5.2 Oral Cavity - Lecture note 14 PDF

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By Anneliese Hulme...

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HLTH213 ORAL*CAVITY

Week*5*– Lecture*1 Anneliese Hulme [email protected]

1.*Orientation; 2.*Boundaries; 3.*Lips; 4.*Cheeks; 5.*Gums; 6.*Teeth; 7.*Tongue; 8.*Palate; 9.*Salivary*glands. ORAL CAVITY

ORAL CAVITY:1. Orientation

ORAL CAVITY:1. ORIENTATION

There*are*TWO*parts: Q Vestibule Q the*narrow* space*between*lips,* teeth,*gums*and*cheeks; Q Oral,cavity,proper. They*are*separated*by*the* dental*arches ORAL CAVITY:2. BOUNDARIES

Floor

•

Tongue;*

•

Muscular*diaphragm*made*of*paired*mylohyoid muscles;*

•

Two*cordQlike*geniohyoid muscles*running*from*mandible* anteriorly*to*hyoid*bone*posteriorly;

Walls

Cheeks*(S******D

Roof

Hard*palate,*soft*palate

in,*fascia,*buccinator muscles,*mucosa

Anterior,aperture Oral*fissure Posterior,aperture Oropharyngeal isthmus

ORAL CAVITY:2. BOUNDARIES

The*skeletal*framework*is*formed*by*the*following* bones: • Maxillae;** • Palatine; • Sphenoid; • Temporal; • Mandible;* • Hyoid.

ORAL CAVITY:2. BOUNDARIES

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Musculofibrous*folds;

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Extend*from:* – Nasolabial*sulci*and*nares*(superior*and*lateral)*to – Mentolabial*sulcus*(inferior);

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Covered*externally*by*skin,*internally*by*mucous*membrane;

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Contain:* – orbicularis*oris;* – superior*and*inferior*labial*muscles; – Vessels*and*nerves.

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Labial*frenula*join*gums*to*mucosa*of*lips.*

ORAL CAVITY:3. LIPS

•

Innervation: – Upper*lip*supplied*by*branches*of*the*infraQorbital*nerves*(br of*maxillary) – Lower*lip*supplied*by*branches*of*the*mental*nerves*(br of*mandibular)

•

Arterial,supplyQ superior(and(inferior(labial(arteries((branches*of*facial*artery)

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Venous,drainage:*into*facial*vein

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Lymphatic,drainage:*into*subQmandibular,*subQmental*and*deep*cervical*nodes

• Function: – Controls*entry*and*exit*of*substances*into*mouth,*and*hence*upper*alimentary*tract,* and*partially*to*respiratory*tract – Grasping – Sucking – Helps*in*formulation*of*speech

Cheeks • Essentially*the*same*structure*as*the*lips; • External*area*known*as*the*‘buccal’*region; • Muscle*forming*the*cheek*is*the*buccinator; • Buccal fat*pad*lies*superficial*to*muscle,*buccal glands lie*deep*to* muscle.

ORAL CAVITY:4. CHEEKS

Gums • Comprise*fibrous*tissue,*covered*by*mucous* membranes. • Gingiva is*described*as: – Gingiva*proper*(pink*colour):*attached*to*the* alveolar*processes*of*maxillae*and*mandible,*and* the*necks*of*teeth; – Alveolar*mucosa*and*mucolabial folds*(shiny*red)* join*the*gingiva*proper*to*the*mucosa*lining*the* lips.

ORAL CAVITY:5. GUMS

• Arterial*supply:*Branches*of*maxillary,*inf.*alverolar and*lingual* arteries;

• Venous*drainage:*Into*either*facial*vein*or*pterygoid plexus*of* veins;

• Lymphatics:*into*subQmandibular,*submental or*deep*cervical*nodes; • Innervation: – Upper*gingiva*supplied*by*branches*of*the*maxillary*nerve*(superior*alveolar* nerves); – Lower*gingiva*supplied*by*branches*of*the*mandibular*nerve*(inferior*alveolar* nerves).

ORAL CAVITY:5. GUMS

Teeth • Located in sockets within the alveolar processes of maxillae and mandible •

Functions: – Cut food, mix food, chewing; – Protect the tissues which support them; – Assist in articulation;

•

20 deciduous teeth in children are eventually replaced by 32 adult teeth.

ORAL CAVITY:6. TEETH

From Gartner LP, Hiatt JL: Color Textbook of Histology, 3rd ed. Philadelphia, Saunders, 2007, pp 368 and 369

ORAL CAVITY:6. TEETH

ORAL CAVITY:6. TEETH

Deciduous teeth Deciduous, teeth

Medial, Lateral, incisors incisors

Canine

First, molar

Second, molar

Eruption* (monts)

6Q8

16Q20

12Q16

20Q24

8Q10

ORAL CAVITY:6. TEETH

Permanent teeth Perman ent teeth

Med., Lat., incisor incisor s

Eruption 7Q8 (years)

8Q9

canine

1st premol ar

2nd premol ar

1st molar

2nd molar

3rd molar

10Q12

10Q11

11Q12

6Q7

12

13Q25

ORAL CAVITY:6. TEETH

http://www.enchantedlearning.com/subjects/anatomy/teeth/toothanatomy.shtml Gartner*LP,*Hiatt*JL:*Color*Textbook*of*Histology,*3rd*ed.*Philadelphia,* Saunders,*2007,*pp 368*and*369.

