board review dh227 concorde career college anatomy & physiology lisa mayo, rdh, bsdh
TRANSCRIPT
Board Review DH227Concorde Career College
Anatomy & PhysiologyLisa Mayo, RDH, BSDH
Cells
• Cells – Tissues – Organs – Organ Systems• Functions
1. Excitability2. Synthesis: secreting products for body’s needs3. Membrane Transport: moving in and out of cell4. Reproduction5. Differentiation6. Organize chemicals
Cells
Structures to Review1. Cell Membrane: semipermeable surrounding of a cell. Lipids &
PRO are major components2. Endoplasmic Reticulum: synthesize, circulate, package
materials3. Golgi Apparatus: site for PRO synthesis and recycling4. Mitochondria: powerhouse of cell (ATP produced)5. Lysosomes: surrounded by own membrane, degradation of
hydrolytic enzymes6. Cytoplasm: surrounds and supports7. Ribosomes: synthesis for PRO molecules8. Nucleus: genetic codes, controls cell, mitosis
Cells
Transport through cell membranes(know definitions)
1. Diffusion2. Osmosis3. Active Transport4. Phagocytosis5. Pinocytosis
Question
Protein synthesis occurs in thea. Cytoplasmb. Mitochondriac. Cell membraned. Rough endoplasmic reticulum
Answer
Protein synthesis occurs in thea. Cytoplasmb. Mitochondriac. Cell membraned. Rough endoplasmic reticulum
Question
The organelle responsible for cellular digestion is the
a. Lysosomeb. Golgi bodyc. Mitochondriad. Endoplasmic reticulum
Answer
The organelle responsible for cellular digestion is the
a. Lysosomeb. Golgi bodyc. Mitochondriad. Endoplasmic reticulum
Question
Energy production for the cell is accomplished through oxidation of nutrient in the
a. Lysosomesb. Mitochondriac. Cell membraned. Endoplasmic reticulum
Answer
Energy production for the cell is accomplished through oxidation of nutrient in the
a. Lysosomesb. Mitochondriac. Cell membraned. Endoplasmic reticulum
TissuesClassification: grp of cells which work together to perform a specific function
1. Epithelial: • Simple squamous, stratified squamous (lines oral cavity),
simple columna• Protection, absorption, secretion, covering or lining
tissues/glands2. Connective: Vascular. Holds together, supports and connects body
parts1. Reticular2. Adipose3. Dense Fibrous4. Bone5. Cartilage6. Blood
Tissues
Classification: grp of cells which work together to perform a specific function
3. Nerve: reaction to stimuli, transmission of impulses, central and peripheral nervous systems
1. Neurons2. Neuroglia
4. Muscle: movement, smooth/involuntary, skeletal/voluntary, cardiac
1. Skeletal2. Cardiac3. Visceral
Membranes and Glands
• Membranes Types1. Mucous: protect, secrete, absorb2. Serous: visceral/parietal/synovial layers3. Cutaneous: skin
• Glands1. Endocrine: secrete directly into blood2. Exocrine: simple and compound. Secrete directly
into ducts
SKELETAL SYSTEM
Skeletal System
• Functions– Protection– Involved in formation blood cells– Supply Ca2+ to the bones– Allow movement through joints
• Marrow: fills spaces. Red and Yellow• Formation– Begin: 8th week of embryonic life– Ossification: Intramembranous or Endochondral
Skeletal System
Types Bones1. Long2. Short3. Flat4. Irregular
Skeletal System• Articulations
1. Fibrous Joints: syndemosis, sutures, gomphosis2. Cartilaginous Joints: synchondrosis, symphyses3. Synovial Joints: hinge, pivot, saddle, ball-n-socket
• Divisions1. Axial 2. Appendicular3. Auditory Ossicles
Skeletal System
Movements1. Gliding2. Flexion3. Extension4. Abduction5. Adduction6. Circumduction7. Rotation
Skeletal System
Skull1. Cranium2. Frontal3. Parietal4. Temporal: squamous portion (zygomatic), petrous, mastoid,
glenoid, styloid process, stylomastoid foramen, jugular foramen5. Sphenoid: greater wings (foramens: rotundium, ovale,
spinosum, lacerum, superior orbital fissure). Lesser wings (optic foramen)
6. Ethmoid7. Occipital: foramen magnum, condyles, external occipital
