Board Review DH227
Concorde Career College
Anatomy & Physiology
Lisa Mayo, RDH, BSDH
Cells
• Cells – Tissues – Organs – Organ Systems
• Functions
1.
2.
3.
4.
5.
6.
Excitability
Synthesis: secreting products for body’s needs
Membrane Transport: moving in and out of cell
Reproduction
Differentiation
Organize chemicals
Cells
Structures to Review
1. Cell Membrane: semipermeable surrounding of a cell.
Lipids & PRO are major components
2. Endoplasmic Reticulum: synthesize, circulate, package
materials
3. Golgi Apparatus: site for PRO synthesis and recycling
4. Mitochondria: powerhouse of cell (ATP produced)
5. Lysosomes: surrounded by own membrane, degradation
of hydrolytic enzymes
6. Cytoplasm: surrounds and supports
7. Ribosomes: synthesis for PRO molecules
8. Nucleus: genetic codes, controls cell, mitosis
Cells
Transport through cell membranes
(know definitions)
1.
2.
3.
4.
5.
Diffusion
Osmosis
Active Transport
Phagocytosis
Pinocytosis
Question
Protein synthesis occurs in the
a.
b.
c.
d.
Cytoplasm
Mitochondria
Cell membrane
Rough endoplasmic reticulum
Answer
Protein synthesis occurs in the
a.
b.
c.
d.
Cytoplasm
Mitochondria
Cell membrane
Rough endoplasmic reticulum
Question
The organelle responsible for cellular digestion is
the
a.
b.
c.
d.
Lysosome
Golgi body
Mitochondria
Endoplasmic reticulum
Answer
The organelle responsible for cellular digestion is
the
a.
b.
c.
d.
Lysosome
Golgi body
Mitochondria
Endoplasmic reticulum
Question
Energy production for the cell is accomplished
through oxidation of nutrient in the
a.
b.
c.
d.
Lysosomes
Mitochondria
Cell membrane
Endoplasmic reticulum
Answer
Energy production for the cell is accomplished
through oxidation of nutrient in the
a.
b.
c.
d.
Lysosomes
Mitochondria
Cell membrane
Endoplasmic reticulum
Tissues
Classification: 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/glands
2. Connective: Vascular. Holds together, supports and connects body
parts
1. Reticular
2. Adipose
3. Dense Fibrous
4. Bone
5. Cartilage
6. 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. Neurons
2. Neuroglia
4. Muscle: movement, smooth/involuntary, skeletal/voluntary,
cardiac
1. Skeletal
2. Cardiac
3. Visceral
Membranes and Glands
• Membranes Types
1. Mucous: protect, secrete, absorb
2. Serous: visceral/parietal/synovial layers
3. Cutaneous: skin
• Glands
1. Endocrine: secrete directly into blood
2. 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 Bones
1.
2.
3.
4.
Long
Short
Flat
Irregular
Skeletal System
• Articulations
1. Fibrous Joints: syndemosis, sutures, gomphosis
2. Cartilaginous Joints: synchondrosis, symphyses
3. Synovial Joints: hinge, pivot, saddle, ball-n-socket
• Divisions
1. Axial
2. Appendicular
3. Auditory Ossicles
Skeletal System
Movements
1.
2.
3.
4.
5.
6.
7.
Gliding
Flexion
Extension
Abduction
Adduction
Circumduction
Rotation
Skeletal System
Skull
1.
2.
3.
4.
Cranium
Frontal
Parietal
Temporal: squamous portion (zygomatic), petrous,
mastoid, glenoid, styloid process, stylomastoid foramen,
jugular foramen
5. Sphenoid: greater wings (foramens: rotundium, ovale,
spinosum, lacerum, superior orbital fissure). Lesser wings
(optic foramen)
6. Ethmoid
7. 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.
b.
c.
d.
Adrenalin
Histamine
Acetylcholine
Norepinephrine
Answer
The chemical transmitting agent that acts at the
myoneural junction of skeletal muscle is
a.
b.
c.
d.
Adrenalin
Histamine
Acetylcholine
Norepinephrine
Question
The hamulus is a landmark of the
a.
b.
c.
d.
Hyoid bone
Sphenoid bone
Temporal bone
Maxillary first premolar tooth
Answer
The hamulus is a landmark of the
a.
b.
c.
d.
Hyoid bone
Sphenoid bone
Temporal bone
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=CepeYFvqm
k4
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 sodiumpotassium pump
Sodium Pump Animation
http://highered.mcgrawhill.com/sites/0072495855/student_view0/cha
pter2/animation__how_the_sodium_potassiu
m_pump_works.html
Nervous System
• 31 pairs Spinal Nerves
• Brain: cerebrum, cerebellum, medulla
oblongata, mesencephalon
• 12 pairs Cranial Nerves
Cranial Nerves
Question
The cranial nerve which provides
parasympathetic innervation to the parotid
gland:
a.
b.
c.
d.
Vagus
Trochlear
Hypoglossal
Glossopharyngeal
Answer
The cranial nerve which provides
parasympathetic innervation to the parotid
gland:
a.
b.
c.
d.
