Oral cavity and pharynx

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Oral cavity andpharynx
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Face Facies

• labia oris (sup.inf.)
• frenulum
• angulus oris
• philtrum
• sulcus
• mentolabialis
• nasolabialis
• bucca cheek
• m. buccinator
• corpus adiposum buccae Bichati buccal pat pad
• extensions

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General structure of digestive tube

• tunica mucosa (mucosa mucous membrane)
• epithelium
• lamina propria mucosae
• lamina muscularis mucosae
• tela submucosa (submucosa)
• tunica muscularis (muscular layer)
• tunica serosa (serosa) x tunica adventitia
  (adventitia)

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General structure of digestive tube
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Tunica mucosa
connective tissue blood vessels, lymphatics,
macrophages and lymphocytes, sometimes glands
smooth muscles movements of mucosa
better contact with food
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Tela submucosa
connective tissue blood and lymph
vessels, glands, lymphoid tissue
submucous plexus (of Meissner) of autonomic
nerves function secretion
submucous plexus
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Tunica muscularis
smooth muscle cells 2 sublayers
longitudinal
1) internal - circular
circular
2) external - longitudinal
myenteric plexus (of Auerbach) contraction
of muscular layer

• Enteric nervous system part of autonomic
  nervous system
• plexus submucosus et myentericus
• aggregates of nerve cells that form
  parasympathetic ganglia (contains autonomic
  neurons)
• origin from neural crest

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Enteric nervous system

• Hirschsprung disease (megacolon congetinum,
  aganglionosis intestinalis)
• cells from neural crest do not migrate properly
• Chagas disease (American trypanosomiasis)
• parasite (Trypanosoma cruzi)
• trasmitted by "kissing bugs
• injures nervous plexuses
• dilations (mega-oesophagus, megacolon)

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Tunica serosa / Tunica adventitia

• tunica serosa
• simple squamous
• mesothel
• tela subserosa
• connective tissue
• rich in vessels and adipose tissue
• continuous with mesenterium and peritoneum
• only on organs which are inside the abdominal
  cavity ( intraperitoneal organs)
• tunica adventitia
• connective tissue
• on organs outside the abdominal cavity and on
  retroperitoneal organs

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Oral cavity (Cavitas oris)

• oral vestibule (vestibulum oris)
• oral cavity proper (cavitas oris propria)
• hard palate (palatum durum)
• soft palate (palatum molle)
• gum (gingiva)
• tongue (lingua)
• teeth (dentes)
• salivary glands (glandulae salivariae)

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Oral cavity (Cavitas oris)

• lips transition to keratinizing epithelium
• pars cutanea
• pars intermedia (vermilion part) glandulae
  sebaceae
• pars mucosa glandulae labiales
• m. orbicularis oris (n. VII
• stratified sqamous non-keratinizing epithelium
  (epithelium stratificatum squamosum non
  cornificatum / paracornificatum)
• lamina propria mucosae underlied with submucosa
  containing small salivary or mucinous gland (soft
  palate)

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Stratified sqamous epithelium

• keratinizing skin, hard palate, gum
• non-keratinizing rest of oral cavity, pharynx,
  oesophagus

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Cheek (bucca)
https//web.duke.edu/anatomy/Lab17/Lab17.html

• m. buccinator (n. VII) covered by fascia
  buccopharyngea
• corpus adiposum buccae (buccal fat pad of Bichat)
  reaches under ramus mandibulae into the fossa
  infratemporalis
• glandulae buccales
• ductus parotideus
• papilla parotidea in vestibulum oris
• at the level of the 2nd upper molar

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Oral cavity (Cavitas oris)

• rima oris (oral fissure) ? isthmus faucium
  (isthmus of fauces)
• borders
• ventrally and externally lips (labia oris) and
  cheeks (buccae)
• roof palate (palatum)
• floor m. mylohyoideus and m. geniohyoideus
• vestibulum oris (oral vestibule)
• fornix vestibuli sup. inf.
• frenulum labii sup. inf.
• papilla parotidea

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Tongue (Lingua, Gr. glossa)

• apex
• corpus (body)
• dorsum
• facies inferior
• radix (root)
• margo (margin)
• sulcus (groove)
• terminalis
• medianus (midline)
• foramen caecum
• tonsilla lingualis

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Development of tongue - overview

• 1st pharyngeal arch ? tuberculum impar
  tubercula lateralia
• 2nd pharyngeal arch ? overgrown by 1st
• 3rd pharyngeal arch ? cupola
• 4th pharyngeal arch ? eminetia hypopharyngea
• occipital somites ? muscles