protuberance, transverse sinus
Skeletal system
Facial Bones• All Facial bones except mand bone touch maxilla – Alveolar process– Infraorbital foramen– Nasal cavities– Max sinus
• Mand Bone– Mental foramen– Ramus: condyle, coronoid process, mand. foramen
Skeletal System
Facial Bones• Zygomatic • Lacrimal• Nasal• Inferior Nasal Concha• Palatine• Vomer
Skeletal System
• Vertebral Column• Thorax• Appendicular Skeleton– Lower Extremity
• Hip, Ilium, pubic, ischium, pelvis• Femur, patella, tibia, fibula• Foot: talus, calcaneus (heel), cuboid, metatarsals, phalanges
– Upper Extremity• Shoulder: clavicle, scapula• Humerus, radius, ulna• Hand: carpal, metacarpal, phalanges
Skeletal System
Spinal Nerves– Carries motor, sensory, and autonomic signals
between the spinal cord and the body. – 31 left-right pairs of spinal nerves, each roughly
corresponding to a segment of vertebral column
8 cervical spinal nerve pairs (C1-C8)12 thoracic pairs (T1-T12)5 lumbar pairs (L1-L5)5 sacral pairs (S1-S5)1 coccygeal pair
– The spinal nerves are part of the PNS (peripheral NS)
Question
The chemical transmitting agent that acts at the myoneural junction of skeletal muscle is
a. Adrenalinb. Histaminec. Acetylcholined. Norepinephrine
Answer
The chemical transmitting agent that acts at the myoneural junction of skeletal muscle is
a. Adrenalinb. Histaminec. Acetylcholined. Norepinephrine
Question
The hamulus is a landmark of thea. Hyoid boneb. Sphenoid bonec. Temporal boned. Maxillary first premolar tooth
Answer
The hamulus is a landmark of thea. Hyoid boneb. Sphenoid bonec. Temporal boned. Maxillary first premolar tooth
Skeletal System
Skeletal Muscular Tissue• Myofibrils: actin (thin), myosin (thick)• Z-Line• M-Line• I-Band• A-Band• H-Zone• Muscle Contraction: see handout (see handout)
Muscle Contraction Video
http://www.youtube.com/watch?v=CepeYFvqmk4
Muscles
NERVOUS SYSTEM
Nervous System
• Organization– CNS– PNS– ANS– Nerve Cell = neuron
• Cell body/Soma• Neurofibril• Dendrite• Axon• Myelin sheath• Afferent current: to CNS• Efferent current: away from CNS
Nervous System
• Nerve impulse balance controlled by sodium-potassium pump
Sodium Pump Animation
http://highered.mcgraw-hill.com/sites/0072495855/student_view0/chapter2/animation__how_the_sodium_potassium_pump_works.html
Nervous System
• 31 pairs Spinal Nerves• Brain: cerebrum, cerebellum, medulla
oblongata, mesencephalon• 12 pairs Cranial Nerves
Question
The cranial nerve which provides parasympathetic innervation to the parotid gland:
a. Vagusb. Trochlearc. Hypoglossald. Glossopharyngeal
Answer
The cranial nerve which provides parasympathetic innervation to the parotid gland:
a. Vagusb. Trochlearc. Hypoglossald. Glossopharyngeal
Question
As a general rule, parasympathetic preganglionic neurons synapse with postganglionic axons in ganglia:
a. Near the thoracolumbaer regionb. At the cranial nerve nucleic. Near or within target organsd. Along the paravetebral chain
Answer
As a general rule, parasympathetic preganglionic neurons synapse with postganglionic axons in ganglia:
a. Near the thoracolumbaer regionb. At the cranial nerve nucleic. Near or within target organsd. Along the paravetebral chain
SPECIAL SENSES
Special Senses
• Lacrimal Glands• Nasolacrimal Ducts• Eye: iris, pupil, lens, sclera, vitreous body,
optic disk, retina• Ears: external middle, inner ear
Special Senses
• Tongue– VII provides sensory fibers to the anterior 2/3
(fungiform, foliate papillae, sweet/sour/salt)– IX provides sensations of taste to post 1/3
(circumvallate papillae, taste is bitter)• Olfactory: Cranial nerve I• Touch– Meissner’s, Pacinian, Ruffini’s Corpuscles, Krause’s
end bulbs
Blood
• Connective tissue that originates from embryonic mesoderm
• Functions1. Nutrition2. Respiration3. Fluid balance4. Acid-base balance5. Excretion6. Projection7. Temperature regulation8. Endocrine adjunct
