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Oral cavity and pharynx. Face = Facies labia oris (sup.+inf.) –frenulum angulus oris philtrum sulcus –mentolabialis –nasolabialis bucca = cheek –m. buccinator.

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Presentation on theme: "Oral cavity and pharynx. Face = Facies labia oris (sup.+inf.) –frenulum angulus oris philtrum sulcus –mentolabialis –nasolabialis bucca = cheek –m. buccinator."— Presentation transcript:

1 Oral cavity and pharynx

2 Face = Facies labia oris (sup.+inf.) –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 tunica mucosa tela submucosa tunica muscularis tunica serosa / tunica adventitia General structure of digestive tube

5 Tunica mucosa mucosa epithelium lamina propria mucosae connective tissue blood vessels, lymphatics, macrophages and lymphocytes, sometimes glands lamina muscularis mucosae smooth muscles movements of mucosa – better contact with food

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

7 Tunica muscularis smooth muscle cells 2 sublayers muscularis 1) internal - circular 2) external - longitudinal circular longitudinal 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 Cajal cells - pacemaker

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 serosa / adventitia tunica serosa 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 connective tissue on organs outside the abdominal cavity and on retroperitoneal organs

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

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14 Cheek (bucca) 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 https://web.duke.edu/anatomy/Lab17/Lab17.html

15 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 Oral cavity (Cavitas oris)

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 fungiformes papillae filiformes papillae foliatae papillae vallatae

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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

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

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29 lymph drainage 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 !

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33 Glandulae oris 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)

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)

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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

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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

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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

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53 End Identification of dead

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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

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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 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) Peridontium

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 –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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