Surgical Anatomy
of Palate
Dr. Amit T. Suryawanshi
Oral and Maxillofacial Surgeon
Pune, India
Contact details :
Email ID - amitsuryawanshi999@gmail.com
Mobile No - 9405622455
Contents • Introduction• Development of palate.
• Hard Palate
• Soft Palate
Hard Palate - Boundaries
- Anatomical
structures
Soft palate - Borders and Surfaces
- Contents
- Movements and
Functions
Introduction • Studying surgical anatomy of palate helps
Oral surgeons to have complete knowledge
while performing surgeries of the palate.
Which include ,
1. Cleft palate surgery
2. Squamous cell carcinoma of palate
3. Adenoid cystic carcinoma of palate.
4. Surgical removal of Torus palatinus
Introduction • Palate forms the roof
of the Oral cavity.
• It is the partition
between nasal and oral
cavities.
• The palate is divided
into two parts,
• 1. Hard palate,
• 2.Soft palate or velum.
Development of Face
Development of palate
• Palate develops from 3 parts.
A. Two Palatal processes
B. Frontonasal process.
• From each maxillary process, a plate like shelf
grows medially . This is called as a Palatal Process.
Development of palate
• Palate is formed by the fusion of these 3 parts1.Each palatal process fuses with posterior margin
of primitive palate(premaxilla).
2. Two palatal processes fuse with each other in the
midline .Their fusion begins anteriorly and
proceeds posteriorly.
Development of palate
3. The medial edges of the palatal processes
fuse with the free lower edge of the nasal
septum, thus separating two nasal cavities,
from each other and from the mouth.
4. At later stage mesoderm in the palate
undergoes intramembranous ossification to
form hard palate.
Development of palate
5. However, ossification does not extend to the
most posterior portion hence it remains as the
Soft palate.
6. Part of the palate developed from frontonasal
process is Primary palate.
7. Part of palate developed from Palatal processes
is Secondary palate.
• Elevation of the palatine shelves occurs when
tongue descends , which allows their meeting
in the midline and fusion.
HARD PALATE•Its anterior 2/3rd
is formed by
Palatine
processes of
Maxilla .
•Posterior 1/3rd is
formed by
Horizontal plates
of Palatine bone.
• The hard palate is covered by a mucous
membrane which is attached to the
periosteum.
• Deep to the membrane, there are mucussecreting palatine glands.
• The anterior mucous membrane has 3-4
transverse palatine folds called as Rugae.
Rugae
Boundaries of Hard palate
Antero-lateral margins –
Posterior margins Superior Surface Inferior Surface –
Continuous with alveolar arches
and gingiva .
Gives attachment to Soft Palate.
Forms the floor of nasal cavity.
Forms the roof of the oral cavity.
Anatomical structures of Hard palate
Median palatine
suture
Anatomical structures of Hard palate
• The incisive foramen - The opening of the incisive canal.
Neurovasculature -The Nasopalatine nerve
-The terminal branch of the Sphenopalatine artery
• Greater palatine foramen -One opening of the palatine
canal.
Neurovasculature -The Greater palatine nerve and vessels.
Anatomical structures of Hard palate
• Lesser palatine foramen -Another opening of
the palatine canal.
Neurovasculature -The Lesser palatine nerve and vessels.
Anatomical structures of Hard palate
Lymphatics –
They drain mostly to Upper deep cervical lymph
nodes and partly to Retropharyngeal lymph
nodes .
Soft Palate
• It is a movable, muscular
fold suspended from the
posterior border of hard
Palate.
• It separates the
Nasopharynx from the
Oropharynx.
Soft Palate
• It is covered with a mucous membrane.
• Its free posterior border has a conical
projection in the midline called Uvula.
• It has no bony framework.
• Soft Palate has 2
surfaces1. Anterior Surface.
2. Posterior Surface.
• It has 2 borders –
1. Superior Border.
2. Inferior Border.
Contents of Soft Palate
•
•
•
•
Palatine aponeurosis
Muscles
Lymphoid tissues
Glands.
Palatine aponeurosis
• It is a fibrous
sheet
attached to
the posterior
border of the
hard palate.
• It is a
extended
tendon of
Tensor veli
palatini and
forms the
fibrous basis
of the palate.
Palatine
aponeurosis
Musculus
Uvulae
Uvula
Soft palate
Spine of
Sphenoid
bone
Pterygoid
hamulus
Tensor veli
palatini
Palatine aponeurosis
• Near median plane, the aponeurosis splits to
enclose the musculus uvulae.
Muscles of Soft Palate
1.
2.
3.
4.
5.
Tensor veli palatini.
Levator veli palatini.
Musculus uvulae.
Palatoglossus.
Palatopharyngeus.
