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Mouth (oral cavity) Statue at Buddha Park, near Vientiane, Laos 1. Oral cavity: vestibule oral cavity proper 2. Palate – hard and soft palate 3. Floor of the oral cavity 4. Tongue SPLANCHNOLOGY Oral cavity, cavitas oris Cavitas (cavum) oris Gr. stoma, stomatos: located in the face oral fissure, rima oris throat (fauces), isthmus faucium Parts: oral vestibule, vestibulum oris parotid papilla, papilla ductus parotidei oral cavity proper, cavitas oris propria boundaries: o o o o gums and teeth hard palate part of the soft palate oral floor, diaphragma oris content: o tongue o teeth Prof. Dr. Nikolai Lazarov 2 SPLANCHNOLOGY Lips, labia oris Macroscopic anatomy: oral fissure, rima oris angle of mouth, angulus oris commissure of lips, commissura labiorum Upper lip, labium superius: medial and two lateral parts frenulum of upper lip nasolabial fold, sulcus nasolabialis philtral ridges, philtrum tuberculum labii superioris Lower lip, labium inferius: frenulum of lower lip mentolabial fold, sulcus mentolabialis buccolabial fold, sulcus buccolabialis Prof. Dr. Nikolai Lazarov 3 SPLANCHNOLOGY Lips, labia oris Microscopic structure: external surface, skin multilayered stratified keratinizing squamous epithelium hair follicles, sebaceous and sweat glands vermilion border, modified skin transparent epithelium rich microvasculature – red margin internal surface, mucous membrane stratified nonkeratinized squamous seromucous labial glands internally – orbicularis oris muscle fibroadipose connective tissue, rich in nerve fibers and blood vessels Prof. Dr. Nikolai Lazarov 4 SPLANCHNOLOGY Cheeks, buccae Macroscopic anatomy: form the sides of the mouth similar to lips structure composed externally of integument muscular stratum – m. buccinator buccal fat-pad tissue (of Bichat) – corpus adiposum buccae (Bichat) composed internally of mucous membrane Prof. Dr. Nikolai Lazarov 5 SPLANCHNOLOGY Cheeks, buccae Histological structure: external surface – hairy skin: stratified keratinized squamous epithelium hair follicles, sebaceous and sweat glands the buccinator muscle, m. buccinator internal surface – buccal mucosa stratified non-keratinized squamous epithelium with a high regenerative capacity buccal and molar glands buccal fat-pad tissue (of Bichat) Prof. Dr. Nikolai Lazarov 6 SPLANCHNOLOGY Oral cavity proper, cavitas oris propria Palate, palatum: roof of the oral cavity proper resonance in phonation hard palate, palatum durum (osseum) soft palate, palatum molle Hard palate, palatum durum – anterior ⅔: processus palatinus maxillae lamina horizontalis ossis palatini plicae palatinae transversae papilla incisiva; raphe palati gll. palatinae stratified non-keratinized squamous epithelium keratinization lamina propria – firmly attached to the periosteum Prof. Dr. Nikolai Lazarov 7 SPLANCHNOLOGY Oral cavity proper, cavitas oris propria Palate, palatum: roof of the oral cavity proper resonance in phonation hard palate, palatum durum (osseum) soft palate, palatum molle Hard palate, palatum durum – anterior ⅔: processus palatinus maxillae lamina horizontalis ossis palatini plicae palatinae transversae papilla incisiva; raphe palati gll. palatinae stratified non-keratinized squamous epithelium keratinization lamina propria – firmly attached to the periosteum Prof. Dr. Nikolai Lazarov 8 SPLANCHNOLOGY Oral cavity proper, cavitas oris propria Palate, palatum: roof of the oral cavity proper resonance in phonation hard palate, palatum durum (osseum) soft palate, palatum molle Hard palate, palatum durum – anterior ⅔: processus palatinus maxillae lamina horizontalis ossis palatini plicae palatinae transversae papilla incisiva; raphe palati gll. palatinae stratified non-keratinized squamous epithelium keratinization lamina propria – firmly attached to the periosteum Prof. Dr. Nikolai Lazarov 9 SPLANCHNOLOGY Oral cavity proper, cavitas oris propria Soft palate, palatum molle – posterior ⅓ velum palatini with uvula arcus palataglossus and arcus palatopharyngeus stratified columnar epithelium nasally stratified non-keratinized squamous orally muscles of the soft palate Prof. Dr. Nikolai Lazarov 10 SPLANCHNOLOGY Oral cavity proper, cavitas oris propria Gums, gingivae: attached gingiva marginal gingiva Macroscopic structure: free gingival margin gingival sulcus gingival papilla (interdental papilla) vestibular oral Microscopic structure: lamina epithelialis stratified squamous parakeratinized epithelium lamina propria – papillae rich vascularization dense innervation Prof. Dr. Nikolai Lazarov 11 SPLANCHNOLOGY Floor of the oral cavity Oral floor: a muscular layer between the tongue and the mandible Muscular base: mylohyoid, m. mylohyoideus geniohyoid, m. geniohyoideus Mucosa: thin and loosely attached to the underlying structures mucosal folds lingual frenulum sublingual folds sublingual papilla (caruncle) Blood supply and venous drainage: aa. et vv. sublingualis, facialis et thyroidea sup. Lymphatic drainage: nodi lymphatici submandibulares et cervicales profundi Prof. Dr. Nikolai Lazarov 12 SPLANCHNOLOGY Floor of the oral cavity Oral floor: a muscular layer between the tongue and the mandible Muscular base: mylohyoid, m. mylohyoideus geniohyoid, m. geniohyoideus Mucosa: thin and loosely attached to the underlying structures mucosal folds lingual frenulum sublingual folds sublingual papilla (caruncle) Blood supply and venous drainage: aa. et vv. sublingualis, facialis et thyroidea sup. Lymphatic drainage: nodi lymphatici submandibulares et cervicales profundi Prof. Dr. Nikolai Lazarov 13 SPLANCHNOLOGY Embryonic development Oral cavity – first pharyngeal arch maxillary process mandibular process frontonasal prominence middle part of nasal prominence lateral parts Nose: frontonasal prominence nasal root two medial nasal prominences nasal dorsum and apex two lateral nasal prominences nasal sidewalls and alae nasal (olfactory) placode nostrils Eye – eye rudiments: lateral nasal prominences maxillary processes Prof. Dr. Nikolai Lazarov 14 SPLANCHNOLOGY Facial abnormalities Facial clefts: cleft lip, labium leporinum cleft palate, palatum fissum (palatoschisis s. faux lupina) congenital macrostoma congenital microstoma congenital cleft in the face, meloschisis Prof. Dr. Nikolai Lazarov 15 SPLANCHNOLOGY Tongue Tongue – lingua (Gr. glossa): on the floor of the mouth a muscular organ possessing great mobility important role in digestion: active role in chewing (mastication) involved in sucking and deglutition reflex essential role in articulation and phonation the primary organ of taste Prof. Dr. Nikolai Lazarov 16 SPLANCHNOLOGY Phylogenesis of the tongue Phylogenesis: fishes a fold in the floor of the mouth epithelial lining, no glands and muscles connective tissue of hyoid arch amphibians and reptiles tactile organ well-developed mucous glands intrinsic muscles mammals important organ of the digestive system; vital role in feeding and sucking highly differentiated mucosa proper musculature Prof. Dr. Nikolai Lazarov 17 SPLANCHNOLOGY Embryonic development Onthogenesis: begin – 4 mo. origin – from branchial arches body of tongue – Ist pharyngeal arch: mesodermal cells from the 1st (mandibular) pharyngeal arch two lateral lingual swellings – 5 we. median lingual swelling, tuberculum impar root of tongue: hypobranchial eminence, copula of His – II-IV pharyngeal arch mucosa: body – 1st pharyngeal arch root – 3rd-4th arch tongue musculature: from occipital (postotic) myotomes (3rd and 4th occipital myotomes) taste buds: 7 we. Prof. Dr. Nikolai Lazarov 18 SPLANCHNOLOGY Structure of the tongue Parts of the tongue: body, corpus linguae tip, apex linguae root, radix linguae divided by a V-shaped furrow, sulcus terminalis Surface anatomy: dorsal surface, dorsum linguae oral (presulcal) part (pars oralis) pharyngeal (postsulcal) part (pars pharyngealis) sulcus terminalis foramen cecum median furrow, sulcus medianus inferior surface, facies inferior plica fimbriata frenulum linguae caruncula sublingualis sublingual fold margin of the tongue, margo linguae Prof. Dr. Nikolai Lazarov 19 SPLANCHNOLOGY Papillae of the tongue Lingual papillae – 4 types: filiform (conical) papillae fungiform papillae vallate papillae foliate papillae Prof. Dr. Nikolai Lazarov 20 SPLANCHNOLOGY Papillae of the tongue Filiform papillae, papillae filiformes: thin, long, thread-shaped papillae arranged in regular parallel rows over the entire anterior dorsal surface of the tongue smallest in size, most numerous in humans keratinized epithelium the velvet surface lamina propria – 10-30 papillae secundariae mechanical role, do not contain taste buds Conical papillae, papillae conicae larger and longer filiform