Ministry of Public Health of Ukraine Ukrainian Medical Stomatological Academy

"Approved" at the meeting of the Department of Human «29» 08 2020 Minutes № Head of the Department Professor O.O. Sherstjuk ______

METHODICAL GUIDANCE for the lecture

Academic subject Human Anatomy Module No 1 "Anatomy of the locomotor system. Splanchnology. Endocrine glands" Lecture No 6 Oral cavity. Dental system Year of study І Faculty Foreign students' training faculty, specialty «Stomatology» Number of 2 academic hours

Poltava – 2020

1. Educational basis of the topic Oral cavity is a first part of digestive system. Knowledge about oral cavity is necessary for future doctors, especially for future dentists. The science of teeth - odontology (odus, odontus - tooth) is a part of dentistry. Knowledge of anatomy of the teeth, their development, order and timing of the eruption of primary and secondary teeth are necessary for the studying of these sections as childhood diseases, diseases of the teeth and . Knowledge of anatomy end of this section is important for students to further studies.

2. Learning objectives of the lecture: . Determine the importance of the dental system in the human body . To be able to characterize the teeth of the upper and lower jaws . Be able to characterize the age differences in the dental system .Select methods for examining the dental system

3. Objectives of developing the future specialist’s personality (educational aims and objectives): familiarization with axiological, ethical and deontological principles of medical profession.

4. Interdisciplinary integration The preceding The acquired knowledge subjects Biology Phylogeny of the digestive system

Anatomy, histology Ontogeny of the digestive system; oral cavity, teeth. The name of pathologies

5. The plan and organization of lecture structure No The main stages of the lecture and Type of lecture. Time their content Means of motivation. allocation Teaching materials The preparatory stage 5% 1. Determining the relevance of the pp. 1-2 topic, learning objectives and motivation. The main stage Introductory lecture 85% 2. Delivering the lecture material according to the plan: Feedback and questions 1. Anatomy of the mouth. to students 2. General anatomy of teeth. 3. Anatomy of permanent teeth. PPT presentation with 4. Anatomy of the temporary teeth. diagrams and tables. 5. Anomalies of tooth development. 6. Methods of research The final stage Human Anatomy. In three 10% 3. General conclusions to the lecture. volumes. Volume 2: Answers to possible questions. textbook / Edited by V.G. Tasks for students’ self-directed Koveshnikov. - Lugansk: work. LTD «Virtualnaya realnost», 2008. – 248p.

