The Mouth

Oral Vestibule: Area between the teeth and lips, or the teeth and cheeks Most anterior portion of the oral cavity Oral Cavity Proper: The space occupied by the tongue Oral Cavity Proper Boundaries Anterior: lips Posterior: oropharyngeal isthmus of fauces Roof: Hard palate, soft palate more posterior Floor: Tongue and mucosa under the tongue Note: The teeth are inserted into the alveolar process of mandible and maxilla bones

Cheek Lateral walls of oral cavity Four major layers: 1. Skin - Non-keratinized, stratified squamous epithelium 2. Buccopharyngeal fascia - Covers buccinator muscle 3. Buccinator muscle - From outer surface of alveolar processes of mandible and maxilla 4. Mucous membrane Floor of Mouth The anterior 2/3 of the tongue constitutes its body, and makes up most of the floor of the mouth The floor also consists of the mucous membrane region from the base of the tongue to the gingiva of the mandible. This includes the lingual frenulum, a fold of mucous membrane which connects the tongue to the floor. The submandibular duct is located at the base of the frenulum, with papillae on either side. Posteriorly and laterally from the papilla is the location of the sublingual folds which contain the sublingual salivary glands. The anterior 2/3 of the tongue is innervated by all branches of the trigeminal nerve, particularly the lingual branch. These branches transmit sensory information.

Teeth Usually there are 32 permanent teeth 16 on the upper jaw, and 16 on the lower jaw Each side of the jaw contains the same 4 tooth types, constituting 8 teeth on each side 1. Incisor (x2) 2. Canine 3. Premolar (x2) 4. Upper molar (x3) Palate: Hard and Soft Forms roof of mouth and floor of nasal cavity Hard Anterior Formed by 2 bones 1. Palatal process of maxilla 2. Horizontal plate of palatine bone Covered by periosteum and oral mucosa (mucoperiosteum) Sharpeys fibers - Thin fibers of bone which connect the mucoperiosteum to the underlying bone - Absent at the horizontal plate Soft No bones Posterior to hard palate Attaches to hard palate by the tensor veli palatini aponeurosis Muscular posteriorly 1. Levator veli palatini: raises the soft palate during swallowing 2. Palatoglossus: elevated posterior 1/3 of tongue 3. Palatopharyngeus: pulls pharynx up and forward during swallowing 4. Tensor veli palatini: swallowing Muscles attach to hyoid bone

Palate continued Blood Supply Arterial: Greater palatine artery on each side Emerges through greater palatine foramen, lateral to the greater palatine nerve Venous: pterygoid plexus and pharyngeal plexus Lymph Retropharyngeal cervical nodes Deep cervical nodes Nerve Trigeminal nerve (maxillary branch) supplies the palate Branches into greater palatine nerve

Tongue Body: anterior 2/3 Root: posterior 1/3 Movement Intrinsic and extrinsic muscles Intrinsic: alter the shape of the tongue Extrinsic: alter position of the tongue 1. Genioglossus - Bulk of the tongue - Protrusion/forward movement - Side to side 2. Styloglossus - Retracts tongue - Curls sides 3. Hyoglosus - Draws sides of the tongue down - Aids retraction - Depresses tongue 4. Palatoglossus 5. Mylohyoid - Muscular floor of oral cavity - Runs from mandible to hyoid bone - Swallowing and speaking

Pharynx Muscular tube that is deficient anteriorly due to openings of nasal and oral cavities Extends from posterior nasal cavity to oesophagus (continuous with oesophagus and larynx) Anterior to pre-vertebral fascia Three Parts 1. Nasopharynx 2. Oropharynx 3. Laryngopharynx

Layers of Pharyngeal Wall External: buccopharyngeal fascia Muscle - Outer circular constrictor muscles (x3) ! Superior, middle, and inferior ! Forms a muscular sleeve - Inner longitudinal muscles: stylopharyngeus, palatopharyngeus, salpingopharyngeus Submucosa Mucous membrane

Four Constrictor Gaps: openings for structures to and from the pharynx 1. Above superior constrictor - Auditory tube 2. Between superior and middle constrictor - Stylopharangeus muscle - Glossopharyngeal nerve 3. Between middle and inferior constrictor - Internal laryngeal nerve - Superior laryngeal artery (from superior thyroid artery) 4. Below inferior constrictor - Recurrent laryngeal nerve - Inferior laryngeal artery

Carotid Triangle Boundaries Superior: stylohyoid Posterior: sternocleidomastoid Inferior: superior omohyoid Floor: pharynx