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Oral Cavity

semester 2

What makes up the lips? Muscles of facial expression esp. orbicularis oris, but also buccinator, levator anguli & labii superioris, depressor anguli & labii inferioris, mentalis, risorius, platysma, zygomaticus major & minor. Haired skin. Mucous membrane w/labial salivary gland.
What is the vermillion border/zone? The red area/transition btwn extern & internal skin of the lips.
What is the purpose of the nasolabial sulci? To separate the upper lip from the cheeks.
What is the purpose of the mentolabial sulcus? To demarcate the lower lip from chin.
What is the philtrum? That midline groove going up from upper lip to your nasal septum.
What is the commissure of the lips? Where does it usually lie in neutral position? The lateral angle btwn upper and lower lips. Will usually be at about 1st premolar in neutral.
What is the labial frenula? Midline folds of mucosa from upper and lower lips to gingiva close to central incisors.
Where does blood to the lips come from? Superior and inferior labial branches of facial artery. Upper also gets infraorbital artery (off maxillary). Lower also gets mental artery off inferior maxillary.
Where does lymph from UPPER and LATERAL part of LOWER lip drain into? Submandibular lymph nodes.
Where does lymph from CENTRAL part of LOWER lip drain into? Submental nodes (and some will cross near midline).
What is motor innervation to lips? Sensory? Motor is CN7. Sensory for lower lip is inferior labial branches off mental (off inferior alveolar from V3). Upper lip is superior labial branches (off infraorbital from V2).
What makes up the cheeks? Buccinator, pterygomandibular raphe, skin, mucous membrane, buccal mucous glands (aka minor salivary glands).
Where does blood to the cheeks come from? Facial artery branches, buccal artery (off 2nd pt of maxillary) & transverse facial (off superficial temporal).
Where does blood drain to from the cheeks? Tributaries of facial & transverse facial veins, and pterygoid plexus.
Where does blood drain to from the lips? Tributaries of similarly named arteries, then into facial veins, and pterygoid plexus. Then ophthalmic veins & emissary veins to cavernous sinus.
Where does lymph drain into from the cheeks? Mostly to submandibular nodes, but also superficial parotid & external jugular (aka superficial cervical) nodes.
What is motor innervation to cheeks? Sensory? Motor is buccal branches of CN7. Sensory is buccal branch of mandibular (V3) & zygomatical facial and infraorbital branches of maxillary (V2).
What do the mylohyoid and geniohyoid form? Where are they located? They form floor of oral cavity. Deep to mucosal membrane and medial to intervening sublingual & submandibular glands (the deep part).
Where does the mylohyoid attach? Both sides come together at median raphe and attaches along entire mylohyoid line & down to body of hyoid.
Where does the posterior margin of the mylohyoid attach? What does it form? NOWHERE. IT IS FREE OF ATTACHMENTS. Rather, it forms one of the borders of the gap btwn superior and middle constrictors.
Where does the geniohyoid attach? Inferior mental spines of mandible to body of hyoid.
Where is the geniohyoid in relation to mylohyoid? Just superior to mylohyoid muscle. On either side of midline.
What does the mylohyoid do? Elevates hyoid when swallowing. If hyoid is fixed, it will depress mandible to open the mouth.
What does the geniohyoid do? Also elevates hyoid when swallowing. As well as depresses mandible to open mouth when hyoid stays fixed.
What innervates mylohyoid? Nerve to mylohyoid.
What is the path of nerve to mylohyoid? Comes off inferior alveolar from V3 right before it goes into mandibular foramen. Then it goes through mylohyoid groove & innervates mylohyoid from below.
What innervates geniohyoid? Ventral ramus of C1! NOT A CRANIAL NERVE.
What is the path of C1 for geniohyoid? Travels with CN12 & then jumps off where superior root of ansa cervcalis is to get to geniohyoid.
Where is the parotid gland located? Where is its duct going? COMPLETELY OUTSIDE the oral cavity. Partoid duct goes anterior and superficial to masseter, and then pierces buccinators & enters oral cavity on cheek, opposite to 2nd molar.
Where is the superficial part of submandibular gland located? Largest part is superficial & fills up a lot of submandibular triangle. Deep to skin & deep cervical fascia that encloses it. Inferior to mylohyoid & forms submandibular fossa on medial mandible.
Where is the deep part of submandibular gland located? Superior to mylohyoid & lateral to hyoglossus & styloglossus. Pretty small part.
Where does the submandibular gland's duct go? Comes out deep part of gland & goes anterior on flow of mouth to open on sublingual caruncle next to base of frenulum of tongue.
What nerve loops around the submandibular duct? The lingual nerve. It will start out lateral to the duct then loops medially as you go anteriorly along the duct.
