1. Oral cavity and pharynx

2. Face = Facies labia oris (sup.+inf.) angulus oris philtrum sulcus
frenulum
angulus oris
philtrum
sulcus
mentolabialis
nasolabialis
bucca = cheek
m. buccinator
corpus adiposum buccae Bichati = buccal pat pad
extensions

3. General structure of digestive tube
tunica mucosa (mucosa; mucous membrane)
epithelium
lamina propria mucosae
lamina muscularis mucosae
tela submucosa (submucosa)
tunica muscularis (muscular layer)
tunica serosa (serosa) x tunica adventitia (adventitia)

4. General structure of digestive tube
tunica serosa /
tunica adventitia
tunica muscularis
tela submucosa
The digestive tract is actually a tube with a lumen and a wall. The wall is made up of four layers. These are: the mucous membrane, submucosa, muscularis and serosa. The mucous membrane consists of 3 layers: an epithelial lining, lamina propria and lamina muscularis mucosae. Lamina propria is a connective tissue which comprises blood vessels, lymphatics Lamina muscularis mu
tunica mucosa 4

5. Tunica mucosa epithelium lamina propria mucosae lamina muscularis
connective tissue
blood vessels, lymphatics,
macrophages and lymphocytes,
sometimes glands
mucosa
What do you expect to be in connective tissue in terms of proportion between cells and extracellular material?
What do you think the lymphocytes are here for? They produce IgA, the epithelial lining cells produce a protein, they are bound together and secreted into the lumen
What is between the epithelial lining and lamina propria? Basal lamina
Can we see basal lamina? It´s visible only with the electron microscope
What does basal lamina contain? Name one protein, one glycoprotein and one proteoglycan: collagen IV (protein), laminin (glycoprotein), heparan sulfate (proteoglycan).
smooth muscles
movements of mucosa – better
contact with food 5

6. Tela submucosa connective tissue blood and lymph vessels,
glands, lymphoid
tissue
submucosa
submucous plexus
(of Meissner) of
autonomic nerves
function: secretion
submucous plexus 6

7. Tunica muscularis
smooth muscle cells
2 sublayers
longitudinal
Cajal cells
- pacemaker
circular
1) internal - circular
2) external - longitudinal
muscularis
myenteric plexus –
(of Auerbach)
contraction of
muscular layer
Enteric nervous system – part of autonomic nervous system
plexus submucosus et myentericus
aggregates of nerve cells that form parasympathetic ganglia (contains autonomic neurons)
origin from neural crest 7

8. Enteric nervous system
Hirschsprung disease (megacolon congetinum, aganglionosis intestinalis)
cells from neural crest do not migrate properly
Chagas disease (American trypanosomiasis)
parasite (Trypanosoma cruzi)
trasmitted by "kissing bugs“
injures nervous plexuses
dilations (mega-oesophagus, megacolon)

9. Tunica serosa / Tunica adventitia
simple squamous
mesothel
+ tela subserosa
connective tissue
rich in vessels and adipose tissue
continuous with mesenterium and peritoneum
only on organs which are inside the abdominal cavity (= intraperitoneal organs)
tunica adventitia
on organs outside the abdominal cavity and on retroperitoneal organs
serosa /
adventitia
What does is mean simple squamous epithelium? How many layers are there? Is the cell high or low? 9

10. Oral cavity (Cavitas oris)
oral vestibule (vestibulum oris)
oral cavity proper (cavitas oris propria)
hard palate (palatum durum)
soft palate (palatum molle)
gum (gingiva)
tongue (lingua)
teeth (dentes)
salivary glands (glandulae salivariae)

11. Oral cavity (Cavitas oris)
lips – transition to keratinizing epithelium
pars cutanea
pars intermedia (vermilion part) – glandulae sebaceae
pars mucosa – glandulae labiales
m. orbicularis oris (n. VII
stratified sqamous non-keratinizing epithelium (epithelium stratificatum squamosum non cornificatum / paracornificatum)
lamina propria mucosae underlied with submucosa containing small salivary or mucinous gland (soft palate)

12. Stratified sqamous epithelium
keratinizing – skin, hard palate, gum
non-keratinizing – rest of oral cavity, pharynx, oesophagus

14. Cheek (bucca) m. buccinator (n. VII) covered by fascia buccopharyngea
m. buccinator (n. VII) covered by fascia buccopharyngea
corpus adiposum buccae (buccal fat pad of Bichat) – reaches under ramus mandibulae into the fossa infratemporalis
glandulae buccales
ductus parotideus
papilla parotidea in vestibulum oris
at the level of the 2nd upper molar 14 14

15. Oral cavity (Cavitas oris)
rima oris (oral fissure)  isthmus faucium (isthmus of fauces)
borders:
ventrally and externally: lips (labia oris) and cheeks (buccae)
roof: palate (palatum)
floor: m. mylohyoideus and m. geniohyoideus
vestibulum oris (oral vestibule)
fornix vestibuli sup. + inf.
frenulum labii sup. + inf.
papilla parotidea 15