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Tongue structure

• dorsum papillae
• radix tonsilla lingualis
• facies inferior linguae
• frenulum
• plica sublingualis
• openings of ductus sublinguales minores
• caruncula sublingualis (sublingual caruncle)
• opening of ductus sublingualis major et dutcus
  submandibularis
• plica fimbriata (remnant of mucous sublingua)

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Tongue - structure

• lamina propria mucosae tvorí vysoké papily
• papillae filiformes
• papillae fungiformes
• sparse gustatory buds
• papillae foliatae - rudimentary
• papillae vallatae - 12 shaped as letter V
• glandulae gustatoriae ( Ebners serous glands)
• gustatory buds
• tunica submucosa is missing at dorsum!
• stratified muscle in 3 planes

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Papillae of tongue (Papillae linguales)
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papillae vallatae
papillae foliatae
papillae filiformes
papillae fungiformes
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Taste buds (Gemmae gustatoriae)

• in all papillae (except for papillae filiformes)
• most of them within papillae vallatae
• papilla vallata
• vallum papillae
• sulcus papillae
• serous salivary glands (of von Ebner) glandulae
  gustatoriae
• wash food particles away

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Tongue muscles

• aponeurosis, septum (incomplete)
• intraglossal n. hypoglossus
• m. longitudinalis sup. et inf.
• m. transversus
• m. verticalis

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Extraglossal muscle of tongue

• innervation n. hypoglossus
• m. genioglossus
• m. hyoglossus
• m. styloglossus
• m. palatoglossus
• ! exception ! n. vagus

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Extraglossal muscle of tongue
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Tongue vessels and nerves

• arteries a. carotis ext. ? a. lingualis
• veins v. lingualis, v. comitans n. XII. ? v.
  jugularis int.
• nerves
• motor n.XII, n.X (m. palatoglossus)
• sensory n.V3. (n. lingualis), n.IX, n.X
• gustatory VII. (chorda tympani), n.IX, n.X

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Tongue lymph drainage

• nodi lymphoidei cervicales profundi
• tip ? n.l. submentales
• margins ? n.l. submandibulares
• corpus, dorsum ? n.l. cervicales profundi
• n.l. jugulo-digastricus jugulo-omohyoideus
• ! contralateral connections !

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Salivary glands (Glandulae oris)

• major salivary glands (glandulae salivariae
  majores)
• gl. parotidea
• gl. sublingualis
• gl. submandibularis
• minor salivary glands (glandulae salivariae
  minores)
• gll. labiales, buccales, molares, palatinae
• gll. linguales anteriores (Blandini-Nuhni)
• gll. lingulaes posteriores
• pars profunda gl. gustatoria (von Ebneri)
• pars superficialis gl. radicis linguae (Weberi)

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Throat (Fauces)

• hrad palate (palatum durum)
• soft palate (palatum molle)
• aponeurosis (formed by fuesd tendons of tensor
  veli palatini)
• uvula (seals nasopharynx in swallowing)
• arcus palatoglossus
• arcus palatopharyngeus isthmus faucium
• palatine tonsil (tonsilla palatina)

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Isthmus faucium

• arcus palatoglossus (palatoglossal arch anterior
  pillar of fauces)
• fossa (sinus) tonsillaris
• tonsilla palatina
• capsula
• fossula
• cryptae
• fossa supratonsillaris
• arcus palatopharyngeus palatopharyngeal arch
  (posteiror pillar of fauces)

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Muscles of soft palate

• innervation plexus pharyngeus n. vagus (n.X)
• m. levator veli palatini
• m. uvulae
• m. palatoglossus
• m. palatopharyngeus
• m. tensor veli palatini ! exception ! n.V3
  (mandibularis)

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Hltan pars nasalis

• nasopharynx epipharynx
• fornix
• fascia pharyngobasilaris
• sinus Morgagni
• recessus pharyngeus Luschkae (remnant after
  notochord)
• pharyngeal tonsil (tonsilla pharyngealis
  Luschkae)
• tuba auditiva Eustachii
• torus tubarius
• tonsilla tubaria Gerlachi
• recessus pharyngeus Rosenmülleri
• pseudostatified columnar epithelium with kinocilia

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Hltan (Pharynx)
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Hltan other parts

• pars oralis (oropharynx mezopharynx)
• valleculae epiglotticae
• plica glossoepiglottica mediana laterales
• pars laryngea (laryngopharynx hypopharynx)
• recessus piriformis
• aditus laryngis
• both lined with stratified nonkeratinizing
  squamous epithelium

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Pharynx surrounding spaces

• fascia cervicalis
• spatium parapharyngeum (lateropharyngeum)
• spatium prestyloideum
• septum styloideum (aponeusoris stylopharyngea)
• 5 muscles and ligament
• m. stylopharyngeus m. styloglossus m.
  stylohyoideus lig. stylohyoideum venter
  posterior m. digastrici m. sternocleidomastoideu
  s
• spatium retrostyloideum
• spatium retropharyngeum