Blood
• Plasma: 55%– Fluid portion: 90% water, 10% PRO/solids– Serum albumin/globulins (osmotic pressure), fibrinogen (blood
clots), non-protein (amino acid, urea), non-nitrogenous materials (CHO, Fats)
• RBC: 45%– Transfer oxygen to body, remove CO2
– Hematocrit: measures RBC• Thrombocytes
– Blood coagulation• WBC: less then 1%
– Immune system
Blood Typing
• RBC carry antigens on their surface• Serum carries antibodies• Type A – carry A agglutinogen, plasma carries anti-B
agglutinins• Type B – carry B agglutinogen, plasma carries anti-A
agglutinins• Type AB – carry A&B agglutinogen, plasma carries no
agglutinins• Type O – carries no agglutinogen, serum carries both
anti-A and anti-B agglutinins
Heart
• Wall has 3 layers1. Visceral Pericardium2. Myocardium3. Endocardium
• Valves 1. AV Valve: Tricuspid, Bicuspid (mitral valve)2. SL Valves: Pulmonary, aortic
Heart
• Heartbeat 70-72 beats/min• Nerves regulate heart beat– SA Node– AV node– Purkinje’s Fibers– 4 steps (next slide)
Heart BeatStep 1: Pacemaker Impulse Generation
The SA (also referred to as the pacemaker of the heart) contracts generating nerve impulses that travel throughout the heart wall. Both atria contract.
Step 2: AV Node Impulse ConductionThe AV node lies on the right side of the partition that divides the atria, near the bottom of the right atrium. When the impulses from the SA node reach the AV node they are delayed for about a tenth of a second. This delay allows the atria to contract and empty their contents first.
Step 3: AV Bundle Impulse ConductionThe impulses are then sent down the atrioventricular bundle. This bundle of fibers branches off into two bundles and the impulses are carried down the center of the heart to the left and right ventricles.
Step 4: Purkinje Fibers Impulse ConductionAt the base of the heart the atrioventricular bundles start to divide further into Purkinje fibers. When the impulses reach these fibers they trigger the muscle fibers in the ventricles to contract.
Heart Beat You Tube
http://www.youtube.com/watch?v=tWWZKGN9h74
Heart Beat You Tube
http://www.youtube.com/watch?v=II5RPs1hlGI
EKG• An electrocardiogram, also called an EKG or ECG, is a simple,
painless test that records the heart's electrical activity• With each heartbeat, an electrical signal spreads from the top of
the heart to the bottom– As it travels, the signal causes the heart to contract and pump
blood– The process repeats with each new heartbeat
• The heart's electrical signals set the rhythm of the heartbeat. • An EKG shows:
1. How fast your heart is beating2. Whether the rhythm of your heartbeat is steady or irregular3. The strength and timing of electrical signals as they pass
through each part of your heart
EKG
Question
The mitral valve separates thea. Left atrium from the aortab. Left atrium from the left ventriclec. Right atrium from the right ventricled. Left atrium from the pulmonary vein
Answer
The mitral valve separates thea. Left atrium from the aortab. Left atrium from the left ventriclec. Right atrium from the right ventricled. Left atrium from the pulmonary vein
Circulatory System• Arteries: thick and elastic, tunica adventitia, tunica
media, tunica intima, vasa vasorum• Arteriole: smallest branch of an artery• Venules• Veins: thinner then artery, will collapse without blood• Capillaries: connect small veins and arteries.– Meta-arterioles are the passageways between
arterioles and venules– Dilate or constrict
Circulatory System
• Lymphatic system: carries lymph, maintain fluid pressure, contains lymph glands– Post auricular– Deep cervical– Axillary– Inguinal– Popliteal– Lymph tissue: spleen, thymus, tonsils (palatine,
lingual, pharyngeal, Waldeyer’s ring)
Circulatory System
http://www.youtube.com/watch?v=mH0QTWzU-xI
Circulatory SystemKnow parts of heart by heart!
