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374 Cards in this Set
- Front
- Back
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The tarsal plates (skeleton of eyelids) are made of what type of tissue?
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dense fibroelastic tissue
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What 2 glands lubricate the edges of the eyelid?
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Tarsal and Meibomian glands
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What is a stye?
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Inflammation of the eyelid glands
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What is "pink eye"
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Infection of the conjunctivum
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What is the orbicularis oculi innervation?
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CN 7 (facial)
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The corneal reflex tests which nerve?
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CN5, (V1 specifically)
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Corneal afferent neurons travel in what nerve?
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V1
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Fun Fact: A patient with bell's palsy has no corneal reflex due to damaged CN7
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I wanna take a ride on your disco stick
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Levator palpebrae is innvervated by what CN?
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3
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The Muller's Muscle (smooth muscle) is a part of what skeletal muscle?
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levator palpebrae
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Muller Muscle innervation
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postganglionic sympathetics from superior cervical ganglion
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Damage to the levator palpebrae results in ....
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complete ptosis, eyelid cannot open at all
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Damage to the Muller's muscle results in .....
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partial ptosis, eyelid has difficulty opening a little bit. due to damaged sympathetics
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Tear production is controlled by what nerve?
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parasympathetics in CN7
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Describe the flow of tears after they enter the lacrimal puncta.
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Lacrimal puncta - canaliculi - lacrimal sac - nasolacrimal duct - inferior nasal meatus
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Fun Fact: The lacrimal gland is a modified salivary gland.
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I love you like a fat kid loves cake
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What is the superior wall of the orbit?
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orbital portion of frontal bone
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What is the medial wall of the orbit?
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Ethmoid bone
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What is the inferior wall of the orbit?
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maxillary bone
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What is the lateral wall of the orbit?
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Frontal portion of zygomatic and greater wing of sphenoid
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The optic canal is in which bone?
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lesser wing of sphenoid
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The lateral orbital walls converge to form what angle?
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90 degrees (each lateral angle is 45 from the median). The optic axis is always straight ahead
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In a medial wall blow out of the orbit, what sinus may be involved?
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Ethmoid sinus
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In a blowout fracture involving the floor of the orbit, what sinus may be involved?
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maxillary sinus
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Damage to the roof of the orbit can damage what structure?
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frontal lobe of brain
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Bleeding in the orbit can lead to what symptom?
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exopthalmos (eyes protrude form head)
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What is the 1st branch off the internal carotid artery?
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opthalmic artery
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The central retinal artery comes from where?
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opthalmic artery (from the internal carotid)
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Major blood supply to the orbit is from what artery?
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opthalmic
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Occlusion of what small artery can quickly cause blindness?
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central retinal artery
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Posterior ciliary arteries penetrate the sclera to supply what?
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choroid and outer retina (rods/cones, pigment epithelium)
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The infraorbital artery anastomoses with the opthalmic artery using what artery?
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angular artery
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Despite the anastomoses to the opthalmic artery using the angular artery, why does blindness still occur with the blockage of the central retinal artery?
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angular artery anastomoses is not big enough
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What major veins of the face comprise the danger zone (drain to the cavernous sinus)?
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nasofrontal, facial, supraorbital/inferior orbital, angular, superior/inferior opthalmic veins and (pterygoid plexu)
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What 4 muscles make the tendinous ring?
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superior, medial, lateral, inferior rectus
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What cranial nerves go through the tendinous ring?
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2, 3, 6 (4 is just superior to it)
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The frontal and lacrimal nerve are branches of what Cranial nerve?
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V1
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What nerve lies on levator palpebrae?
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frontal (branch of V1)
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The ciliary ganglion receives what type of nerves from CN3?
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preganglionic parasympathetics
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CN4 innervates what extrocular eye muscle?
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Superior oblique
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CN6 innervates what extraocular eye muscle?
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Lateral rectus
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CN3 innervates what 4 extraocular eye muscles and additional superior muscle?
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Inferior oblique, medial rectus, inferior rectus, superior rectus and also the levator palpebrae
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Contraction of the superior oblique results in what eye movement?
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intortion
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Contraction of the inferior oblique results in what eye movement?
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extrotion
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To test the superior oblique, what direction should the patients eye be?
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medial and down
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To test the inferior oblique, what direction should the patients eye move?
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medial and up
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To test the superior rectus, what direction should the patients eye move?
