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Block IV > Pharynx, Nasal Cavity, Oral Cavity > Flashcards

Pharynx, Nasal Cavity, Oral Cavity Flashcards

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1
Q

Nasal vestibule, respiratory region, and olfactory region

A

Vestibule - hair to catch particulates

Respiratory region- neurovascular supply & warmth

Olfactory region - lined by olfactory epithelium

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2
Q

4 air channels of the nasal cavity

A
  • Inferior nasal meatus between inferior concha & nasal floor
  • Middle nasal meatus: between inferior and middle concha
  • Superior nasal meatus: between middle and superior concha
  • Spheno-ethmoidal recess: between superior concha and nasal roof
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3
Q

The sphenopalatine foramen connects the nasal cavity to the …

The incisive canal connects the nasal cavity to the…

The foramen cecum connects the nasal cavity to…

A

Sphenopalatine foramen –> Pterygopalatine fossa

Incisive canal -> oral cavity

Foramen caecum -> emissary vein

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4
Q

What nerves give sensation in the anterior nasal cavity and external superior nose?

A

Anteiror & posterior ethmoidal nerves, which are branches off the ophthalmic nerve [V1].

Anterior ethmoidal terminate as external nasal nerve, giving sensation to the external skin of the superior nerve.

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5
Q

What goes through the sphenopalatine foramen? What does it do?

A

Maxillary nerve [V2] goes through and ultimately provides sensation to the posterior nasal cavity. Branches:

  • Posterior superior lateral nasal nerves
  • Posterior superior medial nasal nerves
  • Nasopalatine n
  • Posterior inferior nasal nerves
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6
Q

What separates the nasal cavity from the oral cavity? from the cranial cavity?

A

Separation from oral cavity - hard palate

Separation from cranial cavity - frontal, ethmoid, sphenoid bones

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7
Q

the superior and middle concha are part of what bone?

A

Ethmoid bone

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8
Q

Parasympathetic fibers for the nasal cavity come from

A

Facial nerve (CN7) joins branches of V2 in the pterygopalatine fossa (synapsing in the ptergopalatine ganglion) innervate the glands of the nasal cavity & sinus glands.

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9
Q

Sympathetics in the nasal cavity come from ___, synapse in ___ and then postgnagliionic fibers reach the NC along blood vessels or by joining V2

A

Come from T1

Synapse in superior sympathetic ganglion

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10
Q

The ICA supplies blood to the nose via ____

The ECA supplies blood to the nose via ____

A

ICA:

  • ophthalmic artery –> anterior & posterior ethmoidal arteries

ECA:

- maxillary artery –> sphenopalatine artery

  • facial artery –> superior labial artery
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11
Q

Nasal cavity venous drainage

A
  • Drain into cavernous sinus & pterygoid plexus posteriorly
  • Facial vein & nasal vein anteriorly
  • Emissary veins (allow for infection)
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12
Q

Nasal lymphatic drainage

A
  • Anterior: Submandibular and submental lymph nodes
  • Posterior: Retropharyngeal and anterior deep cervical nodes
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13
Q

Posterior ethmoidal sinus drains into the

A

Superior meatus

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14
Q

Anterior ethmoidal sinus, maxillary sinus, and frontal sinus drain into the

A

Middle meatus

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15
Q

Nasolacrimal duct drains into

A

inferior meatus

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16
Q

Sphenoid sinus drains into

A

sphenoethmoidal recess

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17
Q

Innervation of the frontal sinus

A

Supraorbital nerve from ophthalmic n (V1)

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18
Q

Maxillary sinuses open near the top in the center of the semilunar hiatus. What is their innervation?

A

Infraorbital and alveolar branches of the maxillary nerve (V2)

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19
Q

Ethmoid cells fill the ethmoidal labyrinth on each side.

  • Anterior ethmoid cells open into the ___ or ___.
  • Middle ethmoid cells open onto the ___ or the ___
  • Posterior ethmoid cells open onto the _____
  • The anterior & posterior are innervated by ___ and ___ from ___ and __ by way of branches from the __ ganglion
A

Anterior ethmoid cells open into the ethmoidal infundibulum or frontal nasal duct.

Middle ethmoid cells open onto the ethmoidal bulla or the lateral wall of nasal cavity above the bulla

Posterior ethmoid cells open onto the lateral wall of superior nasal meatus

The anterior & posterior are innervated by anterior** and **posterior ethmoidal branches of nasociliary n from V1 and V2 by way of branches from the pterygopalatine ganglion

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20
Q

Sphenoid sinuses open onto the roof of the nasal cavity on the posterior wall of the ____

What is their innervation?

A

Posterior ethmoidal branch of V1 and maxillary [V2] by way of branches from the pterygopalatine ganglion

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21
Q

An autonomic pathway from the CNS to the mucous membrane of the inferior nasal concha would include which ganglia?

