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Oral cavity, Hypoglossal Nerve, and Tongue
Cole 6/23/11 lecture 2.5 hrs
102
Anatomy
Undergraduate 4
06/06/2011

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Term
1) bone (maxilla and mandible)
2) teeths
3) tongue
4) salivary glands
5) lymphoid tissue (tonsils)
6) skeletal musc of the tongue and soft palate
7) nerves and vessels
Definition
list the contents of the oral cavity
Term
1) ceiling: hard and soft palate
2) posterior: oropharynx(palatopharyngeal arch)
3) floor: skin in mandible
4) lateral: buccinator?
Definition
what makes the boundaries of the oral cavity?
Term
palatine tonsil
Definition
what tonsil is found between the palatopharyngeal and palatoglossal arches?
Term
anterior: palatoglossal arch
posterior: palatopharyngeal arch (this is the border between the oral cavity and the pharynx)
Definition
which arch surrounding the palatine tonsil is more posterior? which is more anterior?
Term
hard
Definition
which is more anterior, hard palate or soft palate?
Term
soft palate
Definition
what does the uvula hang off?
Term
5-8, roof of the mouth, help to manipulate a bolus of food and helps a little with speech
Definition
how many palatine rugae do you have, where do you find them, and what is their purpose?
Term
superior labial frenulum
Definition
what structure just deep to the upper lip gets torn a lot in kids and bleeds a lot?
Term
frenulum lingue
Definition
name the midline stringy thing underneath the tongue
Term
the space between the teeth and cheek
Definition
where is the vestibule in the mouth?
Term
the buccinator musc and the buccal mucosa
Definition
what forms the lateral border of the oral vestibule?
Term
maxilla
Definition
what bone forms the hard palate?
Term
palatal mucosa
Definition
what covers the hard palate?
Term
the tongue mucosa blends with the gums to form the floor
Definition
how does the floor of the mouth work in terms of mucosa?
Term
hypoglossal canal
Definition
how does CN 12 exit the skull?
Term
somatic motor ONLY to intrinsic/extrinsic tongue muscles
Definition
what are the modalities of CN 12? what do these go to?
Term
1)superior longitudinal
2)inferior longitudinal
3)verticalis
4)transversus

-we didn't learn them, he just mentioned them
-function: change the shape of the tongue and do not attach to bone
Definition
list the 4 intrinsic tongue muscles, what is their function?
Term
1)genioglossus
2)hyoglossus
3)styloglossus
4)palatoglossus

function: change position of the tongue, these ARE anchored to bone
Definition
list the 4 extrinsic tongue muscles, what is their function?
Term
genioglossus:

mostly PROTRUDES the tongue, but some fibers on the anterior tip of the tongue retract it
Definition
name the main muscle of the tongue that you see, what does it do?
Term
styloglossus
Definition
this muscle elevates and retracts the tongue
Term
hyoglossus
Definition
this muscle DEPRESSES and retracts the tongue
Term
mandibular symphysis (the other side attaches to the thick CT layer on the top of the tongue called the lingual aponeurosis which is deep to the intrinsic tongue muscles)
Definition
what bone does genioglossus attach to?
Term
hyoid
Definition
what bone does hyoglossus attach to?
Term
styloid process of temporal bone
Definition
what bone does styloglossus attach to?
Term
stylohyoid ligament
Definition
name the ligament that attaches the styloid process and the hyoid bone
Term
UMNL: fasciculations without atrophy, deviation to opposite side nerve lesion (remember that UMN's cross over, so a R side UMN lesion, tongue deviates to the left, because the left side muscle is paralyzed)

LMNL: flaccid paralysis with atrophy, lesion to nerve on SAME side
Definition
how do you distinguish a UMN lesion and an LMN lesion of CN 12 with the tongue? which way does the tongue deviate?
Term
the MYLOHYOID (FO SHO), geniohyoid below that, and anterior digastric sort of
Definition
what muscles form the floor of the oral cavity?
Term
mylohyoid
Definition
what muscle in the floor of the oral cavity that makes a hammock shape, and has a free posterior and lateral edge?
Term
there is a left and right with a midline raphe, the fibers are in coronal planes.

ACTION: stiffen tongue to give a solid foundation
Definition
what direction do the fibers of mylohyoid go and what does this muscle do?
Term
V3!!!!!!!!!!!!!!
Definition
what innervates mylohyoid?
Term
pulls hyoid closer to mandible to help with swallowing, it is perpendicular to mylohyoid which means its fibers run in sagittal planes
Definition
how are the fibers of geniohyoid oriented? what does geniohyoid do?
Term
CN XII hypoglossus (NOT V3 and NOT ansa cervicalis)
Definition
what innervates geniohyoid?
Term
1) genioglossus
2) geniohyoid
3) mylohyoid
Definition
order these from superior to inferior (internal to external): mylohyoid, geniohyoid, genioglossus
Term
internal jugular vein and carotid arteries
Definition
what major vessels does the hypoglossal nerve run forward and between?
Term
it runs on the lateral surface of hyoglossus ABOVE mylohyoid
Definition
when CN XII turns in the neck and runs anterior, what muscle does it run alongside?
Term
its from C1, it just travels with CN 12
Definition
the nerve to thyrohyoid branches off CNXII, but what nerve does it actually come from?
Term
C1 ventral rami

