4: Hna A4: Oral Cavity

Front 1

What divides the mucosa of the hard palate? What is it a embryological sign of?

Back 1

Midline palatal raphe - connective tissue sign of embryological development of hard palate and mucosa, where to began laterally as anlage and grew towards the midline as they merged.

Front 2

1) What do you see when you elevate the tongue?
2) Where is the labial frenulum run from?

Back 2

1) Lingual frenulum
2) On the maxillary and mandibular arches, from inner portion of the lip to the vestibular gingiva between the central incisors.

Front 3

1) Name of the anterior dental arch? What muscle does it contain?
2) Name of the posterior dental arch? What muscle does it contain?
3) A swelling in these areas could be due to what factors?

Back 3

1) Palatoglossal arch, palatoglossus muscle
2) Palatopharyngeal arch, palatopharyngeal muscle.
3) Tonsillitis, poor lympathic drainage, infection in lateral pharyngeal or retropharyngeal space.

Front 4

What is the landmark for the opening of the parotid duct?

Back 4

Papilla right at the area of the second maxillary molar.

Front 5

What is the landmark for the opening of the submandibular duct?

Back 5

Sublingual papilla on the inferior aspect of the tongue, right on the midline

Front 6

1) What does the sulcus terminalis do?
2) What is the foramen cecum and what is it a remnant of?
3) What does the median sulcus do?

Back 6

1) Separates the dorsal aspect of the tongue into the anterior 2/3rds and posterior 1/3
2) A depression at the apex of the sulcus terminalis. Remnant of the fetal thyroglossal duct that connected the tongue to the thyroid gland
3) Separates the anterior aspect of the tongue into right and left portions

Front 7

1) Which papillae are hairlike and small, but most numerous?
2) Which papillae are shaped like small mushrooms?
3) What papillae are located primarily along the sulcus terminalis?
4) What papillae are found on the lateral aspects of the tongue and what are they often mistaken for?

Back 7

1) Filiform
2) Fungiform
3) Circumvallate
4) Foliate, cancer

Front 8

1) What nerves innervate what parts of the tongue?
2) The muscles that innervate the tongue are from what type of origin? What nerve innervates them? What is the exception?

Back 8

1) 7 (anterior 2/3rds), 9 (posterior 1/3), 10 (epiglottis)

2) Somatic, hypoglossal. Exception - palatoglossus. Although it moves the tongue, technically not considered a muscle of the tongue, and innervated by XI via X.

Front 9

What are the three true extrinsic muscles of the tongue, origin/insertion, function, innervation? What is the fourth muscle that helps, but is not a true muscle?

Back 9

1) Styloglossus - styloid process -> lateral aspect of tongue. Elevates/retracts, trough XII

3) Hyoglossus - superior aspect of greater/lesser horns of hyoid, lateral aspect of tongue. Depress, retrude, XII

2) Genioglossus - superior mental spines -> total dorsum of tongue and hyoid process. Protrusion, depresses dorsum of tongue, retracts extreme tip of tongue. XII

4) Palatoglossus - palatine aponeurosis -> lateral aspect of tongue. Elevates posterior aspect of tongue. Closure of oropharyngeal isthmus by bringing tongue towards soft palate. X, or XI via X

Front 10

1) What is the nucleus that sends out motor fibers through CN 9, 10, 11?
2) Does the vagus carry branchial motor?

Back 10

1) Nucleus ambiguus
2) No - motor fibers from the nucleus ambiguus travel in 11, hop on to 10 after exiting the jugular foramen.

Front 11

Longitudinal fibers:

1) Extrinsic or intrinsic muscle of the tongue?
2) Direction of travel?
3) Two bundles and where they're found?
4) Action?
5) Innervation?

Back 11

1) Intrinsic
2) Anteroposterior
3) Superior - inferior to mucosa of dorsum of tongue
Inferior - between genioglossus and hyoglossus
4) Shorten length of tongue, curl tongue
5) CN XII

Front 12

What are the intrinsic muscles of the tongue?

Back 12

1) Longitudinal fibers
2) Transverse fibers
3) Vertical fibers

Front 13

Transverse fibers:

1) Extrinsic or intrinsic?
2) Direction of travel?
3) Action?
4) Innervation?

Back 13

1) Intrinsic
2) Perp. to inferior bundle of the longitudinal fibers
3) Curl tongue, form longitudinal trough
4) CN XII

Front 14

Vertical fibers:

1) Extrinsic or intrinsic?
2) Direction of travel
3) Action
4) Innervation

Back 14

1) Intrinsic
2) Dorsum of tongue in inferior direciotn
3) Flatten/broaden the tongue
4) CN XII

Front 15

When speaking, what parts of the mouth does the tongue make contact with? What does sensory on the inside of the teeth include?

Back 15

Teeth, mucosa of inside of the cheek, palate. Trigeminal nerve.

Front 16

What papillae are tastebuds primarily associated with? Where are some other taste buds scattered?

