Head & Neck: Oral Cavity And Pharynx

Front 1

What are the 3 regions of the pharynx?

Back 1

1) nasopharynx
2) Oropharynx
3) Laryngopharynx

Front 2

What are the 3 layers of cervical viscera and what are their contents?

Back 2

-Endocrine: thyroid, thymus, parathyroid
-Respiratory: larynx trachea
-Alimentary: pharynx, esophagus

Front 3

What are the 2 parts of the palate?

Back 3

-Hard Palate:maxilla and palantine bone
innervated by: greater palantine & nasopalantine

-Soft Palate
innervated: lesser palantine

Front 4

What are the foramen associated with the hard palate?

Back 4

1. incisive foramen
2. greater palantine
3. lesser palatine

Front 5

Elevating muscles of the palate.

Back 5

1. Levator veli palantini:
-attach: base of auditory tube to palatal aponeurosis - CN X
2. Tensor veli palantini:
-attach: lat. aspect of aud tube & scaphoid/pterygoid fossa, around hamulus to palatal aponeurosis
-action: also tenses palate & opens auditory tube - CN V3

Front 6

Depressing muscles of the palate.

Back 6

1. Palatopharyngeus:
-attach: palatal aponeurosis to lat. wall of pharynx
Action: also elevate pharynx - CN X
2. Palatoglossus:
-attach: palatal aponeurosis to dorsum/lateral tongue
action: also raise tongue

Front 7

5th muscle associated with the soft palate?

Back 7

Musculus uvulae (bilateral)
-Attach: post. nasal spine to both sides of soft palate
-action: raise uvula
CN X

Front 8

What is one category of muscles of the pharynx?

Back 8

-Superior pharyngeal: pterygoid hamulus & pterygoidmandibular raphe to mandible then pharyngeal tubercle & median raphe constrictor
-Middle pharyngeal constrictor: hyoid bone to median raphe
-Inferior pharyngeal constrictor: thyroid & cricoid cartilage to median raphae
* all constrict the pharynx during swallowing
*all innervated by CN X

Front 9

What is the 2nd category of muscles of the pharynx?

Back 9

elevate pharynx or depress palate during swallow/speak
-palatopharyngeus: palatal apaneurosis to lat. wall of pharynx CNX

-Stylopharyngeus: styloid process to lat. wall of pharynx, thyroid cart, and cricoid cart. CN IX

-Salpingopharyngeus: auditory tube to pharynx CN X

Front 10

Structures that enter the pharynx

Back 10

-Above sup. constritor (gap 1):
>levator veli palintini
>Ascending palantine branch of facial artery
>Auditory tube

Bw sup & mid (gap 2):
>stylopharyngeus muscle
> Glossopharyngeal nerve
>Stylohyoid ligament

Bw mid & inf (gap 3):
>internal laryngeal nerve CN X
>Sup. laryngeal branch of sup. thyroid artery

Bw inferior constrictor (gap 4):
>recurrent laryngeal nerve
>inf. laryngeal branch of inf thyroid art.

Front 11

What is the pharyngeal plexus?

Back 11

CN IX, X, and sympathetic:
Branchial motor
-all CN X except stylopharyngeus = CN IX
General sensory (IX and X)
-except nasopharynx (V2)
Autonomic -
Sympathetic
Parasympathetic CN X
-mucosa

Front 12

Topical landmarks of the pharynx:

Back 12

Nasopharynx:
-mouth of auditory tube
-salpingopharngeal fold
-pharyngeal recess
-pharyngeal tonsils (adenoids)

Oropharynx:
-palatoglossal arch
-palatopharyngeal arch
-palatine tonsil

Laraygopharynx:
-epiglottis

Front 13

Layers of the pharynx

Back 13

internal --> external:
1. muscosa membrane
2. fibrous pharyngobasilar fascia
3. muscular layer
4. buccopharyngeal fascia (contains plexus)

Front 14

External features of the oral cavity - lips:

Back 14

Nasolabial groove
Philtrum
Columella
Labiomental groove

Front 15

Oral cavity - lips, layers:

Back 15

Skin:
-verminllion border
-transitional zone
-muscle
-glands
-mucous membrane
-vestibular (mucolabial fold)
-labial frenula

Front 16

Arterial supply and sensory nerve of:
1. upper lip
2. lower lip

Motor nerve supply to lip:

Back 16

1. sup labial art & nerve
2.mental artery art & nerve and inf. labial art.

Mandibular branch (facial nerve)

Front 17

Layers of the cheek:

Back 17

1. skin
2. muscle
3. glands
4. mucosa (mucobuccal fold)

Front 18

Arterial supply to the cheek

Back 18

upper cheek:
transverse facial
zygomatico -facial/temporal

lower cheek:
buccal artery

Front 19

Sensory nerve supply to the cheek:

Back 19

upper 1/2:
zygomaticofacial (V2)
lower 1/2:
buccal nerve (V3)

Motor nerve supply: facial nerve

Front 20

What are the divisions of the tongue?

Back 20

Body- ant. 2/3 (1st arch)
Root- post 1/3 (3rd arch)
Sulcus terminalis

Foramen secum (apex of terminal sulcus)

Front 21

What kind of structures can be found on the superior surface of the tongue?

Back 21

Papillae:
1. filiform: most numerous; give rough texture, sensory nerve endings
2. fungiform: flobular and red, less numerous, at tip and lat. margins, taste buds
3. vallate: at sulcus terminalis, contains most taste buds
4. foliate: 3 or 4 vertical folds at lateral surface, taste buds
* taste buds also found on:
-palate
-pharynx

Front 22

Where is the lingual tonsil located?

What is on the sublingual surface?