Heart Basics per MD
http://www.youtube.com/watch?v=H04d3rJCLCE
Question
Where does the heartbeat originate?a. Left atriumb. Sino-atrial nodec. Ventricular noded. Atrioventricular node
Answer
Where does the heartbeat originate?a. Left atriumb. Sino-atrial nodec. Ventricular noded. Atrioventricular node
Cardiac Cycle See Handout
• Diastole– Period of the heart beat when there is no ventricular
muscular activity and the ventricles are filling with blood from the atria
• Systole– Period of the heart beat when the ventricular muscles are
contracting and forcing blood out of the ventricles
Blood Pressure
• Pressure of the blood exerts on walls of vessels• Systolic Pressure– Pressure in blood vessels during systole when blood is
pumped into arteries from ventricles– Pressure is higher since there is more blood in the
vessels at this time• Diastolic Pressure– Pressure inside the blood vessels during diastole when
there is no blood being forced into the vessels so the pressure is lower
Diseases of the Heart
• Congenital heart disease• Rheumatic heart disease• Hypertension• Coronary heart disease
Heart Failure
• Congestive heart failure• Right heart failure• Anginal failure or coronary thrombosis• Heart block: first, second, complete
Diseases of Circulation
• Arteriosclerosis• Atherosclerosis• Thrombus• Embolism
Respiratory SystemFunctions
1. Supply O2
2. Remove CO2
Parts3. Nasal Passage: superior, inferior, middle turbinates, paranasal sinuses (frontal,
ethmoid, max, spenoidal)4. Pharynx (naso/oro/laryngo)5. Epiglottis6. Larynx7. Vocal Cords8. Trachea9. Primary Bronchi: LF & RT10. Secondary Bronchi: : 3 on RT, 2 on LF11. Tertiary Bronchi: 10 per lung12. Bronchioles13. Respiratory Bronchioles14. Alveolar Ducts: branch off resp. bronchioles, sacs attach to ducts15. Surfactant: decrease surface tension, allow lungs to expand
Nostrils↓
Pharynx↓
Larynx↓
Vocal Cords↓
Trachea↓
LF/RT Bronchus↓
Tertiary↓
Bronchioles↓
Terminal↓
Respiratory↓
Alveolar Ducts↓
Alveolar Sacs
Respiratory System
• RT Lung: 3 lobes. Larger than LF• LF Lung: 2 Lobes, 2/3 of heart contained in it• Ten broncho-pulmonary segments per lung• Cardiac Notch• Hilus: point of attachment, in notch• Pleura: serous membrane surrounding the visceral
and parietal layers. Lungs not located in pleural cavity• Alveoli: terminal branches of resp. bronchioles. Dead
end pockets which are the actual site of gas exchange
Respiratory System
Mechanics of Breathing1. Expiration2. Inspiration3. Intrapleural pressure always negative: diff. between alveolar and
intrapleural pressure causes lungs to pull away from thoracic cage
4. Diaphragm: muscle, pulls lungs down when contract. Main muscle respiration
5. Intercostal muscles: lift rib cage and ↑ volume of thoracic cavity6. Breathing controlled by: medulla and pons in brainstem7. Hypoxic drive: stimulated breathing and monitors blood
composition8. Blood gas exchange: allows O2 and CO2 to move along their
gradient
Respiratory System
Malfunctions/Diseases1. Pneumothorax: chest wall punctured, air enters pleural cavity, lungs
collapse2. Dyspnea: labored breathing3. Apnea: cessation breathing4. Hypernea: increase respiration5. Orthopnea: person can breathe better in 1 position then another6. Cheyne-Stokes Respiration: abnormal periodic respiration that consist
of long period apnea followed by burst of hyperpnea then apnea again7. Asthma8. Chronic Bronchitis9. Emphysema10. COPD11. Atelectasis
Respiratory System
Malfunctions/Diseases12. Bronchiectasis13. Pneumothorax14. Pleural effusion15. Hypoxemia16. Hemoptysis17. Pneumonoconiosis18. Orthopnea19. Paroxysmal Nocturnal Dyspnea20. Cor Pulmonale21. Bronchogenic Carcinomas
Respiratory System
