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Session 9 Flashcards

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1
Q

Tongue muscles

A
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2
Q

Parotid gland anatomy

A
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3
Q

Features of salivary gland stones

A

Sialolithiasis

  • Most stones are located in the submandibular glands
  • Dehydration, reduced salivary flow
  • Most stones less than 1cm diameter
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4
Q

Symptoms of salivary gland stones

A

Eating stimulates

Pain in gland, swelling, infection

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5
Q

Diagnosis of salivary gland stones

A

History, X ray, sialogram

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6
Q

Features of tonsillitis

A

Inflammation of palatine tonsils

Fever, sore throat, dysphagia, cervical lymph nodes, bad breath

Viral causes most common
Bacterial up to 40% of cases, e.g Strep pyogenes

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7
Q

Features of peritonsilar abscess

A

Severe throat pain, fever, bad breath, drooling, difficulty opening mouth

Can follow on from untreated or partially treated tonsillitis

Can arise on its own from aerobic and anaerobic bacteria

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8
Q

Nerve innervation of pharynx plexus

A

Pharyngeal plexus

Located mainly on surface of middle constrictor muscle

Vagus, glossopharyngeal, and cervical sympathetic nerves

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9
Q

Nerve innervation of pharynx- motor

A

CN X innervates all muscles

Except stylopharyngeus (glossopharyngeal nerve CN 9)

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10
Q

Nerve innervation of pharynx- sensory

A

Nasopharynx (maxillary nerve CN Vb)
Oropharynx (glossopharyngeal nerve CN 9)
Laryngopharynx (vagus nerve CN X)

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11
Q

Submandibular gland duct

A

Wharton duct

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12
Q

Parotid gland duct

A

Stensens duct

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13
Q

IX and X Cranial nerve problems in mouth area

A

Absent gag, deviated uvula (away from lesion)

Dysphagia, taste impairment posterior tongue, loss of oropharynx sensation

Caused by medullary infarct, jugular foramen issue (fracture)

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14
Q

XII cranial nerve problems in mouth area

A

Wasted tongue
Deviated tongue when stuck out - damage to nerve itself (point to side of lesion)
Muscle wasting
Fasiculations

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15
Q

Oral cavity consists of

A

2 lateral walls, a floor and a roof

Lateral walls- buccinators
Roof- Hard and soft palate
Floor- 2 mylohyoid muscles, tongue

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16
Q

The oral cavity begins anteriorly at the

A

Oral fissure- bounded by the lips

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17
Q

Oral cavity extends posteriorly to the

A

Oropharyngeal isthmus (arch formed by soft palate above and upper surface of tongue below)

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18
Q

Sides of the Oropharyngeal isthmus are formed by the

A

Anterior and posterior pillars of the fauces

Formed by palatoglossus (anterior) and palatopharyngeal (posterior) muscles

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19
Q

What does contraction of palatoglossus and palatopharyngeal muscles cause

A

Pulls soft palate down towards back of tongue, closes Oropharyngeal isthmus, ensures food remains in oral cavity

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20
Q

What lies between the anterior and posterior pillars of fauces

A

Tonsillar fossa, within this the palatine tonsil, making up Waldeyer’s ring

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21
Q

Palatine tonsil is often easily visible and readily noticed when swollen due to inflammation in

A

Tonsillitis

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22
Q
A
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23
Q

Broadly describe the tongue

Study These Flashcards
A

Entirely muscular tissue covered in mucous membrane (squamous epithelium)

Intrinsic and extrinsic muscles

24
Q

Describe the intrinsic muscles of the tongue

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A

4

Lie entirely within the tongue and run longitudinally, vertically and transversely

