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LCSC06 Biological Sciences Head & Neck 2 Oral & Pharyngeal Structures Marianne Bos-Clark MSc BA(Hons) MCRSLT HPC [email protected] This session • • • • • Oral & pharyngeal structures Dentition Tongue Taste & Sensation Tonsilar Tissue Oral & pharyngeal anatomy Cavities of the oropharynx: • Oral • Nasal • Oropharynx, naso- and laryngopharynx • Pharynx The oral cavity Extends from oral opening (lips) to pillars of fauces at back Teeth and alveolar ridge or maxillae make up lateral margins Dentition Housed in alveolar of maxillae and mandible Function: Mastication Articulatory surface for speech sounds Upper and lower dental arches: equal numbers of teeth 1. Incisors 2. Cuspids 3. Bicuspids 4. Molars Each has root in gingival or gum line Crown is visible 1/3: surface of dental enamel Heart of tooth is pulp: contains nerve supply Dentition Dentition Zsigmond system • Upper right quadrant 87654321 EDCBA • Upper left quadrant 12345678 ABCDE • Lower right quadrant EDCBA 87654321 • Lower left quadrant ABCDE 12345678 Dentition Dentition Deciduous/ permanent Dentition For development of decidious & permanent dentition, see Atkinson & McHanwell (2002) Basic Medical Science for SLT students. London:Whurr (p308) The hard palate •Rugae •Median raphe •Soft palate Soft palate •Uvula •Velum Pillars of fauces •Anterior •Posterior Muscles of the velum Muscle Function Levator veli palatine Elevator *also movement of Eustachian tube Musculus uvulae Elevator/bunching Tensor veli palatine Tenses and shortens Palatoglossus Depressor Palatopharyngeus Depressor The tongue Occupies floor of mouth Functions include: • Articulation • Mastication • Deglutition • Etc… The tongue • MEDIAN FIBROUS SEPTUM • TIP or APEX • BASE OF TONGUE • DORSUM • TERMINAL SULCUS • LINGUAL PAPILLAE • LINGUAL TONSILS • INFERIOR SURFACE – SUBLINGUAL FRENULUM – SUBLINGUAL FOLD The tongue muscles and movement 1 Intrinsic muscles of the tongue Muscle Location Action CN SUPERIOR LONGDITUDINAL NEAR EPIGLOTTISSIDES OF TONGUE WIDENS, THICKENS AND SHORTENS TONGUE TIP AND EDGES XII INFERIOR LONGDITUDINAL HYOID BONE/BASE OF TONGUE-APEX OF TONGUE WIDENS, SHORTENS, CREATES CONVEX DORSUM, DEPRESSES TIP XII TRANSVERSE TONGUE SEPTUMMUCOSA AT SIDES OF TONGUE ELONGATES, NARROWS, THICKENS, LIFTS SIDES XII VERTICAL SUPERIOR SURFACEINFERIOR SURFACE WIDENS AND FLATTENS TONGUE TIP XII Intrinsic tongue muscles The tongue muscles and movement 2 Extrinsic muscles of the tongue: Muscle Action CN GENIOGLOSSUS Anterior Posterior MANDIBLEDORSUM + HYOID HYOGLOSSUS TONGUE-HYOID DEPRESSES AND RETRACTS TONGUE XII PALATOGLOSSUS SOFT PALATETONGUE CONTRATION=ELEVATION OF BACK OF TONGUE XI Accessory STYLOGLOSSUS TEMPORAL BONESIDES OF TONGUE CONTRACTION=UPWARDS XII AND BACKWARDS MOVEMENT •Ant. Contraction =retraction. •Post. Contractio=protusion XII Hypoglossal Extrinsic tongue muscles Extrinsic tongue muscles Therapy Therapy Therapy Therapy The tongue taste and sensation Taste: • Tip sweet/sour • Sides sour & salty • Posterior bitter Salivation Salivary glands • Parotid • Submandibular • Sublingual Saliva: two types of saliva • SEROUS : thin and watery • MUCOIDAL: more viscous/sticky Function of saliva: • DIGESTIVE • DISINFECTANT Tonsils 1 • Palatine tonsils • Lingual tonsils • Pharyngeal tonsils (adenoids) Tonsils 2 Function: Part of limbic system/immune response • Believed to be involved in helping fight pharyngeal and URT infection Name Location Adenoids: pharyngeal tonsils Roof of pharynx Palatine tonsils Sides of pharynx between faucial arches Lingual tonsils Behind terminal sulcus (tongue) Nasal cavities •Nasal septum •Turbinates •Nares •Paranasal air sinuses Paranasal Sinuses Air-filled spaces, communicating with nasal cavity within the bones of the skull and face Function: debated •Decrease skull weight •Increased vocal resonance •Protection •Insulation Eustachian tube Location: Function: The pharynx Divided into areas: 1. Oropharynx 2. Nasopharynx 3. Laryngopharynx Pharyngeal muscles • Superior pharyngeal constrictor • Middle pharyngeal constrictor • Inferior pharyngeal constrictors Pharyngeal musculature Muscle function Innervation Superior pharyngeal constrictor Velopharyngeal closure Reduces diameter CN XI & X Middle pharyngeal constrictor Reduces diameter CN XI & X Inferior pharyngeal constrictor Reduces diameter: Two parts: CN XI & X 1. Cricopharyngeal muscle Muscular orifice of oesophagus *arises from cricoid 2. Thyropharyngeal muscle *arises from thyroid Salpingopharyngeus Elevates lateral pharyngeal wall CN XI & X Stylopharyngeus Elevates pharynx CN IX The epiglottis • Leaf-shaped cartilage • Attached to root of tongue