THE MOUTH
o Buccal nerve, a branch of mandibular
Mouth Cavity
– Extends from the lips to the oropharyngeal isthmus
 Subdivided into:
 Vestibule
o lies between the lips and the cheeks
externally and the gums and teeth
internally
o slit like space that communicates with
the exterior through the oral fissure
between the lips
o cheek forms the lateral wall which is
made up if buccinators muscle
o opposite the upper 2nd molar tooth is
a small papilla opening into the
vestibule known as parotid duct
opening
 Mouth Proper
o Has a roof which forms the hard and
soft palate
o The floor is the anterior 2/3 of the
tongue
o Frenulum of the tongue
 a fold of the mucous
membrane that connects the
undersurface of the tongue in
the midline to the floor of the
mouth
 submandibular duct of the
submandibular gland opens
on each side of the frenulum
 sublingual gland projects up
into the mouth, producing a
low fold of mucous
membrane, the sublingual
fold
 Sensory nerve supply
 Roof
o greater palatine and nasopalatine
nerves
 Floor
o Lingual nerve, branch of mandibular
nerve
o Taste fibers travel in the chorda
tympani nerves, a branch of facial
nerve
 Cheek
division of trigeminal nerve
 Teeth
 Has 2 sets
o Deciduous teeth – temporary teeth
o Permanent teeth
 Deciduous teeth
o 20 in number
o 4 incisors
o 2 canines
o 4 molars each jaw
o Begin to erupt at 6 months after birth
o End at 2 years old
o Approximate times of eruption
 Center incisors – 6-8 mos
 Lateral incisors – 8-10 mos
 1st molars – 1 year
 Canines – 18 mos
 2nd molars – 2 years
o Teeth lower jaw appear before the
upper jaw
 Permanent Teeth
o 32 in number
o 4 incisors
o 2 canines
o 4 premolars
o 6 molars
o Begin to erupt during the 6th year of
life
o Last tooth to erupt is the 3d molar
between 17th to 30th year
o Approximate times of eruption:
 1st molars – 6 yrs
 Central incisors – 7 yrs
 Lateral incisors – 8 yrs
 1st premolars – 9 yrs
 2nd premolars – 10 yrs
 Canines – 11 yrs
 2nd molars - 12 yrs
 3rd molars – (wisdom teeth)
17-30 yrs
 Tongue
 mass of striated muscles
 covered with mucous membrane
 anterior 2/3 in the mouth
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 posterior 1/3 lies in the pharynx  Insertion – blends
 fibrous septum with other muscles of
 divides the tongue medially into right and left the tongue
halves  Nerve supply –
 mucous membrane hypoglossal nerve
o has 3 types of papillae in the anterior  Action – depresses
2/3 of the tongue the tongue
 filiform  Styloglossus
 fungiform  Origin – styloid
 vallate process of the
o posterior 1/3 temporal bone
 devoid of papillae but has  Insertion – blends
nodular irregular surface with the other
caused by underlying lymph muscles of the
nodules, the lingual tonsil tongue
 muscles of the tongue:  Nerve supply –
o intrinsic muscle hypoglossal nerve
 confined in the tongue  Action – draws the
 not attached to the bone tongue upward and
 consists of longitudinal, backward
transverse, and vertical fibers  Palatoglossus
 nerve supply – Hypoglossal  Origin – palatine
nerve aponeurosis
 action – after the shape of the  Insertion - side of
tongue the tongue
o extrinsic muscles  Nerve supply –
 attached to the bones and pharyngeal plexus
the soft palate  Action – pulls roots
 Geniuglossus of the tongue
 Origin – superior upward and
genital spine of backward, narrows
mandible the oropharyngeal
 Insertion – blends isthmus
with the other  Blood supply:
muscles of the o Lingual artery
tongue o Tonsillar branch of the facial artery
 Nerve supply – o Ascending pharyngeal artery
hypoglossal nerve o Veins drain into the internal jugular
 Action – protrudes vein
apex  Lymph drainage
 Hypoglossus o Submental LN
 Origin – body at the o Anterior 2/3 drains into the
greater comu of the submandibular and deep cervical LN
hyoid bone on both sides
o Posterior 1/3 drains into the deep
cervical LN on both sides

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  Sensory innervation
o General sensation anterior 2/3 of the
tongue – lingual nerve
o Taste fibers from the anterior 2/3 of
the tongue excluding the vallate
papillae – chorda tympani branch of
the facial nerve
o General sensation at the taste
including vallate papillae –
glossopharyngeal nerve
 Movements
o Protrusions of the tongue –
geniuglossus
o Retraction – styloglossus and
hypoglossus
o Depression – hypoglossus and
genioglossus
o Retraction and elevation posterior 1/3
of the tongue – styloglossus and
palatoglossus
 Shape changes
o modified in shape by the action of its
intrinsic muscles
o long curving course taken by the 12
cranial nerve (hypoglossal nerve)
 Palate
– Forms the roof of the mouth
– Divide into:
o Hard palate - in front
o Soft palate – behind
– Hard palate
o Formed by the palatine process of
the maxillae and the horizontal
plates of the palatine bones
o It forms the floor of the nasal
cavities
– Soft palate
o Mobile fold
o Has a conical projection known as
uvula
o Composed of:
 Mucous membrane
 Palatine membrane
o Muscles
 tensor veli palatine
