PARAORAL TISSUES
of the external carotid artery. It supplies the lips by its
LIPS - are a visible organ, at the mouth of humans and
many animals. Lips are soft, protruding, movable, and
serve as the opening for food intake, as an erogenous
organ used in kissing and other acts of intimacy, as a
tactile sensory organ, and in the articulation of speech.
ANATOMICAL BASIS OF THE HUMAN LIP
One differentiates between the Upper (Labia superfluos
entafada) and lower lip (Labium inferius). The lower lip
is usually somewhat larger. The border between the lips
and the surrounding skin is referred to as the vermilion
border, or simply the vermilion. The vertical groove on
the upper lip, is known as the philtrum. The entire skin
between the upper lip and the nose is referred to as the
"ergotrid".
The skin of the lip, with three to five cellular layers, is
very thin compared to typical face skin, which has up to
16 layers. With light skin color, the lip skin contains less
melanocytes (cells which produce melanin pigment ,
which give skin its color). Because of this, the blood
vessels appear through the skin of the lips, which leads
to their notable red coloring. With darker skin color this
effect is less prominent, as in this case the skin of the
lips contains more melanin and thus is visually thicker.
The lip skin is not hairy, and does not have sweat
glands or sebaceous glands. Therefore it does not have
the usual protection layer of sweat and body oils which
keep the skin smooth, inhibit pathogens, and regulate
warmth. For these reasons, the lips dry out faster and
become chapped more easily.
ANATOMY IN DETAIL
The skin of the lips is stratified squamous epithelium.
The mucous membrane is represented by a large area
in the sensory cortex, and is therefore highly sensitive.
The Frenulum Labii Inferioris is the frenulum of the
lower lip. The Frenulum Labii Superioris is the frenulum
of the upper lip.
Sensory nerve supply
• Trigeminal nerve
o The infraorbital nerve is a branch of
the maxillary branch. It supplies not
only the upper lip, but much of the
skin of the face between the upper
lip and the lower eyelid, except for
the bridge of the nose.
o The mental nerve is a branch of the
mandibular branch ( via the inferior
alveolar nerve). It supplies the skin
and mucous membrane of the
lower lip and labial gingiva (gum)
anteriorly.
Blood supply
The facial artery is one of the six non-terminal branches
superior and inferior labial branches, each of which
bifurcate and anastomose with their companion artery
from the other side.
Muscles acting on the lips
The muscles acting on the lips are considered part of
the muscles of facial expression. All muscles of facial
expression are derived from the mesoderm of the
second pharyngeal arch, and are therefore supplied
(motor supply) by the nerve of the second pharyngeal
arch, the facial nerve (7th cranial nerve). The muscles
of facial expression are all specialised members, of the
panniculus carnosus, which attach to the dermis and so
wrinkle, or dimple the overlying skin. Functionally, the
muscles of facial expression are arranged in groups
around the orbits, nose and mouth.
The muscles acting on the lips:
• sphincters of the oral orifice
o buccinator
o orbicularis oris
• anchor point for several muscles
o modiolus
• lip elevation
o levator labii superioris
o levator labii superioris alaeque nasi
o levator anguli oris
o zygomaticus minor
o zygomaticus major
• lip depression
o risorius
o depressor anguli oris
o depressor labii inferioris
o mentalis
FUNCTIONS OF THE LIP
Food intake
Because they have their own muscles and bordering
muscles, the lips are very movable. Lips are used for
eating functions, like holding food or to get it in the
mouth. In addition, lips serve to close the mouth airtight
shut, and to, hold food and drink inside, and to keep out
unwanted objects. Through making a narrow funnel
with the lips, the suction of the mouth is increased. This
suction is essential for babies to breast feed. Lips can
also be used to suck in other contexts, such as tactile
stimulation of other people.
Erogenous zone
Because of their high amounts of nerve endings, the
lips are an erogenous zone. The lips therefore play a
crucial role in kissing and other acts of intimacy. As the
mouth, lips, and tongue are among a woman's most
erogenous zones, stimulating a woman's mouth and
lips during acts of intimacy has been shown to elicit
pleasure and to have a direct stimulatory effect on
arousing her genital organs. [1]
A woman's lips are also a visible expression of her
fertility. In studies performed on the science of human
attraction, psychologists have concluded that a
woman's facial and sexual attractiveness is closely
linked to the makeup of her hormones during puberty
and development. Contrary to the effects of
testosterone on a man's facial structure, the effects of a
woman's estrogen levels serve to maintain a relatively
"childlike" and youthful facial structure during puberty
and during final maturation. It has been shown that the
more estrogen a woman has, the larger her eyes and
the fuller her lips. Surveys performed by sexual
psychologists have also found that universally, men find
a woman's full lips to be more sexually attractive than
lips that are less so.[2] A woman's lips are therefore
sexually attractive to males because they serve as a
biological indicator of a woman's health and fertility. As
such, a woman's lipstick (or collagen lip enhancement)
takes advantage by "tricking" men into thinking that a
women has more estrogen than she actually has, and
thus that she is more fertile and attractive.[3]
Tactile organ
• an oral part (anterior two-thirds of the tongue)
that lies mostly in the mouth
• a pharyngeal part (posterior third of the
tongue), which faces backward to the
oropharynx
The two parts are separated by a V-shaped groove,
which marks the sulcus terminalis (or terminal sulcus).
Since the tongue contains no bony supports for the
muscles, the tongue is an example of a muscular
hydrostat, similar in concept to an octopus arm. Instead
of bony attachments, the extrinsic muscles of the
tongue anchor the tongue firmly to surrounding bones
and prevent the mythical possibility of 'swallowing' the
tongue.
Muscles of the Tongue
Extrinsic muscles
Extrinsic muscles of the tongue by definition originate
from structures outside the tongue and insert into the
tongue. The four paired extrinsic muscles protrude,
retract, depress, and elevate the tongue:

The lip has many nerve endings and reacts as part of

the tactile (touch) senses. Lips are very sensitive to
touch, warmth, and, cold. It is therefore an important Muscle From Nerve Function
aide for exploring unknown objects for babies and
toddlers.

protrudes the
Articulation
Genioglossus hypoglossal tongue as well
mandible
muscle nerve as depressing
The lips serve for creating different sounds - mainly the its center.
labial, bilabial, and labiodental consonant sounds - and
thus create an important part of the speech apparatus.
The lips enable whistling and the performing of wind
instruments such as the trumpet, clarinet, and flute. Hyoglossus hypoglossal depresses the
hyoid bone
muscle nerve tongue.
Facial expressions

TONGUE - is the large bundle of skeletal muscles on elevates and

the floor of the mouth that manipulates food Styloglossus styloid hypoglossal
retracts the
for chewing and swallowing (deglutition). It muscle process nerve
tongue.
is the primary organ of taste. Much of the
surface of the tongue is covered in taste
buds. The tongue, with its wide variety of
possible movements, assists in forming the
depresses the
sounds of speech. It is sensitive and kept
soft palate,
moist by saliva, and is richly supplied with
moves the
nerves and blood vessels to help it move.
pharyngeal palatoglossal
Palatoglossu palatine
branch of fold towards
s muscle aponeurosis
Structure vagus nerve the midline,
and elevates
the back of
The tongue is made mainly of skeletal muscle. The
the tongue.
tongue extends much further than is commonly
perceived, past the posterior border of the mouth and
into the oropharynx.
Intrinsic muscles
The dorsum (upper surface) of the tongue can be
divided into two parts:
Coronal section of tongue, showing intrinsic muscles
Four paired intrinsic muscles of the tongue originate
and insert within the tongue, running along its length.
These muscles alter the shape of the tongue by:
lengthening and shortening it, curling and uncurling its
apex and edges, and flattening and rounding its
surface.[2]
• The superior longitudinal muscle runs along
the superior surface of the tongue under the
mucous membrane, and elevates, assists in
retraction of, or deviates the tip of the tongue.
It originates near the epiglottis, the hyoid
bone, from the median fibrous septum.
• The inferior longitudinal muscle lines the
sides of the tongue, and is joined to the
styloglossus muscle.
• The verticalis muscle is located in the middle
of the tongue, and joins the superior and
inferior longitudinal muscles.
• The transversus muscle divides the tongue at
the middle, and is attached to the mucous
membranes that run along the sides.
The tongue is often cited as the "strongest muscle in
the body," a claim that does not correspond to any
conventional definition of strength.
Papillae and taste buds
The oral part of the tongue is covered with small bumpy
projections called papillae. There are four types of
papillae:
• filiform (thread-shape)
• fungiform (mushroom-shape)
• circumvallate (ringed-circle)
• foliate (leaf-shape)
All papillae except the filiform have taste buds on their
surface.
The circumvallate are the largest of the papillae. There
are 8 to 14 circumvallate papillae arranged in a V-
shape in front of the sulcus terminalis, creating a border
between the oral and pharyngeal parts of the tongue.
There are no lingual papillae on the underside of the
tongue. It is covered with a smooth mucous membrane,
with a fold (the lingual frenulum) in the center. If the
lingual frenulum is too taut or too far forward, it can
impede motion of the tongue, a condition called
Tongue-tie (Ankyloglossia).
The upper side of the posterior tongue (pharyngeal
part) has no visible taste buds, but it is bumpy because
of the lymphatic nodules lying underneath. These
follicles are known as the lingual tonsil.
The human tongue can detect five basic taste
components: sweet, sour, salty, bitter and savory[citation
needed]
. The sense of taste is referred to as a gustatory
sense. Contrary to the popular myth and generations of
schoolbooks, there are no distinct regions for tasting
different tastes. This myth arose because Edwin G.
Boring replotted data from one of Wundt's students
(Hanig) without labeling the axes, leading some to
misinterpret the graph as all or nothing response.[3] The
common conception of taste has a significant
contribution from olfaction.
Innervation of the tongue
Motor innervation of the tongue is complex and involves
several cranial nerves. All the muscles of the tongue
are innervated by the hypoglossal nerve (cranial nerve
XII) with one exception: the palatoglossal muscle is
innervated by the pharyngeal branch of vagus nerve
(cranial nerve X).
Sensory innervation of the tongue is different for taste
sensation and general sensation.
• For the anterior two-thirds of the tongue,
general sensations and taste sensations are
carried via different nerves.
o Somatic sensations travel from the
tongue via the lingual nerve, a
major branch of the mandibular
nerve (itself a branch of the
trigeminal nerve). This nerve also
carries general sensation from
areas of the oral mucosa and
gingiva of the lower teeth.
o Taste sensation is carried to the
facial nerve via the chorda tympani.
The chorda tympani also carries
parasympathetic fibers from the
facial nerve to the submandibular
ganglion.
• The posterior one-third of the tounge has a
more simple innervation, as both taste and
general sensations are carried by the
glossopharyngeal nerve.
Vasculature of the tongue
The tongue receives its blood supply primarily from the
lingual artery, a branch of the external
carotid artery. The floor of the mouth also
