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Oral Cavity, Lip, Tongue, and Salivary Glands

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Oral Cavity, Lip, Tongue, and Salivary Glands THE GASTROINTESTINAL TRACT Oral Cavity, Lip, Tongue, and Salivary Glands Dr. Andrea D. Székely Semmelweis University Department of Anatomy, Histology and Embryology Budapest THE GASTROINTESTINAL SYSTEM INTERNAL ORGANS GENERAL CLASSIFICATION VISCUS internal organ - VISCERA plural COMPACT , or SOLID, or PARENCHYMAL organs (glands and lymphoid organs) HOLLOW, or TUBULAR, or LUMINAL organs (vessels, respiratory conduits and the „guts” from pharynx to rectum) GENERAL WALL STRUCTURE OF HOLLOW ORGANS PARENCHYMAL (COMPACT) ORGANS LOBATED STRUCTURE and/or CORTEX + MEDULLA (e.g. kidney, adrenals, lymph nodes) CONNECTIVE TISSUE capsule LOBES and lobuli CONNECTIVE TISSUE septa ORAL CAVITY ANATOMICAL RELATIONS ORAL CAVITY Designed for articulation in speech and mastication of food, the oral cavity also functions as an alternate airway. BOUNDARIES Anterior - lips Posterior - the anterior tonsillar pillars Roof - hard and soft palate Floor - mucosa overlying sublingual and submandibular glands + tongue. Walls - buccal mucosa ROOF Palate ORAL CAVITY LATERAL PROPER WALL Bucca TONGUE Sulcus paralingualis FLOOR ORAL Oral diaphragm VESTIBULE ORAL CAVITY PARTS Vestibule vs o.c. proper CONTENT ·Alveolar processes and teeth ·Anterior part of tongue to circumvallate papillae ·Orifice of parotid duct (Stenon's duct) in buccal mucosa opposite upper second molars ·Orifice of submandibular duct (Wharton's duct) in anterior floor of mouth ·Orifices of sublingual glands OROFACIAL SURFACE FEATURES „HABSBURGER UNTERLIPPE” STRUCTURE OF THE LIP wing nostril philtrum angle infant Labium superius / inferius oris small kid Vermilion border (lips meet the surrounding skin) adult The superior outline - cupid's bow Tubercles (B) Philtrum (C) before after collagen Vermilion zone HISTOLOGY OF THE LIP vermillion pars cutanea border vermillion zone orbicularis oris pars mucosa CONTENT: m. orbicularis oris LIP Pars cutanea: stratified, keratinizing squamous epithelium Hair follicles, sebaceous and sweat glands Rubor labii (= Vermilion zone) Few sebaceous glands at the border High connective tissue papillae, dense capillary network, no pigmentation → RED Pars mucosa: Stratified non-keratinizing sqaumous epithelium Gll. labiales - mixed (= seromucous) salivary glands BLOOD SUPPLY Facial a. → Sup, inf. Labial aa. → arterious SENSORY /parasympathetic ring → angular/facial vein INNERVATION LYPMH DRAINAGE Infraorbital nerve (V/2) Submandibular, submental, upper cervical Mental nerve (V/3) lymph nodes ROOF Palate ORAL CAVITY LATERAL PROPER WALL Bucca TONGUE Sulcus paralingualis FLOOR ORAL Oral diiaphragm VESTIBULE BLOOD SUPPLY TO THE ORAL CAVITY nasopalatine a. sphenopalatine a (maxillary) palate asc. palatine a. maxillary a palate desc. palatine a. facial a palate lingual a. ext carotid a tongue buccal a. maxillary bucca sup. / inf. labial a. facial a lips infraorbital a. maxillary. upper teeth inf. alveolar a. maxillary a. lower teeth CONTENTS OF THE ORAL CAVITY MUCOSA (mucous membrane) TONGUE Teeth What makes the MUCOSA mucous? Small mixed glands (immediately under the mucosal layer) SALIVARY GLANDS & LARGE, paired salivary glands Lying EXTERNAL to the oral cavity Parotid, submandibular, sublingual glands ORAL MUCOSAL TYPES TWO MAJOR TYPES - lining mucosa (NO KERATINIZATION!) - masticatory mucosa (THIN KERATINIZATION) STRUCTURE OF THE BUCCA LAYERS mucous membrane lamina propria (buccal glands and aperture of the parotid duct) Buccinator corpus adiposum buccae / Bichat fat pad skin GINGIVA – MUCOSA OF THE GUMS ROOF OF THE ORAL CAVITY HARD PALATE FLOOR OF THE ORAL CAVITY CONTENTS OF THE ORAL CAVITY MUCOSA (mucous membrane) TONGUE Teeth Small mixed glands (immediately under the mucosal layer) SALIVARY GLANDS & LARGE, paired salivary glands Lying EXTERNAL to the oral cavity Parotid, submandibular, sublingual glands PARTS OF THE TONGUE Radix linguae Corpus linguae PARS FOLLICULARIS Dorsum linguae Sulcus terminalis PARS PAPILLARIS Apex linguae FEATURES ON THE TWO SIDES OF THE SULCUS TERMINALIS mucinosus mirigy serosus mirigy LINGUAL MUSCLES EXTRINSIC palatoglossus INTRINSIC verticalis tranversus styloglossus longitudinalis sup hyoglossus longitudinalis inf. genioglossus LINGUAL MUSCLES THE INTERNAL AND EXTERNAL MUSCLES OF THE TONGUE NAME SHAPE ORIGIN POSITION FUNCTION INNERVATION EXTRINSIC palatoglossus bundle palatal