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lateral and up
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To test the inferior rectus, what direction should the patients eye move?
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lateral and down
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Damage to the abducens nerve would show what during an eye exam?
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dennervated lateral rectus = lateral gaze deficit. affected eye cannot look laterally. when staring straight, affected eye looks medially due to unopposed medial rectus
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With trochlear palsy, a patient has what symptoms
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head tilt away from affected side, affected eye looks upwards, extorted, diplopia
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With an occulomotor palsy, the affected eye stares in what direction?
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down and out (the direction of the only functional muscles)
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With an occulomotor palsy, why does the affected eye have a dilated pupil?
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parasympathetics travel with CN3 and are no longer functional
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When is the eye first seen during devlopment?
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22 weeks
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Retinal detachment occurs in what developmental space?
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interretinal space
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During development, the hyaloid artery supplies blood to what?
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the lens
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After development, the hyaloid becomes the ....
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central retinal artery
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During development, the hyaloid artery passes through what?
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optic fissure
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After development, the optic fissure becomes what?
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pigmented layer
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During eye development, the eye ectoderm is induced to become the cornea by what structure?
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forming lens vesicle
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choroid is continuous with what meningeal layers of the optic nerve?
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pia and arachnoid
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sclera is continuous with what meningeal layers of the optic nerve?
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dura
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the pigmented layer of the eye is derived from what?
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CNS
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3 major layers of the eyes
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outer (sclera/cornea), middle (vascular coat), inner (retina)
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Why is the cornea avascular?
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so it remains transparent so we can see
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The sclera is made of what tissue?
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dense connective (collagen 4)
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What is the limbus cornea?
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the vascular joint between the sclera and cornea
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The vascular coat/ uvea of the eye contains what?
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choroid, ciliary body, iris
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What are the 2 components of the innermost retinal layer?
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neuroretina and ora serrata
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What is the neuroretina?
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10 layers of CNS sensory retina
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What is the ora serrata?
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2 layer non-sensory retinal layer; anterior limit of neuroretina
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What color does sclera stain in H/E?
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Red due to dense connective tissue collagen 4
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5 layers of the cornea
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Cornea epithelium, Bowman's layer (basement membrane), Stroma, Descemet's membrane, Corneal endothelium
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What is unique about corneal endothelium compared to all other endothelium of the body?
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Corneal is the only endothelium that does not contact blood; it contacts aqueous humor instead
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What is the Bowman's layer?
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The basement membrane for the corneal epithelium
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4 layers of the choroid
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lamina elastica/Bruch's membrane, choriocapillaris, vessel layer, epichoroid
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What is the choriocapillaris?
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the layer of the choroid with blood vessels to supply the outer retina
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Epichoroid is nearest what eye layer?
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sclera
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Which layer of choroid contains elastic?
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lamina elastica/Bruch's
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How do the inner retinal layers get nutrients/blood?
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central retinal artery
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How do outer retinal layers get nutrients/blood?
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choriocapillaris/vessel layers of choroid
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5 layers of Bruch's membrane
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basal lamina of pigmented retinal epithelium, collagen, elastic, collagen, basal lamina of choroid capillaries
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Ciliary body function
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suspend the lens using zonule of zinn fibers
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Ciliary body processes function
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produce aqueous humor
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Where is aqueous humor produced
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ciliary body processes
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The ciliary body has what type of muscle?
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smooth muscle in 2 orientations
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During distant vision, describe the zonule of zinn fibers and ciliary body
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the fibers are taught and the ciliary body muscle is relaxed
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During near vision, describe the zonule of zinn fibers and ciliary body
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the fibers are loose and the ciliary body is contracted
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Where is aqueous humor drained?
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Canal of Schlemm in the anterior chamber. humor drains to venous system
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Innervation of ciliary muscles
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postganglionic parasympathetics from ciliary ganglion (pre-ganglionics are from Edinger Westfall nucleus)
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When the ciliary muscle contracts, the zonule fibers ....
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become relaxed to thicken lens for near vision
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When the ciliary muscle is relaxed, the lens is....
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flattened for distant vision
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The iris is a specialization of which eye layer?
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uvea/vascular coat
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What is the colored part of the eye called?
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Iris
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Eye color is determined by ...
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Concentration of melanocytes in the iris
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Few melanocytes typically results in what color eyes?