Tensor veli palatini
Origin –
1. Spine of the
sphenoid,
Palatine
2. Lateral side of aponeurosis
auditory tube. Musculus
Uvulae
3. Scaphoid
Uvula
fossa.
Soft palate
Spine of
Sphenoid
bone
Pterygoid
hamulus
Tensor veli
palatini
Auditory tube
Tensor veli
palatini
Posterior wall of
pharynx
Musculus Uvulae
Levator veli
palatini
Palatopharyngeus
Scaphoid
fossa
Insertion1. Palatine
aponeurosis
2. Horizontal
part of
palatine
bone.
Tensor veli palatini
Palatine
aponeurosis
Musculus
Uvulae
Uvula
Soft palate
Spine of
Sphenoid
bone
Pterygoid
hamulus
Tensor veli
palatini
Tensor veli palatini.
• Nerve supply –
Nerve to medial pterygoid.
Action –
1. It tenses the soft palate
and assists the levator
veli palatini in elevating
the palate to prevent
entry of food into the
nasopharynx during
swallowing.
Action –
2. It equalises air pressure between the
tympanic cavity and the outside air during
swallowing or yawning.
Levator Veli Palatini
• Origin1. Undersurface
of petrous
Palatine
aponeurosis
part of
Musculus
temporal
Uvulae
bone
Uvula
2. Medial
Soft palate
surface of
Spine of
Sphenoid
cartilage of
bone
auditory tube.
Pterygoid
hamulus
Levator veli
palatini
Levator veli
palatini
Auditory tube
Tensor veli
palatini
Posterior wall of
pharynx
Musculus Uvulae
Palatopharyngeus
Levator Veli Palatini
• InsertionUpper
surface of
the palatine
aponeurosis.
Palatine
aponeurosis
Musculus
Uvulae
Pterygoid
hamulus
Uvula
Soft palate
Spine of
Sphenoid
bone
Levator veli
palatini
Levator Veli Palatini
• Nerve supply-Pharyngeal plexus
• Action-Assists the Tensor veli palatini in
elevating the palate to occlude and prevent
entry of food into the nasopharynx during
swallowing.
Palatoglossus
• OriginFrom the undersurface of
palatine aponeursis, where it
is continuous with the
muscle of opposite side.
• InsertionIt passes in front of tonsil
and it is inserted into the
side of the tongue.
Palatoglossus
• Nerve supply-Cranial part of accessory nerve via
pharyngeal plexus.
• Action-Pulls the root of the tongue upward &
backward. Both muscles contracting together
cause the palatoglossal arches to approach
the midline, thus opening between the
oropharynx & oral cavity is narrowed.
Palatopharyngeus
• Origin –
1. Posterior
border of
hard palate
2. Palatine
aponeurosis
Posterior
border of
hard
palate
Palatine
aponeurosis
Palatopharyngeus
Palatopharyngeus
Palatopharyngeus
Palatopharyngeus
• Insertion –
It is inserted to the posterior border of
lamina of thyroid cartilage .
Palatopharyngeus
• Nerve supply- Cranial part of accessory nerve via
pharyngeal plexus.
• Action –
Pulls the wall of pharynx upwards.
Musculus Uvulae
• Origin –
1. Posterior border
of hard palate
2. Palatine
aponeurosis
• Insertion –
Mucous
membrane of the
Uvula.
Posterior
border of
hard
palate
Palatine
aponeurosis
Musculus Uvulae
• Nerve supply-Pharyngeal plexus
• Action –
Pulls up the Uvula.
Muscles of soft palate
• Blood supply –
All the muscles of soft palate are supplied by
lesser palatine artery.
Faucial pillars of mouth
Passavant’s Ridge
• Some of the upper fibers of the
palatopharyngeus pass circularly deep to the
mucous membrane of the pharynx, and
constitute Passavant’s muscle internal to the
superior constrictor.
• which on contraction raises a ridge
(Passavant’s ridge) on the posterior wall of the
nasopharynx .
• When the soft palate is elevated, it comes in
contact with the ridge and two of them
together close the pharyngeal isthmus
(between the nasopharynx and oropharynx).
Movements & Functions of
Soft palate• Palate control two gates –
1. Pharyngeal isthmus
2. Oropharyngeal isthmus
• It closes gates or regulate their size according
to requirements. Through these movements
,the soft palate plays an important role in
chewing, swallowing, speech, coughing,
sneezing, etc.
Movements & Functions of
Soft palate• It isolates mouth from oropharynx during
chewing so that breathing is unaffected.
• In second stage of swallowing, it separates
oropharynx from nasopharynx.
• It modifies quality of voice.
• During sneezing, it divides blast of air and
directs through nasal & oral cavities.
• During coughing, it directs air & sputum into
mouth & not into the nose.
References •
•
•
•
•
Grey's anatomy
Atlas of anatomy
Snell –Textbook of Anatomy
Sicher
Internet
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