connects the elevates the pharyngeal aponeur. soft palate to root of the plexus (from the side of the tongue glossopharyngeu tongue s and vagus) genioglossus fan shaped mental radiates pulls the hypoglossal spine of towards the tongue nerve (XII.) the root and forward mandible dorsum close to the midline hyoglossus flat and square body and radiates in to flattens the XII. greater the lateral tongue horn of edges the hyoid bone stylohyoideus spindle shaped styloid reaches the pulls the XII. process of lateral portions tongue up and the back temporal bone INTRINSIC longitudinalis flat bundles internal to both stretch shorten the XII. the tongue between the tongue apex and the root - sup. - under the - lifts the dorsum, along apex the midline; - inf. - deep, lateral - turns the to the apex down genioglossi transversus solid mass lingual radiates slighty thins and XII. septum superior and thickens the inferior tongue verticalis separated, hyoid perpendicular flattens and XII. rudimentary bone, bundles thereby portions of mandible passively genioglossus widens the and tongue hyoglossus LINGUAL PAPILLAE FILIFORM FUNGIFORM (LENTIFORM) FOLIATE CIRCUMVALLATE THE ORGAN OF TASTE FOLIATE PAPILLA Axons of the chorda tympani (CN7) GEMMA GUSTATORIA CIRCUMVALLATE PAPILLA TASTE MAP OF THE TONGUE (??) Misconception Based on a publication from 1901 By Hänig, David . „Zur Psychophysik des Geschmackssinnes". Philosophische Studien. 17: 576–623 NEVER PROVED TO BE TRUE „…all taste sensations come from all regions of the tongue, although different parts are more sensitive to certain tastes…” Collings, V. B. (1974). "Human Taste Response as a Function of Locus of Stimulation on the Tongue and Soft Palate". Perception & Psychophysics. 16: 169–174 INNERVATION OF THE TONGUE LYMPHATIC DRAINAGE APEX Submental ly. Nn. DORSUM (med) inferior cervical (JO) ly. nn. bilat DORSUM (lat) submandibularly. nn. unilat PARS TONSILLARIS superior cervical (JO & JD) nn. EPIGLOTTIS ** superior cervical ly. nn. There are less and less lymph vessels towards the larynx To prevent obliteration (laryngeal edema) INNERVATION AND LYMPH DRAINAGE SUBLINGUAL REGION paralingual sulcus lingual frenulum Submandibular duct opens on the sublingual caruncula together with the major sublingual duct sublingual gland – lies under the sublingual fold the minor sublingual ducts open ORAL DIAPHRAGM Mylohyoid + fasciae STRENGTHENED BY: Geniohyoid (inside), anterior belly of digastric (outside) Action: opening odf the mouth, Elevation of larynx, swallowing Increases the negative pressure of the oral cavity SALIVARY GLANDS IN GENERAL PARENCHYMAL ORGANS LOBULAR STRUCTURE COMPOUND GLANDS TUBULOALVEOLAR morphology ACINUS & EXCRETORY DUCT MEROCRINE SECRETION MIXED SECRETORY PRODUCT serous mucous Gianuzzi’s demilune Myoepithelial cells surround the acinus Welsch EXCRETORY DUCTS - intercalated duct (flat cuboidal) - salivary or striated – high cuboidal) Intralobar excretory duct (simple columnar) Interlobar excretory duct (two layered columnar) Large excretory duct (oral epithelium) Welsch DEVELOPMENT OF SALIVARY GLANDS SALIVARY GLANDS PAROTID GLAND Parotideomasseteric fascia Parotid duct (Stenon), accessory lobe Auriculotemporal n. Facial n. Superficial temporal artery and vein lobular structure tubuloalveolar acini PAROTID NEST anterior: masseter serous secretion mandibular ramus med. pterygoideus med. Posterior m.sternocleidomastoid m. digastricus medial: m. stylohyoideus m. stylopharyngeus m. styloglossus POSITION OF THE SUBMANDIBULAR AND SUBLINGUAL GLANDS SUBMANDIBULAR GLAND Divided into (smaller) superficial and deep lobes separated by the mylohyoid muscle Submandibular duct (Wharton) Sulc. lat. linguae Opens through the sublingual caruncles together with the major sublingual duct (Bartholin) Facial artery and vein Submandibular trigone lobular structure tubuloalveolar acini 2/3 serous 1/3 mucous produces the largest amount of saliva SUBLINGUAL GLAND anterior to the submandibular gland under the floor of the mouth. 8-20 minor excretory ducts of Rivinus. major sublingual duct (of Bartholin) joins the submandibular duct opens on the sublingual caruncle lobular structure tubuloalveolar acini 1/3 serous 2/3 mucous Gianuzzi demilunes SULCUS LATERALIS LINGUAE BORDERS: CONTENT: lingual n. med: hyoglossus submandibular d. lat: mylohyoid hypoglossal n. sup: sublingual mucosa SULCUS MEDIALIS LINGUAE BORDERS: CONTENT: lingual a. med: genioglossus glossopharyngeal n. lat: hyoglossus .
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