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Blue
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Many melanocytes typically results in what color eyes?
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Black/dark brown
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Intermediate numbers of melanocytes results in what color eyes typically?
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green or grey
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What is the pupil?
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The central space between the iris projections
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When the lens thickens for close vision, the pupil ....
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constricts. constrictor pupillae muscle works with ciliary body
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Pupil constriction is controlled by what types of nerves
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postganglionic parasympathetics from ciliary ganglion (preganglionics are in Edinger Westfall nucleus)
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Fixed, dilated pupil indicates damage to .....
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constrictor puppilae muscle, brainstem parasympathetics (Edinger Westfall nucleus). uncal herniation can cause this
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The superior cervical ganglion is part of which autonomic nervous system?
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Sympathetics
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The ciliary ganglion is part of which autonomic nervous system?
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parasympathetics
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Dilator pupillae innervation
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postganglionic sympathetics from superior cervical ganglion (preganglionics in T1 IML)
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Where is the pigment found in the iris?
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On the posterior surface
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What is unique about the dilator pupillae muscle cells?
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They are myoepithelial cells
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3 signs of horners syndrom
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Ptosis, Miosis, Anhydrosis
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Horners syndrome cause
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damage to T1 white communicantes = weak sympathetic response
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Why do diabetics have vision loss?
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Water can enter the lens and make it opaque
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How does the lens get nutrients/oxygen since it is avascular?
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from the aqueous and vitreous humors
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How does the lens normally remains transparent?
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the plasma membrane of lens fibers are very impermeable, even to small ions
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What is the accommodation reflex?
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When we need near vision, the ciliary muscle contracts, the fibers relax, the lens thickens (pupil constricts also)
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In presbyopia, why is the accommodation reflex ineffective?
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The lens has lost its flexibility and cannot adjust to near vision
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3 histological parts of the lens
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lens capsule, subcapsular epithelium, lens substance
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What are cataracts?
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opaque lens
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Why do diabetics have myopia and cataracts?
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high glucose in lens stroma = water enters lens stroma = opaque and loses flexibility
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10 layers of neuroretina
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pigment, rods/cones, outer limiting membrane, outer nuclear layer, outer plexiform layer, inner nuclear layer, inner plexiform, ganglion cell layer, optic nerve fiber layer, inner limiting membrane
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The pigmented retinal layer contains a single layer of what cells?
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polygonal
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3 functions of the pigmented retina layer
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store/release vitamin A, absorb/prevent light light reflection, phagocytose old photoreceptor membrane
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Why does the pigmented retina epithelium need to absorb light?
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To prevent reflection of light in the eye which would lead to vision distortion
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Why does the pigmented retina epithelium need to store/release vit A?
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To produce rhodopsin
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Why does the pigmented retina epithelium need to phagocytose old membrane form the photoreceptor lamella?
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debris in the photoreceptor membrane can lead to retinal dystrophy and subsequently retinitis pigmentosa
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Where is rhodopsin photopigment found in the rods?
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cylindrical outer segments in pigment epithelium
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Where in the rod cell are numerous mitochondria found?
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The inner segment
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Most cones are found where on the retina?
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fovea centralis
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Fun Fact: There are many more rods than cones.
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dddddaaaaaayyyummmm
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What does the lamina cribosa separate?
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myelinated and unmyelinated axons of the optic nerve
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How does the lamina cribosa prevent retinal neurons from being myelinated?
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membrane at optic papilla prevents oligodendroglia from entering the eye
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2 main blood supplies to the retina
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outer layers: choriocapillaris vessels. inner layers: central artery branches
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Embolisms that block the central artery of the retina cause ischemia of what?
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retinal ganglion (leads to blindness)
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What is the most prevalent type of Age related macular degeneration?
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Dry ARMD
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What is the most severe type of Age related macular degeneration?
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Wet ARMD
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What is Age related macular degeneration? generally
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separation of the photoreceptors from their blood supply
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What is Dry ARMD?
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Accumulation of material (Drusen) between Bruch's membrans and retinal pigment epithelium
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What is Wet ARMD?
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Blood vessels form under Drusen material and further separate the Bruch's and retinal pigment epithelium
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How do we test for macular degeneration?
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Amsler grid; lines are distorted in ARMD
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If a retina detaches, what 2 layers are separated?