6. The lecture material.

Oral cavity (саvitas oris, stoma) limited front , side - , above - , bottom - hyoid muscles. Oral cavity divided into the vestibule and the actual mouth. Mouth Vestibule (vestibulum oris) is an oral cleft (rima oris), which is placed horizontally between the upper and lower lips. Outside the vestibule limited cheeks and lips separated from the actual oral teeth and alveolar bone jaws, which are covered with , called a (gingiva). The oral cavity of neonates is smaller, shorter, wider and lower, closer to the eye socket. The upper and lower (labium superior et inferior) merge and pass each other and form a mouth angle (angulus oris). The outer surface of the lips - a skin part (pars sutanea) internal - the mucous membrane (pars mucosa) located between the intermediate part (pars intermedia). The skin of the upper lip in the midline is upper lip groove (), that ending tubercle (tuberculum). In the thick lips contains circular muscle mouth, and they covered the inner surface of the mucosa, which continues to cellular processes of the upper and lower jaws, cleft fused with their periosteum. By the middle line between the lips and gums and mucous membrane thickens forms two folds - the upper lip frenulum (frenulum labii superioris) and lower lip frenulum (frenulum labii inferioris). The lips, together on each side, limit the mouth slit, forming a spike lips (comissura labiorum). Newborn upper lip is relatively thick, the midline is a hump that persists for several weeks after birth. The lower lip seems to come. The transition of the lip in newborns narrow, so when the mouth is closed, externally visible mucosa. On the surface of the mucosa of the lips is the villi, which help preserve the nipple. In the thick lips well developed muscles, through which stays child and squeezes the nipple. These structural features of the lips kept for infants; while bottle-fed baby are smoothed rather than when breastfeeding. The Cheeks (buccae) form the sides of the face, and are continuous in front with the lips. They are composed externally of integument; internally of mucous membrane; and between the two of a muscular stratum, besides a large quantity of fat, areolar tissue, vessels, nerves, and buccal glands. The Gums (gingivae) are composed of dense fibrous tissue, closely connected to the periosteum of the alveolar processes, and surrounding the necks of the teeth. They are covered by smooth and vascular mucous membrane, which is remarkable for its limited sensibility. Around the necks of the teeth this membrane presents numerous fine papillae, and is reflected into the alveoli, where it is continuous with the periosteal membrane lining these cavities. Oral vestibule in front and laterally limited by the cheeks (buccae), which consist of skin, muscle and mucosa. Between the skin and muscles are clusters of fat – the (corpus adiposum buccae), which is particularly well developed in babies. Of infants fatty body of the cheek leads to thickening of the wall of the oral cavity and there by reduces the atmospheric pressure on it, which contributes to the process of sucking. Actually oral cavity bounded in front and on the sides of the teeth and jaws alveolar bone. The upper wall of their own oral forms palate (palatum), which are divided into (palatum durum) and (palatum molle). Bone basis palate are the palatine processes of the maxilla and horizontal plate of the palatine bone. The mucous membrane covering the hard palate, thickened and tightly adherent to the periosteum. In front of the palate are several transverse palatine folds (рlісае раlatinae transversae) (papilla incisiva) and is in the middle palatine suture (raphe palatini). The soft palate is a continuation of the hard palate and consists of two layers of mucosa, which is located between palatal aponeurosis (ароnevrosis palatina), and muscle. Soft palate has three parts: the blind palate (velum palatinum) uvula (uvula palatina) and two pairs of brackets. To the muscles of the soft palate include: muscle - palatal lifts curtain (m. levator veli palatini), muscle - palatal curtain tensioner (m. tensor veli palatini), muscle (m. uvulae), palate - lingual muscle (m. palatoglossus) mouth - pharyngeal muscle (m. palatopharingeus). You need to understand is that in the process of swallowing muscles - lifts, muscle - tensioner curtain palatal and velopharyngeal muscle presses the palatal curtain to the rear and side walls of the and thus separates the oral part of the pharynx from the nose, which prevents the entry of food into the nasal cavity. The muscles of the soft palate and pharynx throat constrict and divide food into small portions. The act of swallowing is complex nervous mechanism of its regulation center located in the medulla oblongata. Before the advent of cellular dental arch upper and lower jaws do not close up, and the gap between them manage mucous cheeks. At the free edge of the gums at incisors and canines are moving folds of mucous participating in the act of sucking. The hard palate in newborns, short and wide, arches his poorly marked. Only after a year long palate begins to exceed its width. In the mucosal surface visible transverse palatine folds. In the back of the palate to 3 years of age are whitish clusters of epithelial cells, so-called "epithelial pearls". The soft palate in newborns located horizontally at the level of the vault of the pharynx. Tab rickety little, sometimes it forked, which may indicate the covert of cleft palate. Palatine tonsils newborn small, they do not fill all the holes tonsilis fossa, resulting in over tonsils formed over tonsils fossa. Anterioinferior of tonsil covered with triangular fold of mucous, which is expressed to 3 years of age The surface of the tonsils in young children is relatively plain crypt navagation and shallow. The growth of the tonsils is uneven. The fastest growth is observed up to a year, and at the age of 4-6 years. Abnormalities of development. 