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22 Cards in this Set
- Front
- Back
Teeth:
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*32 in adult
*20 "milk teeth" or deciduous teeth *medial and lateral incisors *caninie *2 premolars *3 molars |
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Tooth Innervation:
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1. mandibular teeth: inferior alveolar nerve (V3)
2. maxillary teeth: posterior superior alveolar (V2), middle superior alveolar (off infraorbital (V2)), anterior superior alveolar (infraorbital) |
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Hard Palate:
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*made up of palatine process of maxilla more anteriorly and horizontal plate of palatine more posteriorly
*intermaxillary suture-separates 2 palatine shelves *palatomaxillary suture-runs trasversely *greater palatine foramen-located around 3rd molar by edges of maxilla and palatine *lesser palatine foramen (posterior to greater) *incisive canal-nasopalatine nerve extis to pass posteriorly and connect with greater palatine nerve |
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Undissected Oral Cavity:
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*uvula-part of soft palate
*palatoglossal and palatopharyngeal arches and respective folds *palatoglossal and palatopharyngeal muscles deep to arches *palatine tonsils-lie in between arches *tongue-posterior portion less mobile and named "root"; anterior surface more mobile and is primarily dorsum of tongue |
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Tongue Elevated:
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1. vestibule-area between lips and teeth
2. frenulum-small band of connective tissue in midline of underside of tongue **undersurface of tongue, mucosa is very thin as to see blood vessels 3. sublingual caruncle-small folds on either side of base of frenulum with openings of submandibular duct |
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Floor of Oral Cavity: inferior view
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1. mylohyoid-main contributor;
2. geniohyoid-superior to mylohyoid; attaches to inferior genial spine of mandible |
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Floor of Oral Cavity: superior view
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1. genioglossus-tongue muscle: attaches to superior genial spine of mandible
**CC: while unconscious, tongue will fall back and occlude airway; pull mandible anteriorly to use genioglossus to pull tongue forward 2. hyoglossus-extrinsic 3. inferior alveolar and lingual nerve-both from V3 *inferior alveolar nerve runs inferiorly to pass into mandibular foramen *lingual nerve travels lateral then medial to submandibular duct |
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Path of Lingual nerve:
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*branch of V3
*carries afferent fibers from anterior 2/3 of tongue for "touch" and sensation *efferent fibers from chorda tympani nerve (off facial) that enter the lingual nerve; these fibers synapse in submandibular ganglion *submandibular ganglion rests on lateral surface of hyglossus *linguan nerve will cross over lateral surface of submandibular duct, then inferior, forming a hammock, and then runs medially to duct (**crosses duct twice) |
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Lateral and Coronal sections of cavity: Buccinator
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1. buccinator-pierced by parotid duct to go to oral cavity just adjacent to upper 2nd molar
*innervated by CNVII but not muscle of facial expression but described as "accessory mastication muscle" *keeps bolus of food out of vestibule 2. buccal fat pad (suctorial)-associated just anterior to anterior edge of buccinator *deficiency in fat pads results in dimples **CC: facial nerve palsy-food gets caught in vestibule |
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Fauces
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1. throat:
*posterior border of oral cavity *between right left palatal arches *another name for arches are "pillar of pharynx" *line of demarcation on tongue between root (oropharynx) and more anterior part |
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Lips:
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*allows for more effective speech, grasping objects, and osculation (kissing)
*innervated by superior labial nerve (infraorbital) and inferior labial nerve (mental nerve) |
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Philtrun
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**small furrow in midline between the columella and upper edge of lip
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Salivary Glands:
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1. 3 major glands:
a) Parotid-largest b) submandibular c) sublingual-smallest *make ~pint of saliva/day 2. parasympathetic innervation: a)facial nerve (via chorda tympani/lingual) for submandibular and sublingual b)glossopharyngeal (CNIX)-via otic ganglion for parotid 3. Accessory Salivary: *can be found just behind lips, adjacent to buccinator, on palate, around tonsils, around tongue, etc. |