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Retina pigment epithelium separates from the rods/cones layer (photoreceptors lose their blood supply)
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What is papilladema?
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Optic disc bulges into the eye due to high cranial pressure
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What is open angle glaucoma?
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blockage of the Canal of Schlemm, normal anterior angle of anterior chamber
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How does aqueous humor drain into the venous system?
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Canal of Schlemm; humor is higher pressure than venous system
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What is closed angle glaucoma?
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Iris blocks the angle of anterior chamber when pupil is dilated
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Which type of glaucoma has a rapid onset with pain?
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closed angle glaucoma
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intraocular pressure over what level leads to blindness?
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pressure > 20 mmHg
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What is optic cupping?
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Increased intraocular pressure; optic disc is pushed into brain (opposite of papilladema)
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What makes up the vitreous fluid?
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99% water, collagen, GAGs,
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What are floaters?
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deposits in the vitreous fluids, usually benign
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The superior cervical ganglion contains what types of nerves for the head?
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postganglionic sympathetics
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To provide sympathetic innervation to the head, the superior cervical ganglion gives what nerve?
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internal carotid nerve
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The internal carotid nerve travels with what artery?
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internal carotid
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Sympathetic fibers of the head travel with what vessels?
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arteries
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Where is the superior cervical ganglion in relation to the internal carotid artery?
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directly posterior to it
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Horner's syndrome can result from damage to what?
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any part of the sympathetic pathway: IML, T1 white communicating rami, axons, superior cervical ganglion, hypothalamus
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What 3 cranial nerves contain parasympathetic visceral efferents in the head?
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3, 7, 9 (occulomotor, facial, Glossopharyngeal)
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Preganglionic parasympathetic Occulomotor nerves are found in what nucleus?
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Edinger- Westfall nucleus
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Preganglionic parasympathetic Facial nerves are found in what nucleus?
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Superior salivary nucleus
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Preganglionic parasympathetic Glossopharyngeal nerves are found in what nucleus?
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Inferior salivary nucleus
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What is the lacrimal nucleus?
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another name for the upper part of the superior salivary nucleus of the facial nerve
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Edinger Westfall nucleus is located in what part of the brain?
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mesencephalon/midbrain
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preganglionics from the edinger westfall nucleus synapse on postganglionic neurons where?
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ciliary ganglion
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Preganglionics from the Edinger Westfall nucleus travel in what Cranial nerve?
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Occulomotor
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preganglionic parasympathetics from the superior salivary nucleus synapse where?
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pterygopalatine and submandibular ganglia
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preganglionic parasympathetics from the superior salivary nucleus travel in what cranial nerve?
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facial nerve
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preganglionic parasympathetics from the inferior salivary nucleus synapse where?
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otic ganglion
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preganglionic parasympathetics from the superior salivary nucleus travel in what cranial nerve?
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glossopharyngeal
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4 parasympathetic postganglionic nuclei
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Ciliary, pterygopalatine, submandibular, otic
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The ciliary nucleus is associated with what branch of the trigeminal nerve?
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nasociliary branch of V1
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The pterygopalatine ganglia is associated with what branch of the trigeminal nerve?
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V2
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The submandibular ganglia is associated with what branch of the trigeminal nerve?
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lingual branch of V3
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The otic ganglia is associated with what branch of the trigeminal nerve?
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V3
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Head parasympathetics use what cranial nerve to distribute branches?
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trigeminal
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What 4 cranial nerves are involved with parasympathetics of the head?
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Occulomotor, Facial, Glossopharyngeal, Trigeminal (Vagus has many parasympathetics, but does not affect head)
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The pterygopalatine ganglion receive preganglionic fibers from what nerves?
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nervus intermedius (facial), greater petrossal, nerve of pterygoid canal
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The submandibular ganglion receive preganglionic fibers from what nerves?
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nervus intermedius (facial), chorda tympani, lingual nerve
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Do sympathetics travel through the ciliary ganglion?
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Yes, postganglionic sympathetic fibers travel through the ciliary ganglion, but do NOT synapse. just pass through
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What is the short ciliary nerve?
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postganglionic parasympathetic form the ciliary ganglion. innervates constrictor pupillae and ciliary body
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During a pupillary reflex, where are the afferent axons located?
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retina
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During a pupillary reflex, where do the afferent fibers travel?
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pretectal membrane of superior colliculi (bypass the lateral geniculate ganglion)
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The pupillary light reflex tests what?
