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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION SECTION 1 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Anatomic Landmarks © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Objectives: © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC • Recognize, define,NOT and describe FOR SALE the soft OR tissue DISTRIBUTION structures and landmarks of the anteriorNOT and FOR posterior SALE oral OR DISTRIBUTION cavity. • Recognize, define, and describe the soft tissue structures and landmarks of the floor of the mouth, tongue, and palate. • Recognize,© Jones define, & Bartlett and describe Learning, the soft LLC tissue structures and landmarks© Jones of the & periodontium. Bartlett Learning, LLC • Recognize,NOT FOR define, SALE and OR describe DISTRIBUTION the bony structures and landmarksNOT of the FOR maxilla SALE and mandible OR DISTRIBUTION and adjacent regions. • Recognize, define, and describe common variants of normal. • In the clinical setting, identify intraoral soft tissue structures and anatomic landmarks in a patient’s mouth. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 1 © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. 9781284240993_PT01_001_016.indd 1 26/04/20 1:54 PM LANDMARKS OF THE ORAL CAVITY © Jones &Lips Bartlett (Fig. 1.1) Learning, The lips form LLC the outer border of the oral© Jonesthese structures& Bartlett lies aLearning, pair of mylohyoid LLC muscles that func- NOT FORcavity. SALE They OR are DISTRIBUTION covered by mucosa and a surface layer NOTof tion FOR in lifting SALE the OR tongue DISTRIBUTION and hyoid bone. parakeratin. Beneath this is connective tissue and rich blood Hard Palate (Fig. 1.6) forms the roof of the oral cavity. The supply. Deeper are muscles that control lip movement (orbi- hard palate is composed of squamous epithelium, connec- cularis oris, levator, and depressor oris). Lips appear pink-red tive tissue, minor salivary glands and ducts (in the posterior but can vary in color depending on the age and pigmentation two thirds only), periosteum, and the palatine processes of of the patient, sun exposure, and history of trauma. The junc- © Jones & Bartlett Learning, LLCthe maxilla. Anatomically, it ©consists Jones of several & Bartlett structures. Learning, LLC tion of the lips with the labial mucosa is the wet line, the NOT FOR SALE OR DISTRIBUTIONThe incisive papilla is directlyNOT behind FOR and SALE between OR the DISTRIBUTION point of contact of the upper and lower lips. The vermilion maxillary incisors. It is a raised, pink ovoid structure that is the portion external to the wet line. The vermilion border overlies the nasopalatine foramen. Therugae are fibrous is the junction of the lip with the skin. The lips should be ridges that are located slightly posterior to the incisive visually inspected and palpated by everting during the oral papilla, in the anterior third of the palate. They run later- examination. The surface should be smooth and uniform in © Jones & Bartlett Learning, LLC ally from the© midlineJones to & within Bartlett several Learning, millimeters LLCof the color; the border should be smooth and well delineated. NOT FOR SALE OR DISTRIBUTION attached gingivaNOT of FOR the anterior SALE teeth. OR A DISTRIBUTION little further back Labial Mucosa (Fig. 1.2) is the thin, pink parakeratotic epi- are the lateral vaults, alveolar bones that support the pala- thelium lining the lips. Thelabial mucosa is usually pink tal aspects of the posterior teeth. In the center of the hard or brownish-pink with small red capillaries nourishing the palate is the median palatal raphe, a yellow-white fibrous band that appears at the junction of the right and left pala- © Jones &region. Bartlett Minor Learning, salivary gland LLC ducts empty onto the surface© Jones & Bartlett Learning, LLC of the mucosa. These ducts appear as small orifices that emit tine processes. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION mucinous saliva. Soft Palate (Fig. 1.7) is located posterior to the hard palate. Buccal Mucosa (Fig. 1.3) is the inner epithelial lining of the It is unique from the hard palate in that the soft palate lacks cheeks. The buccal mucosa broadens bilaterally from the bony support and has more minor salivary glands and lym- labial mucosa to the retromolar pad and extends to the pter- phoid and fatty tissue than the hard palate. The soft palate ygomandibular raphe. Deposits© Jones of fat& withinBartlett the buccal Learning, con- LLCfunctions during mastication ©and Jones swallowing. & Bartlett It is elevated Learning, LLC nective tissue can makeNOT it appear FOR yellow SALE or tan.OR Accessory DISTRIBUTION during swallowing by the levatorNOT palati FOR and SALE tensor OR palati DISTRIBUTION salivary glands are present in this region and moisten the muscles and motor innervated by cranial nerves IX and X. oral mucosa. The caliculus angularis is a normal pinkish Themedian palatal raphe is more prominent and thicker in papule located in the buccal mucosa at the commissure. the soft palate. Just lateral to the raphe are thefovea palati- nae. The foveae are 2-mm excretory ducts of minor salivary Parotid© JonesPapilla (Fig. & Bartlett 1.4) is a triangular, Learning, raised, LLC pink papule glands. They© areJones landmarks & Bartlett of the junction Learning, between theLLC hard on theNOT buccal FOR mucosa SALE adjacent OR to DISTRIBUTION the maxillary first molars and soft palates.NOT At FOR the midline SALE distal OR aspect DISTRIBUTION of the soft palate bilaterally. The parotid papilla forms the end of Stensen is the uvula, which hangs down. duct, the excretory duct of the parotid gland. The gland is Oropharynx and Tonsils (Fig. 1.8) milked by drying the papilla with gauze, pressing the fingers Theoropharynx is the below the mandible, and extending pressure upward and over junction between the mouth and the esophagus. The borders the gland. In health, clear saliva should flow from the duct. of the oropharynx are the uvula along the anterior aspect, the © Jones & Bartlett Learning, LLC © Jonestwo tonsillar & Bartlett pillars (fauces)Learning, along LLCthe anterolateral aspect, NOT FORFloor SALE of the OR Mouth DISTRIBUTION (Fig. 1.5) is the region below the front,NOT and FOR the SALEpharyngeal OR wall DISTRIBUTION at the posterior aspect. The tonsils anterior half of the tongue. It is composed of thin, pink par- are lymphoid tissue located within two pillars. The anterior akeratinized epithelium, connective tissue, salivary glands, tonsillar pillar is formed by the palatoglossus muscle that and associated nerves and blood vessels. Thefloor of the runs downward, outward, and forward to the base of the mouth has U-shaped boundaries bordered anterolaterally by tongue. The posterior pillar is larger and runs posteriorly. It the dental arch and posteriorly© Jones by the & ventral Bartlett tongue Learning, surface. LLCis formed by the palatopharyngeus© Jones muscle. & The Bartlett tonsils areLearning, LLC The anterior portion NOTis smooth, FOR uniform, SALE andOR covered DISTRIBUTION by dome-shaped soft tissue structuresNOT thatFOR have SALE surface OR crypts DISTRIBUTION mucosa. Thelingual frenum is located along the midline of and invaginations (folds), which serve to capture invading the posterior portion. Between the two halves is an elevated microbes. Tonsils enlarge during adolescence (a lymphoid area under which Wharton duct of the submandibular gland growth period) and during infectious, inflammatory, and lies. Saliva from the submandibular gland exits through an neoplastic processes. Islands of tonsillar tissue are seen on elevated© Jones papule called& Bartlett the sublingual Learning, caruncle LLC to moisten the surface ©of theJones posterior & Bartlett pharyngeal Learning, wall. Waldeyer LLC ring the floorNOT ofFOR the mouth.SALE Along OR theDISTRIBUTION posterior portion of the is the ring ofNOT adenoid FOR tissue SALE formed OR by DISTRIBUTION the tonsillar tissue caruncle are multiple small openings, the “ducts of Rivinus,” found on the posterior tongue (lingual tonsils), pharynx that carry saliva from the sublingual salivary gland. Beneath (pharyngeal tonsils), and fauces (tonsillar pillars). © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 2 © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. 9781284240993_PT01_001_016.indd 2 26/04/20 1:54 PM 1 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Fig. 1.1. Lips: normal, healthy
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