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Medial view of Mandible:
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1. gingival: connective tissue lining that helps anchor teeth
2. submandibular gland forms a C shape around mylohyoid, dividing into superficial and deep portions *deep portion is smaller and where duct arises from and runs anteriomedially 3. sublingual gland: has small ductules that drain either directly into oral cavity or in to submandibular duct **CC: lingual nerve in close proximity to 3rd molar; during extraction, roots could torque nerve, resulting in loss of sensation to anterior 2/3 of tongue ipsilaterally |
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Soft Palate:
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1. levator veli palatini-attached to posterior nasal spine (via palatine aponeurosis)
2. tensor veli palatini-wraps around hook of pterygoid hamulus *both attach to cartilaginous portion of Eustachian tube **Sensory innervation to hard/soft palates: greater and lesser palatine **Motor: TVP-mostly V3; remaining muscle of soft palate via pharyngeal plexus (CNX) |
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Extrinsic Tongue Muscles:
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1. styloglossus: arise from styloid process and stylohyoid ligament
*elevates and retracts protruded tongue 2. hyoglossus: arise from hyoid *pulls tongue down flat in cavity 3. genioglossus: forms "meat" of tongue; arises from superior genial spine and runs into tongue *helps protrude tongue 4. intrinsic muscles: paried with extrinsic; arise in substance of tongue and allow tongue to contort, twist, roll, etc **CC: all extrinsic muscles innervated by hypoglossal nerve; test by protruding tongue and moving side to side (genioglossus) and then retract (styloglossus) |
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Hypoglossal nerve, Lingual and Buccal nerves:
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Hypoglossal:
*CNXII *passes deep to mylohyoid, and superficial to hyoglossus as passes toward tongue Lingual: *from V3 *serves gingiva on internal aspect of teeth of mandible Buccal: *from V3 *serve lateral gingiva |
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Clinical Correlations:
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1. vallecula-small depression between glossoepiglottic folds
*CC: putting instrument into vallecula cause epiglottis to fold anteriorly; important when intubating; put blade immediately anterior to epiglottis, which flips out of visual field to expose laryngeal opening 2. paralysis of genioglossus-can lead to obstruction of airway; pull mandible anteriorly 3. lesion of CNXII-genioglossus will not work on side of lesion; other side will push apex of tongue toward side of de-innervation |
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Lymphatic drainage:
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**tongue is divided into anterior 2/3 and posterior 1/3 by terminal sulcus
1. submandibular: gingiva and all teeth except mandibular incisors, lateral portions of anterior 2/3 of tongue 2. jugulodigastric (found between IJV and common facial vein, drains in deep cervical); bilateral-posterior 1/3 of tongue 3. deep cervical; bilateral-medial part of anterior 2/3 of tongue 4. submental-apex of tongue *CC: always palpate jugulodigastric, submandibular, and submental nodes while doing oral cavity exam |
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Tongue arteries and veins:
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**lingual artery (off ECA): will branch into sublingual, deep lingual and dorasal lingual arteries
**lingual vein **hyoglossus separates artery and vein: vein runs superficial and artery deep **common facial vein receives facial and lingual veins **very superficial venous anastomoses on sublingual portion of tongue, which will go to IJV **CC: dehydrated patients are sometimes hard to put IVs in; easier to put drug under tongue; reach heart directly or indirectly |
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Dorsum of Tongue:
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1. sulcus terminalis-inverted "V" groove; points to foramen cecum, which is site of embryological genesis of thyroid gland
2. medial sulcus-separates left and right tongue 3. papillae-taste buds sit on *major papillae are: circum vallate, foliate, filiform, fungiform papillae |
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Taste:
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**taste buds located on tongue, soft palate, oral pharynx, and epiglottis
**SVA **CNVII: convey taste fibers via chorda tympani nerve to anterior 2/3 of tongue **CNIX: both taste and sensation posterior 1/3 of tongue **CNX: via internal laryngeal branch of superior laryngeal will innervate some bud speckling epiglottis and som on posterior 1/3 Ganglia: *CNVII: geniculate ganglion *CNIX: inferior (petrosal) ganglion *CNX: inferior (nodose) ganglion General Sensation of tongue: 1. lingual nerve (V3) for anterior 2/3 (GSA) 2. CNIX for posterior 1/3 (GVA) |