Where is the sublingual gland located? ENTIRELY WITHIN oral cavity. Deep to mucosa in floor of mouth. Just superior to mylohyoid line & forms sublingual fossa of mandible. Lateral to hyoglossus posteriorly, while it is the genioglossus anteriorly, with the lingual nerve & ducts in btwn.
Where does the sublingual gland's duct go? Actually has many ducts. Will open along sublingual fold.
What is the blood supply for the parotid gland? Branches off posterior auricular, superficial temporal (w/the transverse facial branch) & maxillary arteries.
What is the blood supply for submandibular and sublingual glands? Branches off facial & lingual arteries.
Where does lymph drain for submandibular and sublingual glands? Goes to submandibular nodes to (Superior) Deep cervical nodes to the jugulo-omohyoid node (or directly to jugulo-omohyoid). Some from sublingual glands go to submental nodes first though.
Where does lymph drain for parotid gland? superficial & deep parotid nodes??? to superior deep cervical nodes???
What is parasympathetic innervation to the minor salivary glands? If superior to oral fissure, it will be via greater petrosal and pterygopalatine ganglion via branches of maxillary. If below oral fissure, it is through chorda tympani to submandibular ganglion and then via lingual (v3)
What is the parasympathetic innervation to parotid gland? Lesser petrosal and otic ganglion via auriculotemporal of V3.
What is chorda tympani's route to the submandibular and sublingual glands? superior salivatory nucleus > nervous intermedius (small CN7 root)> thru internal acoustic meatus w/rest of CN7 > splits off before rest of CN7 exits thru stylomastoid foramen in temporal bone > leaves petrotympanic fissure > joins lingual nerve >...
...SYNAPSES in submandibular ganglion! > ... Postgang fibers then goes to EITHER SUBMANDIBULAR gland OR back up to lingual nerve to SUBLINGUAL/MINOR SLAIVARY GLANDS.
What does the sympathetic innervation of the salivary gland do? Mostly vasomotor stuff, but will also adjust what gets secreted.
What is the route of sympathetic innervation of oral salivary glands? Pregang cell body in lateral horn > ventral root > white rami > up sympathetic trunk > synapse on postgang neuron in superior cervical ganglion > follows blood vessels OR deep petrosal & then off from pterygopalatine ganglion to salivary gland.
What are the functions of the tongue? speech, mastication, taste & swallowing
Where does the root of the tongue attach to? What does the inferior surface of the tongue attach to? Root attaches to mandible & hyoid. Inferior part attaches to floor of mouth via frenulum.
What separates the body of the tongue from the root? The terminal sulcus
What does the terminal sulcus point to? What did that structure used to be? The foramen cecum. Used to be the proximal part of thyroglossal duct, from which thyroid gland will develop.
Mucosa of dorsal 2/3 of tongue is covered with what? Where are taste buds present? lingual papillae and some contain taste buds. taste butds are on fungiform, vallate & foliate papillae, but NOT filiform.
What are the most numerous papillae? Which ones have the moat and form in a V just anterior to terminal sulcus? Which ones are larger and more sparse and scattered? Most numerous are filiform. Vallate papillae have moats, and we usually only have like 8-12. Fungiform are large, sparse, and scattered.
Is the dorsal mucosa of the tongue completely covered in lingual papillae? No. The posterior 1/3 does not have any.
What *does* the dorsal mucosa of the posterior 1/3 of the tongue contain? Lymphoid nodules that make up the lingual tonsil.
What is the difference btwn extrinsic and intrinsic muscles of the tongue? Extrinsic muscles attach to structures outside tongue and in tongue. Works to change POSITION of tongue. Intrinsic is all w/in the tongue. Works to change SHAPE of tongue.
What are all the extrinsic muscles of the tongue? genioglossus, hyoglossus, styloglossus & palatoglossus
Where does the genioglossus attach? Superior mental spines anteriorly, superior anterior pt of hyoid body. Rest of it attaches to whole length of tongue.
Where is the genioglossus? Comes out inferior to tongue, on both sides of the median lingual septum along the entire length of tongue. Will be just superior to geniohyoid.
What does the genioglossus do? tongue protrusion via superior and anterior fibers. tongue depression in the center via middle fibers.
Where does the styloglossus attach? Anterior and distal end of styloid process to lateral edge of tongue to tip and main mass of tongue.
What does the styloglossus do? elevates & retracts tongue
Where does the hyoglossus attach? Greater cornu & body of hyoid to subtrance of tongue.
Where is the hyoglossus? Inferior part goes between styloglossus laterally & genioglossus w/inferior longitud. muscle of tongue medially. Passes btwn middle & superior constrictor & mylohyoid to reach tongue.
