Oral Cavity and Pharynx 10-26

8/14/2019 Oral Cavity and Pharynx 10-26

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Oral cavity and Pharynx

Dept of AnatomyDept of Anatomy


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ORAL REGION

Includes oral cavity, teeth, gingiva,tongue,Includes oral cavity, teeth, gingiva,tongue,palate, and palatine tonsilspalate, and palatine tonsils

Food is ingested and prepared for digestionFood is ingested and prepared for digestion Food is chewed by teeth and saliva facilitateFood is chewed by teeth and saliva facilitate

formation of manageable food bolusformation of manageable food bolus

Swallowing is initiated [voluntary phase]Swallowing is initiated [voluntary phase] Food is pushed into the pharynx [automaticFood is pushed into the pharynx [automatic

phase]phase]


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Oral Cavity

2 parts:2 parts:

1] Oral vestibule1] Oral vestibule

2]Oral cavity proper2]Oral cavity proper

Oral vestibuleOral vestibule = slit space= slit spacebet teeth- buccal gingiva andbet teeth- buccal gingiva andlips-cheeklips-cheek

>Vestibule communicates with>Vestibule communicates withexterior thru mouthexterior thru mouth

>Size of opening is controlled by>Size of opening is controlled bycircumoral muscles ascircumoral muscles asorbicularis oris,buccinator,orbicularis oris,buccinator,risorius, depressors andrisorius, depressors andelevators of lipselevators of lips


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Oral Cavity Proper

Space bet upper andSpace bet upper and

lower dental archeslower dental arches

Limited laterally andLimited laterally and

anteriorly by maxillaryanteriorly by maxillaryand mandibular alveolarand mandibular alveolar

archesarches

Roof: PalateRoof: Palate

Communicates postlyCommunicates postlyw/ oropharynxw/ oropharynx

When mouth is closed,When mouth is closed,

O.C. occupied by tongueO.C. occupied by tongue


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LIPS

Mobile, muscular foldsMobile, muscular folds

surrounding the mouthsurrounding the mouth

Contain the orbicularisContain the orbicularis

oris, superior and inferiororis, superior and inferior

labial muscles, BV,nerveslabial muscles, BV,nerves

Covered by skin [outside]Covered by skin [outside]

and mucous memb[inside]and mucous memb[inside]

Fxn: Grasping food,Fxn: Grasping food,

sucking liquids,formingsucking liquids,forming

speech, kissingspeech, kissing


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UPPER LIPS

Bet nose and opening of oralBet nose and opening of oralcavitycavity

Vermillion borderVermillion border

Indicates abrupt start ofIndicates abrupt start oftransitional zonetransitional zone

Nasolabial grooves- bet noseNasolabial grooves- bet noseand angle of mouthand angle of mouth

- prominent when smiling- prominent when smiling

Philtrum infranasalPhiltrum infranasaldepressiondepression


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LOWER LIPS

Between mouth andBetween mouth and

labiomental groovelabiomental groove

Labiomental groove = sepLabiomental groove = sep

lower lip from chinlower lip from chin

Labial frenula= free edgedLabial frenula= free edged

folds of mucous memb infolds of mucous memb in

the midlinethe midline

- extends fr vestibular- extends fr vestibular

gingiva to mucosa ofgingiva to mucosa of

upper and lower lipupper and lower lip


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Upper Lip

BS: Superior labial br of facialBS: Superior labial br of facialand infraorbital artand infraorbital art

NS: Superior labial br ofNS: Superior labial br ofinfraorbital nervesinfraorbital nerves

LS: Submandibular LNLS: Submandibular LN

Lower LipLower Lip BS: Inferior labial br of facialBS: Inferior labial br of facial

and mental artand mental art

NS: Inferior labial br of mentalNS: Inferior labial br of mentalnervesnerves

LS: Submental LNLS: Submental LN


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Cheeks

Form the lateralForm the lateral

movable walls of the OCmovable walls of the OC

Buccinator = principalBuccinator = principal

muscle of the cheekmuscle of the cheek Pushes food fromPushes food from

vestibule into mouthvestibule into mouth

properproper

BS: Buccal br ofBS: Buccal br ofmaxillary arterymaxillary artery

NS: Buccal br ofNS: Buccal br of

mandibular nervemandibular nerve


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GINGIVA

Composed of fibrousComposed of fibrous

tissuetissue

Attached gingiva-Attached gingiva-

attached to alveolarattached to alveolar

process of jaws and necksprocess of jaws and necks

of teethof teeth

Loose gingiva-shiny redLoose gingiva-shiny red

and nonkeratinizingand nonkeratinizing

Lingual gingiva-related toLingual gingiva-related to

tonguetongue


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TONGUE Mobile muscular organMobile muscular organ

