Anatomy

 and  Physiology  of  the  Oral  Cavity  |  Otolaryngology    

ANATOMY  AND  PHYSIOLOGY  OF  THE  ORAL  CAVITY  

  • Blood   Supply:   superior   and   inferior   labial   arteries  
Basic  Anatomy:   (branches  of  the  facial  artery)  
1. Oral  vestibule   • Drainage:  facial  vein  
2. Lips   • Lymphatics:  submandibular  and  submental  lymph  nodes  
3. Cheeks   • Innervation:    
4. Masticatory  muscles   o Upper  lip:  infraorbital  nerve  (book);  anterior  and  middle  
5. Teeth   superior  alveolar  nerves  of  V2  (ppt)  
6. Palate   o Lower  lip:  mental  nerve  (V3)  
7. Tongue   3. Cheeks  (Buccal  Mucosa)  
• Forms  the  lateral  boundaries  of  the  oral  vestibule  
• Buccinator  –  forms  the  muscular  framework  of  the  cheek;  
mimetic  muscle  
o Innervation:  Facial  nerve  branches  
• Bichat   fat   pad   (buccal   fat   pad)   –   between   the   buccinators  
muscle   and   the   overlying   masseter   muscle;   fibers   run  
perpendicular   to   the   buccinators;   smooths   the   cheek  
contour   (fills   in   the   depression   at   the   anterior   border   of  
the  muscle)  
• Lining:  non-­‐keratinized  stratified  squamous  epithelium  
• Parotid  papilla:  opposite  the  2nd  molar  
• Upper  vestibule:  V2  
  • Lower  vestibule:  mental  and  buccal  nerve  (V3)  
Boundaries  of  the  Oral  Cavity:   4. Masticatory  Muscles  
Anterior:  Lip   • Masseter  Muscle  
Lateral:  Buccal  mucosa   o Posterior  part  of  the  cheek  
Posterosuperior:  hard  and  soft  palate  junction   o Covers   the   vertical   ramus   of   the   mandible   and   the  
Posterolateral:  retromolar  trigone   mandibular  angle  from  the  outside  
Posteroinferior:  circumvallate  papillae   • Temporalis  Muscle  
  • Medial  and  Lateral  Pterygoid  Muscles  
Parts  of  the  Oral  Cavity:   • Innervation:  mandibular  nerve  
1. Lip  
2. Upper  and  lower  alveolar  ridge  
3. Buccal  mucosa  
4. Floor  of  the  mouth  
5. Anterior  2/3  or  the  tongue  
6. Retromolar  trigone  
7. Hard  palate  
 
ANATOMY  
 
1. Oral  Vestibule  
• Boundaries:    
o External:  lips  and  cheeks   5. Teeth  
o Internal:  Alveolar  processes  and  teeth   • Deciduous  vs  permanent  
• Communicates  with  the  oral  cavity  via  a  space  behind  the   o 2  incisors  
last  molar  when  teeth  are  in  occlusion   o 1  canine  
o 2  premolars  
• Opens  into  the  pharynx  at  the  faucial  isthmus  
o 3  molars  
2. Lips  
o #  of  teeth  on  each  half  of  the  maxilla  and  mandible  
• Internally   (mucosal   side)   lined   by   non-­‐keratinized  
squamous  epithelium   • Primary  function  is  to  tear  and  chew  food  
• Enamel  –  hard  covering  of  teeth  
• Externally   lined   by   keratinized   stratified   squamous  
epithelium   • Cementum   –   covers   the   root   of   a   tooth;   helps   hold   the  
tooth  in  the  socket  
• Nasolabial  fold  –  separates  cheeks  and  lips;  oblique  sulcus  
running  laterally  and  inferiorly  from  the  nasal  alae   • Dentin   –hard   but   porous   tissue   located   under   both   the  
enamel  and  cementum  of  the  tooth  
• Lamina  propria  –  (+)  mucous  salivary  glands  
• Periodontal  ligaments  –  holds  the  tooth  in  place  
• Orbicularis  oris  –  muscular  foundation  
 

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 Anatomy  and  Physiology  of  the  Oral  Cavity  |  Otolaryngology    