Back 22

post 1/3 of tongue

thin mucosa

Front 23

What are the intrinsic tongue muscles?

Back 23

All change the shape of the tongue & innervated by CN XII:
1. superior lonitudinal: curls tongue sup. & shortens
2. inferior longitudinal: curls tongue and inf. shortens
3. vertical: flattens tongue
4. transverse: narrows tongue

Front 24

What are the paired extrinsic tongue muscles?

Back 24

1. Genioglossus (paired):
-superior fibers: genial tubercles (sup. mental spine) to body of tongue = retract tip of tongue
-middle fibers: genial tub. to body of tongue = depress dorsum of tongue & protrude
-inferior fibers: gen. tub to hyoid = protrude tongue, advance hyoid

Front 25

What are the rest of the extrinsic tongue muscles?

Back 25

1. Hyoglossus: hyoid bone to lat. tongue = retrude tongue & draw sides down, raise hyoid CN XII

2. Styloglossus: styloid process to lat. tongue = retrude tongue & draw sides up CN XII

3. palatoglossus: palatal aponeurosis to dorsum & lat. tongue = elevate tongue, depress palate CN X

Front 26

What is deep to the hyoglossus muscles?

Back 26

lingual artery

Front 27

What is superficial to hyoglossus muscle?

Back 27

1. hypoglossal nerve
2. lingual nerve
3. submandibular duct

Front 28

What muscles are invovled in protrusion of the tongue?

Back 28

1. genioglossus
-middle fibers
-inferior fibers

Front 29

Muscles involved in retrusion of the tongue?

Back 29

1. styloglossus
2. hyoglossus
3. genioglossus (sup. fibers)

Front 30

Muscles invovled in depression of tongue?

Back 30

1. hyoglossus
2. genioglossus (mid fibers)

Front 31

Muscles involved in elevation of tongue?

Back 31

1.palatoglossus
2. styloglossus

Front 32

Muscles involved in shortening?

Back 32

sup longitundinal
inf. longitundinal

Front 33

muscles involved in flattening...

muscles involved in narrowing...

Back 33

vertical

transverse

Front 34

What is the motor innervation of the tongue?

What is the sensory innervation of the tongue?

Back 34

Motor: CN XII

Sensory:
-General=ant 2/3: lingual nerve V3
-Special= ant 2/3: CN VII chorda tympani

-Gen/Spec = post 1/3 = CN XI

Front 35

Innervation of the floor of mouth:

Back 35

1. Lingual nerve V3: sesnation of tongue
2. Chorda Tympani & submandibular glanglion CN VII: para & sp. sens.
3. CN XII: somatic motor
4. CN IX: gen/sp. sens to post 1/3 tongue

Front 36

Arteries at the floor of the mouth

Back 36

Lingual artery:
-dorsal lingual
-deep lingual
-sublingual

Front 37

Salivary glands at floor of mouth:

Back 37

-submandibualr
-sublingual

Front 38

Stage 1: of Swallowing & Deglutition:

Back 38

Stage One (Voluntary)
Following mastication, the food is pressed into a bolus on the dorsum of the tongue against the hard palate. The swallow is initiated by pushing the food posteriorly into the oropharynx by the tongue.

Front 39

Stage 2: of Swallowing & Deglutition:

Back 39

Stage Two (Involuntary)
The soft palate elevates to seal the oropharynx from the nasopharynx and prevents regurgitation of food into the nasal cavity. The stylopharyngeus and palatopharyngeus muscles and the suprahyoid muscles contract to raise the larynx.

Front 40

Stage 3: of Swallowing & Deglutition:

Back 40

Stage Three (Involuntary)
The three constrictor muscles contract in a sequential fashion as peristaltic waves. From superior to inferior, each pair of muscles contracts for approximately 0.33 second. Just as the muscles physically overlap, so do their contractions overlap from superior to inferior.

Front 41

Stage 4: of Swallowing & Deglutition:

Back 41

Stage Four (Involuntary)
The bolus enters the esophagus and is propelled downward by peristaltic action.
The cricopharyngeus muscle (lower fibers of the inferior constrictor muscle) is in a constant state of contraction and prevents passage of air to the esophagus below. During the act of swallowing, the cricopharyngeus relaxes to allow passage of the bolus into the esophagus below. The bolus is propelled to the stomach by peristaltic waves of the esophagus.

Front 42

Rules of innervation:

Back 42

ALL OF THE MUSCLES OF THE TONGUE ARE INNERVATED BY CN XII, EXCEPT THE PALATOGLOSSUS – CN X
 
ALL OF THE MUSCLES OF THE PALATE ARE INNERVATED BY X, EXCEPT THE TENSOR VELI PALATINI – CN V3
 
ALL OF THE MUSCLES OF THE PHARYNX ARE INNERVATED BY X, EXCEPT THE STYLOPHARYNGEUS – CN IX

Front 43

HIERARCHICAL RULES

Back 43

TAKE THE NAME OF ANY MUSCLE, GO DOWN THE RULES IN ORDER, AND PLACE THE MUSCLE IN THE FIRST
APPROPRIATE SLOT

1. TENSOR RULE - CN V3 Anything that starts with tensor is innervated by CN V3 this includes tensor tympani
 2.  PALATAL RULE – CN X
Anything that has palate in the name is innervated by CN X; this includes uvula
3.  GLOSSUS RULE – CN XII
Anything that has glossus in the name is innervated by CN XII; this includes intrinsic tongue muscles
4.  STYLOID RULE – CN IX
Any of the muscles we have considered today that have stylo in the name are innervated by IX. This does not include stylohyoid – CN VII
5.  PHARYNGEAL RULE – CN X
Anything left that has pharyngeal in the name is innervated by CN X