What nerves and vessels run alongside the hyoglossus? Lingual artery runs medial to it. Lingual nerve & hypoglossal runs lateral to it!
What does the hyoglossus do? Flattens tongue & can also retract it.
Where does the palatoglossus attach? Palatine aponeurosis above and down to intermingle w/intrinsic tongue muscles in posterolateral aspect of tongue.
What does the palatoglossus do? Elevates the posterior tongue. Depresses palate. Moves palatoglossal arches inward to close off oropharyngeal isthmus.
What are the intrinsic muscles of the tongue? superior longitudinal muscle, inferior longitudinal muscle, transverse muscle & verticle muscle
Where is the superior longitudinal muscle? What does it do? Just deep to mucous membrane on dorsum of tongue from apex to base along margins. Curls tongue up (like rolling your tongue) & shortens it.
Where is the inferior longitudinal muscle? What does it do? Runs on inferior surface of tongue longitudinally btwn genioglossus & hyoglossus. Goes from base to apex. Will curl tongue down and longitudinally. Also shortens tongue tho.
Where is the transverse muscle? What does it do? In plane btwn superior and inferior longitudinal muscles. Attaches to median fibrous septum and laterally to submucosa on sides of tongue. Narrow & elongates tongue.
What does the transverse muscle fibers blend with? The palatoglossus fibers.
Where is the vertical muscle? What does it do? Mainly anterior pt of tongue. Goes vertically btwn superior and inferior longitudinal muscle. Flattens & broadens the tongue.
What supplies motor innervation to the tongue? Hypoglossal (CN12) except palatoglossus.
What innervates the palatoglossus? w/most of the other palate muscles.
What is the route of the hypoglossal nerve? Comes out hypoglossus canal medial & posterior to carotid sheath contents > sweeps around laterally to all that > loops around occipital artery near angle of mandible > passes deep to posterior digastric > runs lateral to hyoglossus & deep to mylohyoid
Where do the terminal branches of the hypoglossal nerve go? Btwn mylohyoid and genioglossus muscles.
What supplies sensory innervation to tongue? Anterior 2/3 is lingual nerve off V3. Posterior 1/3 is CN9.
Where does the lingual nerve arise? How does it travel? From V3, medial to lateral pterygoid. Crosses mandibular attachment of superior constrictor > loops under & around submandibular DUCT > lies on superiolateral aspect of hyoglossus muscle when it enters tongue.
Where does glossopharyngeal nerve travel? It goes down into pharynx by accompanying stylopharyngeus btwn superior & middle constrictor. Will enter pharyngeal pt of tongue by passing deep to styloglossus & hyoglossus.
What tonsil is the glossopharyngeal associated with? Palatine tonsil
Where does taste information from taste buds anterior to the vallate papillae go? Thru lingual nerve then thru chordate tympani to neuron cell bodies in geniculate ganglion for CN7.
Where does taste info from taste buds on the vallate papillae and posterior tongue go? If from taste buds on vallate papillae and post tongue, they go with CN9 to inferior ganglion of CN9.
Where does taste from a small area of posterior tongue AND epiglottis go? Via vagus to inferior ganglion of vagus.
What is the main arterial supply to the tongue? Lingual artery that comes off near greater cornu of hyoid.
What crosses the lingual artery? The hypoglossal nerve, posterior digastric & sylohyoid muscle all cross it laterally.
How does the lingual artery get to the oral cavity? It passes in btwn middle pharyngeal constrictor and hyoglossus.
Where does the lingual artery branch? What does it branch into? Lingual artery branches into deep lingual artery on the deep side of anterior part of hyoglossus muscle.
Where does the deep lingual artery go? It is near the inferior surface of the tongue by the frenulum & sublinqual artery.
Where does the sublingual artery run? Anteriorly on the floor of the mouth btwn genioglossus & mylohyoid.
What supplies blood to root of tongue? Dorsal lingual artery off lingual artery.
How does blood drain from the tongue? Via veins that accompany dorsal lingual artery, deep lingual artery & sublinqual artery. Those drain into lingual vein OR vena comitans of hypoglossal nerve.
How does lymph drain from the tongue? It depends on where you are coming from on the tongue...So...
Where does lymph drain from root of the tongue? Goes to superior deep cervical lymph nodes, especially jugulodigastric lymph nodes.
Where does lymph drain from central part of the tongue (body of tongue)? Drains bilaterally to deep cervical lymph nodes.
Where does lymph drain from R & L margins of the tongue? First goes to submandibular nodes.
Where does lymph from the tongue apex drain into? Drains bilaterally to submental nodes.
What is gingiva? Dense fibrous CT covered with mucous membrane attached to alveolar processes of maxillae & mandible.