Back 16

Circumvallate and fungiform, few on foliate. Scattered taste buds on epithelium of soft palate, posterior wall of pharynx, area adjacent to epiglottis.

Front 17

Filiform papillae:

1) What epithelium lines it?
2) Is there connective tissue?
3) How numerous are they?
4) What is their job?
5) Are there taste buds here?

Back 17

1) Stratified squamous epithelium, keratinized
2) NO
3) Most numerous
4) Move things back and forth
5) NO taste buds

Front 18

Submandibular gland:

1) How large is it?
2) How much salivary output does it produce?
3) What does it secrete into?
4) What kind of product does it secrete?
5) Where does the submandibular duct terminate?

Back 18

1) 2nd largest of major salivary glands
2) 60% of salivary output
3) Wharton's Duct
4) Sero-mucous product (serous will be dark, mucous will be light)
5) Adjacent to lingual frenulum, posterior to mental spines of the mandible

Front 19

Parotid duct:

1) Where does it terminate?
2) How large is it?
3) How much salivary output does it produce?
4) Enclosed by?
5) What duct does it secrete through?
6) What kind of product does it secrete?

Back 19

1) Small orifice and papilla in oral mucosa, lateral to second maxillary molar
2) Largest of the salivary glands
3) 30% of salivary output
4) Capsule
5) Stensen's Duct
6) Serous product

Front 20

What is ankyloglossia?

Back 20

Tongue tie

Front 21

What is geographic tongue due to?

Back 21

Increased hyperkeratosis, variances in height of papillae.

Front 22

Fissured tongue - what is it strongly related to?

Back 22

Geographic tongue - the same genes may be related to it.

Front 23

What is coated tongue due to? Is it symptomatic? What else can it be confused with?

Back 23

Elevated filiform papillae, accumulation of keratin. Asymptomatic but may have bad taste in their mouths. Hairy tongue, hairy leukoplakia look similar.

Front 24

Hairy tongue - what does it result from? What % of adults have it? What is the cause?

Back 24

Keratin on filiform papillae. 0.5% adults. Heavy smoking, poor oral health, poor oral hygiene, radiation therapy to head and neck.

Front 25

What two bones does the palate develop from?

Back 25

Maxillary and palatine

Front 26

What is coated tongue due to? Is it symptomatic? What else can it be confused with?

Back 26

Elevated filiform papillae, accumulation of keratin. Asymptomatic but may have bad taste in their mouths. Hairy tongue, hairy leukoplakia look similar.

Front 27

What is the hard palate covered by? What nerves innervate it?

Back 27

Substantial mucosal lining.

Sensory innervation via all branches of the maxillary branch of the trigeminal nerve -

1) Nasopalatine nerve - lingual gingiva, palatal mucosa anterior to maxillary canines

2) Greater palatine nerve - lingual gingiva, palatal mucosa posterior to maxillary canines

3) Lesser palatine nerve - mucosa of anterior aspect of soft palate.

4) Posterior area of hard palate is glossopharyngeal nerve, responsible for the gag reflex

Front 28

What are the two muscles of the soft palate? Origin/insertion/function/innervation?

Back 28

1) Palatopharyngeus, palatine aponeurosis->lateral wall of pharynx, pulls tongue/soft palate towards pharynx to help seal oropharyngeal opening. XI via X, or X entirely

2) Palatoglossus - palatine aponeurosis -> lateral aspect of tongue, same as palatopharyngeus, XI via X or X entirely

Front 29

Hairy leukoplakia:

What is it due to? Who does it occur in?

Back 29

Vertical streaks of keratin on the lateral border of the tongue, immunocompromised patients, HIV patients

Front 30

Contact stomatitis due to cinammon flavoring - is it removable, and what is it?

Back 30

Allergic reaction, removable.

Front 31

1) What are the four structural portions of the soft palate?
2) What are the five muscles of the soft palate? What are they innervated by?

Back 31

1) Mucosal lining, mucous glands, midline palatine aponeurosis, muscles that move the soft palate
2) Palatopharyngeus, palatoglossus, levator palati, tensor palati, uvular muscle. All innervated by XI via X except for tensor palati (branch of mandibular nerve of trigeminal nerve).

Front 32

Levator palati:

1) Origin/insertion?
2) Function
3) Innervation

Back 32

1) Medial floor of auditory tube/palatine aponeurosis
2) Elevate soft palate to seal nasopharynx from oropharynx, can open the auditory tube
3) XI via X, or X entirely

Front 33

Tensor palati:

1) Origin/insertion
2) Function
3) Innervation

Back 33

1) Lateral aspect of auditory tube -> palatine aponeurosis. Hooks around hamulus of medial pterygoid plate.
2) Tenses soft palate, open auditory tube
3) Nerve to tensor palati, branch of mandibular nerve of trigeminal

Front 34

Uvular muscle:

1) Origin/insertion
2) Function
3) Innervation

Back 34

1) Posterior nasal spine -> submucosa of uvula
2) Pull uvula superior to help seal nasopharynx
3) XI via X or vagus nerve entirely