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parasympathetic pupil innervation
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During a pupillary reflex, what is the consensual reflex?
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The opposite eye pupil will also constrict
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What is the accommodation reflex?
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Pupils constrict bilaterally in response to near vision. Ciliary body also constricts. test parasympathetics
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During a pupillary reflex, where are the preganglionic efferent axons located?
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pretectal membrane of superior colliculi to Edinger Westfall nucleus
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During a pupillary reflex, where are the postganglionic efferent axons located?
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ciliary ganglion
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What are some possible causes of a blown pupil?
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anything that damages the parasympathetic pathways of the eye: uncal herniation, Edinger Westfall nucleus damage, brainstem damage
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The largest of the 4 postganglionic parasympathetic ganglia is the ...
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pterygopalatine ganglia
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What nerves is the Vidian Canal made up of?
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The pterygoid/Vidian canal = greater petrossal + deep petrossal nerve
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Where does the Vidian canal go?
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carries preganglionic parasympathetics to the pterygopalatine ganglion
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Postganglionic parasympathetic neurons from the pterygopalatine ganglion travel with which CN
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V2
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Through what foramen does the greater petrossal nerve leave the skull?
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foramen lacerum
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Deep petrossal nerve carries what type of nerve fibers?
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post ganglionic sympathetics
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Greater petrossal nerve carries what type of nerve fibers?
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preganglionic parasympathetics
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How does the lesser petrosal leave the skull?
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foramen ovale
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Where do the lesser petrossal preganglionic nerves synapse with post ganglionics?
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otic ganglion
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To synapse with the otic ganglion, the lesser petrossal crosses which foramen?
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Ovale
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How do glossopharyngeal parasympathetic fibers get to the otic ganglion?
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preganglionics from the inferior salivatory nucleus travel via the tympanic branch to the tympanic plexus. lesser petrossal leave tympanic plexus to otic ganglion via foramen ovale
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How does the tympanic branch of CN9 leave the skull?
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Jugular foramen
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What branch of CNV3 do the postganglionic parasympathetics from the otic ganglion travel with?
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auricotemporal nerve
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The lesser petrossal nerve from the otic ganglion innervates what?
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Parotid salivary gland
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Where is the ciliary ganglion found in relation to the optic nerve and lateral rectus
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between them (lateral to optic nerve, medial to lat. rectus)
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The nerve of the pterygoid canal carries sympathetics from what nerve and plexus?
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deep petrosal nerve from the internal carotid plexus
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The nerve of the pterygoid canal carries parasympathetics from what nerve?
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greater petrosal from salivatory nucleus
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Submandibular ganglion is attached to what CNV branch
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Lingual nerve off V3
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How do parasympathetic fibers from the facial nerve reach the lacrimal gland?
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preganglionics travel to pterygopalatine ganglion, synapse with postganglionic parasympathetics, enter zygomatic then zygomaticotemporal to reach lacrimal gland
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Desscribe the lateral part of the External auditory meatus.
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lateral 1/3 is cartilage, has hairs and cerumen and sebaceous glands
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3 major nerves innervating the external auditory meatus
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Facial, Vagus, auricotemporal
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Outer tympanic membrane innervation
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auricotemporal nerve
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Inner tympanic membrane innervation
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Glossopharyngeal nerve
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Why is otitis media more common in children?
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Their pharyngotympanic tubes are more angled and drainage of middle ear is impaired
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When placing a tympanostomy tube for otitis media, what nerve are w trying to miss?
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Chorda tympani
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Damage to the chorda tympani leads to what?
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loss of taste in anterior 2/3 of tongue and loss of salivation
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Tensor tympani innervation
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CNV3
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Stapedius innervation
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CN7
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The ossicles transmit waves from the eardrum to the ...
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oval window
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What artery runs right by the middle ear?
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internal carotid
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Stapedius function
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prevent excessive stapes bone movement
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Why does facial nerve damage or Bell's Palsy lead to hyperacusis?
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stapedius is no longer innervated and stapes can expand range of movement and vibrate more
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Untreated otitis media can become ....
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mastoiditis as fluid enters mastoid antrum of middle ear
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Embryonic origin of the Malleus and Incus
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1st Brachial arch (Meckel's Cartilage)
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Embryonic origin of stapes
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2nd brachial arch (Reichert's Cartilage)
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What comprises the bony labyrinth of the inner ear?
