The Oral Cavity and Pharynx Flashcards Preview

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Flashcards in The Oral Cavity and Pharynx Deck (30):
1

State the organisation of the fauces

- The fauces are arches formed by the palatoglossus, palatopharyngeal muscles and palatine tonsil
- anterior to posterior - palatoglossus arch, palatine tonsil, palatopharyngeal arch

2

Describe the muscles of the tongue and their innervation

- Has intrinsic muscles which are not attached to bone but alter the shape of the tongue
- 4 paired muscles all innervated by hypoglossal nerve
- 4 extrinsic muscles change position of tongue and anchor it
- Genioglossus, hypoglossus, styloglossus, palatoglossus
- All innervated by hypoglossal nerve except palatoglossus, which is innervated by the vagus nerve

3

Describe the sensory and special sensory nerves of the tongue

- Anterior 2/3 sensation provided by mandibular branch of trigeminal
- Taste provided by facial nerve
- Posterior 1/3 sensation and taste from glossopharyngeal

4

Describe the location and drainage of the submandibular gland

Submandibular gland located below the mouth and secrete through Wharton ducts under the tongue medially

5

Describe the location and drainage of the parotid gland

Parotid gland secretes saliva through the Stensen duct, located within the cheek next to the 2nd pre-molar

6

Describe the location and drainage of the sublingual gland

Sublingual gland has multiple ducts to release saliva laterally to the submandibular ducts

7

State possible pathology within the oral cavity

- Salivary gland stones (siololithiasis)
- Tonsilitis
- Peritonsilar abscess

8

Describe how salivary gland stones present

- Siololithiasis
- Most stones are located in the submandibular glands
- Leads to dehydration and reduced salivary flow
- Symptoms during eating include pain in gland, swelling or infection

9

Describe how tonsillitis presents

- Inflammation of the palatine tonsils
- Present with fever, sore throat, pain during swelling, bad breath, cervical lymph nodes

10

Describe how peritonsillar abscesses present

- Abscess of surrounding tissue around palatine tonsils
- Symptoms include severe throat pain, fever, bad breath, drooling, difficulty opening mouth
- Can follow on from tonsillitis or can arise on its own
- Leads to a deviated uvula

11

Explain how CN XII is tested

- Wasted tongue
- Stock tongue out, and if affected it deviates to side of lesion
- Protrusion of the tongue is through the genioglossus muscle (innervated by CN XII)

12

Explain how CN IX and CN X are tested

- Absent gag reflex or uvula deviation
- Gag reflex
- Afferent limb - glossopharyngeal nerve which provides sensation to posterior tongue and oropharynx
- Efferent limb - vagus nerve allows contraction of pharyngeal muscles
- Uvula deviation
- Deviation of the uvula to one side implies a motor lesion of the vagus nerve on the opposite side of the uvula deviating towards

13

Describe the boundaries and contents of the nasopharynx

- Boundaries - base of skull to upper border of soft palate
- Anterior border is the nasal cavity
- Posterior border is C1, C2
- Contains the pharyngeal tonsil - adenoids
- Also contains the opening of Eustachian tube

14

Describe the boundaries and contents of the oropharynx

- Boundaries - soft palate to epiglottis
- Anterior border - oral cavity
- Posterior - C2, C3
- Contains the palatine tonsils
- The depressed fossa between the palatoglossal and palatopharyngeal arches is where the palatine tonsils lie

15

Describe the boundaries and contents of the laryngopharynx

- Boundaries - oropharynx to oesophagus or from epiglottis to cricoid cartilage
- Anterior border - larynx
- Posterior border - C4, C5, C6
- Contains the piriform fossa

16

State the names and action of the longitudinal muscles of the pharynx

- Stylopharyngeus
- Palatopharyngeus
- Salpingopharyngeus
- Elevate pharynx and larynx during swallowing

17

Stylopharyngeus AI

- Styloid process to posterior border of thyroid cartilage
- Innervated by glossopharyngeal nerve

18

Palatopharyngeus AI

- Hard palate to posterior border of thyroid cartilage
- Innervated by pharyngeal branch of vagus nerve

19

Salpingopharyngeus AI

- Cartilaginous part of Eustachian tube and merges with palatopharyngeus
- Swallowing opens Eustachian tube to equilibrate pressure
- Innervated by pharyngeal branch of vagus

20

State the names, innervation and action of the pharyngeal constrictors

- 3 circular muscles which constrict walls of pharynx when swallowing
- Superior pharyngeal constrictor
- Middle pharyngeal constrictor
- Inferior pharyngeal constrictor
- Has thyropharyngeal and cricopharyngeal part
- All innervated by vagus nerve

21

Describe the motor and sensory innervation to the pharynx

- Motor - vagus nerve innervates all muscles except stylopharyngeus
- Sensory
- Nasopharynx - maxillary nerve
- Oropharynx - glossopharyngeal nerve
- Laryngopharynx - vagus nerve

22

Describe the pharyngeal pouch

- Small area of weakness between the two parts of the inferior pharyngeal constrictor
- Pharyngeal mucosa can herniate through the gap, forming a gap that can trap food
- Leads to failure of the UOS to relax - raised pressure in the area
- Abnormal timing of swallowing

23

Describe enlarged adenoids and its presentation

- May obstruct passage of air from nasal cavity into the nasopharynx
- Pharyngotympanic tube can be blocked - cause middle ear infections such as otitis media with effusion
- Present with mouth breathing and 'nasal tone' when speaking

24

Describe the oral phase of swallowing including muscles and nerves involved

- Voluntary
- Preparatory phase - making bolus
- Transit phase - bolus compressed against palate and pushed into oropharynx by tongue and soft palate
- Done through muscles of tongue innervated by hypoglossal nerve

25

Describe the pharyngeal phase of swallowing including muscles and nerves involved

- Involuntary
- Tongue positioned against hard palate - CN XII through intrinsic and extrinsic muscles of the tongue
- Soft palate elevated to seal off nasopharynx - CN X
- Suprahyoid and longitudinal muscles shorten - CN IX, CN X
- Larynx elevated and sealed off by vocal cords
- Pharynx widens and shortens to receive bolus
- Epiglottis closes over larynx
- Bolus moves through pharynx by sequential contraction of constrictors
- Relaxation of UOS

26

Describe the oesophageal phase of swallowing including muscles and nerves involved

- Involuntary
- Upper striated muscle of oesophagus - CN X
- Lower smooth muscle

27

Describe the articulations within the TMJ

- TMJ joint formed from the articulation of the mandible and the temporal bone
- Head of the mandible articulates with the articular disk
- Mandibular fossa also articulates with the articular disk
- Articulating surfaces are lined with fibrocartilage

28

Describe the ligaments present at the TMJ

- Lateral ligament - runs from articular tubercle to mandibular neck
- Prevents posterior dislocation of the joint
- Sphenomandibular ligament - sphenoid spine to mandible
- Stylomandibular ligament - thickening of the parotid fascia

29

Describe what muscles are involved in the movement at the TMJ

- Protrusion and retraction through upper part of the jaw
- Protrusion - lateral pterygoid
- Retraction - geniohyoid, digastric
- Elevation and depression through lower jaw - opens and closes mouth
- Depression - normally through gravity, but if resistance then digastric, geniohyoid and mylohyoid
- Elevation - temporalis, masseter, medial pterygoid

30

Outline how dislocation of the TMJ can occur

- Can occur from trauma, yawning or taking a large bite
- Head of the mandible slips out of the mandibular fossa and is pulled anteriorly
- Facial nerve can be damaged