Oral Cavity, TMJ And Tongue

Question 1

What forms the roof of the oral cavity?

Answer 1

Hard and soft palate

Question 2

What forms the lateral wall of the oral cavity?

Answer 2

Cheek

Buccinator muscle

Question 3

What is the anterior boundary of the oral cavity?

Answer 3

Oral fissure

Question 4

What is the posterior boundary of the oral cavity?

Answer 4

Oropharyngeal isthmus

Opening to oropharynx

Question 5

What is the floor of the oral cavity?

Answer 5

Tongue and other soft tissues

Question 6

What is the oral vestibule?

Answer 6

Space between teeth and cheek/lips

Running tongue along outside of teeth

Question 7

What are alternative names for the anterior and posterior arches of the oral cavity?

Answer 7

Anterior = palatoglossal 
Posterior = palatopharyngeal

Question 8

What muscles form part of the soft palate and what is their function?

Answer 8

Palatoglossus
Palatopharyngeus
Tense and elevate the soft palate during yawning and swallowing

Question 9

What nerve innervates the muscles of the soft palate?

Answer 9

Vagus nerve

Question 10

What is the sign in the oral cavity if the vagus nerve is damaged?

Answer 10

Uvula pulled AWAY FROM side of affected nerve

Question 11

Describe the limbs of the gag reflex

Answer 11

Afferent = glossopharyngeal - sensory to back of tongue and throat 
Efferent = vagus - motor to pharyngeal muscles of soft palate

Question 12

Name the different types of teeth in the mouth from front to back

Answer 12

Central incisor 
Lateral incisor
Canine 
First premolar
Second premolar
First molar
Second molar
Third molar/wisdom tooth

Question 13

What is the sensory supply to the lower jaw?

Answer 13

Inferior alveolar nerve

Branch of V3

Question 14

What are the extrinsic muscles of the tongue and give their action?

Answer 14

Styloglossus - elevate
Hyoglossus - depress and retract
Genioglossus - protrude

Question 15

Name the intrinsic muscles of the tongue and their actions

Answer 15

Superior and inferior longitudinal - curl up or down
Vertical - flatten tongue
Transverse - pull in tongue, make smaller and rounder

Question 16

Which nerve innervates the tongue muscles?

Answer 16

Hypoglossal

Question 17

Describe the innervation to anterior 2/3 of tongue

Answer 17

General sensory = V3 (mandibular of trigeminal)

Special sensory = VII (chorda tympani of facial nerve)

Question 18

Describe the innervation to posterior 1/3 of tongue

Answer 18

General and special sensory via glossopharyngeal nerve

Question 19

Which is the only tongue muscle not innervated by hypoglossal and which nerve innervates it?

Answer 19

Palatoglossus

Vagus

Question 20

If there is a lesion of hypoglossal nerve, how will it present in the tongue?

Answer 20

Tongue deviation TOWARDS the side of the lesion

Question 21

Give the names of the ducts that the parotid and submandibular glands drain via

Answer 21

Parotid = Stenson's 
Submandibular = Wharton's

Question 22

Which salivary gland has many ducts?

Answer 22

Sublingual

Question 23

Salivary stones are usually …. based

Answer 23

Calcium

Question 24

Which is the most common salivary gland to get a stone in and why?

Answer 24

Submandibular

Normal salvia is comparatively thicker from here

Question 25

What are the Sx of a salivary stone?

Answer 25

Pain or swelling of a gland at meal times

Question 26

What are the most common viral causes of tonsillitis?

Answer 26

Rhinovirus | Adenovirus

Question 27

What are the most common bacterial causes of tonsillitis?

Answer 27

Beta haemolytic strep

Question 28

How do we tell the difference between bacterial and viral tonsillitis?

Answer 28

``` Viral = Sx of URTI eg. Dry cough Bacterial = lymphadenopathy, fever and pus (often absence of cough) ```

Question 29

What is a peritonsillar abscess?

Answer 29

Quinsy | Severe complication of bacterial tonsillitis

Question 30

Which bacteria are most likely to cause quinsy?

Answer 30

Strep pyogenes Staph aureus H influenzae

Question 31

Describe the signs and Sx of quinsy

Answer 31

Systemically unwell and trismus Pain in mouth - cannot open much Drooling due to dysphagia Unilateral - uvula may deviate away

Question 32

What is the Mx for quinsy?

Answer 32

Same day referral to ENT | Drainage and Abx

Question 33

Describe the TMJ

Answer 33

``` Jaw joint Modified synovial hinge joint Between cranium (temporal bone) and mandible ```

Question 34

Where does the condyle of the mandible sit?

Answer 34

In the mandibular fossa of the articular tubercle of the temporal bone

Question 35

What are the 3 ligaments supporting the TMJ?

Answer 35

Lateral lig (TM lig) - main one Stylomandibular lig Sphenomandibular lig

Question 36

Which muscles elevate the mandible?

Answer 36

Temporalis Masseter Medial pterygoid

Question 37

Which muscles depress the mandible?

Answer 37

GRAVITY! | Lateral pterygoid, supra and infrahyoid

Question 38

Which muscle protrudes the mandible?

Answer 38

Lateral pterygoid

Question 39

Which muscle retrudes the mandible?

Answer 39

Temporalis

Question 40

Which muscles cause lateral movements of mandible?

Answer 40

Temporalis (on same side) Pterygoids (of opposite side) Masseter

Question 41

What are the muscles of mastication and what nerve innervates them?

Answer 41

Temporalis, masseter and pterygoids | Mandibular branch of trigeminal (V3)

Question 42

What is the common mechanism of TMJ dislocation?

Answer 42

Blow to the side of chin when the mouth is open | Anterior dislocation

Question 43

What is temporal arteritis?

Answer 43

A type of vasculitis Causes TMJ pain Must always think of because pt can lose eyesight Rare

Question 44

What is bruxism?

Answer 44

Grinding of teeth

Question 45

What is the infratemporal fossa?

Answer 45

Irregularly shaped space deep and inferior to the zygomatic arch and deep to ramus of the mandible

Question 46

What is the contents of the infratemporal fossa?

Answer 46

``` Inferior part of temporalis muscle Lateral and medial pterygoid Maxillary artery Pterygoid venous plexus Lots of nerves (V3 and branches of, chorda tympani and otic ganglion) ```

Question 47

What is the otic ganglion?

Answer 47

PNS supply to parotid gland | Glossopharyngeal nerve

Question 48

What is the clinical relevance of the infratemporal fossa?

Answer 48

Isolated infections can occur here (rare) Infections can causes cavernous sinus thrombosis - connected via venous plexus And fossa can be used as a site for mandibular nerve block