Professional Documents
Culture Documents
Vestibule
Slitlike space between the cheeks and the gums Communicates with the exterior through the oral fissure When the jaws are closed, communicates with the oral cavity proper behind the 3rd molar tooth on each side Superiorly and inferiorly limited by the reflection of mucous membrane from lips and cheek onto the gums
Functions
The function of the mouth and its associated structures is to form a receptacle for food, to begin mechanical digestion through chewing (mastication), and to form words in speech. It can also assist the respiratory system in the passage of air.
Vestibule contd
The lateral wall of the vestibule is formed by the cheek The cheek is composed of Buccinator muscle, covered laterally by the skin & medially by the mucous membrane A small papilla on the mucosa opposite the upper 2nd molar tooth marks the opening of the duct of the parotid gland
mylohyoi d
Nerve Supply
o Sensory
Roof: by Greater Palatine And Nasopalatine Nerves (branches of maxillary nerve) Floor: by lingual nerve (branch of Mandibular Nerve) Cheek: by buccal nerve (branch of Mandibular Nerve)
o Motor
Muscle in the cheek (buccinator) and the lip (orbicularis oris) are supplied by the Branches Of The Facial Nerve
The Tongue
The tongue is the principal organ of the sense of taste, and an important organ of speech; it also assists in the mastication and deglutition of the food (Accessory GIT Organ). Its divided into Anterior 2/3 & Posterior 1/3 by Sulcus Terminalis (V-shape-depression) Its Ant. 2/3 form most of floor of the mouth. Its Inferior surface is connected to the midline of the floor of the mouth by a fold of mucous membrane called Frenulum of the tongue. Its muscles (Extrinsic) are connected upward to the Styloid process and soft palate and downwards to mandible and Hyoid bones.
Tongue
Sulcus Terminalis tip points backward and marks Foramen Cecum (Remnant of thyroglossal duct). Connection with the epiglottis creates three folds (glossoepiglottic). Its Ant. 2/3 Upper surface is covered by Papillae which are: Filliform, Fungiform & Valate Papillae. No papillae in the posterior surface Inferiorly: Lingual tonsil are present under the post. 1/3 and two deep lingual veins run in the lateral margins. Lingual Frenulum attaches it to midline of floor of the mouth.
Tongue
Mass of Striated Muscles covered with the mucous membrane Divided into right and left halves by a median septum Three parts: Oral (anterior ) Pharyngeal (posterior ) Root (base) Two surfaces: Dorsal Ventral
Functions
The tongue is the most important articulator for Speech Production. During speech, the tongue can make amazing range of movements The primary function of the tongue is to Provide A Mechanism For Taste. Taste buds are located on different areas of the tongue, but are generally found around the edges. They are sensitive to four main tastes: Bitter, Sour, Salty & Sweet
The tongue is needed for sucking, chewing, swallowing, eating, drinking, kissing, sweeping the mouth for food debris and other particles and for making funny faces (poking the tongue out, waggling it) Trumpeters And Horn & Flute Players Have Very Well Developed Tongue Muscles, and are able to perform rapid, controlled movements or articulations
Dorsal Surface
Divided into anterior two third and posterior one third by a V-shaped sulcus terminalis. The apex of the sulcus faces backward and is marked by a pit called the foramen cecum Foramen cecum, an embryological remnant, marks the site of the upper end of the thyroglossal duct
Anterior two third: mucosa is rough, shows three types of papillae: Filliform Fungiform Vallate Posterior one third: No papillae but shows nodular surface because of underlying lymphatic nodules, the lingual tonsils
Ventral Surface
Smooth (no papillae) In the midline anteriorly, a mucosal fold, frenulum connects the tongue with the floor of the mouth Lateral to frenulum, deep lingual vein can be seen through the mucosa Lateral to lingual vein, a fold of mucosa forms the plica fimbriata
Tongue
Sulcus Terminalis tip points backward and marks Foramen Cecum (Remnant of thyroglossal duct). Connection with the epiglottis creates three folds (glossoepiglottic). Its Ant. 2/3 Upper surface is covered by Papillae which are: Filliform, Fungiform & Valate Papillae. No papillae in the posterior surface Inferiorly: Lingual tonsil are present under the post. 1/3 and two deep lingual veins run in the lateral margins. Lingual Frenulum attaches it to midline of floor of the mouth.
