ORAL & PHARYNGEAL STRUCTURES

Transcription

1 ORAL & PHARYNGEAL STRUCTURES Pedro Amarante Andrade, PhD LCSC06 BIOSCIENCES FOR SPEECH AND LANGUAGE THERAPY 09/10/2017 1

2 Oral & pharyngeal structures Dentition THIS SESSION Tongue Taste & Sensation Tonsillar Tissue 09/10/2017 2

3 ORAL & PHARYNGEAL ANATOMY Cavities of the oropharynx: Oral Nasal Pharynx Laryngopharynx Oropharynx 09/10/2017 3

4 THE ORAL CAVITY Extends from oral opening (lips) to pillars of fauces at back Teeth and alveolar ridge or maxillae make up lateral margins Wikicommons. Public Domain 09/10/2017 4

5 DENTITION Housed in alveolar of maxillae and mandible Function: Mastication Articulatory surface for speech sounds Upper and lower dental arches: equal numbers of teeth 1. Incisors 2. Cuspids 3. Bicuspids 4. Molars Each has root in gingival or gum line Crown is visible 1/3: surface of dental enamel Heart of tooth is pulp: contains nerve supply Blausen gallery. Bruce Blaus. 09/10/2017 5

6 DENTITION ZSIGMOND DENTITION SYSTEM Public These domain bones by of mine. author. Wikicommons. th-development/ 09/10/2017 6

7 DENTITION ZSIGMOND SYSTEM Upper right quadrant Upper left quadrant Lower right quadrant Lower left quadrant Teeth model front by Xauxa. Modified by Partynia. Wikicommons. 09/10/2017 7

8 DENTITION Types of occlusion: A+B : Class I Normal occlusion (upper teeth slightly in front of lower teeth) C+D: Class II Malocclusion (upper teeth too far in front of lower teeth) E+F: Class III Malocclusion (upper teeth behind lower teeth) From pocket dentistry 09/10/2017 8

9 DECIDUOUS/ PERMANENT DENTITION For development of decidious & permanent dentition, see Atkinson & McHanwell (2002) Basic Medical Science for SLT students. London:Whurr (p308) 09/10/2017 9

10 THE HARD PALATE Palatine Rugae Median raphe Soft palate Anatomy of the Human Body. Gray s Anatomy Author: Henry Vandyke Carter Easy Notecards. 09/10/

11 THE HARD PALATE 09/10/

12 SOFT PALATE Soft Palate (Velum) Uvula Pillars of the fauces Anterior Posterior Wikicommons. Public Domain 09/10/

13 MUSCLES OF THE VELUM MUSCLE Levator veli palatine Musculus uvulae Tensor veli palatine Palatoglossus Palatopharyngeus FUNCTION Elevator (also movement of Eustachian tube) Elevator/bunching Tenses and shortens Depressor Depressor 09/10/

14 Levator veli palatine MUSCLES OF THE VELUM Wikicommons. Public Domain 09/10/

15 Levator veli palatine Musculus uvulae Tensor veli palatine Palatoglossus Palatopharyngeus MUSCLES OF THE VELUM Wikicommons. Public Domain 09/10/

16 THE TONGUE Occupies floor of mouth Functions include: Articulation Mastication Deglutition Etc Wikicommons. Public Domain 09/10/

17 THE TONGUE Median fibrous septum TIP or APEX Base of tongue Dorsum Terminal sulcus Lingual papillae Lingual tonsils Inferior surface Sublingual frenulum Sublingual fold Diagram Resources. 09/10/

18 THE TONGUE TASTE AND SENSATION Taste: 1. Bitter 2. Sour 3. Salt 4. Sweet Wikicommons. Messer Woland 09/10/

19 THE TONGUE TASTE AND SENSATION Anatomy & Physiology. OpenStax College 09/10/

20 THE TONGUE Anatomy & Physiology. OpenStax College 09/10/

21 THE TONGUE - MUSCLES and MOVEMENT Intrinsic muscles of the tongue Muscle Location Action CN Superior Longditudinal Inferior Longditudinal Transverse Vertical Near Epiglottis-sides of Tongue Hyoid Bone/Base of Tongue-apex of Tongue Tongue Septummucosa At Sides of Tongue Superior Surfaceinferior Surface Widens, Thickens and Shortens Tongue Tip and Edges Widens, Shortens, Creates Convex Dorsum, Depresses Tip Elongates, Narrows, Thickens, Lifts Sides Widens and Flattens Tongue Tip Xii Xii Xii Xii 09/10/