1. Cleft upper lip ( «cleft lip», labium leporinum); 2. Splitting of palatine (faucis lupinum); 3. Spit crack face; 4. Increased or decreased tongue; 5. Forked tongue; 6. Double tongue. The Tongue (lingua).—The tongue is the principal organ of the sense of taste, and an important organ of speech; it also assists in the mastication and deglutition of the food. It is situated in the floor of the mouth, within the curve of the body of the mandible. Its Root (radix linguae base) is directed backward, and connected with the hyoid bone by the Hyoglossi and Genioglossi muscles and the hyoglossal membrane; with the epiglottis by three folds (glossoepiglottic) of mucous membrane; with the soft palate by the glossopalatine arches; and with the pharynx by the Constrictores pharyngis superiores and the mucous membrane. Its Apex (apex linguae tip), thin and narrow, is directed forward against the lingual surfaces of the lower incisor teeth. Its Inferior Surface (facies inferior linguae under surface) is connected with the mandible by the Genioglossi; the mucous membrane is reflected from it to the lingual surface of the gum and on to the floor of the mouth, where, in the middle line, it is elevated into a distinct vertical fold, the frenulum linguae. On either side lateral to the frenulum is a slight fold of the mucous membrane, the plica fimbriata, the free edge of which occasionally exhibits a series of fringe-like processes.The apex of the tongue, part of the inferior surface, the sides, and dorsum are free. The Dorsum of the Tongue (dorsum linguae) is convex and marked by a median sulcus, which divides it into symmetrical halves; this sulcus ends behind, about 2.5 cm. from the root of the organ, in a depression, the foramen cecum, from which a shallow groove, the sulcus terminalis, runs lateralward and forward on either side to the margin of the tongue. The part of the dorsum of the tongue in front of this groove, forming about two-thirds of its surface, looks upward, and is rough and covered with papillae; the posterior third looks backward, and is smoother, and contains numerous muciparous glands and lymph follicles (lingual tonsil). The foramen cecum is the remains of the upper part of the thyroglossal duct or diverticulum from which the thyroid gland is developed; the pyramidal lobe of the thyroid gland indicates the position of the lower part of the duct. The Papillae of the Tongue are projections of the corium. They are thickly distributed over the anterior two-thirds of its dorsum, giving to this surface its characteristic roughness. The varieties of papillae met with are the papillae vallatae, papillae fungiformes, papillae filiformes, and papillae simplices. The papillae vallatae (circumvallate papillae) are of large size, and vary from eight to twelve in number. They are situated on the dorsum of the tongue immediately in front of the foramen cecum and sulcus terminalis. The papillae fungiformes (fungiform papillae), more numerous than the preceding, are found chiefly at the sides and apex, but are scattered irregularly and sparingly over the dorsum. The papillae filiformes (filiform or conical papilae) cover the anterior two- thirds of the dorsum. They are very minute, filiform in shape, and arranged in lines parallel with the two rows of the papillae vallatae, excepting at the apex of the organ, where their direction is transverse. The papillae simplices are similar to those of the skin, and cover the whole of the mucous membrane of the tongue, as well as the larger papillae. They consist of closely set microscopic elevations of the corium, each containing a capillary loop, covered by a layer of epithelium. Muscles of the Tongue. The tongue is divided into lateral halves by a median fibrous septum which extends throughout its entire length and is fixed below to the hyoid bone. In either half there are two sets of muscles, extrinsic and intrinsic; the former have their origins outside the tongue, the latter are contained entirely within it. The Genioglossus (Geniohyoglossus) arises by a short tendon from the superior mental spine on the inner surface of the symphysis menti, immediately above the Geniohyoideus, and from this point spreads out in a fan-like form. The inferior fibers extend downward, to be attached by a thin aponeurosis to the upper part of the body of the hyoid bone; the middle fibers pass backward, and the superior ones upward and forward, to enter the whole length of the under surface of the tongue, from the root to the apex. The muscles of opposite sides are separated at their insertions by the median fibrous septum of the tongue. The Hyoglossus, arises from the side of the body and from the whole length of the greater cornu of the hyoid bone, and passes almost vertically upward to enter the side of the tongue. The Styloglossus arises from the anterior and lateral surfaces of the styloid process, near its apex, and from the stylomandibular ligament. Passing downward and forward it divides upon the side of the tongue near its dorsal surface, blending with the fibers of the Longitudinalis inferior in front of the Hyoglossus; the other, oblique, overlaps the Hyoglossus and decussates with its fibers. The Longitudinalis linguae superior (Superior lingualis) is a thin stratum of oblique and longitudinal fibers immediately underlying the mucous membrane on the dorsum of the tongue. It arises from the submucous fibrous layer close to the epiglottis and from the median fibrous septum, and runs forward to the edges of the tongue. The Longitudinalis linguae inferior (Inferior lingualis) extends from the root to the apex of the tongue: behind, some of its fibers are connected with the body of the hyoid bone; in front it blends with the fibers of the Styloglossus. The Transversus linguae (Transverse lingualis) consists of fibers which arise from the median fibrous septum and pass lateralward to be inserted into the submucous fibrous tissue at the sides of the tongue. The Verticalis linguae (Vertical lingualis) is found only at the borders of the forepart of the tongue. Its fibers extend from the upper to the under surface ofthe organ. Movements of Tongue Protrusion: Genioglossus muscles on both sides Retraction: Styloglossus and hyoglossus muscles on both sides Depression: Hyoglossus muscles on both sides Retraction and elevation of posterior third: Styloglossus and palatoglossus muscles on both sides Shape changes: Intrinsic muscles The Salivary Glands. Three large pairs of salivary glands communicate with the mouth, and pour their secretion into its cavity; they are the parotid, submandibulary, and sublingual. Besides the salivary glands proper, numerous other glands are found in the mouth. Many of these glands are found at the posterior part of the dorsum of the tongue behind the vallate papillae, and also along its margins as far forward as the apex. Others lie around and in the between its crypts, and large numbers are present in the soft palate, the lips, and cheeks. These glands are of the same structure as the larger salivary glands, and are of the mucous or mixed type. (glandula parotis). The parotid gland, the largest of the three, varies in weight from 14 to 28 gm. It lies upon the side of the face, immediately below and in front of the external ear. The main portion of the gland is superficial, somewhat flattened and quadrilateral in form, and is placed between the ramus of the mandible in front and the mastoid process and Sternocleidomastoideus behind, overlapping, however, both boundaries. The gland is enclosed within a capsule continuous with the deep cervical fascia; the layer covering the superficial surface is dense and closely adherent to the gland; a portion of the fascia, attached to the styloid process and the angle of the mandible, is thickened to form the stylomandibular ligament which intervenes between the parotid and submandibulary glands. The (ductus parotideus; Stensen’s duct) is about 7 cm. long. It begins by numerous branches from the anterior part of the gland, crosses the Masseter, and at the anterior border of this muscle turns inward nearly at a right angle, passes through the corpus adiposum of the cheek and pierces the Buccinator; it then runs for a short distance obliquely forward between the Buccinator and mucous membrane of the mouth, and opens upon the oral surface of the cheek by a small orifice, opposite the second upper molar tooth. While crossing the Masseter, it receives the duct of the accessory portion; in this position it lies between the branches of the facial nerve; the accessory part of the gland and the transverse facial are above it. Submandibulary Gland (glandula submandibularis).—The submandibulary gland is irregular in form and about the size of a walnut. A considerable part of it is situated in the submandibulary triangle, reaching forward to the anterior belly of the Digastricus and backward to the stylomandibular ligament, which intervenes between it and the parotid gland. Above, it extends under cover of the body of the mandible; below, it usually overlaps the intermediate tendon of the Digastricus and the insertion of the Stylohyoideus, while from its deep surface a tongue-like deep process extends forward above the Mylohyoideus muscle. The submandibulary duct (ductus submaxillaris; Wharton’s duct) is about 5 cm. long, and its wall is much thinner than that of the parotid duct. It begins by numerous branches from the deep surface of the gland, and runs forward between the Mylohyoideus and the Hyoglossus and Genioglossus, then between the and the Genioglossus, and opens by a narrow orifice on the summit of a small papilla, at the side of the frenulum linguae. On the Hyoglossus it lies between the lingual and hypoglossal nerves, but at the anterior border of the muscle it is crossed laterally by the lingual nerve; the terminal branches of the lingual nerve ascend on its medial side. Sublingual Gland (glandula sublingualis). The sublingual gland is the smallest of the three glands. It is situated beneath the mucous membrane of the floor of the mouth, at the side of the frenulum linguae, in contact with the sublingual depression on the inner surface of the mandible, close to the symphysis. It is narrow, flattened, shaped somewhat like an almond, and weighs nearly 2 gm. It is in relation, above, with the mucous membrane; below, with the Mylohyoideus; behind, with the deep part of the submandibulary gland; laterally, with the mandible; and medially, with the Genioglossus, from which it is separated by the lingual nerve and the submandibulary duct. Its excretory ducts are from eight to twenty in number. The Labial Glands (glandulœ labiales) are situated between the mucous membrane and the Orbicularis oris, around the orifice of the mouth. They are circular in form, and about the size of small peas; their ducts open by minute orifices upon the mucous membrane. In structure they resemble the salivary glands. The buccal glands are placed between the mucous membrane and Buccinator muscle: they are similar in structure to the labial glands, but smaller. About five, of a larger size than the rest, are placed between the Masseter and Buccinator muscles around the distal extremity of the parotid duct; their ducts open in the mouth opposite the last molar tooth. They are called molar glands. Glands of the Tongue. The tongue is provided with mucous and serous glands. The mucous glands are similar