Oral cavity and
pharynx
Face = Face = FaciesFacies• labia oris (sup.+inf.)
– frenulum
• angulus oris• philtrum• sulcus
– mentolabialis– nasolabialis
• bucca = cheek– m. buccinator– corpus adiposum
buccae Bichati = buccal pat pad
• extensions
General structure of digestive tubeGeneral 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)
tunica mucosa
tela submucosa
tunica muscularis
tunica serosa / tunica adventitia
General structure of digestive tubeGeneral structure of digestive tube
Tunica mucosaTunica mucosa
mucosa
epithelium
lamina propria mucosae
connective tissueblood vessels, lymphatics, macrophages and lymphocytes,sometimes glands
lamina muscularismucosae
smooth musclesmovements of mucosa – bettercontact with food
Tela submucosaTela submucosa
submucosasubmucous plexus(of Meissner) ofautonomic nervesfunction: secretion
submucous plexus
connective tissueblood and lymph vessels,glands, lymphoidtissue
Tunica muscularisTunica muscularissmooth muscle cells2 sublayers
muscularis
1) internal - circular
2) external - longitudinal
circular
longitudinal
myenteric plexus – (of Auerbach)contraction ofmuscular layer
Enteric nervous systemEnteric nervous system – part of autonomic 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
Enteric nervous systemEnteric 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)
Tunica serosa / Tunica adventitiaTunica serosa / Tunica adventitiaserosa /
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
Oral cavity (Cavitas oris)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)
Oral cavity (Oral cavity (Cavitas orisCavitas 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)
SStratified sqamous epitheliumtratified sqamous epithelium
• keratinizing – skin, hard palate, gum
• non-keratinizing – rest of oral cavity, pharynx, oesophagus
Cheek (Cheek (buccabucca))
• 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
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• 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 (Oral cavity (Cavitas orisCavitas oris))
Tongue (Tongue (LinguaLingua, , Gr. glossa)Gr. glossa)• apex• corpus (body)
– dorsum– facies inferior
• radix (root)• margo (margin)• sulcus (groove)
– terminalis– medianus (midline)
• foramen caecum• tonsilla lingualis
Development of tongue - overviewDevelopment 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
Tongue – Tongue – structurestructure
• 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“)
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
Papillae of tongue (Papillae of tongue (Papillae lingualesPapillae linguales))
papillae fungiformes
papillae filiformes
papillae foliatae
papillae vallatae
Taste buds (Gemmae gustatoriae)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
Tongue Tongue – – musclesmuscles
• aponeurosis, septum (incomplete)
• intraglossal – n. hypoglossus– m. longitudinalis sup. et inf.– m. transversus– m. verticalis
Extraglossal muscle of tongueExtraglossal muscle of tongue
innervation – n. hypoglossus
• m. genioglossus
• m. hyoglossus
• m. styloglossus
• m. palatoglossus
! exception ! – n. vagus
Extraglossal muscle of tongueExtraglossal muscle of tongue
Tongue – vessels and nervesTongue – 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
Tongue – lymph drainagelymph 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 !
Salivary glands (Glandulae orisGlandulae 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)
Throat Throat ((FaucesFauces))
• 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)
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)
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)
Hltan – pars nasalisHltan – 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
Hltan (Hltan (PharynxPharynx))
Hltan – other partsHltan – 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
Pharynx – surrounding spacesPharynx – 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
Muscles of pharynxMuscles of pharynx• raphe pharyngis• fascia
pharyngobasilaris• sinus Morgagni• 3 constrictors• 3 levators• innervation: plexus
pharyngeus (n.X)– except m.
stylopharyngeus (n.IX)
Muscles of pharynxMuscles 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
Pharynx – blood supplyPharynx – 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
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
Anulus lymphoideus pharyngisAnulus lymphoideus pharyngis Waldeyeri 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
Sites with weakened wallSites 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
End
Identification of dead
TEETHdens, dentis
odus, odonotos
Dentes = Teeth
• arcus dentalis superior (elipsoid)• inferior (parabolic)
• dentes permanentes - 32• dentes decidui - 20dens incisivus (= cutter, incisive/incisor tooth) 8/8
caninus (= eyetooth, cuspid) 4/4
premolaris (= premolar, bicuspid tooth) 8/0
molaris (= molar, grinder, cheetooth) 12/8
Teeth – parts
• corona
• cervix
• radix
• pulpa
Surfaces and directions
• occlusalis
• vestibularis (buccalis/labialis)
• lingualis (upper teeth)
palatinalis (lower teeth)
• mesialis
• distalis
Teeth – fixation
• gomphosis = dentoalveolar juncture
• situated in the bonyalveolus dentalis of jaw
• periodontium
parodontium = all structures around tooth
• 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
Macroscopy and fication of tooth
Dentition as a wholemordex = 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
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
Dental formula
Teeth - structure
• dentine = dentinum (substantia eburnea)
• enamel = enamelum (substantia adamantina)
• cement = cementum (substantia ossea)
• pulp = pulpa– loose connective tissue, vessels,
nerves