papillae Prof. Dr. Nikolai Lazarov 21 SPLANCHNOLOGY Papillae of the tongue Fungiform papillae, papillae fungiformes: less numerous, throughout the filiform mushroom-shaped projections at the tip and margins of the tongue nonkeratinized epithelium pink spots lamina propria – secondary papillae have mechanical and thermal receptors contain taste buds Prof. Dr. Nikolai Lazarov 22 SPLANCHNOLOGY Papillae of the tongue Vallate papillae, papillae (circum)vallatae: the largest papillae – d=1-3 mm dome-shaped structures 7-12 papillae in front of sulcus terminalis narrow moats – von Ebner’s glands stratified squamous epithelium lamina propria – papillae secundariae contain numerous (80-100) taste buds Prof. Dr. Nikolai Lazarov 23 SPLANCHNOLOGY Papillae of the tongue Foliate papillae, papillae foliatae: parallel low ridges on the lateral edge of the tongue well-developed only in children folium papillae; sulcus papillae multilayered stratified epithelium lamina propria – brush-like secondary papillae small serous gustatory glands in the subepithelial connective tissue numerous taste buds are present Prof. Dr. Nikolai Lazarov 24 SPLANCHNOLOGY The tongue and taste Taste buds, caliculi (gemmae) gustatorii – 2000-9000: vallate papillae – most numerous plentiful in the posterior ⅓ of the tongue fungiform and foliate papillae soft palate, epiglottis and pharynx reduction in number (up to ⅓) with age our sense of taste can and do change over time! Prof. Dr. Nikolai Lazarov 25 SPLANCHNOLOGY Lingual glands Glandulae linguales – minor salivary glands: mixed (seromucous) glands – close to the tip anterior linglual (Nuhn’s) glands serous glands – in vallate papillae gustatory (von Ebner’s) glands mucous glands – in the lingual root posterior lingual (Weber’s) glands Prof. Dr. Nikolai Lazarov 26 SPLANCHNOLOGY Lingual tonsils Tonsilla lingualis: small, rounded mass of lymphoid tissue in the posterior ⅓ of the tongue tonsillar papillae tonsillar crypts Weber’s salivary glands lymphatic nodules (MALT) covered with stratified squamous non-keratinized epithelium Prof. Dr. Nikolai Lazarov 27 SPLANCHNOLOGY The lingual musculature Extrinsic lingual muscles – move the tongue: genioglossus – best developed muscle hyoglossus styloglossus – the shortest and smallest chondroglossus – variable, sometimes absent palatoglossus – associated with the soft palate Prof. Dr. Nikolai Lazarov 28 SPLANCHNOLOGY The lingual musculature Intrinsic lingual muscles – alter its shape: superior longitudinal muscle inferior longitudinal muscle the transverse muscle the vertical muscle Prof. Dr. Nikolai Lazarov 29 SPLANCHNOLOGY Tongue histology Lingual mucous membrane – lingual papillae: body – endoderm of the stomodeum root – endoderm of primitive gut stratified squamous non-keratinized epithelium dorsal surface – thicker inferior surface – thinner lamina propria glands and lymphatic nodules tela submucosa – absent minor salivary glands – serous and mucous lymphoid tissue – lingual tonsil (root) Tongue core: skeletal striated muscle tissue Prof. Dr. Nikolai Lazarov 30 SPLANCHNOLOGY Vessels of the tongue Blood supply – lingual artery: sublingual and deep lingual arteries Branches form: facial artery ascending pharyngeal artery Venous drainage – lingual vein: drains into the jugular internal vein Prof. Dr. Nikolai Lazarov 31 SPLANCHNOLOGY Lymphatic drainage of the tongue Lymphatic drainage: tip – submental lymph nodes body – submandibular lymph nodes root – retropharyngeal lymph nodes Prof. Dr. Nikolai Lazarov 32 SPLANCHNOLOGY Nerve supply of the tongue Somatosensory innervation: anterior ⅔ and inferior surface: lingual nerve (n. trigeminus) facial nerve chorda tympani posterior ⅓ of the tongue: glossopharyngeal nerve vagus nerve lingual glands: parasympathetic – n. facialis, n. glossopharyngeus et n. vagus sympathetic – plexus caroticus ext. (ganglion cervicale superius) Prof. Dr. Nikolai Lazarov 33 SPLANCHNOLOGY Nerve supply of the tongue Somatosensory innervation: anterior ⅔ and inferior surface: lingual nerve (n. trigeminus) facial nerve chorda tympani posterior ⅓ of the tongue: glossopharyngeal nerve vagus nerve lingual glands: parasympathetic – n. facialis, n. glossopharyngeus et n. vagus sympathetic – plexus caroticus ext. (ganglion cervicale superius) Prof. Dr. Nikolai Lazarov 34 SPLANCHNOLOGY Thank you ... Prof. Dr. Nikolai Lazarov