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semicircular canals, vestibule, cochlea, perilymph
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What comprises the membranous layer of the inner ear?
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cochlear duct, saccule, utricle, semicircular ducts, endolympathic duct, endolymph
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Embryonic origin of the semicircular ducts
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otic vesicle become utricle and saccule. utricle becomes semicircular ducts
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Embryonic origin of the cochlear duct
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otic vesicle become utricle and saccule. saccule becomes cochlear duct
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Vestibular apparatus measures ...
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linear and angular acceleration (head movement and position)
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What are Kinocilia
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single cilia, on hair cells of the semicircular canals, attached to otolith
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Stereocilia in the vestibular apparatus stimulate axons that travel to what ganglion?
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vestibular ganglion
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What are maculae?
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region of specialized neuroepithelial cells to detect head position/movement in ear
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Where are maculae found in the ear?
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utricle and saccule
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In the utricle, where is the macula found?
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on the floor
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In the saccule where is the macula found?
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on its lateral wall
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What is important about the maculae orietantion relative to each other?
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they are perpendicular to each other to detect position in 2 planes
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What is the crista ampullaris?
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crest of neuroepithelial cells in the ampulla of the semicircular canals
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The utricle and saccule have maculae to measure what?
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head position (gravity/linear acceleration)
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In pathological (vestibular) nystagmus, the eye move slowly towards .....
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the damaged side
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How does physiological nystagmus occur?
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vestibular nuclei are connected to the occulomotor nuclei
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What pathway connects the vestibular nuclei to the occulomotor nuclei?
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MLF (Medial longitudinal fasciculus)
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What cranial nerves are associated with the occulomotor nuclei?
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3, 4, 6 (the innervations for the extraocular eye muscles)
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What symptoms are seen in the ear in a patient with Meinere's disease?
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more endolymph
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Fluid waves in the ear travel through ...
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perilymph
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What characteristic of perilymph make it a good conductor of a fluid wave?
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it is not compressible
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What nerves does the modiolus contain?
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spiral ganglion, acoustic portion of vestibulocochlear nerve
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3 spaces of the cochlea
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scala vestibulli, scala media. scala tympani
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Scala media contains what fluid?
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endolymph (part of membranous)
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Scala vestibuli and scala tympani contain what fluid
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perilymph (part of bony labyrinth)
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Fun Fact: There are no Kinocilia in the cochlea. just in the vestibular apparatus.
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goooood riddance
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Cochlear hair cells are embedded in ...
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the tectorial membrane
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The only vascularized epithelium in the body is the ...
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stria vascularis (in the cochlea)
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On the Organ of Corti, the early portions of the basilar membrane sense ...
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high frequency sounds
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On the Organ of Corti, the late portions of the basilar membrane sense ...
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low frequency
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Why are pillar cells of Organ of Corti rigid?
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have microtubules so they can act as fulcrum for tectoral membrane movement
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Vestibulocochlear nerve can be damaged to cause hearing loss by what type of tumor
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Schwannoma at entrance of brainstem (may also compress facial nerve)
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the sphenomandibular muscle attaches to what part of the medial mandible?
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lingula
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Jaw dislocation is associated with damage to what nerve?
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Auricotemporal nerve is near the TMJ
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During wide opening of the jaw, how does the TMJ move?
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Anteriorly over the articular tubercle
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Masseter muscle insertion and origin
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zygomatic arch; lateral mandible
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Contents of the temporal fossa
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temporalis muscle and zygomaticotemporal nerve (off V2)
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Temporalis muscle function
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mandible elevation, retraction and lateral movements during chewing
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Lateral pterygoid muscle function
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protrusion of mandible
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4 muscles of mastication
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temporalis, lateral pterygoid, medial pterygoid, masseter (not buccinator)
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All branches of the mandibular nerve originate in what fossa?
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infratemporal
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All motor innervation for muscles of mastication is from ...
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V3
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Auricotemporal nerve converges and diverges around what artery?
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middle meningeal artery
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What is craniosynostosis?
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premature closure of the cranial sutures
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A depressed fetal fontanelle can indicate ...
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dehydration (due to diarrhea possibly)
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An elevated fetal fontanelle can indicate ...
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high intracranial pressure
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Auricotemporal branch of V3 innervates ...
