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Dr. Mohamed Ahmad Taha Mousa

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1 Dr. Mohamed Ahmad Taha Mousa
Assistant Professor of Anatomy and Embryology

2 Objectives a. Identify different components of the oral cavity
b. Describe the relationships of salivary glands to its surrounding structures

3 Mouth Lips: They are two folds surrounding the oral orifice.
- It is formed by orbicularis oris muscle covered by mucous membrane. Mouth cavity: It extends from the lips to the pharynx. - It is divided into the vestibule and the mouth cavity proper. A. Vestibule: It lies between: - Lips and cheeks  Externally. - Gums and teeth  Internally. - The cheek is made up by the buccinator muscle and is lined with mucous membrane. - The duct of the parotid gland: It opens into the vestibule of the mouth opposite the upper nd molar tooth.

4 B. Mouth cavity proper: It has roof and floor.
- Roof of mouth: It is formed by the hard palate in front and the soft palate behind - Floor of mouth: It is formed by the anterior 2/3 of the tongue. - The duct of the submandibular gland opens onto the floor of the mouth on either side of frenulum of the tongue. - The sublingual gland projects up into the floor of the mouth producing the sublingual fold. - Numerous ducts of the gland open on the summit of the fold. Sensory innervations of the mouth: Roof: Greater palatine and nasopalatine nerves from maxillary division of the trigeminal nerve.

5 Floor: A- General sensation by lingual nerve (branch from mandibular division of the trigeminal N). B- Taste sensation by the chorda tympani nerve (branch from the facial N). Cheek: Buccal nerve (branch from mandibular division of the trigeminal nerve). Teeth: Deciduous teeth: There are 20 deciduous teeth. Permanent teeth: There are 32 permanent teeth. Tongue: It is a mass of striated muscle covered by mucous membrane. Mucous membrane of the tongue: It is divided by a V-shaped sulcus (sulcus terminalis) into anterior 2/3 (oral part containing papillae) and posterior 1/3 (pharyngeal part containing lingual tonsils). - The apex of the V shaped is the foramen cecum

6 Muscles of the tongue: It divided into two types
A- Intrinsic muscles: They consists of longitudinal, transverse and vertical fibers. B- Extrinsic muscles: It includes genioglossus, hyoglossus, styloglossus and palatoglossus. - Nerve supply: All of intrinsic and extrinsic muscles are supplied by hypoglossal nerve except palatoglossus muscle is supplied by pharyngeal plexus. Blood supply: - Lingual artery, facial artery, and ascending pharyngeal artery. - The veins drain into the internal jugular vein. Lymph drainage: Submental, Submandibular and deep cervical lymph nodes Sensory innervations: - Anterior 2/3: General sensation by lingual nerve - Taste sensation by chorda tympani nerve. - Posterior 1/3: Glossopharyngeal nerve (general and taste sensation).

7 The Palate - It forms the roof of the mouth and the floor of the nasal cavity. - It is divided into two parts: A. Hard palate: It is formed by: - Palatine processes of the maxillae. - Horizontal plates of the palatine bones. B. Soft palate: It is a mobile fold attached to the posterior border of the hard palate. - Its free posterior border presents in the midline a conical projection called the uvula. - It is composed of muscles, palatine aponeurosis and covered by mucous membrane. Mucous membrane: It covers the upper and lower surfaces of the soft palate. Palatine aponeurosis: It is a fibrous sheet attached to the posterior border of the hard palate.

8 Muscles of the soft palate: It includes tensor veli palatini, levator veli palatini, palatoglossus, palatopharyngeus and musculus uvulae. Nerve supply of the palate: Sensory: - Greater, lesser palatine and nasopalatine nerves (from the maxillary division of the trigeminal nerve). - Glossopharyngeal nerve also supplies the soft palate. Motor: - All muscles are supplied by cranial part of the accessory nerve via the pharyngeal plexus except tensor veli palatini supplied by mandibular nerve. Blood supply of the palate: - Greater palatine branch of the maxillary artery. - Ascending palatine branch of the facial artery. - Ascending pharyngeal artery Lymph drainage: Deep cervical lymph nodes.

9 Parotid gland Definition: It is the largest salivary gland and it is composed mostly of serous acini. Site: It lies in a deep hollow below the external auditory meatus, behind the ramus of the mandible and in front of sternocleidomastoid muscle. Parts of the glands: The facial nerve divides the gland into superficial and deep lobes. Parotid duct: - It emerges from the anterior border of the gland and passes over the lateral surface of masseter. - It opens in the vestibule of the mouth opposite the upper 2nd molar tooth.

10 Relation of parotid gland: It is pyramidal form.
- The concave superior surface (base): It is related to external auditory meatus, temporomandibular joint and auriculotemporal nerve. - Apex: It overlaps the posterior belly of digastric - Superficial surface: It is covered by skin and superficial fascia containing great auricular nerve and superficial parotid lymph nodes). - Anteromedial surface: It is related to masseter muscle, posterior border of the ramus of the mandible and medial pterygoid muscle. - Posteromedial surface: It is related to: Mastoid process, sternocleidomastoid and posterior belly of the digastric. - Styloid process and its associated muscles. - Carotid sheath containing (internal carotid artery, vagus nerve and internal jugular vein) and it is separated from the gland by the styloid process.

11 Structures within the parotid gland:
1. External carotid artery: It is the deepest structures in the gland and it divides into maxillary and superficial temporal artery. 2. Retromandibular vein: It is formed by union of the maxillary and superficial temporal veins. - It is superficial to the external carotid artery. 3. Facial nerve: It is the most superficial. Nerve supply:- Parasympathetic secretomotor supply from the glossopharyngeal nerve  tympanic branch  lesser petrosal nerve  relay in otic ganglion  auriculotemporal nerve - Sensory supply: By auriculotemporal nerve. Blood supply: It is supplied by the external carotid artery. - Veins drain into the external jugular vein.

12 Submandibular salivary gland
Structure: It is consists of a mixture of serous and mucous acini. Site: - It is situated in the digastric triangle. Relation : -Inferior surface: It is covered by skin, superficial fascia containing (platysma, facial vein and cervical branch of the facial nerve) and deep fascia. - Lateral surface: It is related to submandibular fossa on the body of the mandible. - Facial artery grooves its posterosuperior part then it lies between the lateral surface of the gland and mandible. - Medial surface: It is related to: - Mylohyoid muscle, mylohyoid nerve and vessels - Hyoglossus, lingual nerve, submandibular ganglion and hypoglossal nerve. - Styloglossus, stylohyoid ligament and glossopharyngeal nerve.

13 Submandibular duct: It emerges from the anterior end of the deep part of the gland then it opens into the mouth at both sides of the frenulum of the tongue. Arterial supply: It is supplied by facial and lingual arteries. Lymphatic drainage: It drain into the deep cervical lymph nodes Nerve supply: - Parasympathetic secretomotor supply is from the facial nerve via the chorda tympani and the submandibular ganglion. The postganglionic fibers pass directly to the gland - General sensation by lingual nerve.

14 Sublingual gland Structure: It has both serous and mucous acini, with the latter predominating. Site: It lies under the mucous membrane (sublingual fold) of the floor of the mouth, close to the frenulum of the tongue. Sublingual ducts (8 to 20 in number): It opens into the mouth on the summit of the sublingual fold. Arterial supply: It is supplied by facial and lingual arteries. Nerve supply: - Parasympathetic secretomotor supply is from the facial nerve via the chorda tympani  relay in the submandibular ganglion  Postganglionic fibers pass directly to the gland.

15 Thank you


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