Tongue
The circumvallate papill are of large size, and vary from eight to twelve in number. They are situated on the dorsum of the tongue immediately in front of the foramen cecum and sulcus terminalis and meet in the middle line, like the limbs of the letter V inverted. The fungiform papill more numerous are found chiefly at the sides and apex, but are scattered irregularly and sparingly over the dorsum. They are easily recognized, among the other papill, by their large size, rounded eminences, and deep red color.
Tongue
The filiform papil cover the anterior twothirds of the dorsum. They are very minute, filiform in shape. Projecting from their apices are numerous filamentous processes, or secondary papill these are of a whitish tint, owing to the thickness and density of the epithelium of which they are composed, which has here undergone a peculiar modification, the cells having become cornified and elongated into dense, creating brush-like processes (CATS).
Extrinsic Muscles
They are: Genioglossus. Hyoglossus. Styloglossus. Palatoglossus
Muscles
The tongue is composed of two types of muscles: Intrinsic Extrinsic
Intrinsic Muscles
Confined to tongue No bony attachment Consist of: Longitudinal fibers Transverse fibers Vertical fibers Function: Alter the shape of the tongue
Connect the tongue to the surrounding structures: the soft palate and the bones (mandible, hyoid bone, styloid process) Include: Palatoglossus Genioglossus Hyoglossus Styloglossus Function: Help in movements of the tongue
Extrinsic Muscles
Movements
Protrusion:
Genioglossus on both sides acting together
Retraction:
Styloglossus and hyoglossus on both sides acting together
Depression:
Hyoglossus and genioglossus on both sides acting together
Elevation:
Styloglossus and palatoglossus on both sides acting together
Anterior :
Posterior :
General & special sensations: glossopharyngeal nerve
Base:
General & special sensations: internal laryngeal nerve
Blood Supply
Arteries: Lingual artery Tonsillar branch of facial artery Ascending pharyngeal artery Veins: Lingual vein, ultimately drains into the internal jugular vein
Lingual artery & vein Dorsal lingual artery & vein
Hypoglossal nerve
Lymphatic Drainage
Tip:
Submental Nodes bilaterally & then Deep Cervical Nodes
Posterior third:
Deep Cervical Nodes (jugulodigastric mainly)
Clinical Notes
Lacerations of the tongue Tongue-Tie (ankyloglossia) (due to
large frenulum)
Palate
The Palate forms the roof of the mouth and floor of Nasal Cavity. It is divided into twp parts; The hard palate in front, (Incisive foramen) the soft palate behind. The Hard Palate is formed by the Palatine Process of Maxilla and Horizontal plate of Palatine bone. The Palate is bounded in front and at the sides by the alveolar arches and gums; behind, it is continuous with the soft palate. It is covered by mucous membrane of the mouth (stratified squamous epithelium). Along the middle line is Incisive foramen that divides the two parts of hard palate. The Soft Palate is a movable fold, attached to the posterior part of Hard Palate. It ends with a Muscular conical projection; Uvula.
Hard Palate
Posteriorly, continuous with soft palate Its undersurface covered by mucoperiosteum Shows transverse ridges in the anterior parts
Soft Palate
Attached To The Posterior border of the hard palate Covered on its upper and lower surfaces by mucous membrane Composed of: Muscle fibers An aponeurosis Lymphoid tissue Glands Blood vessels Nerves
Palatine Aponeurosis
Fibrous Sheath Attached To Posterior border of hard palate Is expanded tendon of Tensor Velli Palatini Splits to enclose musculus uvulae Gives origin & insertion to Palatine Muscles
Muscles
Origin: spine of sphenoid; auditory tube Insertion: forms palatine aponeurosis Action: Tenses soft palate
Musculus uvulae
Origin: posterior border of hard palate Insertion: mucosa of uvula Action: Elevates uvula
Muscles
Palatoglossus
Origin: Palatine Aponeurosis Insertion: Side Of Tongue Action: Pulls Root Of Tongue Upward, Narrowing Oropharyngeal Isthmus
Palatopharyngeus
Origin: Palatine Aponeurosis Insertion: Posterior Border Of Thyroid Cartilage Action: Elevates Wall Of The Pharynx
Blood Supply
Branches of the maxillary artery Greater palatine Lesser palatine Sphenopalatine Ascending Palatine, Branch Of The Facial Artery Ascending Pharyngeal, Branch Of The External Carotid Artery
Clinical Notes
Cleft palate: Unilateral Bilateral Median Paralysis of the soft palate The pharyngeal isthmus can not be closed during swallowing and speech
Pharyngeal isthmus
Tongue
The circumvallate papill are of large size, and vary from eight to twelve in number. They are situated on the dorsum of the tongue immediately in front of the foramen cecum and sulcus terminalis and meet in the middle line, like the limbs of the letter V inverted. The fungiform papill more numerous are found chiefly at the sides and apex, but are scattered irregularly and sparingly over the dorsum. They are easily recognized, among the other papill, by their large size, rounded eminences, and deep red color.
