The Oral Cavity
No Disclosures
Oral Cavity Anatomy
Karen K. Moeller M.D. Norton Children’s Hospital University of Louisville
Oral Cavity Oral Cavity
Anterior Tonsillar Pillar
Circumvallate Papillae
F.Netter
Oral Cavity Oral Cavity Oral Cavity Oropharynx
* *
***The base of tongue/lingual tonsils and palatine tonsils are in the oropharynx.
Oral Cavity Oral Cavity
Oral mucosal space Sublingual space Oral mucosal space Sublingual space
Root of tongue Submandibular space Root of tongue Submandibular space
Oral Cavity Oral Cavity
Oral mucosal space Sublingual space Oral mucosal space Sublingual space
Root of tongue Submandibular space Root of tongue Submandibular space Oral Cavity Oral Tongue
Oral mucosal space Sublingual space
Root of tongue Submandibular space
Oral Tongue Tongue: extrinsic muscles
Palatoglossus
Styloglossus Genioglossus Hyoglossus
T1 T2
Intrinsic tongue muscles
Amirsys
Tongue: extrinsic muscles Tongue: extrinsic muscles
Palatoglossus Palatoglossus
Styloglossus Styloglossus Genioglossus Genioglossus Hyoglossus Hyoglossus
Amirsys Amirsys Tongue: extrinsic muscles Tongue: extrinsic muscles
Palatoglossus Palatoglossus
Styloglossus Styloglossus Genioglossus Genioglossus Hyoglossus Hyoglossus
Amirsys Amirsys
Tongue: Motor Innervation Tongue: extrinsic muscles
Intrinsic tongue muscles Palatoglossus (CN 10) (CN 12) Styloglossus (CN 12) Genioglossus (CN 12) Hyoglossus (CN 12)
Amirsys
Genioglossus
Tongue: extrinsic muscles Tongue: extrinsic muscles
Palatoglossus Hyoglossus Tongue: extrinsic muscles Root of Tongue
Styloglossus
Root of Tongue Root of Tongue
Genioglossus Lingual septum
Floor of Mouth Floor of mouth Mylohyoid Mylohyoid
Geniohyoid Anatomy Expert Floor of mouth Sublingual Space
Mylohyoid msc Geniohyoid F.Netter
Sublingual Space Sublingual Space
Hyoglossus msc
F.Netter Mylohyoid msc
Sublingual Space Sublingual Space
! Glossopharyngeal ! Glossopharyngeal nerve nerve ! Lingual artery & vein ! Lingual artery ! Hypoglossal nerve ! Hypoglossal nerve ! Sublingual gland ! Lingual nerve ! Lingual nerve ! Sublingual gland
F.Netter ! Submandibular duct & F.Netter ! Submandibular duct & deep gland deep gland Sublingual Space Sublingual Space
! Glossopharyngeal ! Glossopharyngeal nerve nerve ! Lingual vein ! Lingual artery & vein ! Hypoglossal nerve ! Hypoglossal nerve ! Lingual nerve ! Lingual nerve ! Sublingual gland ! Sublingual gland ! ! F.Netter Submandibular duct & F.Netter Submandibular duct & deep gland deep gland
Sublingual Space Sublingual Space
! Glossopharyngeal ! Glossopharyngeal nerve nerve ! Lingual artery & vein ! Lingual artery & vein ! Hypoglossal nerve ! Hypoglossal nerve ! Lingual nerve ! Lingual nerve ! Sublingual gland ! Sublingual gland ! ! F.Netter Submandibular duct & F.Netter Submandibular duct & deep gland deep gland
Sublingual Space Sublingual Space
! Glossopharyngeal nerve Sublingual gland ! Lingual artery & vein ! Hypoglossal nerve ! Lingual nerve ! Sublingual gland
F.Netter ! Submandibular duct & deep gland Sublingual Space Sublingual Space
Lingual artery Lingual vein
Sublingual Space Sublingual Space
Sublingual gland
Submandibular Space Submandibular Space
Mylohyoid
F.Netter Platysma Submandibular Space Submandibular Space
! Submandibular gland ! Submandibular gland ! Facial vein and artery ! Facial vein and artery ! Submandibular l.nodes ! Submandibular l.nodes ! Anterior belly of ! Anterior belly of digastric msc. digastric msc. ! Submental l. nodes ! Submental l. nodes ! Caudal loop of CN #12 F.Netter ! Caudal loop of CN #12 F.Netter
Submandibular Space Submandibular Space
! Submandibular gland ! Submandibular gland ! Facial vein and artery ! Facial vein and artery ! Submandibular l.nodes ! Submandibular l.nodes ! Anterior belly of ! Anterior belly of digastric msc. digastric msc. ! Submental l. nodes ! Submental l. nodes
! Caudal loop of CN #12 F.Netter ! Caudal loop of CN #12 Lippincott
Submandibular Space Submandibular Space
