Anatomy of Oral Cavity and Tongue Flashcards by Mollie O

What are the boundaries of the oral cavity?

Roof
Floor
Lateral walls
Anterior
Posterior

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What is the roof of the oral cavity made up of?

Hard palate
Soft palate

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What is the hard palate formed by?

The maxilla and palatine bones, the same bones that form the floor of the nasal cavity

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What is the soft palate made up of?

Muscles

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What do the palatoglossus muscle of the soft palate do?

Forms the palatoglossal (anterior) arch

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What does the palatopharyngeus of the soft palate fo?

Forms the palatopharyngeal (posterior) arch

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What is the function of the muscles of the soft palate?

To tense and elevate the soft palate during swallowing and yawning

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What is the innervation of the soft palate?

Predominantly the vagus nerve

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What happens if the vagus nerve is damaged, regarding the soft palate?

The stronger side is unoppsed, and therefore pulls the uvula away from the side of the affected nerve

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What forms the floor of the oral cavity?

Tongue
Other soft tissues

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What forms the lateral walls of the oral cavity?

Cheek

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What is the cheek made of?

Buccinator muscles

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What forms the anterior walls of the oral cavity?

Oral fissure

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What is the oral fissure?

The space between the lips

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What forms the posterior boundary of the oral cavity?

The oropharyngeal isthmus

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What is the oropharyngeal isthmus?

Opening to oropharynx

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What is the oral vestible?

The space between the teeth and the cheek/lips

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What is the oral cavity proper?

From the teeth, to the ring made by the palatopharyngeal arch, the uvula, and the tip of the epiglottis

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What is the gag reflex important in?

Preventing choking

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What is testing of the gag reflex part of?

Cranial nerve examination

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Why is testing of the gag reflex not routinely done?

Because it is unpleasant for the patient

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Where is testing for the gag reflex important?

For assessing brainstem funciton

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What is the afferent limb of the gag reflex?

Sensation from the back of the tongue/throat, uvula, and tonsillar area, provided by glossopharyngeal nerve

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What is the efferent limb of the gag reflex?

The vagus nerve, which innervates the pharyngeal muscles on both sides to lift the soft palate

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Draw a labelled diagram illustrating the names of the teeth

What is the nervous supply of the lower jaw?

The inferior alveolar nerve

What is the inferior alveolar nerve a branch of?

CN V3

What is the clinical relevance of the inferior alveolar nerve?

* Can loose sensation during mandibular nerve fracture * Site of anaesthesia use in dental surgery

Why can a mandibular nerve fracture lead to a loss of sensation in the lower jaw?

Because it runs through the mandibular fossa

What are the extrinsic muscles of the tongue?

* Styloglossus * Genioglossus * Hyoglossus * Palatoglossus

What does the styloglossus do?

Retracts and elevates

What does the genioglossus do?

Protrudes tongue

What does the hyoglossus do?

Retracts and depresses

What is the palatoglossus innervated by?

The vagus nerve, *because is part of the soft palate*

What is the function of the extrinsic muscles of the tongue?

* Help anchor tongue * Allow tongue to change position

How do the extrinsic muscles of the tongue help anchor the tongue?

Attach tongue to hyoid bone and mandible

What are the intrinsic muscles of the tongue?

* Superior longitudinal * Vertical * Transverse * Inferior longitudinal

What do the superior and inferior longitudinal muscles of the tongue do?

Curl

What does the vertical intrinsic muscle of the tongue do?

Flattens tongue

What does the transverse intrinsic muscle of the tongue do?

Pulls tongue in, making it smaller and round

Draw a diagram illustrating the innervation of the tongue

What happens in pathologies of the nerves supplying the tongue?

The unaffected side dominates- the normal tongue overpowers the weakened muscle on the affected side, so tongue deviation is towards the side of the lesion

How do the parotid and submandibular glands enter the oral cavity?

Through a single opening

What is the opening of the parotid gland into the oral cavity?

Stenson's duct

What is the opening of the submandibular gland into the oral cavity?

Wharton's duct

How does the sublingual gland open into the oral cavity?

Via multiple ducts

Where are the ducts of the sublingual glands?

Lateral to frenulum and base of tongue

What are salivary gland stones made of?

Usually calcium-based

How do salivary gland stones aries?

Saliva crystallises and blocks the salivary ducts

Which salivary duct to salivary gland stones most commonly affect?

The submandibular gland

Why is the submandibular gland most commonly affected by salivary gland stones?

Because it produces saliva that is comparatively thicker than parotid gland

How common are sublingual stones?

Very rare

How do salivary gland stones present?

As pain or swelling of the affected gland at meal times

What salivary gland stone may be visible?

Wharton's duct stone

How are salivary gland stones managed?

Small stones may resolve spontaneously, but they commonly need removal

What is tonsillitis?

Inflammation of the palatine tonsil

How does tonsillitis present?

* Sore throat * Odonophagia/dysphagia if severe * Enlarged and erythematous tonsils

Why does tonsillitis cause odonophagia and dysphagia if severe?

Tonsils are so englarged, they are causing a blockage

What causes tonsilltis?

Usually infective

Give two pathogens that commonly cause viral tonsillitis

* Rhinovirus * Adenovirus

What are the symptoms of viral tonsillitis accompanied by?

The symptoms of UTRI; * Dry cough * Run down * Headaches

What is bacterial tonsillitis most commonly caused by?

ß-haemolytic strep

What are the symptoms of bacterial tonsillitis accompanied by?

* Cervical lymphademopathy * Fever * Pus

What happens to the anterior and posterior arches in tonsillitis?

The anterior arch is still present, but the posterior arch is obscured by the enlarged tonsils

What complication can tonsillitis lead to?

Peritonsillar abscess, or 'quinsy'

What is quinsy caused by?

Usually caused by strep. pyogenes, but other organisms include; * Staph aureus * H. influenza * Mixed flora

What are the symptoms of quinsy?

* Patients systemically unwell * Trismus * 'Hot potato' voice * Drooling

What causes trismus and hot potato voice in quinsy?

They don't want to open their mouth too much

Why may patients with quinsy be drooling?

Because of dysphagia

Is quinsy unilateral or bilateral?

Often unilateral

What happens to the uvula in quinsy?

It can deviate away from the lesion

What happens to the anterior arch in quinsy?

It is lost

How is quinsy managed?

Requires immediate referral to ENT for drainage and antibiotics