in structure to the labial and buccal glands. They are found especially at the back part behind the vallate papillae, but are also present at the apex and marginal parts. In this connection the anterior lingual glands (Blandin or Nuhn) require special notice. They are situated on the under surface of the apex of the tongue, one on either side of the frenulum, where they are covered by a fasciculus of muscular fibers derived from the Styloglossus and Longitudinalis inferior. They are from 12 to 25 mm. long, and about 8 mm. broad, and each opens by three or four ducts on the under surface of the apex. The serous glands occur only at the back of the tongue in the neighborhood of the taste-buds, their ducts opening for the most part into the fossae of the vallate papillae. These glands are racemose, the duct of each branching into several minute ducts, which end in alveoli, lined by a single layer of more or less columnar epithelium. Their secretion is of a watery nature, and probably assists in the distribution of the substance to be tasted over the taste area. Teeth. The teeth are divided into two sets — namely, the temporary, milk, or deciduous, which belong to early infancy, and the permanent, which replace the temporary. The temporary teeth are twenty in number — ten upper, five in each maxilla, and ten lower, five in each half of the mandible. The number of permanent teeth is thirty-two — sixteen upper, and sixteen lower. Structure of a Tooth. — The crown of a tooth contains a central cavity, called the pulp cavity, which is occupied by the dental pulp. The shape of the pulp cavity corresponds with that of the crown, and it extends into the root, and as many fangs as compose it, terminating in a small opening on the apex of the fang. The cavity also extends for a little into the cusps of the premolars and molars, and in the incisors it is continued into each angle of the crown. The wall of the cavity presents a number of openings, which lead into the dental canaliculi. The dental pulp is composed of a matrix of connective tissue, containing bloodvessels, nerves, cells, and fibres, which latter seem to be processes of the cells. It is destitute of lymphatics. The cells are scattered throughout the matrix, and at the surface of the pulp they form a continuous layer, being there known as the odontoblasts. This layer is sometimes spoken of as the membrana eboris The pulp is very vascular and sensitive, its vessels and nerves reaching it through the minute openings at the apices of the roots. The substance of the tooth is formed of three tissues — namely, ivory or dentine, enamel, and cement or crusta petrosa. The dentine forms the principal part of the tooth, surrounding the pulp cavity and its prolongations; the enamel covers the exposed part or crown; and the cement covers the root. Dentine. This bears a resemblance to bone, but contains rather less animal and more earthy matter, the proportion in ioo parts being about 28 of animal matter to 72 of earthy. The dentine has a striated appearance, due to the fact that it is traversed by a number of minute branched channels, called the dental canaliculi, which radiate in a curved manner outwards from the pulp cavity to the deep aspect of the enamel and cement. These tubules contain processes of the odontoblasts which are known as Tomes' fibres. The part of the dentine adjacent to the enamel and cement is known as the granular layer of Purkinje. It presents a number of irregular spaces, known as the interglobular spaces, which are surrounded by minute globules of calcareous matter. Enamel. This caps and protects the dentine of the crown. It is exceedingly hard, which is due to the fact that it contains no animal matter — at least, to any appreciable extent. It consists of solid hexagonal prisms, which are marked by transverse striations. These are received by their deep extremities into depressions on the dentine, and are placed vertically on the summit of the crown, but horizontally on its sides. At the period of eruption of a tooth, and for some little time thereafter, the enamel of the crown is covered by a thin membrane, called the enamel cuticle, or Nasmyth's membrane. Cement, or Crusta Petrosa. — This covers the dentine which forms the root of the tooth. It is true bone, and contains lacunae and canaliculi, but it is destitute of Haversian canals. The root of a tooth is maintained in its socket by the dental periosteum (periodontal membrane), which covers the cement, and lines the wall of the socket, being continuous with the gum at the neck of the tooth. The articulation is called gomphosis. Tooth surface: 4 Occlusal surfaces (for cutting tools - cutting, for canines - tearing, for premolars - shredding, for molars - chewing); 5 Vestibular surfaces; 6 Oral surface (for lower teeth - lingual, for upper - palatine); 7 Approximal (contact) surface - mesial and distal. Groups of teeth: Signs teeth: Incisor; 1. Signs of root. Canine; 2. Signs angle of crown. Premolars; 3. Signs curvature of crown. Molars. 4. Number of roots. Paradontal (amfodontoz) - tissue surrounding the tooth, periodontal gum, alveoli, jaw. Periodontal - a ligament, nerves and blood vessels, placed in the jaw cement between the tooth and the wall of the cell. Function: Hold, amortization, touch. Temporary occlusion (deciduous) - 20 teeth. Specifics: - No premolars and third molars; - Smaller; - On the blue-colored milk; - The vestibular surface with a roller; - Flat molars roots diluted. Permanent bite - 28-32 tooth. Mixed bite - from 5-6 years to 13-14 years. General plan of tooth: Anatomical formula milk bite 2102 2102 2012 2102 Clinical formula milk bite V IV III II I І ІІ ІІІ ІV V V IV III II I I II III IV V Cerebral international clinical formula milk bite 55…..51 61..65 85...... 81 71..75

