Oral cavity and Tongue

Parts of digestive
system
 Oral Cavity/ Mouth
• 1st part of digestive tube
• Subdivided by the
alveolar process, gum and
teeth into 2 parts
- Vestibule – outer smaller
part
- Mouth cavity proper –
inner larger part
 Vestibule

Boundaries
• Externally- by lips and cheeks
• Internally- teeth and gums
• Roof and floor – reflection of mucous membrane from
lips and cheeks to gum
• Communicates externally through oral fissure
• With teeth occluded-small communication remain behind
the third molar tooth
 Other features
• Opening of parotid duct-
lateral wall of
vestibule(inner surface of
Cheek) opp. the upper 2nd
(maxillary) molar tooth

• Buccal(mucous) and labial

glands

• Lined by NKSSE

• Forms median fold –

frenulum of lips
 Gums and Teeth
Gums (Gingivae)
• soft tissues which cover the alveolar processes
of upper and lower jaws, surround the necks of
teeth

Teeth
• part of chewing apparatus
• Deciduous teeth(20) and permanent teeth(32)
Teeth
• Concerned for mastication
• Parts – Root, Crown and
neck

• Structure –
Pulp ,Dentine ,Enamel ,Cem
ent and periodontal
membrane
• Eruption or dentition of
tooth-

– diphyodonty(mammals)
1st set – milk/deciduous teeth
2nd set – permanent teeth

– Polyphyodonty- fishes ;
reptiles, continuously
replaced.
– Monophyodont - rat
• Parts of the teeth:
– Crown
– Root
– Neck
Deciduous teeth – primary teeth- 20 in number
• In each half of jaw –5 in number
• The dental formula for each side of the arch reads-212
• Incisors –two, canine – one, milk molars- two

• Time of eruption
Teeth Central Lat. Incisor 1st molar canine 2nd molar
Incisor
Months 6-8 months 8- 10 months 12-16 months 16- 20 20- 22
months months
 Permanent teeth- second set of teeth in mammals
that grows as the primary teeth are shed. In human
-32 in number
• each half of jaw –8 in number
• Dental formula on each side of the arch reads
2,1,2,3
– Incisors –two (central and lateral),
– Canine – one
– Pre-molars-two(first and second),
– Molars- three (1st, 2nd and 3rd)

Time of Eruption
Teeth 1st Central Lat. 1st pre 2nd pre canine 2nd 3rd
molar incisor incisor molar molar molar molar

Year 6 6-7 8 9 - 11 10 -13 9-11 12 17 -25

 Vessels and Nerve supply of Teeth
• Arterial supply-
Maxillary artery
– Upper jaw
– Lower jaw
• Venous drainage-
Pterygoid venous
plexus or
Anterior facial vein
• Lymphatic drainage-
Submandibular nodes
Nerve supply
• Upper jaw- posterior,
middle and anterior
superior alveolar nerve -
maxillary nerve
• Palatine surface – greater
palatine n-pterygo-
palatine ganglion, naso
palatine nerve
• Lower jaw-inferior
alveolar nerve-
mandibular nerve
Applied
• Study of ontogeny(origination and dev of organism)
and phylogeny(study of evolution) by providing good
data
• Helps in medico legal study for identification in
unrecognized dead bodies
• Bad oral hygiene- pyorrhoea – foul breath
• Caries tooth – pain during mastication
• Pulp infection – apical abscess
• Scurvy – spongy and bleeding gum
• Rickets- irregular dentiton, upper permanent incisors-
notched
• Congenital syphilis –Hutchison’s teeth- notching of
permanent teeth
 Oral Cavity Proper
Boundaries
• Anterolaterally -Teeth,
Gums. alveolar arches of
jaws
• Roof-hard and soft palate
• Floor-tongue and sublingual
region
Posteriorly-communicates
with pharynx through
oropharyngeal isthmus
 Oro- pharyangeal isthmus(faucial
isthmus)
Boundaries -
• Above – soft palate
• Below – dorsal surface of
tongue
• On each side – palato-
glossal arch
 Palate