Measure Breathing1. Tidal Volume: total air that passes in & out of lungs2. Inspiratory Capacity: amt air can intake into lungs3. Expiratory Reserve volume: amt air can exhale after normal
expiration4. Residual volume: air left in lungs after forceful expiration5. Vital capacity: greatest amt air can exchange in forced respiration6. Hering-Breuer Reflex: prevents over-inflation of lungs. Stimuli
sent over VAGUS nerve to brain7. CO2 conc. in blood is most important stimulus. RESP CONTROL
CENTER8. Cyanosis: excess amt of reduced hemoglobin in capillary 9. Hypoxia: decreased O2 supply to tissue below levels needed in
blood
Question
Air exchange takes place in which of the following?
a. Alveolib. Veniolesc. Arteriolesd. All the above
Answer
Air exchange takes place in which of the following?
a. Alveolib. Veniolesc. Arteriolesd. All the above
Digestive System
• From mouth to anus• 6m long• Parts
1. Mouth2. Stomach3. Small Intestine: duodenum, jejunum, ileum4. Large Intestine: cecum, colon, rectum, anus5. Pancreas (endocrine and exocrine gland), insulin6. Liver7. Kidneys
pH Scale: Stomach acids = low pH
Digestive System Mouth
• Saliva must add to food to roll into bolus – glycoproteins in saliva allow bolus to slip down esophagus
• 3 Major Paired Glands1. Parotid Glands: saliva contains ptyalin, which initiates
digestion of starches. Saliva travels down Stenson’s duct, opens to maxillary molar
2. Sublingual Glands: under tongue and rest against mand in the sublingual fossa. Saliva travels down Bartholin’s Duct and enter oral cavity through Rivinus’ ducts on sublingual fold
3. Submandibular Glands: medial surface man, saliva travels down the tortuous Wharton’s Duct and is released into mouth at sublingual caruncles
Digestive System Steps1. Starts in mouth
a) Lubricateb) Solventc) Moistend) Cleansinge) Buffering
2. Elevate tongue to push bolus of food toward pharynx3. Wavelike contraction4. Food converted to chyme in stomach5. 3 phases of digestion: cephalic, gastric, intestinal6. Stomach secretes mucus, hydrochloric acid acts on pepsinogen – pepsin – converts milk PRO and collagen to proteases and peptones
Continued onto next slide
Digestive System Steps
7. Pancreas produced enz that act on chyme in small intestine
8. Enz brakes up molecules (catabolism), they are selectively absorbed through small intestine (lipase, amylase, carboxypeptidase, trypsinogen, chymotrypsinogen)
-Glycogenesis, glycogenolysis (BIOCHEM)9. Large intestine holds fecal material, reabsorbs water
to maintain the internal env.
Digestive System: Kidney
• 2 kidneys - a pair of purplish-brown organs located below the ribs toward the middle of the back
• Function – remove liquid waste from the blood in the form of urine– keep a stable balance of salts and other substances in the
blood– produce erythropoietin, a hormone that aids the
formation of red blood cells
Digestive System: Kidney• Remove urea from the blood through tiny filtering units called
nephrons• Each nephron consists of a ball formed of small blood
capillaries, called a glomerulus, and a small tube called a renal tubule
• Urea + H2O + waste substances = forms urine as it passes through the nephrons and down the renal tubules of the kidney
Digestive System: Kidney
• 2 Ureters– Narrow tubes that carry urine from the kidneys to the
bladder– Muscles in the ureter walls continually tighten and relax
forcing urine downward, away from the kidneys– If urine backs up, or is allowed to stand still, a kidney
infection can develop– About every 10 to 15 seconds, small amounts of urine are
emptied into the bladder from the ureters
Digestive System: Kidney• Bladder - a triangle-shaped, hollow organ located in the lower abdomen.