Permanent teeth formula. 1. Group 2123 number Alphanumeric

І1С1Р2М3

2. Clinical 12345678

3. International 18 …11 21….28

Teeth erupt in the postnatal (after birth) period at a certain time and in a specific order. Infants appearance of baby teeth reflects the general processes of skeletal bone formation and absorption of minerals. Missing deadlines eruption of primary teeth can be an indicator of rickets.

Medium term eruption of primary teeth medial incisors 6-9 months. The lateral incisors 9-12 months. The first molars 12-15 months. Fangs 17-20 months. Second kutno 21-24 months.

The period from the beginning of the 3rd year of life to the end 6-8 was called a period of rest - in the years functioning teeth. Eruption term (years) Teeth mandible Maxilla The medial incisor 6-7 7-8 lateral incisor 7-8 8-9 Fang 9-10 11-12 1 premolar 10-12 10-11 2 premolar 11-12 10-12 1 large molar 6-7 6-7 2 large molar 11-13 12-13 3 large molar 12-26 17-21

Teeth are placed in cells to form dental arch. On the upper jaw it has the shape of an ellipse at the bottom - the shape of a parabola. The line centered occlusal surface of teeth - dental arch; line of cells jaw - alveolar arch; line on the tips of the roots of teeth - root arc. At the root mandibular arch more things of tooth on the upper jaw vice versa. Articulation - Any value of the lower jaw to the upper (talking, chewing). Occlusion - closing the dental arches with maximum contact. Distinguished: - Central occlusion - matches rizyyamy medial lines between the upper and lower jaws; - Side occlusion - right (lower jaw is shifted to the right) and left. Bite (mordex) - closing the dental arches in occlusion of the central position where each tooth has two antagonists except medial incisors of the lower jaw and upper third molars. Bite are normal and abnormal. Normal occlusion is characterized in that the upper jaw teeth (incisors) go in front, on the lower and fangs, Kutno Kutno small and large merge with corresponding teeth of the lower jaw, but on the side of them. Types bite. 1. Physiological (normal) bite: - Ortohnatychnyy; - Direct. 2. Pathological (main types): - Prognathism (rrognatia); - Open (hiatodontia); - Progeny (rrogenia); Anomalies of the teeth. 1. Violation of eruption: - Aedentia (partial, full); - Retention; - Violation of the terms and order of eruption. 2. Violation of accommodation: - Diastema; - Outside the arc (oral or vestibular position); - Cluster teeth (kraudynh). 3. Anomaly structure: - Hypoplasia; - Hyperplasia; - Fluorosis; - Wedge-shaped defect. 4. Changing shape: - Subulate teeth - Anomalies roots (length, number, distortion).

