Why are the sublingual veins important clinically?
Absorption of sublingual meds
Why are the salivary ducts important?
- They can become obstructed causing pain
- Parotid gland secretes mucus and amylase
- Submandibular and sublingual glands a more serous fluid
What is the anatomical importance of the uvula?
It closes off the nasopharynx. (If the uvula is surgically removed, food can reflux into the nasopharynx)
What is the anatomical importance of the anterior
and posterior arches (palatoglossal and palatopharyngeal) surrounding the palatine tonsil?
Accidently removing them can cause speech impediments
Which salivary duct becomes obstructed most
often? Why?
Stensen’s duct is the most frequent salivary gland to have stones (parotid) Why?
- Iincidence of stones has been increasing as people have become more and more relatively dehydrated
- Also salivary amylase is produced here and also in the pancreas, so that blood levels of amylase reflect the concentrations provided by both glands
What structures are involved in cleft palate?
Upper Lip, soft and hard palate
How does cleft palate result in malnutrition?
Cleft palate creates a condition where breathing and chewing cannot occur at the same time so
decreased amounts are taken in
What are the anatomical parts of the tooth?
Cusps, tooth socket, clinical crown, anatomical crown, periodontal membrane
Describe the cusps of the tooth
Elevations present on the occlusal (biting) surface of posterior teeth
Describe the tooth socket
The alveolus/alveolar process of the maxilla or mandible (which is covered by perosteum) forms a fibrous membrane called the periodontal membrane
What is Gomphosis?
Dental-alveolar joint (aka periodontal membrane)
“joint that binds the teeth to bony sockets (dental alveoli) in the maxillary bone and mandible”
What is the difference between the clinical crown and the anatomical crown?
Anatomical crown is the superior portion of the tooth that is covered by enamel.
Clinical crown is the portion of the anatomical crown that is visible above the gingiva.
Why is the anatomical crown important?
It provides the explanation why dentists say it is so important to floss (you need to clean around the
hidden anatomical crown)
Some teeth have variable number of roots, why is this important?
- The dentist might miss one during a root canal
- Tooth morphology is important because the loss of certain teeth means that you have to alter the diet of individuals (for instance molars are used for grinding and crushing… so if they are missing the person has to have a “soft mechanical diet”)
What are the dental formulas for deciduous teeth?
Deciduous = 20 8 incisors 4 canines 0 premolars 8 molars
What are the dental formulas for permanent teeth?
Permanent = 32 8 incisors 4 canines 8 premolars 12 molars
Which branch of which nerve does the dentist block?
V3 The mandibular division of the trigeminal nerve
Why, when the dentist numbs your gums, does your tongue numb? And why does your tongue not work well afterword?
1) Blocking the mandibular branch will also block part of the tongue.
2) V3 is mixed, both sensory and some motor
What is a T&A, and what structures are involved?
T&A = Tonsillectomy and Adenoidectomy
There are 3 tonsils 2 of them, adenoids and palatine, were removed in the past. Now mostly just the palatine tonsils are removed surgically.
Where is the epiglottis and what does it do? What can happen to it?
Epiglottis is attached to the root of the tongue, and gaits food into the esophagus keeping it from going down the trachea. It can become infected (epiglottitis)
What are the 5 types of chemoreceptors found in the tongue?
Sweet -sugars
Sour - acids (citric, lactic)
Salty - salts (NaCl, NaI, KCl)
Bitter - complex organic molecules, aspirin
Unami - amino acids, MSG (glutamic acid) “savory, meaty, brothy”
Why is tasting bitter important?
Bitter tastes are often poisons. People have a strong reaction not to swallow bitter
What are the four types of tongue papillae?
Filiform, fungiform, circumvallate, foliate
What do fungiform papillae do? Where are they located?
Fungiform - anterior part of the tongue (pink dots) and contain one or more taste buds, involved in taste
What do circumvallate papillae do? Where are they located?
Circumvallate(12) - distributed in the shape of an inverted V near the back of the tongue, involved in taste
What do filiform papillae do? Where are they located?
Filiform - no taste buds, for touch, pain and temperature
small prominences on the surface of the tongue. most numerous, covering most of the dorsum (upper surface)
What do foliate papillae do? Where are they located?
Foliate - in small trenches on the sides of the posterior tongue, involved in taste
Which nerve innervates the pharyngeal constrictor muscles? Which nerve innervates the UES?
CN X (Vagus) innervates both
Why was the uvula removed? Did it work?
Previously we believed that snoring was causing obstructive sleep apnea, so we started surgically removing the uvula, which we felt was causing the obstruction. It cured the snoring, but not the sleep apnea.
What causes cavities (carries)?
Metabolic byproducts of bacteria like lactic acid
What is xerostomia and what role does xerostomia play in development and why?
Dry mouth. Decreases circulating IgA
What is periodontitis?
Infection of the alveolar socket (formerly known as pyorrhea) extension of gingivitis
What is Waldeyer’s ring, and what does it do?
A network of lymphatic tissue in the pharynx that acts as the first line of defense against inhaled or ingested pathogens. Consists of all the tonsils and other lympatic tissue.
Which taste receptors are membrane channels, and which are TMR (transmembrane receptors)?
Salty and sour are membrane channels. Sweet, Bitter and Unami are trans-membrane receptors.
What is the ion channel for salty taste receptors?
Salty – Na+ channel
What is the ion channel for sour taste receptors?
Sour - H+/K+ channel
Which 2nd messenger does Bitter use?
IP3
Which 2nd messenger does Sweet use?
cAMP
Which 2nd messenger does Unami use?
IP3 ?? (unknown)
What is the common mechanism that most of the taste receptors share?
depolarization –> Ca++ influx –> transmitter release –> increase firing of afferent nerve
Which CN provides motor innervation to the tongue? Why is this important?
CN XII (hypoglossal) When trying to localize the site of a tumor or stroke, the cranial nerves are examined. If the tongue deviates during the exam, it indicates the location at which the stroke or tumor acting (the nucleus or nerve root of CN XII)
Which nerve innervates the posterior pharynx? Why is this important?
CN IX, It is used to test the gag reflex, for example after a stroke
What type of cells line the Nasopharynx?
Ciliated mucus membrane (pseudostratified columnar ciliated epithelium with Goblet cells) line the respiratory tract. (wherever air and only air flows, those passageways will be lined with cilia)
Why is it important to know what types of cells line different areas?
Different areas have different linings, these are important to know because they indicate which types of tumors are likely to be present. For example if an area is lined with squamous cells, it is likely that a cancer there would be squamous cell carcinoma, if the area is lined with columnar cells, they are likely to get adenocarcinoma there.
Squamous cell carcinomas are likely to form in the oropharynx. Why?
The oropharynx is lined with squamous epithelium. (non-keratinizing stratified epithelium).
What structures “closes” the airway so that food does not travel to the lungs
The epiglottis
What is stomatitis?
Inflammation of the mucus membrane of any of the structures of the mouth. May involve the buccal mucosa, gums, tongue, lips, throat or palate
What causes stomatitis?
Inflammation can be caused by poor oral hygiene, dietary protein deficiency, poorly fitted dentures, burns from hot food or drinks, toxic plants, or by conditions that affect the entire body, such as infections and allergic reactions. Viral aphthous ulcers.Stevens Johnson syndrome.
What causes thrush?
Oral Candida
Where can Candida be found?
Anywhere in the oral cavity and esophagus (and other places not covered in the GI lectures)