Partly in oral cavity andPartly in oral cavity and

pharynxpharynx

At rest, occupies oralAt rest, occupies oral

cavity propercavity proper

Main functions:Main functions:

1] Forming words1] Forming words

2] squeezing food into the2] squeezing food into the

pharynx when swallowingpharynx when swallowing


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Parts of the Tongue BodyBody anterior 2/3 anterior 2/3

RootRoot posterior third posterior third

ApexApex pointed anterior pointed anterior

DorsumDorsum

>>Terminal sulcusTerminal sulcus

- Vshaped groove- Vshaped groove

>>Foramen cecumForamen cecum

- small pit- small pit

>>Lingual papillaLingual papilla

- rough anterior mucous- rough anterior mucousmembranemembrane


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LINGUAL PAPILLAE VallateVallate

- large and flat topped- large and flat topped

- anterior to terminal sulcus- anterior to terminal sulcus

FoliateFoliate

- small lateral folds- small lateral folds

- poorly developed- poorly developed

FiliformFiliform- long and numerous- long and numerous

- contain afferent nerve ending- contain afferent nerve ending

- sensitive to touch- sensitive to touch

- V-shaped row parallel to- V-shaped row parallel to

terminal sulcusterminal sulcus FungiformFungiform

- mushroom shaped- mushroom shaped

- apex and sides- apex and sides


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Muscles of the Tongue

Details about thisDetails about this

topictopic

SupportingSupportinginformation andinformation and

examplesexamples

How it relates to yourHow it relates to your

audienceaudience


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END of Oral Cavity


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Pharynx

Dept. of AnatomyDept. of Anatomy


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PHARYNX

Fibromuscular tubeFibromuscular tube

Extends from the base of the skull to the lowerExtends from the base of the skull to the lower

border of the cricoid cartilage (at which point itborder of the cricoid cartilage (at which point itbecomes the esophagus)becomes the esophagus)

Portions of the pharynx lie posterior to:Portions of the pharynx lie posterior to:

nasal cavity (nasopharynx)nasal cavity (nasopharynx)

oral cavity (oropharynx)oral cavity (oropharynx)

larynx (laryngopharynx)larynx (laryngopharynx)


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PHARYNX

Behind nasal cavities,Behind nasal cavities,

mouth, larynxmouth, larynx

Funnel-shapedFunnel-shaped

Musculo membranousMusculo membranouswallwall


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Mucous membrane

Continuous with nasalContinuous with nasal

cavity, mouth, larynxcavity, mouth, larynx

and tympanic cavityand tympanic cavity UPPER: ciliatedUPPER: ciliated

columnar epitheliumcolumnar epithelium

LOWER: stratifiedLOWER: stratified

squamous epitheliumsquamous epithelium


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Fibrous layer

ABOVE: thicker,ABOVE: thicker,

stronger, connected tostronger, connected to

base of skullbase of skull BELOW: continuousBELOW: continuous

with submucous coatwith submucous coat

of esophagusof esophagus


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Muscular layer

Consists of:Consists of:

superior constrictorssuperior constrictors

middle constrictorsmiddle constrictors

inferior constrictorsinferior constrictors

Fibers:Fibers:

circular fashioncircular fashion

stylopharyngeus ms.stylopharyngeus ms.

salpingopharyngeus ms.salpingopharyngeus ms.


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Superior Constrictor Muscle

Origin: medial pterygoidOrigin: medial pterygoidplateplate

pterygoid hamuluspterygoid hamulus

pterygomandibularpterygomandibularligamentligament

mylohyoid linemylohyoid line

Insertion:Insertion:Upper - pharygeal tubercleUpper - pharygeal tubercle

Middle median fibrousMiddle median fibrousrapheraphe


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Superior Constrictor Muscle

Nerve supply:Nerve supply:

pharyngeal plexuspharyngeal plexus

Action: contract andAction: contract andpull post pharyngealpull post pharyngeal

wall forward duringwall forward during

swallowing aid softswallowing aid soft

plate in closing offplate in closing off

nasopharynxnasopharynx


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Middle Constrictor Muscle

Origin: stylohyoidOrigin: stylohyoid

ligament lesser andligament lesser and

greater cornua ofgreater cornua ofhyoidhyoid

Insertion: medianInsertion: median

fibrous raphefibrous raphe


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Middle Constrictor Muscle



Action: contracts andAction: contracts andpropels food boluspropels food bolus

down into esophagusdown into esophagus


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Inferior Constrictor Muscle

Origin:Origin:

thyroid cartilagethyroid cartilage

cricoid cartilagecricoid cartilage Insertion:Insertion:

superior fibers MCMsuperior fibers MCM

lower fibers esophaguslower fibers esophagusmedian fibrous raphemedian fibrous raphe


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Inferior Constrictor Muscle



Action: propel bolusAction: propel bolusof food into esophagusof food into esophagus

cricopharyngeuscricopharyngeus

muscle sphinctericmuscle sphincteric

effecteffect


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Stylopharyngeus Muscle Origin: styloid process,Origin: styloid process,

temporal bonetemporal bone

Insertion:Insertion:

between SCM and MCMbetween SCM and MCM

Nerve supply:Nerve supply:glossopharyngeal nerveglossopharyngeal nerve

Action: elevate larynxAction: elevate larynx

and pharynx duringand pharynx duringswallowingswallowing


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Salpingopharyngeus

Origin: lower part,Origin: lower part,

auditory tubeauditory tube

Insertion: blend withInsertion: blend withpalatopharyngeuspalatopharyngeus



Action: assists inAction: assists in

elevating pharynxelevating pharynx


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Palatopharyngeus The PALATOPHARYNGEUSThe PALATOPHARYNGEUS

takes origin, as the nametakes origin, as the name

suggests, from the soft palate,suggests, from the soft palate,

and runs down the length ofand runs down the length of

the pharynx, interminglingthe pharynx, interminglingwith fibers of thewith fibers of the

stylopharyngeus below thestylopharyngeus below the

inferior border of the superiorinferior border of the superior

constrictorconstrictor


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Nasopharynx

Roof: body of sphenoidRoof: body of sphenoid

basilar part of occipitalbasilar part of occipital

bonebonepharyngeal tonsilpharyngeal tonsil

Floor: soft palateFloor: soft palate

pharyngeal isthmuspharyngeal isthmus


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Nasopharynx

Anterior wall: post. nasalAnterior wall: post. nasalaperturesapertures

Posterior wall: ant. arch ofPosterior wall: ant. arch ofatlasatlas

Lateral wall: auditory tubeLateral wall: auditory tube

tubal elevationtubal elevation

salpingo pharyngeal foldsalpingo pharyngeal foldpharyngeal foldpharyngeal fold

tubal tonsiltubal tonsil


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Oropharynx

Roof: soft palate,Roof: soft palate,pharyngeal isthmuspharyngeal isthmus

Floor: post. 1/3 tongueFloor: post. 1/3 tongueand epiglottisand epiglottis

lingual tonsillingual tonsil

median glossoepiglotticmedian glossoepiglottic

foldfold2 lateral glosso epiglottic2 lateral glosso epiglottic

foldfold

valleculavallecula


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Anterior wall:Anterior wall:

mouth, tonguemouth, tongue

Posterior wall: C2, C3Posterior wall: C2, C3 Lateral wall: palatoLateral wall: palato

glossal and palatoglossal and palato

pharyngealpharyngeal

arches/foldsarches/folds

palatine tonsilspalatine tonsils

Oropharynx


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Laryngo pharynx

Upper epiglottis andUpper epiglottis and

cricoidcricoid

Walls:Walls:

Ant. inlet of pharynxAnt. inlet of pharynx

Post. C3 C6Post. C3 C6

Lat. thyroid cartillageLat. thyroid cartillage Pyriform fossaPyriform fossa


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Palatine tonsils

Lymphoid tissueLymphoid tissue

Lateral walls ofLateral walls oforopharynx (tonsilaroropharynx (tonsilar

sinuses)sinuses) Tonsillar cryptsTonsillar crypts

Intratonsillar cleftIntratonsillar cleft

CapsuleCapsule Early childhood:Early childhood:

maximum sizemaximum size

Post puberty:Post puberty:

diminishes in sizediminishes in size


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Pharynx



CN 9, 10CN 9, 10sympathetic nervessympathetic nerves

Motor: CN 10, 11Motor: CN 10, 11

Sensory: maxillarySensory: maxillarynerve, CN 9, 10nerve, CN 9, 10

Ph


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Pharynx Arterial supply:Arterial supply:

ascending pharyngealascending pharyngeal

ascending palatineascending palatinefacialfacial

maxillarymaxillary

linguallingual

Venous supply:Venous supply:

pharyngeal venous plexuspharyngeal venous plexus

internal jugular veinsinternal jugular veins

Lymphatic supply:Lymphatic supply:

deep cervicaldeep cervical

retropharyngeal/paratrachealretropharyngeal/paratracheal


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PHARYNX

The muscular walls of the pharynx are comprisedThe muscular walls of the pharynx are comprised

of an outer layer made up of 3 circularly disposedof an outer layer made up of 3 circularly disposed

muscles, the CONSTRICTORSmuscles, the CONSTRICTORS

The constrictors are logically named (fromThe constrictors are logically named (from

superior most to inferior most) the SUPERIOR,superior most to inferior most) the SUPERIOR,

MIDDLE and INFERIOR PHARYNGEALMIDDLE and INFERIOR PHARYNGEAL

CONSTRICTORSCONSTRICTORS


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PHARYNX

ACTIONS OF THE PHARYNGEAL MUSCLESACTIONS OF THE PHARYNGEAL MUSCLES

During swallowing, successive contraction of theDuring swallowing, successive contraction of the

superior, middle, and inferior constrictor musclessuperior, middle, and inferior constrictor muscles

helps to propel the bolus (ball) of food down intohelps to propel the bolus (ball) of food down into

the esophagusthe esophagus


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PHARYNX


contraction of the 3 longitudinal muscles of thecontraction of the 3 longitudinal muscles of the

pharynx helps to raise the pharynx, effectivelypharynx helps to raise the pharynx, effectively

aiding it in engulfing the bolus of foodaiding it in engulfing the bolus of food


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PHARYNX


In between acts of swallowing, the lowest fibers ofIn between acts of swallowing, the lowest fibers of

the inferior constrictor are thought to act as athe inferior constrictor are thought to act as a

sphincter, guarding the entrance to the esophagussphincter, guarding the entrance to the esophagus

and preventing the entry of air into the digestiveand preventing the entry of air into the digestive

systemsystem


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PHARYNX

MOTOR INNERVATION OF THE MUSCLES OF THEMOTOR INNERVATION OF THE MUSCLES OF THE

PHARYNX AND LARYNX arises mainly from thePHARYNX AND LARYNX arises mainly from the

CRANIAL DIVISION of the ACCESSORY NERVE (XI).CRANIAL DIVISION of the ACCESSORY NERVE (XI).

Note, however, that these axons TRAVEL with those ofNote, however, that these axons TRAVEL with those ofthe VAGUS NERVE, and are indistinguishable from itthe VAGUS NERVE, and are indistinguishable from it

Exception: The STYLOPHARYNGEUS MUSCLEException: The STYLOPHARYNGEUS MUSCLE

receives its motor innervation from thereceives its motor innervation from the

GLOSSOPHARYNGEAL NERVE (TX) Note that this isGLOSSOPHARYNGEAL NERVE (TX) Note that this isthe ONLY muscle innervated by this nervethe ONLY muscle innervated by this nerve


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PHARYNX

SENSORY INNERVATION OF THESENSORY INNERVATION OF THE

PHARYNX.PHARYNX.

via the GLOSSOPHARYNGEAL NERVEvia the GLOSSOPHARYNGEAL NERVE PARASYMPATHETIC INNERVATION OFPARASYMPATHETIC INNERVATION OF

THE PHARYNX is mainly by way of branches ofTHE PHARYNX is mainly by way of branches of

the vagus nerve.the vagus nerve.


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PHARYNX

SPECIAL LYMPHATIC TISSUE OF THESPECIAL LYMPHATIC TISSUE OF THE

PHARYNXPHARYNX

the pharynx contains a "ring" of specializedthe pharynx contains a "ring" of specialized

lymphatic tissue designed to prevent the entry oflymphatic tissue designed to prevent the entry of

pathogens into the digestive and respiratory tractspathogens into the digestive and respiratory tracts


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Oral Cavity and Pharynx 10-26