7. Materials for activating students during the lecture: Models of the oral cavity. Teeth. Tables. Models. Theoretical questions. 1. Description of the teeth: a) parts of a tooth; b) interior of a tooth; c) types of teeth and their characteristics. 2. How many dentitions do humans develop? 3. Describe the dental formula for deciduous teeth. 4. Name beginning and end terms of eruption. 5. Dental formula of the permanent teeth and their eruption terms. Situational problems 1. Patient 45-years-old accidentally drank acetic acid. Burn what department of alimentary system will occur firstly? A. Small intestine B. Oesophagus C. Oral cavity, oropharynx. D. Pharynx E. Stomach. 2. The examination of the patient revealed hypertrophy and inflammation of the lymphoid tissue, swelling of the mucous membrane of the soft palate between the arches (acute tonsillitis). Which of the tonsils is contained in the norm in this place? A. Tonsilla tubaria B. Tonsilla pharyngealis C. Tonsilla lingualis D. Tonsilla palatina E. All answers are correct 3. During the first days of a newborn child, a pediatrician detected that milk gets into the child's nasal cavity. What malformation does this fact indicate? A. Esophagus constriction. B. Diverticulum of esophagus. C. Esophageal atresia, D. Cleft clip. E. Non-closed palate. 4. During a meal, milk gets into the nasal cavity of a newborn child. What is the probable cause of this pathology? A. Cleft palate. B. Nasal septum deviation to the right. C. Basal skull fracture. D. Cleft clip. E. Nasal septum deviation to the left. 5. On examination, the doctor found a small ulcer on the front left palatine arch. On what muscle possible spread infection process? A. M. uvulae B. M. palatoglossus C. M. palatopharyngeus D. M. genioglossus E. M. hyoglossus 6. A 35-year-old patient complained of pain and edema in the site of oral cavity floor. After exanimation, the inflammatory process in the site of the excretory duct of was diagnosed. Where does this duct open to? A. Plica sublingualis. B. Vestibulum oris. C. Caruncula sublingualis. D. Foramen caecum linguae. E. Recessus gingivalis. 7. A 40-year-old patient complained of pain and edema in the site of oral cavity floor. After exanimation, the inflammatory process in the site of the major excretory duct of the sublingual gland was diagnosed. Where does this duct open to? A. Plica sublingualis. B. Vestibulum oris. C. Foramen caecum linguae. D. Caruncula sublingualis. E. Recessus gingivalis. 8. A 56-year-old patient complained of pain and edema in the site of oral cavity floor. After exanimation, the inflammatory process in the site of the minor excretory duct of the sublingual gland was diagnosed. Where does this duct open to? A. Recessus gingivalis. B. Vestibulum oris. C. Foramen caecum linguae. D. Caruncula sublingualis. E. Plica sublingualis. 9. A 53-year-old patient complained of pain and edema in the site of oral cavity floor. After exanimation, the inflammatory process in the site of the excretory duct of the parotid gland was diagnosed. Where does this duct open to? A. Vestibulum oris. B. Recessus gingivalis. C. Foramen caecum linguae. D. Caruncula sublingualis. E. Plica sublingualis. 10. After a face injury, a patient has hematoma in the cheek area. What salivary glands secretion outflow is blocked by the hematoma? A. Bucral. B. Parotid. C. Submandibular. D. Labial. E. Sublingual. 11. Dentist during the inspection of the oral cavity found between the middle and posterior third of tongue papillae inflammation. Inflammation which papillae doctor found? A. Papillae foliatae B. Papillae fungiformes C. Papillae vallatae D. Papillae filiformes E. Papillae conіcae 12. On examination, vestibule of mouth dentist found redness on the buccal mucosa, opposite to the upper second molar tooth. Which major can be damaged the first place? A. Submandibular B. Sublingual C. Palatine D. Parotid E. Lingual 13. Children frequently have nasal breathing affection caused by the overgrowth of the pharyngeal mucous membrane lymphoid tissue. Which tonsils excrescence may cause this? A. Palatine. B. Pharyngeal. C. Lingual. D. Tubal. E. All mentioned. 14. A 10-year-old child complains of nasal breathing affection. Examination has shown that the cause of this is lymphoid tissue hypertrophy. Which tonsil is increased? A. Left tubal tonsil. B. Palatine. C. Lingual. D. Pharyngeal. E. Right tubal tonsil. 