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Oral cavity and pharynx

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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

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