Tongue
The filiform papil cover the anterior twothirds of the dorsum. They are very minute, filiform in shape. Projecting from their apices are numerous filamentous processes, or secondary papill these are of a whitish tint, owing to the thickness and density of the epithelium of which they are composed, which has here undergone a peculiar modification, the cells having become cornified and elongated into dense, creating brush-like processes (CATS).
Extrinsic Muscles
They are: Genioglossus. Hyoglossus. Styloglossus. Palatoglossus
Palate Structure
It consists of: Mucous membrane Enclosing Palatine Aponeurosis muscle Muscles vessels, nerves, adenoid tissue, and mucous glands. Palatine Aponeurosis: Fibrous sheat starts at posterior part of hard palate formed by joint tendon of Tensor veli palatini from both sides. Muscles: Tensor Veli Palatini Levator Veli Palatinin. Musculus uvula. Arching lateral- and downward from the base of the uvula are two curved folds of mucous membrane, containing muscular fibers, called the arches or pillars
Muscles of soft palate Muscle Action Nerve Vagus nerve via pharyngeal plexus
tensor veli palatini Deglutition mandibular nerve Palatine Tenses the Aponeurosis Palate palatoglossus respiration Vagus nerve via pharyngeal plexus Vagus nerve via pharyngeal plexus
palatopharyngeus respiration
Muscles of Soft Palate levator veli palatini. tensor veli palatini. uvulae. palatopharyngeus.
Cleft palate
Cleft palate is a condition in which the two plates of the skull that form the hard palate (roof of the mouth) are not completely joined. The soft palate is in these cases cleft as well. In most cases, cleft lip is also present. Cleft palate occurs in about one in 700 live births worldwide. Palate cleft can occur as complete (soft and hard palate, possibly including a gap in the jaw) or incomplete (a 'hole' in the roof of the mouth, usually as a cleft soft palate). When cleft palate occurs, the uvula is usually split. It occurs due to the failure of fusion of the lateral palatine processes, the nasal septum, and/or the median palatine processes (formation of the secondary palate). The hole in the roof of the mouth caused by a cleft connects the mouth directly to the nasal cavity.
Development of Palate
During the first six to eight weeks of pregnancy, the shape of the embryo's head is formed. Five primitive tissue grow:
a) one from the top of the head down towards the future upper lip; (Frontonasal Prominence) b) two from the cheeks, which meet the first lobe to form the upper lip; (Maxillar Prominence) c) and just below, two additional lobes grow from each side, which form the chin and lower lip; (Mandibular Prominence)
If these tissues fail to meet, a gap appears where the tissues should have joined (fused). This may happen in any single joining site, or simultaneously in several or all of them, resulting in birth defect from a small lip or palate fissure up to a completely malformed face.
Cleft Palate
What are the complications associated with cleft lip and cleft palate? Beyond the cosmetic abnormality, there are other possible complications that may be associated with cleft lip and cleft palate, including the following: Feeding Difficulties Feeding difficulties occur more with cleft palate abnormalities. The infant may be unable to suck properly because the roof of the mouth is not formed completely. Ear Infections And Hearing Loss Ear infections are often due to a dysfunction of the tube that connects the middle ear and the throat. Recurrent infections can then lead to hearing loss. Speech And Language Delay Due to the opening of the roof of the mouth and the lip, muscle function may be decreased, which can lead to a delay in speech or abnormal speech. Referral to a speech therapist should be discussed with your child's physician. Dental Problems As a result of the abnormalities, teeth may not erupt normally and orthodontic treatment is usually required.