15. At examination of oral cavity, dentist found out a carious cavity on the crown of the second premolar, cavity directed to first molar. Name the staggered surface of crown. A. Facies vestibularis B. Facies lingualis C. Facies distalis D. Facies mesialis E. Facies occlusalis 16. Dentist at examination of oral cavity of child found out the short bridle of upper lip. On what teeth will render the negative consequences this anomaly of development? A. Medial lower incisors B. Lateral upper incisors C. Lateral lower incisors D. Medial upper incisors E. Upper canines 17. A mother appealed for help to the pediatrician. Sick girl 9 months, with a high temperature, cries, pushes toys in a mouth. What tooth cuts through in this age? A. Premolar B. Medial lower incisor C. Canine D. Lower molar E. Lateral lower incisor 8. Tasks for self-check 1. Thematical tables. 2. The teeth. 3. Educational literature, methodical guidance for the lecture. 9. Materials for the next lecture (key issues) Next lecture topic: «General anatomy of the respiratory system. Clinical aspects». Questions: 1. 1. What is tissue respiration and external respiration? 2. What is the Bronchial Tree? 3. What difference between bronchi and bronchioles? 4. What is rhinoplasty? 10. References 10. References: The basic literature 1. Human Anatomy. In three volumes. Volume 1 / Edited by V.G. Koveshnikov. - Lugansk: LTD «Virtualnaya realnost», 2009. – 328p. 2. Human Anatomy. In three volumes. Volume 2 / Edited by V.G. Koveshnikov. - Lugansk: LTD «Virtualnaya realnost», 2008. – 248p. 3. Human Anatomy. In three volumes. Volume 3 / Edited by V.G. Koveshnikov. - Lugansk: LTD «Virtualnaya realnost», 2009. - 384p. 4. Gray's anatomy for students / Richard L. Drake, A. Wayne Vogl, and Adam W. M. Mitchell; illustrations by Richard M. Tibbitts and Paul E. Richardson; photographs by Ansell Horn. - 2nd ed. 2012- 1103p. 5. Sobotta Atlas of Human Anatomy / Edited by R. Putz and R. Pabst, 14th ed. - Elsevier GmbH, Munich, 2008 . - 895p. 6. Clay JH, Pounds DM. Basic Clinical Massage Therapy: Integrating Anatomy and Treatment. 2003. 7. Grant's atlas of anatomy/Anne M.R. Agur, Arthur F. Dailey II, 14th ed. - Baltimore: Wolters Kluver, 2017. - 864 p. 8. Martini Frederic H. Martini's atlas of the human body, 8th ed. - Pearson Education, 2009. - 250p. 9. Atlas of Human Anatomy / Frank H. Netter; 7nd ed. // Elsevier Inc, 2019. - 548p. 10.Human Anatomy: textbook / Cherkasov V.G., Herasymiuk I.Ye., Holovatskyi A.S., Kovalchuk O.I. [et al.]. - Vinnytsia Nova Knyha, 2018. - 464 p. The additional literature 1. Beck F. Human embryology: 2 ed / F. Beck, D. Mossat, D. Davies. - Oxford: Blackwell, 1985. - V. 11. - 372p. 2. Moore Keith L. Clinically oriented anatomy: third ed / Keith L. Moore. - 1992. - 917p. 3. Clinical Anatomy. Applied anatomy for clinical students and junior doctors: eleventh edition / Harold Ellis // Oxford, UK: Blackwell publishing. - 2006. - 455p. 4. Pocket atlas of Human Anatomy / Heinz Feneis, Wolfgang Dauber // Thieme, Stuttgart. - 2000. — 5 Юр. Information resources 1. http://www.umsa.edu.ua/kafhome/anatomy/kaf_anatomy_download.html 2. http://anatom.ua/basis/ukr/ 3. http://anatom.ua/basis/rus/ Electronic educational resources 1. Human Anatomy. In three volumes. Volume 1 [educational resources] / edited by V. G. Koveshnikov. - Lugansk: «Шико» TOB «Віртуальна реальність», 2006. - 328 p. https://www.twirpx.com/file/1763162/ 2. Human Anatomy. In three volumes. Volume 2 [educational resources] / edited by V. G. Koveshnikov. - Lugansk: «Шико» TOB «Віртуальна реальність», 2006. - 248 p. https://www.twirpx.eom/file/l 763164/ 3. Human Anatomy. In three volumes. Volume 3 [educational resources] / edited by V. G. Koveshnikov. - Lugansk: «Шико» TOB «Віртуальна реальність», 2006. - 384 p. https://www.twirpx.eom/file/l 763169/ 4. For English-speaking students: a. https://www.umsa.edu.ua/fakultets/stomat/kafedry/anatomiy/resources/navchal ni- materiali-dlya-studentiv-medichnogo-fakultetu b. https://www.umsa.edu.ua/fakultets/stomat/kafedry/anatomiy/resources/uchbovi -materiali-dlya- studentiv-stomatologichnogo-fakultetu-al The methodical guidance has been compiled by N.L. Svinthythka, Associate Professor at the Department of Human Anatomy, PhD in Medicine, Associate Professor