• Separates the nasal

cavities and
nasopharynx from oral
cavity
• Parts of palate
• Anterior 2/3rd-hard
palate
• Posterior 1/3rd-soft
palate
 Hard palate
• Formed by palatine
processes of maxilla
and horizontal
processes of palatine
bone
 Soft palate

• Movable, fibro-muscular fold

• Separates the nasopharynx
from oropharynx
• From posterior free margin-
uvula
• Laterally-palatoglossal and
palatopharyngeal
 Muscles of soft palate
• Levator veli palatini
• Tensor veli palatini
• Palatoglossus
• Palatopharyngeus
• Musculus uvulae
 Nerves of the palate
• Sensory (general )-
greater and lesser palatine nerves
• Sensory (special )-
Glossopharyngeal and lesser palatine nerve
• Motor-
All muscles except tensor palati-pharyngeal plexus
(cranial part of accessory n vagus)
• Tensor palati- mandibular nerve
• Secretomotor –
• Greater and lesser palatine nerves
 Functions of soft palate
• Controls and regulates the size of the
pharyngeal isthmus during speech,
swallowing, coughing, sneezing

• Prevents the entry of food into nasopharynx

 Clinical Anatomy

• Paralysis of muscles
• nasal regurgitation of
liquid, nasal sound,
flattening of palatal arch
• Cleft palate
• Congenital defect-non-
fusion of right and left
palatine process
 Tongue
• Highly mobile muscular
organ
• Situated partly in mouth and
oropharynx
• Parts
• Root, body, tip, base, dorsal
surface, ventral surface and
two lateral borders
 Functions
• Taste
• Mastication
• Deglutition
• Speech
• Oral cleansing
• Lower animal-thermo- regulating by panting
• Sometime tongue –prints –displaying the pattern
of lingual papillae – medico- legal purpose-
personal identification
• Acts as mirror in various disturbances of
alimentary tract
 Dorsal surface
• Divided into anterior
2/3rd or oral part and
posterior 1/3rd or
pharyngeal part.

• By V-shaped groove-
sulcus terminalis
• Foramen caecum
Types of papillae

1. Circumvallate papillae
– large, drum-shaped
– 8-12 in no.
– Lies in front of sulcus
terminalis
– presence of taste buds

2. Fungiform papillae
– Red, mushroom shaped
– margin n tip of tongue
– with taste buds
3. Filliform papillae
• most numerous,
• Conical,
• all over the dorsum of
the anterior two third
of tongue
• velvety appearance

4. Papillae foliate
• 3,4 vertical mucous
folds,
• margin of the tongue
 Taste buds
Modified epithelial cells.

Sites- within the epithelium of

• mucous membrane of tongue
• Palatoglossal arch
• Inferior surface of soft palate
• Posterior surface of epiglottis
• Posterior wall of oropharynx
• On the side of vallate and fungiform papillae

