HEAD & NECK 2
ORAL & PHARYNGEAL STRUCTURES
Pedro Amarante Andrade, PhD
LCSC06
BIOSCIENCES FOR SLT
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THIS SESSION
Oral & pharyngeal
structures
Dentition
Tongue
Taste & Sensation
Tonsillar Tissue
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ORAL & PHARYNGEAL ANATOMY
•
•
•
•
•
Cavities of the
oropharynx:
Oral
Nasal
Pharynx
Laryngopharynx
Oropharynx
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THE ORAL CAVITY
Extends from oral
opening (lips) to
“pillars of the
fauces”
at back
Teeth and alveolar
ridge or maxillae
make up lateral
margins
Wikicommons. Public Domain
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DENTITION
Housed in alveolar of maxillae and mandible
Function: Mastication
Articulatory surface for speech sounds
Upper and lower dental arches: equal numbers of teeth
1. Incisors
2. Cuspids
3. Bicuspids
4. Molars
Each has root in gingival or gum line
Crown is visible 1/3: surface of dental enamel
Heart of tooth is pulp: contains nerve supply
Blausen gallery.
Bruce Blaus.
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DENTITION
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DENTITION
Thesedomain
bones by
of mine.
Public
author.
https://thesebonesofmine.wordpress.com/category/teethWikicommons.
development/
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DENTITION ZSIGMOND SYSTEM
Upper right quadrant
87654321
EDCBA
(primary dentition,
deciduous, milk teeth)
Upper left quadrant
12345678
ABCDE
Lower right
quadrant
EDCBA
87654321
Lower
left quadrant
ABCDE
12345678
Teeth model front by Xauxa. Modified by Partynia.
Wikicommons.
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DENTITION
Types of occlusion:
A+B : Class I Normal
occlusion
(upper teeth slightly in front of
lower teeth)
C+D: Class II Malocclusion
(upper teeth too far in front of
lower teeth)
E+F: Class III Malocclusion
(upper teeth behind lower teeth)
From pocket dentistry
http://pocketdentistry.com/26-mastication/
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DENTITION
DECIDUOUS/ PERMANENT
For development of decidious & permanent
dentition, see Atkinson & McHanwell (2002)
Basic Medical Science for SLT students.
London:Whurr (p308)
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THE HARD PALATE
• Palatine Rugae
• Median raphe
(groove, ridge)
• Soft palate
Anatomy of the Human Body. Gray’s Anatomy
Author: Henry Vandyke Carter
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THE HARD PALATE
• Palatine Rugae
• Median raphe
(groove, ridge)
• Soft palate
Anatomy of the Human Body. Gray’s Anatomy
Author: Henry Vandyke Carter
Easy Notecards.http://www.easynotecards.com/notecard_set/38466
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MUSCLES
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SOFT PALATE
Soft Palate
(Velum)
•Uvula
Pillars of the
fauces
•Anterior
•Posterior
Wikicommons. Public Domain
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MUSCLES OF THE VELUM
MUSCLE
FUNCTION
Levator veli palatine
Musculus uvulae
Tensor veli palatine
Palatoglossus
Palatopharyngeus
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MUSCLES OF THE VELUM
Levator veli palatine
Wikicommons.
Public Domain
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MUSCLES OF THE VELUM
Levator veli palatine
Musculus uvulae
Tensor veli palatine
Palatoglossus
Palatopharyngeus
Wikicommons.
Public Domain
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THE TONGUE
Occupies floor of
mouth
Functions
include:
• Articulation
• Mastication
• Deglutition
• Etc…
Wikicommons. Public Domain
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THE TONGUE
Median fibrous septum
TIP or APEX
Base of tongue
Dorsum
Terminal sulcus
Lingual papillae
Lingual tonsils
Inferior surface
• Sublingual frenulum
• Sublingual fold
StudyBlue.
Diagram Resources. http://diagramreview.com/humanhttps://classconnection.s3.amazonaws.com/158/flashcards
tongue-diagram/
/2026158/png/lingualfrenulum1351008092072.png
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THE TONGUE TASTE
AND SENSATION
Taste:
1. Bitter
2. Sour
3. Salt
4. Sweet
Wikicommons. Messer Woland
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THE TONGUE TASTE
AND SENSATION
Anatomy & Physiology. OpenStax College
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THE TONGUE - MUSCLES AND MOVEMENT
INTRINSIC muscles of the tongue
MUSCLE
LOCATION
ACTION
CN
Superior
longitudinal
Near epiglottis-sides of
tongue
Widens, thickens and
shortens tongue tip and
edges
Xii
Inferior
longitudinal
Hyoid bone/base of
tongue-apex of tongue
Widens, shortens, creates
convex dorsum,
depresses tip
Xii
Transverse
Tongue septum-mucosa
at sides of tongue
Elongates, narrows,
thickens, lifts sides
Xii
Vertical
Superior surface-inferior
surface
Widens and flattens
tongue tip
Xii
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INTRINSIC TONGUE MUSCLES
Voice & Speech source.
http://www.yorku.ca/earmstro/journey/tongue
.html
StudyBlue.
https://classconnection.s3.amazonaws.com/844/flashcards/2475844/png/verticalmuscle1355942078479.png
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THE TONGUE - MUSCLES AND MOVEMENT
EXTRINSIC muscles of the tongue
Muscle
Location
Action
CN
Genioglossus
Anterior
Posterior
Mandible-dorsum +
hyoid
Ant. Contraction =
retraction.