16. Tongue (Lingua, Gr. glossa)
apex
corpus (body)
dorsum
facies inferior
radix (root)
margo (margin)
sulcus (groove)
terminalis
medianus (midline)
foramen caecum
tonsilla lingualis

17. Development of tongue - overview
1st pharyngeal arch → tuberculum impar + tubercula lateralia
2nd pharyngeal arch → overgrown by 1st
3rd pharyngeal arch → cupola
4th pharyngeal arch → eminetia hypopharyngea
occipital somites → muscles

18. Tongue – structure dorsum – papillae radix – tonsilla lingualis
facies inferior linguae
frenulum
plica sublingualis
openings of ductus sublinguales minores
caruncula sublingualis (sublingual caruncle)
opening of ductus sublingualis major et dutcus submandibularis
plica fimbriata (remnant of mucous „sublingua“)

19. Tongue - structure lamina propria mucosae tvoří vysoké papily
papillae filiformes
papillae fungiformes
sparse gustatory buds
papillae foliatae - rudimentary
papillae vallatae - 12 shaped as letter „V“
glandulae gustatoriae (= Ebner´s serous glands)
gustatory buds
tunica submucosa is missing at dorsum!
stratified muscle in 3 planes

20. Papillae of tongue (Papillae linguales)

21. papillae vallatae papillae foliatae
papillae filiformes
papillae fungiformes 21

23. Taste buds (Gemmae gustatoriae)
in all papillae (except for papillae filiformes)
most of them within papillae vallatae
papilla vallata
vallum papillae
sulcus papillae
serous salivary glands (of von Ebner) glandulae gustatoriae
wash food particles away 23

24. Tongue – muscles aponeurosis, septum (incomplete)
intraglossal – n. hypoglossus
m. longitudinalis sup. et inf.
m. transversus
m. verticalis

25. Extraglossal muscle of tongue
innervation – n. hypoglossus
m. genioglossus
m. hyoglossus
m. styloglossus
m. palatoglossus
! exception ! – n. vagus

26. Extraglossal muscle of tongue

27. Tongue – vessels and nerves
arteries: a. carotis ext. → a. lingualis
veins: v. lingualis, v. comitans n. XII. → v. jugularis int.
nerves:
motor n.XII, n.X (m. palatoglossus)
sensory n.V3. (n. lingualis), n.IX, n.X
gustatory VII. (chorda tympani), n.IX, n.X

29. Tongue – lymph drainage
nodi lymphoidei cervicales profundi
tip  n.l. submentales
margins  n.l. submandibulares
corpus, dorsum  n.l. cervicales profundi
n.l. jugulo-digastricus + jugulo-omohyoideus
! contralateral connections !

33. Salivary glands (Glandulae oris)
major salivary glands (glandulae salivariae majores)
gl. parotidea
gl. sublingualis
gl. submandibularis
minor salivary glands (glandulae salivariae minores)
gll. labiales, buccales, molares, palatinae
gll. linguales anteriores (Blandini-Nuhni)
gll. lingulaes posteriores
pars profunda = gl. gustatoria (von Ebneri)
pars superficialis = gl. radicis linguae (Weberi)

34. Throat (Fauces) hrad palate (palatum durum)
soft palate (palatum molle)
aponeurosis (formed by fuesd tendons of tensor veli palatini)
uvula (seals nasopharynx in swallowing)
arcus palatoglossus
arcus palatopharyngeus = isthmus faucium
palatine tonsil (tonsilla palatina)
Throat (Fauces)

35. Isthmus faucium
arcus palatoglossus (palatoglossal arch; anterior pillar of fauces)
fossa (sinus) tonsillaris
tonsilla palatina
capsula
fossula
cryptae
fossa supratonsillaris
arcus palatopharyngeus palatopharyngeal arch (posteiror pillar of fauces)

36. Muscles of soft palate innervation: plexus pharyngeus = n. vagus (n.X)
m. levator veli palatini
m. uvulae
m. palatoglossus
m. palatopharyngeus
m. tensor veli palatini – ! exception ! n.V3 (mandibularis)

38. Hltan – pars nasalis = nasopharynx; epipharynx fornix
fascia pharyngobasilaris
sinus Morgagni
recessus pharyngeus Luschkae (remnant after notochord)
pharyngeal tonsil (tonsilla pharyngealis Luschkae)
tuba auditiva Eustachii
torus tubarius
tonsilla tubaria Gerlachi
recessus pharyngeus Rosenmülleri
pseudostatified columnar epithelium with kinocilia

39. Hltan (Pharynx)

40. Hltan – other parts pars oralis (oropharynx; mezopharynx)
valleculae epiglotticae
plica glossoepiglottica mediana + laterales
pars laryngea (laryngopharynx; hypopharynx)
recessus piriformis
aditus laryngis
both lined with stratified nonkeratinizing squamous epithelium