receives its blood supply from the lingual
artery.
There is also secondary blood supply to the tongue
from the tonsillar branch of the facial artery and the
ascending pharyngeal artery.
CHEEKS - constitute the area of the face below the
eyes and between the nose and the left or right ear.
It is fleshy in humans and other mammals, the skin
being suspended by the chin and the jaws, and forming
the lateral wall of the human mouth, visibly touching the
cheekbone below the eye.
In vertebrates, markings on the cheek area (malar
stripes/spots/...), particularly immediately beneath the
eye, often serve as important distinguishing features
between species or individuals.
SALIVARY GLANDS - are exocrine glands that
produce saliva. In other organisms such as
insects, salivary glands are often used to
produce biologically important proteins like
silk or glues, and fly salivary glands contain
polytene chromosomes that have been
useful in genetic research.
Cells
There are 3 main types of cells that are found in the
major salivary glands:
1. Serous cells, which are pyramidal in shape
and are joined to usually form a spherical
mass of cells called acinus, with a small
lumen in the centre. Serous demilunes are
found in the submandibular gland.
2. Mucous cells are usually cuboid in shape and
organised as tubules, consisting of cylindrical
arrays of secretory cells surrounding a lumen.
These cells produce glycoproteins that are
used for the moistening and lubricating
functions of saliva.
3. Myoepithelial cells surround each secretory
portion and are able to contract to accelerate
secretion of the saliva.
Ducts
In the duct system, the lumens formed by steph
intercalated ducts, which in turn join to form striated
ducts. These drain into ducts situated between the
lobes of the gland (called interlobar ducts or excretory
ducts).
The main duct of the salivary glands ultimately empties
into the mouth. Salivary glands release saliva that
dilutes the acid found in the stomach.
Parotid Glands
The parotid glands are a pair of glands located in the
subcutaneous tissues of the face overlying the
mandibular ramus and anterior and inferior to the
external ear. The secretion produced by the parotid
glands is serous in nature, and enters the oral cavity
through the Stensen's duct after passing through the
intercalated ducts which are prominent in the gland.
Despite being the largest pair of glands, only
approximately 25% of saliva is produced by the glands.
Submandibular Glands
The submandibular glands are a pair of glands located
beneath the floor of the mouth, superior to the digastric
muscles. The secretion produced is a mixture of both
serous and mucous and enters the oral cavity via
Wharton's ducts. Approximately 70% of saliva in the
oral cavity is produced by the submandibular glands,
even though they are much smaller than the parotid
glands.
Sublingual Gland
The sublingual glands are a pair of glands located
beneath the floor of the mouth anterior to the
submandibular glands. The secretion produced is
mainly mucous in nature, however it is categorized as a
mixed gland. Unlike the other two major glands, the
ductal system of the subligual glands do not have
striated ducts, and exit from 8-20 excretory ducts.
Approximately 5% of saliva entering the oral cavity
come from these glands.
Minor Salivary Glands
There are over 600 minor salivary glands located
throughout the oral cavity within the lamina propria of
the oral mucosa. They are 1-2mm in diameter and
unlike the other glands, they are not encapsulated by
connective tissue only surrounded by it. The gland is
usually a number of acini connected in a tiny lobule. A
minor salivary gland may have a common excretory
duct with another gland, or may have its own excretory
duct. Their secretion is mainly mucous in nature (except
for Von Ebner's glands) and have many functions such
as coating the oral cavity with saliva. Problems with
dentures are usually associated with minor salivary
glands.
Von Ebner's Glands
Von Ebner's glands are glands found in circumvallate
papillae of the tongue. They secrete a serous fluid that
begin lipid hydrolysis. They are an essential component
of taste.
Innervation
Salivary glands are innervated, either directly or
indirectly, by the parasympathetic and sympathetic
arms of the autonomic nervous system.
• Parasympathetic innervation to the salivary
glands is carried via cranial nerves. The
parotid gland receives its parasympathetic
input from the glossopharyngeal nerve (CN
IX) via the otic ganglion, while the
submandibular and sublingual glands receive
their parasympathetic input from the facial
nerve (CN VII) via the submandibular
ganglion.
• Direct sympathetic innervation of the salivary
glands takes place via preganglionic nerves
in the thoracic segments T1-T3 which
synapse in the superior cervical ganglion with
postganglionic neurons that release
norepinephrine, which is then received by β-
 adrenergic receptors on the acinar and ductal • Providing a buffer against blows to the face.
cells of the salivary glands, leading to an
increase in cyclic adenosine monophosphate • Insulating sensitive structures like dental
(cAMP) levels and the corresponding roots and eyes from rapid temperature
increase of saliva secretion. Note that in this fluctuations in the nasal cavity.
regard both parasympathetic and • Humidifying and heating of inhaled air
sympathetic stimuli result in an increase in because of slow air turnover in this region
salivary gland secretions. The sympathetic
nervous system also affects salivary gland
secretions indirectly by innervating the blood
vessels that supply the glands.

