Download tunica adventitia

Oral cavity
and
pharynx
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
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)
General structure of digestive tube
tunica serosa /
tunica adventitia
tunica muscularis
tela submucosa
tunica mucosa
Tunica mucosa
epithelium
lamina propria
mucosae
connective tissue
blood vessels, lymphatics,
macrophages and lymphocytes,
sometimes glands
mucosa
lamina muscularis
mucosae
smooth muscles
movements of mucosa – better
contact with food
Tela submucosa
connective tissue
blood and lymph vessels,
glands, lymphoid
tissue
submucosa
submucous plexus
submucous plexus
(of Meissner) of
autonomic nerves
function: secretion
Tunica muscularis
longitudinal
circular
muscularis
Cajal cells
- pacemaker
smooth muscle cells
2 sublayers
1) internal - circular
2) external - 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
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)
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
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 (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)
Stratified sqamous epithelium
• keratinizing – skin, hard palate, gum
• non-keratinizing – rest of oral cavity,
pharynx, oesophagus
• 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
Cheek (bucca)
Oral cavity (Cavitas oris)
• 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
Tongue (Lingua, Gr. glossa)
• apex
• corpus (body)
– dorsum
– facies inferior
• radix (root)
• margo (margin)
• sulcus (groove)
– terminalis
– medianus (midline)
• foramen caecum
• tonsilla lingualis
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
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“)
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 linguales)
papillae vallatae
papillae foliatae
papillae filiformes
papillae fungiformes
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 – muscles
• aponeurosis, septum (incomplete)
• intraglossal – n. hypoglossus
– m. longitudinalis sup. et inf.
– m. transversus
– m. verticalis
Extraglossal muscle of tongue
innervation – n. hypoglossus
• m. genioglossus
• m. hyoglossus
• m. styloglossus
• m. palatoglossus
! exception ! – n. vagus
Extraglossal muscle of tongue
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
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 !
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)
• 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)
Throat
(Fauces)
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 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 (Pharynx)
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
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
Muscles of pharynx
• raphe pharyngis
• fascia
pharyngobasilaris
• sinus Morgagni
• 3 constrictors
• 3 levators
• innervation: plexus
pharyngeus (n.X)
– except m.
stylopharyngeus
(n.IX)
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
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
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 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
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
End

Identification of dead
TEETH
dens, dentis
odus, odonotos
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
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
Peridontium
• 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)
Macroscopy and fication of tooth
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
Dental formula
• cross with letters
– lower case = deciduous
– UPPER CASE = permament
• cross with numbers
• numerical
– 1-4 quadrants (from right upper one clockwise) = 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