! Submandibular gland ! Submandibular gland ! Facial vein and artery ! Facial vein and artery ! Submandibular l.nodes ! Submandibular l.nodes ! Anterior belly of ! Anterior belly of digastric msc. digastric msc. ! Submental l. nodes ! Submental l. nodes
! Caudal loop of CN #12 Lippincott ! Caudal loop of CN #12 Gray’s anatomy Submandibular Space Submandibular Space
Submandibular gland Submandibular nodes (level IB)
Submandibular Space Submandibular Space
Anterior belly of digastric Submental nodes (level IA)
Oral Mucosal Space Oral Mucosal Space
! Mucosal Surface: ! Oral tongue ! Hard palate ! Lips & cheeks (buccal mucosa) ! Alveolar process (gingiva) ! Floor of mouth ! Retromolar trigone Oral Mucosal Space Oral Mucosal Space
! Mucosal Surface: ! Mucosal Surface: ! Oral tongue ! Oral tongue ! Hard palate ! Hard palate ! Lips & cheeks (buccal ! Lips & cheeks (buccal mucosa) mucosa) ! Alveolar process ! Alveolar process (gingiva) (gingiva) ! Floor of mouth ! Floor of mouth ! Retromolar trigone ! Retromolar trigone
Oral Mucosal Space Oral Mucosal Space
! Mucosal Surface: ! Mucosal Surface: ! Oral tongue ! Oral tongue ! Hard palate ! Hard palate ! Lips & cheeks (buccal ! Lips & cheeks (buccal mucosa) mucosa) ! Alveolar process ! Alveolar process (gingiva) (gingiva) ! Floor of mouth ! Floor of mouth ! Retromolar trigone ! Retromolar trigone
Oral Mucosal Space Oral Mucosal Space
! Mucosal Surface: ! Oral tongue ! Hard palate ! Lips & cheeks (buccal mucosa) ! Alveolar process (gingiva) Gingivobuccal ! Floor of mouth Sulcus ! Retromolar trigone Floor of Mouth “Floor of Mouth”
Mylohyoid msc Mylohyoid msc F.Netter F.Netter
Oral Mucosal Space Retromolar Trigone
! Mucosal Surface: ! RMT mucosa contiguous ! Oral tongue with buccal, alveolar ! Hard palate ridge & anterior tonsillar ! Lips & cheeks (buccal pillar mucosa mucosa) ! Anatomic crossroad: ! Alveolar process ! Floor of mouth (gingiva) ! Oropharynx ! Floor of mouth ! Masticator space ! Retromolar trigone ! Parapharyngeal space ! Buccal space
Retromolar Trigone Retromolar Trigone
! Pterygomandibular Buccinator msc. ! Pterygomandibular Raphe Raphe ! Fascial band between ! Fascial band between buccinator & superior buccinator & superior pharyngeal constrictor pharyngeal constrictor muscle muscle ! Conduit for inferior & ! Conduit for inferior & superior disease spread superior disease spread Superior Pharyngeal from RMT from RMT Constrictor msc. Oral Mucosal Space Teeth
! Minor salivary ! Permanent dentition #32 ! Quadrant- central & lateral glands: incisor, canine, anterior & 1 16 ! Submucosal posterior premolar, 1st, 2nd & 3rd molar throughout oral cavity 32 17 ! Most commonly along ! Numbering convention kenhub inner lip, cheek & ! Maxillary right 3rdmolar (1) palate left 3rd molar (16) ! Mandibular left 3rd molar (17) right 3rd molar (32)
Teeth Primary Teeth
! Permanent dentition #32 ! Quadrant- central & ! “ Milk, baby, lateral incisor, canine, deciduous teeth” anterior & posterior premolar, ! #20 total 1st, 2nd & 3rd molar ! Quadrant- 2 incisors (central & lateral), ! Naming sequence 1 canine, 2 molars ! Jaw-» side »tooth name st nd ! Mandibular left central (1 and 2 ) incisor
Pre- Dentition Primary Dentition
Anterior
Gray’s Anatomy
Gray’s Anatomy
9 months Newborn Primary Dentition Mixed Dentition
Gray’s Anatomy
Gray’s Anatomy
8 years 3 years
Permanent Dentition Permanent Dentition
15 years 12 years 17 years
Conclusion : Oral Cavity Anatomy Teeth ! The oral cavity has 4 imaging subsites: ! Oral mucosal space, Sublingual space, Submandibular space, Root of tongue ! Naming sequence ! Dentition-»jaw-»side ! “Floor of mouth” »tooth name ! Mylohyoid + geniohyoid ! Mucosal surface of anteroinferior oral cavity ! Primary maxillary ! Sublingual space right 2nd molar ! The Retromolar Trigone is an anatomic crossroad
! Maxilla and Mandible have permanent & primary 7 year old boy teeth between 6 months-12 years James Abbott Mcneill Whistler