22 INTRINSIC TONGUE MUSCLES Voice & Speech source. e.html StudyBlue. 9.png 09/10/2017 LCSC06 Biosciences for for 22 SLT SLT

23 THE TONGUE - MUSCLES and MOVEMENT Extrinsic muscles of the tongue Muscle Location Action CN Genioglossus Anterior Posterior Mandible-dorsum + Hyoid Ant. Contraction =Retraction. Post. Contractio=protusion Hyoglossus Tongue-hyoid Depresses And Retracts Tongue Xii Hypoglossal Xii Palatoglossus Soft Palatetongue Contration=elevation Of Back Of Tongue Xi Accessory Styloglossus Temporal Bonesides Of Tongue Contraction=upwards And Backwards Movement Xii 09/10/

24 THE TONGUE Anatomy & Physiology. OpenStax College 09/10/

25 EXTRINSIC TONGUE MUSCLES Intelligent Dental. 09/10/

26 EXTRINSIC TONGUE MUSCLES Voice & Speech source. 09/10/

27 SALIVATION Salivary glands Parotid Submandibular Sublingual Saliva: two types of saliva SEROUS : thin and watery MUCOIDAL: more viscous/sticky Function of saliva: DIGESTIVE DISINFECTANT 09/10/

28 SALIVATION Gland/ Location Saliva [%] Duct location CN Parotid (Largest below the ear) 25 Inside of the check next to the upper molar teeth IX (glossopharyn geal nerve) Submandibular 60 Underneath the front of the tongue, either ide of frenulum (Wharton s duct) Sublingual 15 Under tongue VII (facial nerve) VII (facial nerve) 09/10/

29 TONSILS Pharyngeal tonsils (adenoids) Palatine tonsils Lingual tonsils Blausen.com. Bruce Blaus 09/10/

30 Function: Part of limbic system/immune response TONSILS Believed to be involved in helping fight pharyngeal and URT infection Name Adenoids: pharyngeal tonsils Palatine tonsils Lingual tonsils Location Roof of pharynx Sides of pharynx between faucial arches Behind terminal sulcus (tongue) 09/10/

31 NASAL CAVITIES Nasal septum Turbinates Nares Paranasal air sinuses Dr. Shervin Aminpour. 09/10/

32 Air-filled spaces, communicating with nasal cavity within the bones of the skull and face Function: debated Decrease skull weight Increased vocal resonance Protection Insulation SURFACE ANATOMY Paranasal sinuses Anatomy & Physiology, Connexions Web site. OpenStax College 09/10/

33 Location: Narrow passage leading from the pharynx to the cavity of the middle ear EUSTACHIAN TUBE Function: Equalization of pressure on each side of the eardrum Taken from WebMD. 09/10/

34 THE PHARYNX Divided into areas: 1. Oropharynx 2. Nasopharynx 3. Laryngopharynx 09/10/

35 09/10/

36 PHARYNGEAL MUSCLES Superior pharyngeal constrictor Middle pharyngeal constrictor Inferior pharyngeal constrictors 09/10/

37 PHARYNGEAL MUSCLES Salpingopharyngeus & Palatopharyngeus m. Taken from studyblue. p-1456c4651bd62a18020.png 09/10/

38 PHARYNGEAL MUSCULATURE Muscle function Innervation Superior pharyngeal constrictor Velopharyngeal closure Reduces diameter CN XI & X Middle pharyngeal constrictor Reduces diameter CN XI & X Inferior pharyngeal constrictor 1. Cricopharyngeal muscle *arises from cricoid 2. Thyropharyngeal muscle *arises from thyroid Reduces diameter: Two parts: Muscular orifice of oesophagus CN XI & X Salpingopharyngeus Elevates lateral pharyngeal wall CN XI & X Stylopharyngeus Elevates pharynx CN IX 09/10/

39 THE EPIGLOTTIS Leaf-shaped cartilage Attached to root of tongue 09/10/

40 THE EPIGLOTTIS Epiglottis in action 09/10/

41 CLINICAL ORAL ASSESSMENT Remember to wash your hands 09/10/

42 PALPATION OF ORAL CAVITY In pairs Open wide Torch in non dominant hand: identify faucial pillars and soft palate Say aaah observe soft palate movement: symmetrical? Look for palatine tonsils between faucial pillars Wikicommons. Public Domain 09/10/

43 DENTAL ASSESSMENT Identify: Incisors Cuspids Bicuspids Molars Bite lightly on molars and hold lips (not teeth) open for an /i/ vowel Use gloved finger to palpate lateral margins of the teeth and gums Use tongue depressor to move cheek away from teeth and examine for occlusion 09/10/