A

Pterygopalatine ganglion

Parasympathetics provide secretomotor fibers to the glands in the mucosa of the nasal cavity and paranasal sinuses. Preganglionic parasympathetic fibers synapse with postganglionic ones in the pterygopalatine ganglia.

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22
Q

You push a curved probe through the inferior aspect of the maxillary sinus. What space/cavity might you see the tip of the probe in?

A

Oral cavity.

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23
Q

A child puts a rock up her nose and affects the drainage of the inferior nasal meatus. What symptom is most likely to occur?

A

Tearing of the ipsilateral eye.

Nasolacrimal duct from the orbit empties into the inferior nasal meatus. The ipsilateral eye’s tears cannot drain inferiorly and teasr will exude over the lower eyelid.

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24
Q

What makes up the floor of the oral cavity? What’s the innervation?

A

Mylohoid and geniohyoid muscles

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25
What bones make up the hard palate?
Anteriorly, the palatine process of the maxilla Posteriorly, the horizontal plate of palatine bone
26
**Buccinator muscle** runs from pterygomandibular raphe, alveolar part of mandible, and alveolar process of maxilla to blend with the orbicularis oris muscle & modiolus. Holds cheek against alveolar arches and keeps food between the teeth durign mastication. What innervates the buccinator muscle?
Facial n (CN7)
27
**Tensor veli palatini** vs **Levator veli palatin**i - function & innervation
**Tensor veli palatini** tenses the soft palate to open the pharyngotympanic tube; innervated by **mandibular n (V3)** **Levator veli palatini** elevates the soft palate; innervated by **vagus**
28
Function of soft palate
Valve that can close the orpharyngeal isthmus using the **uvula** and separate the nasopharynx from the oropharynx
29
**Palatopharyngeus, musculus uvulae,** and **palatoglossus** are all innervated by \_\_\_\_. What is each of their functions?
All innervated by **vagus** **Palatopharyngeus:** * Elevate the pharynx * Depress the soft palate * Move the palatopharyngeal arch toward midline **Musculus uvulae**: elevates & retracts uvula; thicken central region of soft palate **Palatoglossus** * Elevate the back of tongue * Move palatoglossal arch toard midline * Depress the palate
30
Name the arteries of the oral cavity
**Greater & lesser palatine arteries** **Ascending palatine artery** coming off the facial artery **Palatine branch** of ascending pharyngeal artery
31
Veins of the palate ultimately drain into the ___ or \_\_\_. Lymphatics drain into the ___ nodes.
Veins ultimately drain into the **pterygoid plexus** or **veins associated with the palatine tonsil** Lymphatics drain into the **deep cervical nodes**
32
Innervation of the palate * Sensory? * Parasympathetics - what nerve and what ganglion? * Sympathetics?
* Sensory innervation: **maxillary n** * Parasympathetics: **greater petrosal n** from **pterygopalatine ganglion** (distributed with CN2) * Sympathetics: T1 \> sympathetic trunk \> superior cervical ganglion; also **deep petrosal nerve** from pterygopalatine ganglion
33
Dental anesthesia targets what nerve?
**\*\*Inferior alveolar nerve** (from **V3**) innervates bottom (mandibular) teeth and lip - Note that the lingual nerve is close by, so tongue will also be numb **Superior alveolar nerve** (from **V2)** innervates the top (maxillary) teeth
34
Where do you insert the needle for dental anesthesia?
Needle in the pterygomandibular raphe to reach the ptergyomandibular space
35
The oral part of the tongue (anterior 2/3) is separated from the pharyngeal part (posterior 1/3) by the \_\_\_\_. Diff types of papillae on tongue
**Foramen cecum** (this is where the thyroid starts and descends into the neck)
36
Extrinsic muscles of tongue actions- protursion, retraction, depression, elevation+retraction of posterior third
* **Protrusion**: genioglossus * **Retraction**: styloglossus + hyoglossus * **Depression:** hyloglossus * **Elevation + retraction** **of posterior third**: styloglossus + palatoglossus
37
Intrinsic muscles of the tongue actions- Superior longitudinal, Inferior longitudinal, transverse, vertical
**Superior longitudinal**: shortens; curl apex & sides of tongue **Inferior longitudinal**: shortens; uncurls apex & turns it downward **Transverse:** narrows & elongates tongue **Vertical**: flattens & widens tongue
38
Tongue innervation * Sensory to anterior 2/3 vs 1/3 * Motor to palatoglossus vs intrinsic muscles, genioglossus, hyoglossus, and styloglossus
* Taste to anterior 2/3 - **Chorda tympani** (from CN7) * General sensation to anterior 2/3 - **Lingual n** (from V3) * General sensation + taste to posterior 1/3 - **Glossopharyngeal n** **​** * Motor to everything except palato glossus - **hypoglossal n** * Motor to palatoglossus - **vagus n**
39