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parotid gland (carries postganglionic parasympathetics from otic ganglion), skin around ear, outer tympanic membrane, EAM, TMJ
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Lingual nerve of V3 innervates...
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anterior 2/3 of tongue general sense, joins chorda tympani for anterior 2/3 taste
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Inferior alveolar nerve of V3 innervates...
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chin and lower teeth sensation
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The submandibular ganglion hangs from what nerve?
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lingual
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2 branches off 1st maxillary artery part ...
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middle meningeal and inferior alveolar
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4 branches off of maxillary artery part 2
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deep temporal, massetteric, buccal, pterygoid branches
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What part of the maxillary artery enters pterygopalatine fossa?
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3rd part
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6 openings into the pterygopalatine fossa
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inf orbital fissure, palatovaginal canal, foramen rotundum, pterygoid canal, palatine canal
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6 Branches off the 3rd part of maxillary artery in pterygopalatine fossa
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infraorbital artery, posterior superior alveolar, greater palatine, sphenopalatine, pharyngeal, artery of pterygoid canal
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What nerve sits in the myohyloid groove?
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Nerve to myohyloid
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What vertebral level does the hyoid bone sit?
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c3
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The palatine tonsils sit between what 2 muscles?
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palatoglossus and palatopharyngeus
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The side of the oral cavity, with the buccinator, is tightly sealed by what structure?
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pterygomandibular raphe
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How can the strat squam non-keratinized layer of the oral mucosa become keratinized?
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after under going stress (chewing, tobacco)
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Why is the oral mucosa of the floor of the mouth a good place for intravenous drug injection?
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It is thin and permeable. absorbed into blood quickly
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Leukoplakia and squamous cell carnimoa of the mouth can be caused by ...
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smoking, alcohol, irritation
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What is the most common malignancy of the oral cavity?
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squamous cell carcinoma
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Upper lip blood supply
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superior labial branches of infraorbital and facial artery
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Lower lip blood supply
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inferior labial branches of facial and mental artery
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Upper lip innervation: sensory
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Superior labial branches from infraorbital nerve from V2
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lower lip innervation: sensory
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inferior labial branches from mental nerve from V3
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Motor innervation of lips
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facial nerve
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Lymph from the upper lip and lateral lower lip goes to what nodes?
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submandibular
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Lymph from the medial lower lip goes to what nodes?
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Submental
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epithelium of the vermillion zone of lips
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strat squam keratinized
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Why is the lip vermillion zone red?
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a lot of blood vessels
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What is Stenson's duct?
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duct of the parotid gland
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Where does stenson's duct open into the mouth?
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opposite the 2nd maxillary molar
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Upper teeth innervation
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superior alveolar nerve
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Lower teeth innervation
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inferior alveolar nerve from V3
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Dentin is made by what cells?
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odontoblasts
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The peridontial membrane is made up of what bone type?
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Woven
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teeth nerves are found in what part of the tooth?
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root canal/pulp
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Odontoblasts are derived form what/
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neural crest cells
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Function of periodontal ligament
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absorb shock during chewing; act as periosteum of alveolar bone
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scurvy causes damage to what tooth layer
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periodontal ligament
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Mechanoreceptors for the reflex of opening the jaw when biting on something hard are located in what tooth layer?
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periodontal ligament
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Why can braces change the arrangement of teeth?
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alveolar bone is woven bone
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gingiva attaches to enamel by what structure
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epithelial attachment of gottlieb
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What is predentin?q
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Layer of fresh dentin by odontoblasts
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What are found in dentinal tubules
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odonoblast processes (Tomes Fibers)
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What ameloblasts?
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secrete enamel during development
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What is Caries?
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bacteria can accumulate in the enamel and produce acids that decalcify
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What affect does fluoride have on enamel?
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hardens it
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Thyroid is derived from what part of the tongue?
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foramen caecum
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Anterior 2/3 of tongue (body) is derived from what branchial arch
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1
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General Sensation from tongue body is by which CN
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V3
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Taste from tongue body is by whch CN
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Facial (chorda tympani)
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What is Wharton's Duct
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duct of submandibular gland
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4 types of papilla on tongue body
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filiform, fungiform, foliate, circumvallate
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which tongue papillae have no taste buds
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filiform
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Serous glands of Von Ebner are found in which papillae
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circumvallate
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What do glands of Von Ebner do?