PARANASAL SINUSES - are air-filled spaces,

communicating with the nasal cavity, within the bones
of the skull and face.

Types in humans

Humans possess a number of paranasal sinuses,

divided into subgroups that are named according to the
bones within which the sinuses lie:

• the maxillary sinuses, also called the

maxillary antra and the largest of the
paranasal sinuses, are under the eyes, in the
maxillary bones (cheek bones).
• the frontal sinuses, over the eyes, in the
frontal bone, which forms the hard part of the
forehead.
• the ethmoid sinuses, which are formed from
several discrete air cells within the ethmoid
bone between the nose and the eyes.
• the sphenoid sinuses, in the sphenoid bone
at the center of the skull base under the
pituitary gland.

Development

Paranasal sinuses form developmentally through

excavation of bone by air-filled sacs (pneumatic
diverticula) from the nasal cavity. This process begins
prenatally, and it continues through the course of an
organism's lifetime.

Sinuses in animals

Paranasal sinuses occur in a variety of animals

(including most mammals, birds, non-avian dinosaurs,
and crocodilians). In non-humans, the bones occupied
by sinuses are quite variable.

Biological function

The biological role of the sinuses is debated, but a

number of possible functions have been proposed:

• Decreasing the relative weight of the front of

the skull, and especially the bones of the
face. The shape of the facial bones is
important, as a point of origin and insertion
for the muscles of facial expression.
• Increasing resonance of the voice.