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Muscles of pharynx

• raphe pharyngis
• fascia pharyngobasilaris
• sinus Morgagni
• 3 constrictors
• 3 levators
• innervation plexus pharyngeus (n.X)
• except m. stylopharyngeus (n.IX)

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Muscles of pharynx

• constrictors (mm. constrictores)
• m.c. superior 4 parts origin at skull (3) and
  tongue (1)
• m.c. medius 2 parts origin at hyoid bone
• m.c. inferior 2 parts origin at laryngeal
  cartilages
• levators (mm. levatores)
• m. palatopharygeus
• part of soft palate muscles, base of
  palatopharyngeal arch
• m. salpingopharyngeus
• m. stylopharyngeus
• ! exception ! innervated by n.IX

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Pharynx blood supply

• arteries a. carotis externa ?
• a. pharyngea ascendens
• a. facialis ? a. palatina ascendens
• a. lingualis ? rr. dorsales linguae
• a. maxillaris ? a. palatina major, a. canalis
  pterygoidei, r. pharyngeus
• veins plexus (venosus) pharyngeus ? v. facialis
  ? v. jugularis interna

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Pharynx lymph and nerves

• lymph n.l. retropharyngei, n.l. paratracheales ?
  n.l. cervicales profundi
• nerves form plexus pharyngeus
• motor n.X (plexus pharyngeus), n.IX (m.
  stylopharyngeus)
• sensory n.X n.IX (plexus pharyngeus), n.V2 (n.
  pharyngeus for nasopharynx)
• autonomic (plexus pharyngeus)
• n.X parasympathetic
• rr. laryngopharyngei sympathetic

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Anulus lymphoideus pharyngis Waldeyeri

• tonsilla lingualis
• crypta, noduli
• one smaller crypt
• tonsilla palatina
• fossulae, cryptae, capsula
• thick capsule
• tonsilla pharyngealis adenoid vegetation
• fossulae, cryptae, noduli
• no crypts, thin capsule
• tonsilla tubaria Gerlachi
• cryptae

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Sites with weakened wall

• trigonum Killiani
• cranially m. thyropharyngeus (m. constrictor ph.
  inf.)
• caudally m. cricopharyngeus (m. constrictor ph.
  inf.)
• diverticulum of Zenker ( pharyngo-oesophageal
  diverticle dehiscence of Killian)
• trigonum Laimeri
• cranially m. cricopharyngeus
• caudally upper oblique fibres of longitudinal
  muscle layer of oesophagues
• (area Killian-Jamieson)
• at lateral side of oesophagus
• diverticulum of Killian-Jamieson

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• End
• ?

Identification of dead
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TEETHdens, dentisodus, odonotos
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Dentes Teeth

• arcus dentalis superior (elipsoid)
• inferior (parabolic)
• dentes permanentes - 32
• dentes decidui - 20
• dens incisivus ( cutter, incisive/incisor tooth)
  8/8
• caninus ( eyetooth, cuspid) 4/4
• premolaris ( premolar, bicuspid tooth)
  8/0
• molaris ( molar, grinder, cheetooth)
  12/8

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Teeth parts

• corona
• cervix
• radix
• pulpa

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Surfaces and directions

• occlusalis
• vestibularis (buccalis/labialis)
• lingualis (upper teeth)
• palatinalis (lower teeth)
• mesialis
• distalis

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Teeth fixation

• gomphosis dentoalveolar juncture
• situated in the bonyalveolus dentalis of jaw
• periodontium
• parodontium all structures around tooth

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Peridontium

• ligaments between tooth and alveolus (fixed
  firmly into bone)
• collagen fibres (serve as bone periosteum)
• fixation systém of tooth fibres of various
  directions
• they penetrate into cement
• high connective tissue regeneration, plasticity
  orthodontia
• atrophy in lack of proteins and vitamine C ?
  scurvy ( scorbute)

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Macroscopy and fication of tooth
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Dentition as a wholemordex dentition

• orthodent position (teeth are vretically)
• occlusion
• 80 psalidodontia (scissors occlusion) norm
• progenia lower teeth in front of upper ones
• hiatodontia ( mordex apertus), stegodontia,
  prognathia, opisthodontia

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Dental formula

• cross with letters
• lower case deciduous
• UPPER CASE permament
• cross with numbers
• numerical
• 1-4 quadrants (from right upper one clock-wise)
  PERMANENT
• 5-8 (idem) deciduous

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Dental formula
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Teeth - structure

• dentine dentinum (substantia eburnea)
• enamel enamelum (substantia adamantina)
• cement cementum (substantia ossea)
• pulp pulpa
• loose connective tissue, vessels, nerves