Vagus
Trochlear
Hypoglossal
Glossopharyngeal
Question
As a general rule, parasympathetic preganglionic
neurons synapse with postganglionic axons in
ganglia:
a.
b.
c.
d.
Near the thoracolumbaer region
At the cranial nerve nuclei
Near or within target organs
Along the paravetebral chain
Answer
As a general rule, parasympathetic preganglionic
neurons synapse with postganglionic axons in
ganglia:
a.
b.
c.
d.
Near the thoracolumbaer region
At the cranial nerve nuclei
Near or within target organs
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
Blood
• Connective tissue that originates from embryonic
mesoderm
• Functions
1.
2.
3.
4.
5.
6.
7.
8.
Nutrition
Respiration
Fluid balance
Acid-base balance
Excretion
Projection
Temperature regulation
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), nonnitrogenous 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
Heart
• Wall has 3 layers
1. Visceral Pericardium
2. Myocardium
3. 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 Beat
Step 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 Conduction
The 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 Conduction
The 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 Conduction
At 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=tWWZKGN9
h74
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 beating
2. Whether the rhythm of your heartbeat is steady or irregular
3. The strength and timing of electrical signals as they pass
through each part of your heart
EKG
Question
The mitral valve separates the
a.
b.
c.
d.
Left atrium from the aorta
Left atrium from the left ventricle
Right atrium from the right ventricle
Left atrium from the pulmonary vein
Answer
The mitral valve separates the
a.
b.
c.
d.
Left atrium from the aorta
Left atrium from the left ventricle
Right atrium from the right ventricle
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 System
Know parts of heart by heart!
Heart Basics per MD
http://www.youtube.com/watch?v=H04d3rJCLC
E
Question
Where does the heartbeat originate?
a.
b.
c.
d.
Left atrium
Sino-atrial node
Ventricular node
Atrioventricular node
Answer
Where does the heartbeat originate?
a.
b.
c.
d.
Left atrium
Sino-atrial node
Ventricular node
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 System
Functions
1.
2.
Supply O2
Remove CO2
Parts
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Nasal Passage: superior, inferior, middle turbinates, paranasal sinuses
(frontal, ethmoid, max, spenoidal)
Pharynx (naso/oro/laryngo)
Epiglottis
Larynx
Vocal Cords
Trachea
Primary Bronchi: LF & RT
Secondary Bronchi: : 3 on RT, 2 on LF
Tertiary Bronchi: 10 per lung
Bronchioles
Respiratory Bronchioles
Alveolar Ducts: branch off resp. bronchioles, sacs attach to ducts
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 Breathing
1. Expiration
2. Inspiration
3. 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 cavity
6. Breathing controlled by: medulla and pons in brainstem
7. Hypoxic drive: stimulated breathing and monitors blood
composition
8. Blood gas exchange: allows O2 and CO2 to move along
their gradient
Respiratory System
Malfunctions/Diseases
1.
Pneumothorax: chest wall punctured, air enters pleural cavity, lungs
collapse
2. Dyspnea: labored breathing
3. Apnea: cessation breathing
4. Hypernea: increase respiration
5. Orthopnea: person can breathe better in 1 position then another
6. Cheyne-Stokes Respiration: abnormal periodic respiration that
consist of long period apnea followed by burst of hyperpnea then
apnea again
7. Asthma
8. Chronic Bronchitis
9. Emphysema
10. COPD
11. Atelectasis
Respiratory System
Malfunctions/Diseases
12. Bronchiectasis
13. Pneumothorax
14. Pleural effusion
15. Hypoxemia
16. Hemoptysis
17. Pneumonoconiosis
18. Orthopnea
19. Paroxysmal Nocturnal Dyspnea
20. Cor Pulmonale
21. Bronchogenic Carcinomas
Respiratory System
Measure Breathing
1.
2.
3.
4.
5.
6.
7.
8.
9.
Tidal Volume: total air that passes in & out of lungs
Inspiratory Capacity: amt air can intake into lungs
Expiratory Reserve volume: amt air can exhale after normal
expiration
Residual volume: air left in lungs after forceful expiration
Vital capacity: greatest amt air can exchange in forced
respiration
Hering-Breuer Reflex: prevents over-inflation of lungs. Stimuli
sent over VAGUS nerve to brain
CO2 conc. in blood is most important stimulus. RESP CONTROL
CENTER
Cyanosis: excess amt of reduced hemoglobin in capillary
Hypoxia: decreased O2 supply to tissue below levels needed in
blood
Question
Air exchange takes place in which of the
following?
a.
b.
c.
d.
Alveoli
Venioles
Arterioles
All the above
Answer
Air exchange takes place in which of the
following?
a.
b.
c.
d.
Alveoli
Venioles
Arterioles
All the above
Digestive System
• From mouth to anus
• 6m long
• Parts
1.
2.
3.
4.
5.
6.
7.