The bladder's walls relax and expand to store urine, and contract and flatten to empty urine through the urethra. The typical healthy adult bladder can store up to two cups of urine for two to five hours.
• 2 sphincter muscles - circular muscles that help keep urine from leaking by closing tightly like a rubber band around the opening of the bladder.
• Nerves in the bladder - alert a person when it is time to urinate, or empty the bladder.
• Urethra - the tube that allows urine to pass outside the body. The brain signals the bladder muscles to tighten, which squeezes urine out of the bladder. At the same time, the brain signals the sphincter muscles to relax to let urine exit the bladder through the urethra. When all the signals occur in the correct order, normal urination occurs.
Endocrine System
• Glands that secrete hormones• Functions
1. Supply Nervous system with hormones2. Glands: secreted into system, not ducts3. Product is a hormone: regulate metabolism,
reproduction, acid-base and fluid balance4. Control endocrine secretion5. Pituitary Gland
Endocrine system
Pituitary Gland1. Growth hormone2. Prolactin3. ACTH (adrenocorticotropic)4. TSH (thyroid stimulating)5. LH (Luteinizing)6. FSH (follicle stimulating)7. Pars intermedia8. Pars tuberalis9. ADH (antidiuretic): acts on kidneys to decrease urine
Endocrine SystemReview Below Glands
• Hypothalamus• Thyroid Gland• Parathyroid Gland• Pancreas: diabetes• Adrenal• Pineal Gland• Thymus
Question
Which of the following plays the major role in maintaining fluid balance?
a. Liverb. Heartc. Kidneyd. Stomache. Panaceas
Answer
Which of the following plays the major role in maintaining fluid balance?
a. Liverb. Heartc. Kidneyd. Stomache. Panaceas
OA: Salivary Glands
Parotid Gland: Largest salivary gland Lies on the masseter muscle and wraps around posterior
aspect of ramus of mandible Parotid duct runs superficial to masseter muscle, perforates
buccinator muscle at second maxillary molar Facial nerve runs through it Produces 25% total saliva Stenson’s duct empties opposite the maxillary molars Serous secretion only (contains amylase to break down
starches) Located in front of and below ears Parasympathetic innervation by cranial nerve IX
OA: Salivary Glands
Sublingual Gland Produces 10% total saliva Ducts of Rivinus (8-20) empty under tongue
Empty onto sublingual fold which has one major duct known as Bartholin’s Duct. Subling caruncle contains duct openings for both the submand and subling salivary glands
Mixed secretion (mostly mucous) Located in floor of mouth near midline Parasympathetic innervation by cranial nerve VII
OA: Salivary Glands
Sumand Gland Produces 65% total saliva Wharton’s duct empties under the tongue Mixed secretion (mostly serous) Located near angle/body of mandible (Staphne’s Defect) Parasympathetic innervation by cranial nerve VII
Oral Anatomy
Nerves1. Facial nerve: exits skull through Stylomastoid
foramen2. Trigeminal nerve (V), 3 divisions
1. Ophthalmic nerve (I): sensory to upper face and skull2. Maxillary nerve(II): sensory to midface and max teeth3. Mandibular nerve(III): sensory to lower face, jaw and
mand teeth and motor to muscles of mastication
Oral Anatomy
Masticatory1. All innervated by CN V32. Masseter (M), medial pterygoid(MP), lateral
pterygoid(LP), temporalis(T)3. Jaw elevation: M, MP, T4. Jaw opening: LP + digastric, mylohyoid5. Lateral excursion: M, MP(closing), LP(opening)6. Protrusion: inf head of lateral pterygoid7. Retrusion: posterior fibers of T
Oral Anatomy
Palate/Pharynx1. All innervated by CR X, except for tensor veli palatini (CN V3) and stylopharyngeus (CN IX)2. Elevate, seal soft palate: tensor veli palatini, levator veli palatini3. Elevate pharyngeal walls: palatophyayngeus, stlopharyngeus4. Peristalic milking of bolus down pharynx: superior,
middle, inferior constrictor muscles5. Constrict fauces: palatoglossus, palatopharyngeus
Oral anatomyTongue:
1. All innervated by CN XII except palatoglossus (X)2. Extrinsic muscles: genioglossus (protrusion), styloglossus