NOTE: this hangs off CN12
Definition
descendens hypoglossi is formed from what nerve(s)?
Term
C2-C3 ventral rami
Definition
descendens cervicalis is formed from what nerve(s)?
Term
C1-C3 ventral rami (aka descendens hyporglossi + descendens cervicalis)
Definition
what makes up the ansa cervicalis?
Term
the occipital artery to SCM
Definition
when CN 12 pierces the carotid sheath, it goes lateral to ICA and ECA, but medial to the IJV. What vessel loops over the top of CN XII and what is it a branch of?
Term
it sits one inch above the hyoid
Definition
how do you locate the hypoglossal nerve using the hyoid bone?
Term
=V3 + chorda tympani (CN 7)
1) somatic sensation to the anterior 2/3 of tongue from V3
2) parasympathetics from CN 7
3) taste anterior 2/3 from CN 7
LINGUAL BRANCHES of hypoglossal n:
4) somatic motor to tongue muscles
5) taste to the posterior 1/3 of tongue
Definition
what info is carried in the lingual nerve?
Term
hypoglossal is medial to post. digastric
Definition
where is the hypoglossal nerve in relation to posterior digastric muscle?
Term
lingual nerve is always superior and both nerves are lateral to hyoglossus
Definition
what muscle are the lingual nerve and hypoglossal nerve both lateral to? which is more superior?
Term
LA is medial to hyoglossus (nerves are lateral)
Definition
where is the lingual artery in relation to hyoglossus?
Term
the submandibular duct
Definition
name the shared duct of the sub lingual and submandibular glands
Term
a pit in the tongue where the thyroglossal duct(atrophies at birth) attaches

-this is where thyroid cells originate
Definition
what is the foramen cecum?
Term
2nd branchial pouch
3rd branchial arch
Definition
mucosa over the palatine forms from what branchial arch? what branchial pouch?
Term
the sulcus terminalis
Definition
what divides the tongue into its body and root?
Term
this is the fibrous CT septum that divides the tongue into l & r halves in the anterior 2/3 of the tongue

(the blood vessels do not cross in the front of the tongue because of this)
Definition
where is the medial sulcus of the tongue?
Term
the lymphoid follicles of the lingual tonsil
Definition
what is the bumpy junk on the posterior 1/3 of the tongue?
Term
foliate papilla
Definition
name the lingual papillae that lose function in early childhood on the sides of the tongue
Term
(circum)vallate papillae
Definition
name the cluster of taste buds back by the suclus terminalis
Term
filiform papilla (these are the keratinized ones designed to grip food)
Definition
name the lingual papilla with no taste buds
Term
fungiform papillae
Definition
name the round hard papillae tjat have taste buds over most of the tongue
Term
it is tightly attached in the anterior 2/3 of the tongue,

but loose and freely moveable in the posterior 1/3
Definition
describe the attachment of the mucous membrane to the connective tissue in the tongue
Term
sublingual gland, uses small ducts in the mucosa of the floor of the mouth, or the submandibular duct
Definition
what salivary gland lies completely within the oral cavity? what duct(s) does it use?
Term
submandibular gland, uses a submandibular duct
Definition
what salivary gland lies partially within the oral cavity, and partially beneath it? what duct(s) does it use?
Term
mylohyoid
Definition
what muscle does the submandibular duct curve around?
Term
the submental branch of the facial artery is the primary blood supply, it crosses below the mandible at the location of the gland.
Definition
what artery supplies the submandibular gland, where does it travel to get to it?
Term
it starts lateral, goes under and medial to it, then superior and lateral again

(spiral around it)
Definition
how does the lingual nerve travel relative to the submandibular duct?
Term
a swelling at the base of the lingual frenulum where the submandibular duct comes out
Definition
what is the sublingual caruncle?
Term
dorsal lingual artery, MIDLINE ANASTAMOSES!!
Definition
what artery supplies the posterior 1/3 of the tongue, and where does it anastamose?
Term
the deep lingual artery, it has no midline ansatamoses