Type of sensation and site of tongue

• Sweet and salty – tip
• Sour – margin
• Bitter- pharyngeal part of tongue
Features of post sulcal
pharyngeal part of tongue
• Devoid of papillae
• submucous coat –
– separates muscles from mucous
membrance
– mucous, serous gland and
numerous lymphatic follicles –
lingual tonsils
• medain glosso –epiglottic fold
• lateral glosso – epiglottic fold
• vallecula- depression , behind
the root of the tongue
 Ventral surface
• Covered by smooth
mucous membrane
• Devoid of papillae
• Frenulum linguae-median
mucosal fold
• Deep lingual vein on
either side
• Sublingual papillae and
openings of
submadibular ducts
 Muscles of tongue
• Intrinsic muscles
• Alter shape
and size of
tongue
 Extrinsic muscles
• Extrinsic muscles –
connect tongue with
other structures
eg.mandible, Hyoid,
palate
• Alter position of
tongue
1. Genioglossus
2. Hyoglossus
3. Styloglossus
4. Palatoglossus
Nerve supply of tongue
• Motor –
– all extrinsic and intrinsic muscles except palatoglossus – hypoglossal nerve
– Palatoglossus – crainal part of accessory nerve via the pharyngeal plexus
• Sensory
• Anterior two third – General sense- lingual n-mandibular n -1st
brachial arch
- Special sense of taste except vallate papillae- the chorda tympani
nerve – 2nd brachial arch ( via Lingual nerve )
• Posterior one third – including vallate papillae – Glosso-pharyngeal n-
both General n Special – 3rd brachial arch
• Posterior most – vallecula- internal laryngeal n-vagus -4th br. arch
• Muscle sense – hypoglossal nerve
Nerve Supply
Blood supply-
• lingual arteries- external
carotid
• Ascending palatine and
tonsillar – facial artery

• Ascending pharyngeal –
external carotid
• Venous drainage-
superficial and deep vein –
drain -internal jugular vein
Lymphatic drainage

• From tip or apical – mainly submental

• From the marginal set or sides - mainly submandibular
• From the central part (anterior two third)- bilaterally
mainly jugulo digastric and jugulo omohyoid
• From the dorsal part (posterior one third)- to
retropharyngeal and to jugulo- omohyoid
 Development of tongue

• from 3 sources

A. Mucous membrane
from endoderm- floor of the pharynx

 Anterior two-third –
a) Lingual swellings- appro. 4 week, 2 lateral lingual swelling
appear at the ventral ends of 1st brachial arch
b) Tuberculum impar – one median swelling behind lingual
swelling
c) Behind it –epithelium proliferate –form – down growth
(thyroglossal duct) – site- foramen caecum
 Posterior one third of tongue
• Developed from third arch element of hypo –branchial
eminence or copula of his – formed by the fusion of second,
third and fourth arch elements

 Posterior most part of tongue

• Developed from the fourth arch element
• Sulcus terminalis represents the line of fusion of anterior
and posterior part of the tongue
B .Muscles
2nd month - invaded -occipital myotomes -
forms the muscles of tongue

C Connective tissue
Develops – the local mesenchyme
 Taste buds – developed from nerve endings
Developmental explanation of innervation

• Anterior two-third- derived from 1st arch - sensory –by

lingual and special – chorda tympani n
• Posterior one third- derived from 3rd arch- both-
Glossopharyngeal nerve
• Posterior most part – derived from 4rth arch- superior
laryngeal nerve
• Muscle of tongue – except palatoglossus – developed
from – occipital myotome – hypoglossal nerve
• Palatoglossus- cranial part of accessary nerve- via the
pharyngeal plexus
Applied anatomy
• Tongue is index of condition of internal organ mirror of gastro
intestinal tract
- Coated – in case of gastro intestinal condition or any pathological
condition
- Raw beef tongue - in some metabolic diseases – diabetes mellitus
- Fissured tongue – vitamin deficiency
- Macroglossia – pituitary tumor
• Cyanosis – marked in tongue
• In jaundice- yellow tinge in undersurface of tongue
• Injury to hypoglossal nerve-Paralysis of muscles of the tongue on
the side of lesion
• Glossitis-ulceration of the mouth cavity
• Referred pain-ear - cancer of tongue- Glossopharyngeal and vagus
nerve
• Genioglossus – paralysis – tongue will fall back
 Congenital Anomalies
• Ankyloglossia/ tongue-tie –frenulum
extends up to tip of the tongue

• Microglossia- abnormal small tongue

• Macroglossia- excessive large tongue

related with hypertrophy
• Aglosia –absence of tongue
• Lingual thyroid- failure of median
thyroid diverticulum

• Glossoschisis- bifid/ cleft tongue

• Congenital cyst and fistula- presence
of remnant of thyroglossal duct 45
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