• Pulp   –   contains   blood   vessels   and   nerves;   nourishes   the   o Divided   into   anterior   2/3   and   posterior   1/3   by   the  
dentin   palatoglossal   arch,   the   V-­‐shaped   sulcus   terminalis   and  
o Contains   connective   tissues,   nerve   fibers,   and   blood   circumvallate  papillae  (lying  anterior  to  the  sulcus).    
vessels   o Composed  of  various  muscular  system  
o Connected  to  the  alveolus  via  the  root  canal   o Occupies  much  of  the  oral  cavity  
• Root  –  anchor  of  the  tooth  that  extends  into  the  jawbone   o Continuous  anteriorly  and  laterally  with  the  floor  of  the  
• Neck   -­‐   area   between   the   crown   and   root;   protrudes   from   mouth  
socketsin   the   alveolar   processes   of   the   maxilla   and   o Apex  
mandible   o Body  
• Crown  –  projects  freely  into  the  oral  cavity   § Separated  from  the  base  by  the  terminal  sulcus    
o Externally  covered  by  enamel   o Base/Root  
• Blood  supply:   o Extrinsic  Muscles    
o Inferior  alveolar  artery   § Changes  position  of  the  tongue  
o Anterior  Alveolar  artery   § Styloglossus  –  elevates  &  retracts  the  tongue  
o Posterior  superior  alveolar  artery   § Hyoglossus  –  depresses  the  tongue  
• Innervation:   § Genioglossus  –  protrude  the  tongue,  depress  center  
o Upper  teeth:  branches  of  the  maxillary  nerve   § Palatoglossus  –  elevates  back  of  the  tongue  
o Lower  teeth:  branches  of  the  mandibular  nerve   o Intrinsic  Muscle  
6. Oral  Cavity   § Change  the  shape  of  the  tongue  
• Palate   § Longitudinal  –  from  hyoid  bone  to  tip;  moves  the  tip  
o Hard  Palate   § Transversus   -­‐     go   across   the   tongue;   narrows   and  
§ Formed  by:   lengthens  the  tongue    
• Anterior:  palatine  processes  of  the  maxilla   § Verticalis   -­‐   go   up   and   down   the   tongue;   flattens   and  
depresses  the  tongue    
• Posterior:  horizontal  plates  of  the  palatine  bones  
o Mucosa   –   (+)   papillae   that   project   from   the   surface   à  
• Incisive  bone  (book)  
roughness  
• Incisive   foramen   or   foramina   of   Stenson   –  
o 4  Types  of  Papillae:  
nasopalatine  nerve  &  descending  palatine  artery  
§ Filiform  –  thread-­‐like;  no  taste  buds  
o Gums  of  the  incisors  and  canine  palatal  side  
§ Fungiform  -­‐  mushroom  
§ Innervation  and  Blood  supply:  
§ Vallate  
• Greater   palatine   foramen   –   greater   palatine   artery,   § Foliate  
vein,  and  nerve  
o Taste  buds  –  specific  taste  perception  
• Lesser   palatine   foramen   –   lesser   palatine   artery,   § Most  numerous  in  the  vallate  and  foliate  papillae  
vein,  and  nerve   § 30-­‐80   elongated   cells   that   extend   superficially   to   the  
o Soft  Palate   gustatory  pore  
§ Seals   the   oral   cavity   posteriorly   through   the   uvula   o Lingual   tonsil   –   lymphoepithelial   tissue   (Waldeyer’s  
(pendulant  process)   ring)  
§ Muscles  of  the  soft  palate:   o Blood   supply:   lingual   and   sublingual   arteries   (from   the  
• Tensor  veli  palatini   external  carotid  artery)  
• Levator  veli  palatini  –  elevates  the  soft  palate  during   § Lingual  Artery:  
swallowing  to  keep  food  form  entering  the  nose   • Medial  to  the  hyoglossus  muscle  
• Palatoglossus  –  runs  from  the  anterior  faucial  pillar   • Dorsal  lingual  artery  –  base  of  the  tongue  
• Palatopharyngeus   muscle   of   the   posterior   faucial   • Deep  lingual  artery  –  body  of  the  tongue  
pillar   o Drainage:  facial  vein  to  the  internal  jugular  vein  
§ Palatal  mucosa   o Lymphatic  drainage:  
• (+)  salivary  glands   § Ipsilateral   and   contralateral   submandibular   and  
§ Innervation:  CN  IX  and  X   submental  lymph  nodes  
o Blood   Supply:   ascending   palatine   branch   of   the   facial   § Tip  –  submental  glands  bilaterally  
artery   § Dorsum  –  submandibular  gland  and  jugulodigastric  LN  
• Tongue     o Innervation:  CN  V,  VII,  IX,  and  XII  
o Derived  from  1st  –  4th  branchial  arches   § Most  motor  innervation:  CN  XII  
o The  anterior  2/3  (body  or  oral  part)  is  derived  from  the   § Terminal  sulcus:  lingual  nerve  (from  the  3rd  division  of  
ectodermal  stomodeum     the  CN  V)  
o The   posterior   1/3   (pharyngeal   part   or   root)   is   derived   § Tongue   base   region:   Glossopharyngeal   and   superior  
from  the  endodermal  foregut     laryngeal  nerves  
o Foramen  caecum  –  point  of  origin  of  the  thyroid  gland   § Taste  buds  –  chorda  tympani  (from  CN  VII)  
§ Anterior  2/3  –  CN  IX  
 