41. Pharynx – surrounding spaces
fascia cervicalis
spatium parapharyngeum (lateropharyngeum)
spatium prestyloideum
septum styloideum (aponeusoris stylopharyngea)
5 muscles and ligament
m. stylopharyngeus + m. styloglossus + m. stylohyoideus + lig. stylohyoideum + venter posterior m. digastrici + m. sternocleidomastoideus
spatium retrostyloideum
spatium retropharyngeum

43. Muscles of pharynx raphe pharyngis fascia pharyngobasilaris
sinus Morgagni
3 constrictors
3 levators
innervation: plexus pharyngeus (n.X)
except m. stylopharyngeus (n.IX)

44. Muscles of pharynx constrictors (mm. constrictores)
m.c. superior – 4 parts – origin at skull (3) and tongue (1)
m.c. medius – 2 parts – origin at hyoid bone
m.c. inferior – 2 parts – origin at laryngeal cartilages
levators (mm. levatores)
m. palatopharygeus
part of soft palate muscles, base of palatopharyngeal arch
m. salpingopharyngeus
m. stylopharyngeus
! exception ! – innervated by n.IX

46. Pharynx – blood supply arteries: a. carotis externa →
a. pharyngea ascendens
a. facialis → a. palatina ascendens
a. lingualis → rr. dorsales linguae
a. maxillaris → a. palatina major, a. canalis pterygoidei, r. pharyngeus
veins: plexus (venosus) pharyngeus → v. facialis → v. jugularis interna

47. Pharynx – lymph and nerves
lymph: n.l. retropharyngei, n.l. paratracheales → n.l. cervicales profundi
nerves: form plexus pharyngeus
motor n.X (plexus pharyngeus), n.IX (m. stylopharyngeus)
sensory n.X + n.IX (plexus pharyngeus), n.V2 (n. pharyngeus for nasopharynx)
autonomic (plexus pharyngeus)
n.X = parasympathetic
rr. laryngopharyngei = sympathetic

48. Anulus lymphoideus pharyngis Waldeyeri
tonsilla lingualis
crypta, noduli
one smaller crypt
tonsilla palatina
fossulae, cryptae, capsula
thick capsule
tonsilla pharyngealis = adenoid vegetation
fossulae, cryptae, noduli
no crypts, thin capsule
tonsilla tubaria Gerlachi
cryptae

49. Sites with weakened wall
trigonum Killiani
cranially: m. thyropharyngeus (m. constrictor ph. inf.)
caudally: m. cricopharyngeus (m. constrictor ph. inf.)
diverticulum of Zenker (= pharyngo-oesophageal diverticle; dehiscence of Killian)
trigonum Laimeri
cranially: m. cricopharyngeus
caudally: upper oblique fibres of longitudinal muscle layer of oesophagues
(area Killian-Jamieson)
at lateral side of oesophagus
diverticulum of Killian-Jamieson

53. End 
Identification of dead

55. TEETH dens, dentis odus, odonotos

56. Dentes = Teeth arcus dentalis superior (elipsoid) inferior (parabolic)
dentes permanentes - 32
dentes decidui - 20
dens incisivus (= cutter, incisive/incisor tooth) 8/8
caninus (= eyetooth, cuspid) 4/4
premolaris (= premolar, bicuspid tooth) 8/0
molaris (= molar, grinder, cheetooth) 12/8

58. Teeth – parts
corona
cervix
radix
pulpa

59. Surfaces and directions
occlusalis
vestibularis (buccalis/labialis)
lingualis (upper teeth)
palatinalis (lower teeth)
mesialis
distalis

60. Teeth – fixation gomphosis = dentoalveolar juncture
situated in the bonyalveolus dentalis of jaw
periodontium
parodontium = all structures around tooth

61. Peridontium
ligaments between tooth and alveolus (fixed firmly into bone)
collagen fibres (serve as bone periosteum)
fixation systém of tooth = fibres of various directions
they penetrate into cement
high connective tissue regeneration, plasticity – orthodontia
atrophy in lack of proteins and vitamine C  scurvy (= scorbute)
Vit. C - kofaktor prolin hydroxylázy (hydroxyprolin je specifický pro kolagen)

62. Macroscopy and fication of tooth

63. Dentition as a whole mordex = dentition
orthodent position (teeth are vretically)
occlusion
80% psalidodontia („scissors occlusion“) = norm
progenia = lower teeth in front of upper ones
hiatodontia (= mordex apertus), stegodontia, prognathia, opisthodontia

64. Dental formula cross with letters cross with numbers numerical
lower case = deciduous
UPPER CASE = permament
cross with numbers
numerical
1-4 quadrants (from right upper one clock-wise) = PERMANENT
5-8 (idem) = deciduous

65. Dental formula

66. Teeth - structure dentine = dentinum (substantia eburnea)
enamel = enamelum (substantia adamantina)
cement = cementum (substantia ossea)
pulp = pulpa
loose connective tissue, vessels, nerves