(retrusion), hypoglossus (flattening, lower), palatoglossus (elevate)
3. Intrinsic muscles: change shape of tongue
OA: Tongue• Blood supply: Lingual Artery• Innervation
– XII (motor nerve to muscles, except palatoglossus)– V3 (sensory to ant 2/3, mand division, trigeminal)– VII (taste to ant 2/3, chorda tympani)– IX (taste, sensory to post 1/3)
• Intrinsic muscles– Start and end within the tongue– Determine the shape of tongue– Superior and inferior longitudinalis, transverse and vertical grps
• Extrinsic muscles– Originate elsewhere and insert into the tongue– Control the position of tongue– Hypoglossus, styloglossus, genioglossus– Palatoglossus (innervated by X,XI)
OA: Tongue Papillae
• Filiform– Keratinized papillaue protect the tongue, but contain no taste buds– Most numerous, give tongue its velvet appearance– Elongated = “Hairy Tongue”
• Fungiform– Fewer, larger, contain taste buds
• Foliate– Folds of tissue at the post, lateral border– Contain taste buds
• Circumvallate– #=8-12, just ant to sulcus terminalis– Contain taste buds & glands of Von Ebner
Oral Anatomy
Facial Expression1. All innervated by CR VII2. Sphincters of mouth (orbicularis oris) and eye
(orbicularis oculi)3. Buccinator: inserts into orbicularis oris at
pterygomandibular raphe4. Bells’ palsy: unilateral paralysis (drooling, dry
eye)
Oral Anatomy
Neck1. Suprahyoid Muscles
-Digastric, mylohyoid, geniohyoid, stylohyoid-Can elevate hyoid or depress mand if hyoid is fixed
2. Infrahyoid Muscles-Depress hyoid-Innervated by cervical nerves
3. Sternocleidomastoid-Divides neck into ant and post cervical triangles-Deep cervical lymph nodes are palpable along
border of this muscle
Oral Anatomy
TMJ1. TMJ is articulation of condyle with temporal bone
(glenoid fossa and articular eminence)2. Has an articular disc which divides joint into 2 spaces3. Lateral pterygoid muscle attaches to condyle (inferior
head) and to articular disc (superior head)4. Upper joint space permits translation (sliding) of mand5. Lower joint space permits rotation of condyle6. Forces of chewing are applied between condyle and
articular eminence
Oral Anatomy
• Vestibule• Oral Cavity Proper• Floor of oral cavity is mylohyoid muscle• Sides: buccinator muscle• Roof is the hard and soft palate• Open posteriorly through the arch of the
fauces (palatal arches) into the oropharynx
Oral Anatomy
• Floor of Mouth1. Sublingual Glands: salivary g. that is completely
intraoral, has numerous small ducts that open into sublingual fold
2. Submandibular Glands: partially below man in neck and partially in floor of mouth, duct open adjacent to lingual frenum at base of tongue
3. Nerves1. Lingual N: general sensory to ant 2/3 tongue2. Glossopharyngeal N: sensory and taste to post 1/33. Hypoglossal N: motor to all tongue muscles except
palatoglossus
Oral Anatomy
• Lymph Drainage– Tip of tongue and mand central incisors: submental nodes– Submand nodes: rest of oral cavity– Deep cervical lymph nodes: all, plus nodes of rest of head
• Lingual artery– Supplies the tongue– Branch external carotid artery
• Salivary glands innervated by PNS– Parotid: glossopharyngeal nerve from otic ganglion– Subling/Submand glands: facial nerve (chorda tympani) from
submand ganglion
Oral Anatomy• Tonsils
1. Palatine tonsils lie between ant and post pillars at fauces
2. Lingual tonsil lies in post 1/3 of tongue3. Pharyngeal tonsils (adenoids) and tubal tonsils
are located in nasopharynx4. Waldeyer’s Ring
Oral Anatomy: Hyoid Muscles
• Muscles originate from the hyoid bone• Important for chewing, swallowing, speaking since
they comprise the floor of the mouth and work well with lateral pterygoid muscles to open the mouth
• Innervation: Trigeminal Nerve (V), Facial Nerve (VII)• Infrahyoid Muscles: stabilize the hyoid bone
– Thyrohyoid, sternohyoid, sternohyoid, omohyoid• Suprahyoid Muscles: open mouth, depress mand
– Mylohyoid, geniohyoid, digastric, stylohyoid– Mylohyoid muscles make up floor of mouth
Question
Which is the strongest muscle of mastication?