What is the function of teeth? To cut, grind, & mix food w/saliva, as well as helping with speech.
How many sets of teeth do you get in your life time? What are they called? 2 sets. 1st set is deciduous teeth. 2nd set are permanent teeth.
When do you see deciduous teeth? In babies & young children (6 mo to 24 mo)
When do you first see permanent teeth? Youth & adolescence (6-12 yo; except wisdom teeth), b/c that's when your facial skeleton starts to enlarge.
What are the different parts of the tooth? Crown, root, neck, cusp.
What is the crown of the tooth? What covers it? The part that sticks out ABOVE gingiva. Enamel caps it.
What is the root of the tooth? What is external to this? The part that is embedded IN the alveolus. Cementum is external to the root.
What is the neck of the tooth? It is the part that is a little constricted/narrow between the crown & root.
To what is the root of the tooth attached, and how does it stay put? It is attached to periosteum of the bone via periodontal ligament.
What forms most of the tooth? Dentine
What forms the pulp cavity of the tooth? Where is it located? CT, nerves & blood vessels. It is in the center of the tooth.
How do the blood vessels & nerves get into the tooth? Thru the root canal via apical foramen to get to the pulp.
What are the different surfaces of the teeth? Vestibular, lingual, mesial, distal & occlusal.
What is the vestibular surface of the tooth? The part of the tooth that face the cheek/lip.
What is the lingual surface of the tooth? The part of the tooth that faces IN toward the tongue & palate
What is the mesial surface of the tooth? The part of the tooth that contacts the other tooth medially.
What is the distal surface of the tooth? The part of the tooth that contacts the other tooth laterally.
What is the occlusal surface of the tooth? The surface that touches the opposite tooth in the opposite jaw.
What are the different types of teeth? incisors, canines, premolars & molars
What shape are the crowns on incisors? What are they spcially used for? What do the roots look like? chisel shaped crown. will cut stuff. roots are single & conical.
What do the crowns look like for canines? What do the roots look like? What are the used for? Big, conical, & blunt cusp. Roots are long, large & singular. Grasping & tearing food.
What do premolars crowns look like? What do the roots look like? What do these do? Two cusps (a labial & lingual) on crowns separated by groove. Single root & the end/apex might be bifid. Helps in chewing.
What do the molar crowns look like? What are they used for? Crowns will have 3-5 cusps. Grinding.
What is the difference between maxillary and mandibular molars? Maxillary ones have 3 roots. Mandibular have 2 roots.
What are wisdom teeth & what do their roots usually look like? These are the last molars of each jaw & will usually have fused roots.
What is the difference btwn deciduous and permanent teeth? 12 extra teeth. There are 20 deciduous teeth (4 incisors, 2 canine, 4 molars, all x2) & 32 permanent teeth (4 incisors, 2 canines, 4 premolars & 6 molars, all X2).
When do wisdom teeth start popping out? 13-25 yo
What supplies mandibular teeth with blood? Inferior alveolar artery coming thru mandibular canal.
What supplies maxillary teeth with blood? Posterior alveolar artery, or a direct branch off maxillary, or middle & anterior superior alveolar artieres off infraorbital artery.
What is the blood supply to the gingivae? It depends on where you are....
So what is the blood supply to the gingivae that face the oral vestibule? Inferior alveolar or superior alveolar arteries.
What is the blood supply to the inferior lingual gingivae? Supplied by lingual artery
What is the blood supply to the superior lingual gingiva? Supplied ANTERIORLY by sphenopalatine artery. Supplied POSTERIORLY by greater palatine artery.
What is the venous drainage of the teeth & gums? The pterygoid plexus as well as some tributaries to facial vein.
Where does lymph from the teeth & gingivae drain? To the submental, submandibular & deep cervical lymph nodes.
What innervates all teeth? CNV
What innervates the teeth in the upper jaw specifically? Branches off maxillary, including posterior superior alveolar nerve & middle & anterior alveolar nerves off infraorbital nerve.
What innervates the teeth in the lower jaw specifically? The inferior alveolar nerves off V3 running thru mandibular canal, and once it goes past mental foramen, it becomes incisive nerve.
What innervate the gingivae associated with upper teeth? V2
What innervate the gingivae associated with lower teeth? V3
What innervates the buccal & labial gingivae of the upper jaw? Posterior, middle & anterior superior alveolar nerve.
What innervates the superior lingual gingiva? The nasoplatine & greater palatine nerves from V2
What innervates labial gingiva of lower jaw? Mental nerve branch of inferior alveolar.
What innervates buccal mandibular gingiva? Buccal branch of V3
What innervates inferior lingual gingiva? Lingual nerve off V3
Created by: h.pang00



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