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ORAL REGION

Includes the:
Oral cavity and its contents (teeth, gums. And tongue) Palate Oropharynx that contains the palatine tonsils.

ORAL CAVITY

Functions
Mastication Passage of air Speech

Consist of: Oral vestibule Oral Cavity Proper

ORAL VESTIBULE
It is bounded externally by the lips and cheeks and internally by the teeth and gums

Oral Cavity Proper


It is the area between the alveolar arches and teeth Its largest content is the tongue.

Surface anatomy of the Oral Vestibule


Zygomatic bone- inferior border Maxilla Anterior(facial) surface Infratemporal Surface Alveolar Process Mandible Coronoid Process and the tendon of temporalis muscle

Surface anatomy of the Oral Vestibule


Masseter Muscle- best palpated when the teeth are clenched Communication between the oral vestibule and the oral cavity proper- posterior to the 3rd molar tooth

Frenulum
Sickle folds of tissue attaching the lips, cheeks and the tongue to the alveolar bone

Opening of the parotid duct


Located lateral to the 2nd maxillary molar tooth

Surface anatomy of the Oral Cavity Proper


Borders: Lateral and Anterior: teeth and gums Posterior- palatoglossal folds Superior- hard palate and soft palate Inferior- mucosa covering the tongue and sublingual area

TONGUE
Is a mass of striated muscle covered with mucous membrane It is divided into right and left halves by a median fibrous septum.

Root- posterior 1/3 Body- anterior 2/3 Apex Dorsum Foramen cecum- midline at the point of the terminal sulcus Terminal sulcus- V-shaped sulcus that divides the anterior 2/3 from the posterior 1/3 Lingual tonsil- posterior to terminal sulcus Lingual Papilla Medial Sulcus

Lingual Papillae Circumvallate Papillae Filiform Papillae Fungiform Papillae Foliate Papillae

Circumvallate Papillae
there are only about 10 to 14 of these papillae on most people, and they are present at the back of the oral part of the tongue. They are arranged in a circular-shaped row just in front of the sulcus terminalis of the tongue. bitter taste

Filiform Papillae
these are thin, long papillae "V"-shaped cones don't contain taste buds but are the most numerous. These papillae are mechanical and not involved in gustation. They are characterized by increased keratinization

Fungiform Papillae
these are slightly mushroom-shaped if looked at in longitudinal section. These are present mostly at the apex(tip) of the tongue, as well as the sides Innervated by facial nerve Sweet and salty

Foliate Papillae
these are ridges and grooves towards the posterior part of the roof of the mouth found on lateral margins. Innervated by facial nerve(anterior papillae) Glassopharyngeal nerve(posterior papillae) Sour taste

Muscles of the Tongue

Intrinsic Muscle Extrinsic Muscle

Intrinsic Muscle
These muscle are confined to the tongue and are not attached to the bone They consist of longitudinal, transverse and vertical fibers Nerve Supply: Hypoglossal nerve Action: alter the shape of the tongue

Extrinsic Muscle
These muscles are attached to the bones and the soft palate. They are the genioglossus, hyoglossus, styloglossus and palatoglossus Nerve supply: Hypoglossal nerve

Blood Supply
The lingual artery , the tonsilar branch of the facial artery , and the ascending pharyngeal artery supply to the tongue. The veins drain into the internal jugular vein

Lymph Drainage
Tip: Submental lymph nodes Sides of the anterior two thirds: submandibular and deep cervical lymph nodes Posterior third: Deep cervical lymph nodes

Sensory Innervation
Anterior two thirds: Lingual nerve branch of mandibular division of trigeminal nerve(general sensation) and chorda tympani branch of the facial nerve(taste). Posterior third: Glossopharyngeal nerve(general sensation and taste)

Movements of the Tongue


Protrusion Retraction Depression Retraction and elevation of the posterior third Shape changes

Teeth
Deciduous teeth Permanent teeth

Deciduous teeth
Also known as baby teeth 20 teeth 4 incisors, 2 canines, 4 molars in each jaw Erupt about 6 months after birth and have all erupted by the end of 2 years

Permanent teeth
32 teeth 4 incisors, 2 canines, 4 premolars, 6 molars in each jaw Begin to erupt at 6 years of age Last tooth to erupt is 3rd molar which may happen between the ages of 17 and 30

Clinical Notes
Laceration of the Tongue -wound is often caused by the patients following a blow on the chin when the tongue is partly protruded from the mouth -Also occurs when the patient accidentally bites the tongue while eating, during recovery from an anesthetic or during epileptic shock.

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