer 11

The duct of the parotid gland that releases saliva into the oral cavity

Question 12

What are some of the symptoms of tonsilitis?

Answer 12

• Fever
• Pain/ difficulty swalling
• Cervical lymph nodes
• Bad Breath

Question 13

How does the uvula appear in tonsilitis?

Answer 13

Remains central

Question 14

How does the uvula appear in a peritonsilar abcess?

Answer 14

Uvula can deviate to one side

Question 15

What are some of the symptoms of a peritonsillar abscess?

Answer 15

• Severe throat pain
• Fever
• Bad Breath
• Drooling
• Difficulty opening mouth

Question 16

What are the boundaries of the Nasopharynx?

Answer 16

• Base of skull
• Posteriorally- C1 and C2
• Anteriorally - nasal cavity

Question 17

What is an adenoid?

Answer 17

An enlarged pharyngeal tonsil

Question 18

What are some of the effects of adenoids?

Answer 18

• Blocked Eustacian Tube → reccurrent middle ear infections
• Snoring / sleep apnoea
• Sleeping with mouth open
• Chronic Sinusitis
• Nasal tone to voice

Question 19

What are the boundaries of the oropharynx?

Answer 19

Anterior: oral cavity

Posterior: C2, C3

Runs from the soft palate to the epiglottis

Question 20

What are the contents fo the orophraynx?

Answer 20

The Palatine Tonsils

Question 21

What are the boundaries of the laryngopharynx?

Answer 21

Runs from the oropharynx to the oesophagus

Anterior: larynx

Posterior: C4, C5, C6

Question 22

What is the piriform fossa of the laryngopharynx?

Answer 22

Recesses either side of the laryngeal inlet that fluid can drain to if the epiglottis doesn’t close

Question 23

What are the 3 longitudinal muscles that elevate the pharynx and larynx during swallowing? What is the nerve innervation of each?

Answer 23

• Stylopharyngeus - Glossopharyngeal nerve CN IX
• Palatopharyngeus - Vagus Nerve CN X
• Salpingopharngeus - Vagus Nerve CN X

Question 24

What are the constrictors of the pharynx and what nerve innervates them?

Answer 24

• Superior pharyngeal constrictor
• Middle pharyngeal constrictor
• Inferior pharyngeal constrictor
  
  • Has 2 Parts: Thyropharyngeal
  • Cricopharyngeal
• All innervated by the Vagus Nerve

Question 25

What is **K****illian's Dehiscence?**

Answer 25

An area of weakness between thyropharyngeus and cricopharyngeus Pharyngeal mucosa can **herniate** through here during swalling causing a **pharyngeal pouch (diverticulum)**

Question 26

What is the **pharyngeal raphe?**

Answer 26

Line at the back of the pharynx where all the pharyngeal constrictors meet

Question 27

What is **Zenker's Diverticulum**?

Answer 27

Herniation of pharynx mucosa between the **2 inferior pharynx constrictors**

Question 28

What things can cause a rise in pressure in the pharynx which could cause Zenker's Diverticulum

Answer 28

* Failure of UOS to relax * Abnormal timing of smallowing * Weakness in Killian's Dehiscence

Question 29

Describe the **sensory** nerve innnervation of the pharynx

Answer 29

**Nasopharynx** - Maxillary branch of Trigeminal **Vb** **Oropharynx** - Glossopharyngeal CN **IX** **Laryngopharynx** - Vagus Nerve **CN X**

Question 30

What obvious signs suggest a problem with cranial nerves IX and X?

Answer 30

Absent gag reflex

Question 31

Which nerve is being tested when the patient is asked to say 'Ahhh'?

Answer 31

**Vagus Nerve** Ulva deviates **Away** from the lesion

Question 32

How would you test for a lesion in hypoglossal nerve CN XII?

Answer 32

Stick Tongue out - muscle wasting and may deviate **towards** the side of the lesion