Alter shape of tongue

Blend with extrinsic muscles as have no attachment to bone

25
Describe the extrinsic muscles of tongue
Change position of tongue Protrusion, retraction and side-to-side Anchor tongue to surrounding structures
26
What do the extrinsic muscles anchor the tongue to
Hyoid and mandible below Styloid process and soft palate above
27
Most important of four extrinsic muscles
Genioglossus- one on each half of tongue Contraction protrudes the tongue (action for determining hypoglossal nerve function)
28
Hypoglossal nerve innervates what part of tongue
All muscles of tongue except 1- the palatoglossus (forms shape of anterior arch and soft palate, vagus nerve)
29
Why does the tongue receive afferent innervation from a number of cranial nerves
Because of its different embryological origins from several pharyngeal arches
30
Innervation of the tongue posterior 1/3
Glossopharyngeal
31
Motor innervation of tongue
Hypoglossal except Palatoglossus (vagus)
32
Sensory innervation of anterior 2/3 tongue
Lingual branch of V3 from trigeminal
33
Taste innervation of anterior 2/3 tongue
Chorda tympani branch of Facial 7, carried by lingual branch
34
Innervation of tongue overview
35
Dorsal surface of tongue is covered in
Papillae Location for sensory receptors for tastes ie taste buds
36
Hypoglossal nerve lesion sign and vagus nerve lesion sign
Hypoglossal = tongue deviation vagus nerve = uvula deviation
37
Describe the pharynx
Muscular tube that continues as the oesophagus, arising from base of skull extending down to level of C6
38
Narrowest part of oesophagus
Inferior end where it becomes continuous with the oesophagus
39
Posterior wall of pharynx is covered with and lies against
Buccopharyngeal fascia, lies against prevertebral layer of deep cervical fascia (where we find retropharyngeal space)
40
Order of 3 parts of pharynx
Nasopharynx Oropharynx Laryngopharynx
41
Where does the Nasopharynx lie
Superior to soft palate Posterior extension of nasal cavities, open into it through nasal apertures/choanae C1 vertebrae lies posteriorly
42
What lies within the Nasopharynx
Orifice of the Pharyngotympanic/Eustachian tube Collection of lymphoid tissue- pharyngeal tonsil/adenoids
43
Where is oropharynx
Level of soft palate to superior border of epiglottis C2 and C3 vertebral bodies lie posteriorly Palatine tonsils lie on either side in interval between palatoglossal and palatopharyngeal arches
44
Where is laryngopharynx
Epiglottis to the oesophagus, level of inferior border of cricoid cartilage Vertebral bodies of C3-6 lie posteriorly Piriform fossa on each side of laryngeal inlet
45
Walls of the pharynx
Externally- circular superior, middle and inferior constrictors Vagus nerve
46
Posterior common insertion point of pharyngeal constrictors
Common midline tendinous insertion called the pharyngeal raphe
47
Inferior pharyngeal constrictor consists of
2 muscle bellies, thyropharyngeus and cricopharyngeus Small area of weakness known as Killian’s dehiscence between the muscle belly components
48
Clinical relevance of Killian’s dehiscence
In coordination of pharynx Pressure rises Part of pharyngeal mucosa herniated through Killian’s dehiscence, forming pharyngeal pouch or diverticulum
49
Internally, the wall of the pharynx consists of
3 longitudinal muscles that act to shorten and widen the pharynx, during swallowing and speaking
50
Majority of the nerve supply to the pharynx is derived from the
Pharyngeal plexus of nerves - formed by branches of the vagus, glossopharyngeal and sympathetic branches from the superior cervical ganglion
51
Vagus nerve supplies
All muscles of the pharynx and soft palate except the stylopharyngeus (supplied by CN 9)
52
Sensory supply to pharynx
Nasopharynx- maxillary branch of trigeminal CN Vb Oropharynx and Pharyngotympanic tube- glossopharyngeal nerve CN IX Laryngopharynx- vagus nerve CN X
53
What is Waldeyer’s ring
Lymphoid ring formed around Nasopharynx and oropharynx Pharyngeal tonsils, palatine tonsils and lingual tonsils
54
Features of pharyngeal tonsils/adenoids
Prominent in children Undergo atrophy after puberty Adenoiditis (chronic inflammation) may obstruct passage of air causing mouth breathing and nasal tone Can block exit of the Pharyngotympanic tube and lead to middle ear infections (acute otitis media) or otitis media with effusion
55
Pharyngotympanic tube provides a
Potential route for infection in the pharynx to spread to the middle ear Common for URTI to be complicated by middle ear infections
56
Tonsillitis may require
Tonsillectomy from tonsillar bed May result in profuse bleeding from the rich blood supply to the tonsil- via tonsillar branch of facial artery
57
What is clinical relevance of piriform fossa
Potential site for foreign bodies entering pharynx to become lodged Site for pharyngeal cancers

HNN (19 decks)

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