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clear out moats and taste buds to allow for new tastes to be sensed
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The posterior 1/3 of tongue senses are from which CN?
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Glossopharyngeal
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Circumvallatepapillae taste is innervated by which CN
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Glossopharyngeal
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tongue motor innervation is from which CN
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Hypoglossal
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4 extrinsic tongue muscles
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genioglossus, hyoglossus, styloglossus, palatoglossus muscles
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3 intrinsic tongue muscles
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lateral, vertical, transverse
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Which extrinsic tongue muscle is not innervated by hypoglossal nerve (CN12)
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Palatoglossus (CNX- vagus)
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Genioglossus function
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depress and protrude tongue
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Hypoglossus function
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depress and retract tongue
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Styloglossus function
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retracts tongue during swallowing; raises it to form a trough
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Palatoglossus function and innervation
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elevate posterior tongue; vagus nerve
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Lingual nerve wraps under what structure in the mouth
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submandibular duct
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Compression of the submandibular duct will likely involve which nerve
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lingual
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If a patients right hypoglossal nerve is damaged, which way will the tongue point?
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right
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3 foramen of the palate
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incisive, greater palatine, lesser palatine foramen
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What passes through the incisive foramen?
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nasopalatine nerve
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What passes through the greater palatine fossa?
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greater palatine nerve and vessels
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What passes through the lesser palatine fossa?
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lesser palatine nerve and vessels
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Soft Palate function
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prevent food from entering nasal cavity during swallowing
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uvula hangs from what structure
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soft palate
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tensor veli palatini function
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tense soft palate, open eustachian tube during yawning
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levator veli palatini function
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elevate soft palate during swallowing and yawning
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tensor veli palatini innervation
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V3
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levator veli palatini innervation
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Vagus
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5 muscles of the soft palate
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tensor and levator veli palatini, palatopharyngeal, palatoglossus, uvular
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palatopharyngeal muscle function
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elevate posterior tongue
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Which soft palate muscle is not innervated by CN X?
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tensor veli palatini (V3), all rest are vagus
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To check the vagus nerve using the tongue, what part would we watch?
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The posterior elevations
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uvular muscle function
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raise uvula
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palatopharyngeus muscle function
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tense soft palate
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Damage to the right vagus nerve would show as a uvula deviated which direction?
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left
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Damage to the right vagus nerve would mainly how in the posterior tongue?
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failure of posterior tongue to elevate on right (ipsilateral)
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3 muscles of the oral cavity floor
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mylohyoid, geniohyoid, anterior belly of digastric
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mylohyoid muscle function
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elevate floor of mouth during speech/swallowing
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mylohyoid innervation
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mylohyoid branch of V3
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geniohyoid function
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hyoid moves anterior and superior during swallow
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geniohyoid innervation
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C1 riding along hypoglossal
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anterior belly of digastric function
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depress mandible, raise/stabilize hyoid
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anterior belly of digastric innervation
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mylohyoid nerve of V3
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inferior alveolar nerve is a branch of what CN
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V3
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mylohyoid nerve is a branch of what cranial nerve
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inferior alveolar from V3
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3 major salivary glands
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parotid, submandibular, sublingual
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What gland can be mistaken for a swollen lymph node in older patients?
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submandibular gland
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2 types of secretory cells in salivary glands and how do they appear in H/E?
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serous (blue) and mucous (clear)
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serous demilunes in salivary glands function
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secrete lysozyme; most common in sublingual
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In which salivary gland are serous demilunes most common?
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sublingual
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myoepithelial cell function in salivary glands
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move the saliva through the ducts
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What are basket cells in the salivary glands?
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stellate shaped myoepithelial cells in the acini
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Describe the duct system saliva uses to get to the mouth from the gland.
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intercalated duct - striated - secretory
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Largest salivary gland
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parotid
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parotid accounts for what % of saliva
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25%
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what separates the parotid gland form others histologically?
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completely serous, most numerous straitions (ducts), fat cells
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Which salivary gland is predominantly mucous secreting?
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sublingual
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70% of saliva comes from which gland?
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sunmandibular
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What is an adenoid?
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inflamed pharyngeal tonsil
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Tonsilar crypts are found in which type of tonsils?
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palatine and few in lingual
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What muscle protrudes the tongue?
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Genioglossus
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What muscle elevates the side of the tongue?
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palatoglossus
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