Post. Contraction =
protrusion
Xii
hypoglossal
Hyoglossus
Tongue-hyoid
Depresses and retracts
tongue
Xii
Palatoglossus
Soft palate-tongue
Contraction = elevation
of back of tongue
Xi accessory
Styloglossus
Temporal bone-sides
of tongue
Contraction = upwards
and backwards
movement
Xii
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THE TONGUE
Anatomy & Physiology. OpenStax College
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EXTRINSIC TONGUE MUSCLES
Intelligent Dental. http://www.intelligentdental.com/2012/01/16/muscles-ofthe-tongue/
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EXTRINSIC TONGUE MUSCLES
Voice & Speech source.
http://www.yorku.ca/earmstro/journey/tongue.html
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CLINICAL ORAL ASSESSMENT
Remember to wash your hands
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PALPATION OF ORAL CAVITY
In pairs
Open wide
Torch in non dominant hand:
• identify faucial pillars
and soft palate
• Say ‘aaah’ observe soft
palate movement:
symmetrical?
• Look for palatine tonsils
between faucial pillars
Wikicommons. Public Domain
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DENTAL ASSESSMENT
Identify:
• Incisors
• Cuspids
• Bicuspids
• Molars
Bite lightly on molars and
hold lips (not teeth) open for an /i/ vowel
Use gloved finger to palpate lateral margins of the teeth and
gums
Use tongue depressor to move cheek away from teeth and
examine for occlusion
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THE HARD PALATE
Observe and palpate:
Run fingers gently back
along hard palate
RUGAE: prominent lateral
ridges
MEDIAN RAPHAE: divides
hard palate into equal
halves
Palpate margin between
hard and soft palate
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THERAPY
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THERAPY
Lip
stimulator
Ora-Light.
http://www.chewytubes.com/oralight/oralighttools.php
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THERAPY
Tongue tip
stimulator
Ora-Light.
http://www.chewytubes.com/oralight/oralighttools.php
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THERAPY
Strengthen
tongue tip
Ora-Light.
http://www.chewytubes.com/oralight/oralighttools.php
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THERAPY
Strengthen
the back of
Tongue
Ora-Light.
http://www.chewytubes.com/oralight/oralighttools.php
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SALIVATION
Salivary glands
• Parotid
• Submandibular
• Sublingual
Saliva: two types of saliva
• SEROUS : thin and watery
• MUCOIDAL: more
viscous/sticky
Function of saliva:
• DIGESTIVE
• DISINFECTANT
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SALIVATION
Gland/
Location
Duct location
CN
25
Inside of the check
next to the upper
molar teeth
IX
(glossopharyn
geal nerve)
Submandibular
60
Underneath the front
of the tongue, either
ide of frenulum
(Wharton’s duct)
VII
(facial nerve)
Sublingual
15
Under tongue
VII
(facial nerve)
Parotid
(Largest –
below the ear)
Saliva
[%]
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TONSILS
• Pharyngeal
tonsils
(adenoids)
• Palatine tonsils
• Lingual tonsils
Blausen.com. Bruce Blaus
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TONSILS
Function:
Part of limbic system/immune response
• Believed to be involved in helping fight pharyngeal and
Upper Respiratory Tract infection
NAME
LOCATION
Adenoids: pharyngeal tonsils
Roof of pharynx
Sides of pharynx between
faucial arches
Behind terminal sulcus
(tongue)
Palatine tonsils
Lingual tonsils
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NASAL
CAVITIES
• Nasal septum
• Turbinates
• Nares
• Paranasal
air sinuses
Dr. Shervin Aminpour. http://laents.com/treatments-andservices/nasal-congestion/balloon-sinuplasty/
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SURFACE ANATOMY
Air-filled spaces,
communicating
with nasal cavity
within the bones of
the skull and face
Function: debated
• Decrease skull
weight
• Increased vocal
resonance
• Protection
• Insulation
Paranasal sinuses
Anatomy & Physiology, Connexions Web site. OpenStax College
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Location:
Narrow passage
leading from
the pharynx to
the cavity of
the middle ear
EUSTACHIAN TUBE
Function:
Equalization of
pressure on
each side of the
eardrum
Taken from WebMD. http://www.webmd.com/a-to-z-guides/eustachian-tubes
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THE PHARYNX
Divided into areas:
1. Oropharynx
2. Nasopharynx
3. Laryngopharynx
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MARK THE STRUCTURES THAT DIVIDE THE
VOCAL TRACT INTO *ynx
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PHARYNGEAL MUSCLES
• Superior pharyngeal
constrictor
• Middle pharyngeal
constrictor
• Inferior pharyngeal
constrictors
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PHARYNGEAL MUSCULATURE
MUSCLE
FUNCTION
INNERVATION
Superior pharyngeal
constrictor
Velopharyngeal closure
Reduces diameter
CN XI & X
Middle pharyngeal constrictor
Reduces diameter
CN XI & X
Inferior pharyngeal constrictor
Reduces diameter:
Two parts:
CN XI & X
1. Cricopharyngeal muscle
*arises from cricoid
Muscular orifice of oesophagus
2. Thyropharyngeal muscle
*arises from thyroid
Salpingopharyngeus
Elevates lateral pharyngeal wall
CN XI & X
Stylopharyngeus
Elevates pharynx
CN IX
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PHARYNGEAL MUSCLES
Salpingopharyngeus & Palatopharyngeus m.
Taken from studyblue.
https://classconnection.s3.amazonaws.com/289/flashcards/3320289/png/p1456C4651BD62A18020.png
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THE EPIGLOTTIS
• Leaf-shaped
cartilage
• Attached to root
of tongue
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THE EPIGLOTTIS
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THE EPIGLOTTIS
Epiglottis in action
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