 levator veli palatine
 palatoglossus
 palato-phyrngeus
 musculus uvulae
o Nerve Supply:
 Hard palate
o greater and
lesser palatine
nerve
o nasopalatine
nerve
 Soft palate
o Glosso-
pharyngeal
nerve
o Blood supply
 Greater palatine branch
of maxillary artery
 Ascending palatine
branch of the facial artery
 Ascending pharyngeal
artery
o Lymph drainage
 Deep cervical LN
th
– Abnormality: cleft palate
 Pharynx
– Nasopharynx, Oropharynx,
Laryngopharynx
– Situated behind the nasal cavities, mouth,
and the larynx respectively
– Funnel shaped
– Musculo-membranous wall that is deficient
anteriorly
– Replaced by post nasal aperture
– Oropharyngeal isthmus and inlet of larynx
– Has 3 layers
o Mucous, fibrous and muscular
– Muscles
o Superior constrictor
o Middle constrictor
o Inferior constrictor
 Fibers run in a more or
less circular direction
o Stylopharyngeal and salpingo-
pharyngeus
 Fibers run in a more or
less longitudinal direction

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 o Crico-pharyngeus muscle
 Prevents entry of air into
the esophagus during
acts of swallowing
– Inferior
o Has 3 parts
o Nasal part
 lies behind the nasal
cavities
 above the soft palate
 has a roof – pharyngeal
tonsil; floor – anterior
wall, posterior wall and
lateral wall
o Oral part
 lies behind mouth cavity
 extends from the soft
palate to the upper
border of the epiglottis
 it has a roof, floor,
anterior wall, posterior
wall, and lateral wall
 Palatine Tonsils
 2 masses of lymphoid
tissue
 located at the lateral wall
 blood supply from:
tonsillar artery, branch of
facial artery
 lymph drainage
o jugudigastric
node
o Laryngeal Part
 lies behind the opening
into the larynx at the
posterior surface of the
larynx
 has anterior wall,
posterior wall, and lateral
wall
A. Arterial Blood Supply
- branches of the:
o ascending pharyngeal,
o ascending palatine
o facial
o maxillary
o lingual
B. Venous Drainage
- pharyngeal venous plexus
C. Lymph Drainage:
- directly to the deep cervical lymph nodes
- indirectly to the retropharyngeal or
paratracheal nodes
 Larynx
- protective sphincter at the inlet of the air
passages
- responsible for the voice production
- framework made up of cartilages, connected by
membranes and ligaments
- moved by muscles
- lined by mucous membrane
- Cartillages
o Cricoid Cartilage
 formed from a complete ring of
hyaline cartilage
 -shaped like a signet ring
 lies below the thyroid cartilage
o Arytenoid Cartilage
 small, 2 in number
 pyramidal
 -located at the back of the larynx
 has an apex at the base
o Cuneiform Cartilage
 two small, rod shaped of cartilage
 supports for the aryepiglotic fold
 Epiglottis
- leaf shaped elastic cartilage
- located behind the roof of the tongue
- Membranes and ligaments
o Thyrohyoid membrame
 median thyrohyoid ligament
 lateral thyrohyoid ligaments
o Fibroelastic Cartilage
 quadrangular membrane
 vestibular ligament
 -cricothyroid ligament
 vocal ligament
- Boundaries
1. Inlet Boundaries
- Front
- upper margin of the epiglottis
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 2. Lateral o forced/deep inspiration – the vocal folds are
- Aryepiglottic of mucous membrane maximally abducted and glottis is diamond
3. Posterior shaped
- Below by the membrane stretching  Nerve supply
between arytenoid cartilages 1. Sensory
4. Cavity a. above the vocal folds – internal laryngeal
- extends from the inlet to the lower branch of the superior laryngeal branch of
border of the cricoid cartilage the vagus nerve
- Division b. below the vocal folds – recurrent laryngeal
A. Upper part or Vestibule nerve
B. Middle part 2. Motor
C. Lower part o All intrinsic muscle except cricothyroid
- Muscles muscle are innervated by recurrent
A. Extrinsic muscles laryngeal nerve
1. Elevators o cricothyroid muscle is innervated by the
a. Digastrics external laryngeal branch of the superior
b. Stylohyoid laryngeal branch of the vagus nerve
c. Mylohyoid  Blood supply
d. Geniohyoid 1. Upper half – superior laryngeal branch
e. Stylopharyngeus of the superior thyroid artery
f. Salpingo-pharnygeus 2. Lower half – inferior laryngeal branch of
g. Palato-pharyngeus the inferior thyroid artery
2. Depressors  Lymph Drainage – deep cervical lymph node
a. Sternohyoid  Example of pathologies
b. Sternothyroid 1. Laryngeal cancer
c. Omohyoid 2. Laryngeal polyp
 These muscles are assisted by the elastic
recoil of the trachea
 The larynx moves up during swallowing
and down after the swallowing.
B. Intrinsic Muscles
Groups:
1. Control the inlet into the larynx
2. Those that moves the vocal cords
 Sphincteric function of the larynx
o in the inlet
o Rima glottidis
 Voice production of the larynx
o intermittent release of expired air between the
adducted vocal folds that results in vibrations
and production of sounds
 Movements of the vocal folds with respiration
o quite inspiration – vocal folds abducted, rima
glottidis is triangular with apex in front
o expiration – vocal folds adducted, leaving a
small gap between them