Answer
Masseter
Question
The mylohoid musclea. Lifts the upper lipb. Tenses the lower lipc. Contributes to a frownd. Comprises the floor of the mouth
Answer
The mylohoid musclea. Lifts the upper lipb. Tenses the lower lipc. Contributes to a frownd. Comprises the floor of the mouth
Oral anatomy: Muscles of Neck
• SternocleidomastoidOrigin: Sternum and clavicleInsertion: mastoid process of the temporal boneFunction: tilts and rotates the head
• TrapeziusOrigin: occipital and vertebral bonesInsertion: scapula, clavicleFunction: rotate and elevate the shoulder
OA: Blood Flow to Face
• 3 Major Branches of the external carotid artery1. Maxillary: teeth, muscles of mastication, ear2. Lingual: tongue, floor of mouth3. Facial: muscles of facial expression, lips, eyelids,
soft palate, throat
OA: Veins of Head/Neck
• Generally: veins run with arteries and often have the same name
• An exception to this in the head and neck is the jugular vein, which runs with the carotid artery
• The teeth drain into the pterygoid plexus which forms the maxillary vein
• Blood is returned to the heart through the retromandibular vein, the external jugular vein, subclavian vein, brachiocephalic vein, superior vena cava to the RT atrium
OA: Veins of Head/Neck1. Internal jugular vein: drains brain, facial vein, superficial temporal vein2. Facial vein: drains facial structures (nose, lips, eyes, submental, submand
areas)3. Pterygoid plexus: found near pterygoid muscles, max tuberosity,
sphenoid bone• Drains to form maxillary vein• Structures which drain into the plexus include the teeth, muscles
of mastication, buccinator, nose, palate4. Superficial Temporal Vein: drains areas supplied by maxillary and
superficial temporal arteries. Superficial temporal vein and max vein form the retromandibular vein
5. Common facial vein: union of the facial and retromand veins6. Cavernous sinus: sinus containing veneous blood located on each side of
the body f the sphenoid bone, near the base of the brain, behind the bridge of the nose
OA: Lymphatic System
• Network tiny channels/nodes• Tender or enlarged lymph nodes may be sign of malignancy• Node Grps
1. Parotid2. Buccal3. Occipital4. Superficial cervical 5. Anterior cervical 6. Submental7. Submandibular8. Deep cervical (superior and inferior)
143Copyright © 2010 by Saunders, an imprint
of Elsevier Inc.
OA: Lymph System• Submental Nodes
– Drain fluid from the mand incisors, tip of tongue, midline of lip, shin, floor of mouth
• Submand Nodes– Drains the submental nodes and remaining teeth– May or may not include 3rd molars
• Deep Cervical Nodes– Drains the submand nodes, 3rd molars, and the wall of the throat– Structures of the oropharynx, drained by superior deep cervical nodes– Superior deep cervical drained by inferior deep cervical nodes
• Primary Nodes– 1st node affected by a disease process
• Secondary Nodes– The next set of nodes affected by a disease process
• Tertiary Nodes– The 3rd nodal set affected by a disease process