ORAL CAVITY:6. TEETH

• Arterial,supply:,branches*of*maxillary*artery*(superior*and*inferior* alveolar*arteries); • Venous,drainage:*superior*and*inferior*alveolar*veins,*drain*into* pterygoid plexus*of*veins*(then__________________*and* __________________) • Lymphatic,drainage:*into*submandibular,*submental and*deep* cervical*nodes • Innervation: – Lower*teeth:*branches*of*inferior*alveolar*nerve*(branch*of* _______________________) – Upper*teeth:*branches*of*superior*alveolar*nerves*(branches*of* _____________________________)

ORAL CAVITY:6. TEETH

Oral*Cavity*Proper • The*space*between*upper*and*lower*dental* arches. • The*roof*is*formed*by*palate • The*floor*by*muscles*and* the*tongue.

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Palate 2*parts* hard*palate* soft*palate bone 5*muscles**

mucous* membrane

Palatine*process**** of*maxilla*(ant*2/3)*+* Horizontal*process*of* palatine*bone*(post*1/3)

Mucous*membrane

palatoglossus,*tensor*veli palatini,*levator veli palatini,* palatopharyngeus,*musculus uvulae

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Hard*palate

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Palate Function*of*the*soft*palate: Act*as*a*‘valve’,*which*can*be: Q depressed,*to*help*close*the*oropharyngeal isthmus Q elevated,*to*separate*the*nasopharynx from*the*oropharynx Muscle,of,the,soft,palate

Action

Levator veli palatini

Elevates*soft*palate

Tensor*veli palatini

Tenses*soft*palate,*opens*auditory*tube

Palatoglossus

Depresses*palate,*elevates*back*of*tongue

Palatopharyngeus

Depresses*palate,*elevates*pharynx

Musculus uvulae

Elevates*and*retracts*uvula,*thickens*central* region of*soft*palate 23

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Palate Innervation: Q hard*palate:*greater*palatine*nerve*and*nasopalatine nerve Q Soft*palate*:*lesser*palatine*nerves Arterial*supply:*branches*of*maxillary,*facial*and*ascending* pharyngeal*arteries Venous*drainage:*into*either – – –

pterygoid plexus*of*veins Pharyngeal*plexus*of*veins Facial*vein

Lymphatic*drainage:*into*deep*cervical*nodes 26

The*floor*of*the*mouth

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Tongue • It*is*a*mobile,*muscular*organ.* • In*combination*with*mylohyoid and*geniohyoid,* helps*to*form*the*floor*of*the*mouth. • Can*alter*both*its*shape*and*its*position • Functions*include: articulation taste oral*cleansing assists*in*formation*of*a*bolus,*and*its*movement*into* the*oropharynx – assists*with*mastication

– – – –

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Tongue • Parts*of*the*tongue: – Root – Body – Apex*

• 2*surfaces:*dorsum*and*inferior*surface • On*the*dorsum,*a*VQshaped*groove*separates* the*tongue*into: – an*anterior*2/3*(in*oral*cavity)***and* – a posterior*1/3*(in*oropharynx) 29

apex

body

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Tongue • Dorsum*has*a*thin*but*rough*mucosa,*due*to* the*presence*of*numerous*papillae: – Vallate – Filiform – Fungiform – Foliate*

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Contain,taste,receptors

Contain,taste,receptors

Have,nerve,endings, sensitive,to,touch

Contain,taste,receptors

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Taste • • • • • •

Sweet Sour Salt Bitter Umami (savoury/glutamate) And?

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Tongue • Inferior*surface* – is*covered*by*a*thin*mucous*membrane – Attached*to*floor*of*mouth*by*the*frenulum of*the*tongue

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Ankyloglossia

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Tongue Muscles*are*classified*as*intrinsic*or*extrinsic

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Tongue Innervation:

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Innervation:

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Blood*supply:

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Salivary*glands • There*are:* – 3*major*pairs*of*salivary*glands • Parotid • Submandibular • Sublingual

– Accessory*salivary*glands,*scattered*through*oral*cavity

• Salivary*glands*secrete*saliva: – – – – – –

Moistens*mucous*membrane*in*oral*cavity Contains*amylase*(starts*converting*polysaccharides*to*disaccharides) Immunity*(contains*Ig A) Lubricates*food Helps*to*prevent*tooth*decay Facilitates*taste

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Salivary*glands Gland

Site

Site*of*duct*opening

Innervation

Parotid

Anterior*&*inferior*to*

Vestibule,*opposite*

Auriculotemporal*

ears,*between*skin*&*

upper*2nd*molar

nerve*(branch*of*V3)*– sensory*+*carries*

masseter

PS*fibres*from* glossopharyngeal*nerve Submandibular

Floor*of*mouth,*medial* Lateral*to*lingual*

Lingual*nerve*(branch*of*V3):* –

and*partly*inferior*to*

frenulum,*at*

sensory*+*carries*PS*fibres

body*of*mandible

sublingual*caruncle

from*chorda tympani*branch****** of*facial*nerve

Sublingual

Inferior*to*tongue,*

Floor*of*mouth*in*

Lingual*nerve*(branch*of*V3):

superior*to*

oral*cavity*proper

sensory*+*carries*

submandibular*

PS*fibres*from*chorda tympani*

glands

branch**of*facial*nerve 44

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Candida*Infection

Mouth*ulcer

Hand*foot*and*mouth

Herpes*simplex

• http://www.dailymail.co.uk/health/articleQ 3000387/HorrificQvideoQshowsQdentistQ removingQ15QMAGGOTSQinsideQlittleQgirlQsQ gum.html?ITO=1490&ns_mchannel=rss&ns_c ampaign=1490...