Mouth
Stomach
Small Intestine: duodenum, jejunum, ileum
Large Intestine: cecum, colon, rectum, anus
Pancreas (endocrine and exocrine gland), insulin
Liver
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 Glands
1. 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 Steps
1. Starts in mouth
a)
b)
c)
d)
e)
2.
3.
4.
5.
6.
Lubricate
Solvent
Moisten
Cleansing
Buffering
Elevate tongue to push bolus of food toward pharynx
Wavelike contraction
Food converted to chyme in stomach
3 phases of digestion: cephalic, gastric, intestinal
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
Endocrine System
• Glands that secrete hormones
• Functions
1. Supply Nervous system with hormones
2. Glands: secreted into system, not ducts
3. Product is a hormone: regulate metabolism,
reproduction, acid-base and fluid balance
4. Control endocrine secretion
5. Pituitary Gland
Endocrine system
Pituitary Gland
1.
2.
3.
4.
5.
6.
7.
8.
9.
Growth hormone
Prolactin
ACTH (adrenocorticotropic)
TSH (thyroid stimulating)
LH (Luteinizing)
FSH (follicle stimulating)
Pars intermedia
Pars tuberalis
ADH (antidiuretic): acts on kidneys to decrease urine
Endocrine System
Review 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.
b.
c.
d.
e.
Liver
Heart
Kidney
Stomach
Panaceas
Answer
Which of the following plays the major role in
maintaining fluid balance?
a.
b.
c.
d.
e.
Liver
Heart
Kidney
Stomach
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
Nerves
1. Facial nerve: exits skull through Stylomastoid
foramen
2. Trigeminal nerve (V), 3 divisions
1. Ophthalmic nerve (I): sensory to upper face and skull
2. Maxillary nerve(II): sensory to midface and max teeth
3. Mandibular nerve(III): sensory to lower face, jaw and
mand teeth and motor to muscles of mastication
Oral Anatomy
Masticatory
1. All innervated by CN V3
2. Masseter (M), medial pterygoid(MP), lateral
pterygoid(LP), temporalis(T)
3. Jaw elevation: M, MP, T
4. Jaw opening: LP + digastric, mylohyoid
5. Lateral excursion: M, MP(closing), LP(opening)
6. Protrusion: inf head of lateral pterygoid
7. Retrusion: posterior fibers of T
Oral Anatomy
Palate/Pharynx
1. 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
palatini
3. Elevate pharyngeal walls: palatophyayngeus,
stlopharyngeus
4. Peristalic milking of bolus down pharynx: superior,
middle, inferior constrictor muscles
5. Constrict fauces: palatoglossus, palatopharyngeus
Oral anatomy
Tongue:
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 Expression
1. All innervated by CR VII
2. Sphincters of mouth (orbicularis oris) and eye
(orbicularis oculi)
3. Buccinator: inserts into orbicularis oris at
pterygomandibular raphe
4. Bells’ palsy: unilateral paralysis (drooling, dry
eye)
Oral Anatomy
Neck
1. 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
TMJ
1. TMJ is articulation of condyle with temporal bone
(glenoid fossa and articular eminence)
2. Has an articular disc which divides joint into 2 spaces
3. Lateral pterygoid muscle attaches to condyle (inferior
head) and to articular disc (superior head)
4. Upper joint space permits translation (sliding) of
mand
5. Lower joint space permits rotation of condyle
6. 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 Mouth
1. 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. Nerves
1. Lingual N: general sensory to ant 2/3 tongue
2. Glossopharyngeal N: sensory and taste to post
1/3
3. 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 tongue
3. Pharyngeal tonsils (adenoids) and tubal tonsils
are located in nasopharynx
4. 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 muscle
a.
b.
c.
d.
Lifts the upper lip
Tenses the lower lip
Contributes to a frown
Comprises the floor of the mouth
Answer
The mylohoid muscle
a.
b.
c.
d.
Lifts the upper lip
Tenses the lower lip
Contributes to a frown
Comprises the floor of the mouth
Oral anatomy: Muscles of Neck
• Sternocleidomastoid
Origin: Sternum and clavicle
Insertion: mastoid process of the temporal bone
Function: tilts and rotates the head
• Trapezius
Origin: occipital and vertebral bones
Insertion: scapula, clavicle
Function: rotate and elevate the shoulder
OA: Blood Flow to Face
• 3 Major Branches of the external carotid
artery
1. Maxillary: teeth, muscles of mastication, ear
2. Lingual: tongue, floor of mouth
3. 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/Neck
1.
2.
3.
4.
5.
6.
Internal jugular vein: drains brain, facial vein, superficial temporal vein
Facial vein: drains facial structures (nose, lips, eyes, submental, submand
areas)
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, palate
Superficial Temporal Vein: drains areas supplied by maxillary and
superficial temporal arteries. Superficial temporal vein and max vein
form the retromandibular vein
Common facial vein: union of the facial and retromand veins
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.
2.
3.
4.
5.
6.
7.
8.
Parotid
Buccal
Occipital
Superficial cervical
Anterior cervical
Submental
Submandibular
Deep cervical (superior and inferior)
143
Copyright © 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