Hypoglossal nerve damage
Tip of tongue goes deviates to the _affected_ side during protrusionbecause the gnioglossus is weak/paralyzed
40
Artery to tongue? Veins to tongue? Lymphatics of tongue?
* **Lingual artery** * **Dorsal lingual** and **deep lingual veins** * Lymphatics * Pharyngeal part - **jugulodigastric node** (deep cervical node) * Oral part * Directly into deep cervical nodes * Indirectly through **submental & submandibular nodes** \> deep cervical * Tip - **mylohyoid \> submental \> jugulomohyoid node of deep cervical chain**
41
Parotid parasympathetic innervation
From fibers that travel in CN IX; joins branch of V3 in infratemporal fossa
42
What gland lies inferior to the mylohyoid muscle against the submandibular fossa on the medial surface of the mandible? Where does it duct open?
**Submandibular gland** ## Footnote **Submandibular duct** opens near the frenulum of the tongue
43
What gland is immediatley lateral to the submandibular duct against the medial surface of the mandible in the sublingual fossa?
Sublingual gland
44
Temporomandibular joint anatomy
45
What muscles and nerves are responsible for protruding the TMJ?
​**Lateral** and **medial pterygoids** innervated by **mandibular nerve V3**
46
What muscles and nerves are responsible for retracting the TMJ?
**Posterior fibers of temporalis** V3 **Deep part of masseter** V3 **Geniohyoid** C1 via the hypoglossal n **Digastric** (anterior - V3, posterior - V2)
47
\_\_\_\_: the posterior opening of the nasal cavity into the nasopharynx \_\_\_\_\_: the posterior opening of teh oral cavity into the oropharynx \_\_\_\_\_: opening of the larynx into the laryngopharynx
**Choanae**: the posterior opening of the nasal cavity into the nasopharynx **Oropharyngeal isthmus**: the posterior opening of teh oral cavity into the oropharynx **Laryngeal inlet**: opening of the larynx into the laryngopharynx
48
What innervates the constrictor muscles of the pharynx?
Vagus n
49
Different attachments of the superior, middle , and inferior constrictors
**Superior**: pterygomandinular raphe; pharyngeal raphe **Middle constrictor:** greater & lesser horn of hyloid; stylohyoid ligament **Inferior**: cricocartilage; oblique line of thyrocartilage; and the ligament that spans it
50
Longitudinal muscles of the pharynx - **stylopharyngeus**, **salpingopharyngeus**, and **palatopharyngeus**. What is the function on the pharynx and innervation?
All of them elevate the pharynx ## Footnote **Stylopharyngeus** - glosspharyngeal n **Salpingopharyngeus-** vagus n **Palatopharyngeus**- vagus n
51
What fascia covers the external side of the muscular wall of teh pharynx?
Buccopharyngeal fascia
52
What fascia lines the inner surface of the muscular pharyngeal wall?
Pharyngobasilar fascia
53
Where is the nasopharynx continuous with the oropharynx?
Pharyngeal isthmus
54
The **pharyngeal tonsil** is a collection of lymphoid tissue in the mucosa on the roof of the \_\_\_\_
nasopharynx. Called **adenoids** when enlarged
55
The pharyngotympanic tube connects the ___ to the \_\_\_, which is connected to the mastoid air cells
Connects the **nasopharynx** to the **middle** **ear** (which is connected to the mastoid ari cells); important for pressure equalization
56
The **pharyngeal recess** is ___ and ___ to the torus tubarius around the entrance of pharyngotympanci tube
Posterior & superior
57
The **oropharynx** is below the soft palate, above the upper edge of the epiglottis, and behind the pharyngeal part of the tongue
58
**Palatoglossal folds/arches** on each side of the oropharynx mark the boundary between the oral pharynx and the \_\_\_\_\_
Oral cavity
59
**Palatopharyngeal folds/arches** cover the
palatopharyngeus muscles
60
Lingual tonsils vs Palatine tonsils- locations in the oropharynx
**Lingual tonsil** is on the pharyngeal part of tongue **Palatine tonsil** are between the palatoglossal and palato pharyngeal folds
61
**Piriform fossa** - where is it and what is its clinical significance?
Between the central part of larynx and inner aspect of the lateral lamina of the thyroid cartilage * Common site for lodging of foreign bodies * Branches of internal laryngeal and recurrent laryngeal n are deep the mucous membrane of the fossa; can be injured when removing foreign body
62
Gag reflex afferent & efferent limb
Afferent: **Glossopharyngeal (CN9)** Efferent: V**agus (CN10)** mostly (a lil from CN12 & V3)
63
Main blood supply to pharynx Main venous drainage of pharynx Lymphatics of pharynx
**Ascending pharyngeal**, giving off the **pharyngeal branch** supplying the roof of the nasal cavity Venous: **pterygoid plexus** drains nose and palate Lymph: tonsils drina into **jugular digastric node**
64
Innervation of the hard palate vs soft palate
Hard palate - **greater palatine n** Soft palate & palatine tonsil - **lesser palatine n**
65
Locations of the tonsils

Block IV (8 decks)

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