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 Anatomy  and  Physiology  of  the  Oral  Cavity  |  Otolaryngology    

o Extrinsic  muscles  –  positions  and  movement  

o Intrinsic  muscles  –  alters  the  shape  of  the  rongue  
• Molars   –   chewing;   located   closest   to   the   insertion   of   the  
masticatory   muscles   à   high   pressure   is   developed  
between  the  occlusive  surfaces  
2. Taste  
• Sweet,  sour,  salty,  bitter  
 
• Combination   of   olfactory,   thermal,   mechanical,   and  
sensory  impressions  
3. Importance  in  Phonation  and  Articulation  
• Musculature  of  the  lips  
• Lingual   articulation   –   controls   the   production   of   vowels,  
certain   consonants,   and   palatal   sounds   through   the  
changes  in  the  shape  and  position  of  the  tongue  
• Supraglottic   vocal   tract   –   tongue,   pharynx,   nose,   and  
paranasal  sinuses;  coordination  of  vocal  sounds  
 
 

 
• Alveolar  Ridge  
o Vestibular   mucosa   from   the   inner   lining   of   the   lip  
becomes   tightly   bound   to   the   alveolar   bone   at   the   muco-­‐
gingival  junction  
o Vestibular  sulcus  
o Innervation:  
§ Upper  alveolar  ridge  –  V2  
§ Molars   –   posterior   superior   alveolar   nerve   from   the  
pterygopalatine  fossa  
§ Bicuspids   –   middle   superior   alveolar   nerve   from   the  
infraorbital  nerve  
§ Incisors  and  canines  –  anterior  superior  alveolar  nerve  
from  the  infraorbital  nerve  
§ Lower   alveolar   ridge   –inferior   alveolar   nerve   (V3)   all  
mandibular  teeth  
§ Gums  of  the  molars  and  bicuspids  –  buccal  nerve  
§ Gums  of  the  incisors  and  canine    
• Lingual  side  –  lingual  nerve  
• Labial  side  –  mental  nerve  
• Oral  Floor  
o Lingual  frenulum    
o Submandibular  gland  duct    
o Sublingual  papilla    
o Innervation  –  lingual  nerve    
o Mylohyoid   muscle   –   muscular   foundation   of   the   oral    
floor    
   
PHYSIOLOGY    
1. Importance  for  Food  Intake    
 
• Lips  –  gateway  to  the  digestive  tract  
o Seals   the   oral   cavity   during   swallowing   and   chewing   to  
prevent   food   spillage   (main   function   of   the   orbicularis  
oculi)  
o Impaired  muscle  function  à  deficiency  in  lip  closure  à  
eating  difficulties  and  drooling  
• Tongue   –   multifunction   organ   with   both   motor   and  
sensory  properties  
 

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