(this artery travels inside genioglosus)
Definition
what artery supplies the anterior 2/3 of the tongue and where does it anastamose?
Term
the affected side will be pale, and the other side will be normal because there is no midline anastamoses in the anterior 2/3 of the tongue
Definition
what happens to the tongue in kids when one side gets decrease blood flow?
Term
lingual artery
Definition
what artery supplies soft tissue of the oral cavity below the palate and comes off the ECA first deep to hyoglossus?
Term
dorsal lingual veins
Definition
what drains the dorsum and sides of the tongue?
Term
deep lingual vein
Definition
what veins drain the tip of the tongue, the sublingual gland, and floor of the mouth?
Term
the hypoglossal nerve, this vein is sometimes called the ranine vein
Definition
what accompanies the deep lingual vein and runs medial to the fimbriated fold of the tongue?
Term
the lingual artery
Definition
what structure runs with the dorsal lingual vein?
Term
ranulas (these are a big benign bubble of saliva that can't drain)
Definition
name the cysts that result from a blocked sublingual duct
Term
ANTERIOR 2/3:
1) sense CN V
2) taste CN VII
POSTERIOR 1/3:
3) sense & taste: CN IX
EPIGLOTTIS
4) taste CN X

MOTOR: CN XII
Definition
name the cranial nerves that innervate the tongue and what type of sensation and where in the tongue.
Term
1) CN V
2) CN VII
3) CN IX
4) CN X

MYOTOMES (muscle) is from CN XII)
Definition
match the branchial arches with cranial nerves, what arches form the tongue?
Term
in their teeth, at the dentoenamel junction (a narrow part of the tooth where the enamel ends below the gum line)
Definition
where is the cervix in the male body?
Term
the outer cover of the tooth below the cervix where the ligament attaches
Definition
where/what is the cementum of a tooth?
Term
this is the enamel coat on the surface of the tooth above the cervix
Definition
what is the crown of the tooth made of?
Term
its the hollow cavity on the inside of the tooth with only nerve endings and blood vessels in it
Definition
what/where is the pulp of the tooth?
Term
the apical foramina (at the apex of the tooth) which is at the base of the tooth
Definition
name the foramina in the tooth that blood and nerves go through
Term
dentin, its like enamel but more organic and less mineralized
Definition
name the tooth layer just deep to the enamel
Term
V2 upper (superior alveolar)
V3 lower (inferior alveolar)
Definition
describe the innervation to the teeth
Term
the brain shuts off the jaw elevators, so you stop biting down and don't break your tooth
Definition
there is a reflex that occurs when you strain the periodontal ligaments, what is the motor component of the reflex loop?
Term
the fit in the alveolae of the mandible, and periodontal ligaments anchor the teeth and act as shock absorbers and have proprioceptive fxn
Definition
what holds the tooth roots in place?
Term
32
Definition
how many teeth does a normal adult have?
Term
I,C,P, or M followed by a superscript numer or subscript for upper/lower tooth
Definition
how do you denote tooth type with permanent dentition?
Term
blade-like or pointed cusp, 1 root
function: incision
cut, slice, tear
Definition
describe the cusps, root number, and function of canines/incisors
Term
cusps: premolars have 2, molars have 3-5
roots: 2 or 3
function: mastication (grinding)
Definition
describe the cusps, root number, and function of premolars/molars
Term
upper right 3rd molar
Definition
where do you start when numbering permanent dentition?
Term
20
Definition
how many teeth make up the deciduous dentition?
Term
NO, they are premolars because they have the same developmental origin
Definition
are there deciduous molars?
Term
lower case i,c,p,m sub/superscript, except for c which gets a line above or below


some weirdos use capital letters with a lowercase d in front for deciduous
Definition
how do you denote tooth type with deciduous dentition?
Term
begin with p2 (right most posterior premolar in the upper jaw) then go 1d-20d or A-T
Definition
how do you number deciduous teeth?
Term
you can screw up your permanent dentition because you may have mixed dentition and teeth developing in the mandible/maxilla
Definition
why is it bad to get a face fracture at 5 years of age?
Term
1) eruption: movement of tooth crown through bone

2) emergence: breaking of the tooth crown through the oral mucosa(gum)
Definition
what is the difference between tooth eruption and tooth emergence? which happens first?
Term
birth until 6-8 months
Definition
when are there no visible teeth in the mouth?
Term
6-8 months to 2-2.5 years, first is usually the lower central incisors
Definition
when do the deciduous teeth emerge? which come first?
Term
2-2.5 yrs to 6 yrs
Definition
when are there deciduous teeth without emergence of permanent teeth?
Term
6-12 years of age
Definition
when is there MIXED dentition?
Term
usually lower first molar pops up around 6 year (lower teeth come before upper usually)
Definition
when do permenent teeth first emerge, which ones first?
Term
6-9 years
Definition
when do the permanent incisors pop up?
Term
9-12 years (there should be no more deciduous teeth after this)
Definition
when do the permenent canines and pre-molars pop up?
Term
12 years
Definition
when do permanent second molars emerge?
Term
17-21 years

NOTE: those little bitches popped out when I was 17. I am now 21, and due to lack of dental insurance they are still screwing with my mouth. I have to get all 4 out which costs around 2 grand. Please donate to the "remove Sadie's wisdom teeth fund" if you have a heart.
Definition
when do permenent 3rd molars emerge?
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