oral cavity and pharynx

lips of the face marks the

anterior boundary of the oral cavity

throat marks the

posterior boundary of the orla cavity

cheeks of the face mark the

lateral boundary of the oral cavity

palate marks the

superior boundary of the oral cavity

floor of the mouth marks the

inferior border of the oral cavity

structures closest to the facial surface

facial

structures closest to the lips

labial

structures close to the inner cheek

buccal

structures closest to the tongue

lingual

structures closest to the palate

palatal

vestibules

upper and lower horseshoe shaped spaces between the lips and cheeks anteriorly and laterally

both maxillary and mandibular

oral vestibules are lined by a mucous membrane

oral mucosa

inner parts of the lips are lined by a pinkish

labial mucosa

labial mucosa is continuous with the equally pinkish

lining the inner cheek

buccal mucosa

inner part of buccal mucosa, opposite maxillary 2nd molar, small elevation of tissue

parotid papilla

parotid papilla protects the opening of

parotid duct of the parotid salivary gland

pinkish labial mucosa or buccal mucosa meets the redder

alveolar mucosa at the mucobuccal fold

labial frenum

fold of tissue located at the midline between the labial mucosa and the alveolar mucosa on the upper and lower dental arches

to asses labial mucosa

pull buccal mucosa away from teeth and bidigitally palpate the inner cheek on each side using circular compression

fordyce spots

visible as small yellowish elevations on the oral mucosa

fordyce spots represent

deeper deposits of sebum from trapped of misplaced sebaceous gland tissue, associated with hair follicles in other regions but not here

linea alba

white ridge of calloused tissue, extends horizontally where the maxillary and mandibular teeth occlude

PDL

attaches teeth to the bony surface of alveoli

allows some slight tooth movement within the alveolus while still supporting the tooth

enamel is only in the

crown

outermost layer of the root(s) is composed of

cementum

dental arches

alveolar processes with the teeth in the alveoli

• maxillary arch

• mandibular arch

maxillary tuberosity

distal to the tooth of the maxillary arch is tissue covered elevation of the bone

retromolar pad

on the lower jaw is a dense pad of tissue located distal of the last tooth of the mandibular arch

primary teeth consist of

incisors, canines and molars

permanent teeth consist of

incisors, canines, premolars and molars

anterior teeth

front of the mouth

(incisors and canines)

posterior teeth

back of the mouth

(premolars and molars)

exostoses

less than common variation present usually on the facial surface of the alveolar process of the maxillary arch is

• localized developmental growths of bone covered in oral mucosa with a possible hereditary etiology and which may be associated with occlusal trauma.

• benign

• may be single or multiple and unilateral or bilateral raised hard areas located in the premolar to molar region covered by oral mucosa. They appear on radiographs as radiopaque (light) areas

mandibular torus

present on the lingual surface of the mandibular arch

developmental growth of bone with a possible hereditary etiology similar to exostoses and may also be associated with grinding, which is considered bruxism.

gingiva

Surrounding the maxillary and mandibular teeth in the alveoli and covering the alveolar processes are the soft tissue gums

attached gingiva

gingival tissue that tightly adheres to the alveolar process surrounding the roots of the teeth

mucogingival junction

line of demarcation between the firmer and pinker attached gingiva and the movable and redder alveolar mucosa that lines the vestibules is the scallop-shaped

marginal gingiva

forms a cuff above the neck of the tooth

free gingival groove

separates the marginal gingiva from the attached gingiva

free gingival crest

most coronal part of the marginal gingiva

interdental gingiva

gingival tissue between adjacent teeth adjoining the attached gingiva

interdental papilla

each individual extension of the interdental gingiva

some gingival tissue may have areas of

melanin pigmentation, especially at the base of each interdental papillae

circular inner surface of the gingival tissue of each tooth faces an equally rounded space

gingival sulcus

inside of the mouth

oral cavity proper

opening from the oral cavity proper into the pharynx or throat is the

fauces

fauces are formed laterally on each side of the oral cavity proper by

anterior and posterior faucial pillar

palatine tonsils

located between the folds of tissue created by underlying muscles

palate

roof of mouth

the palate separates

the oral cavity from the nasal cavity

hard palate

bony, whiter anterior arched part

incisive papilla

small bulge of tissue at the most anterior part of the hard palate, lingual to the anterior teeth

directly posterior to the incisive papilla are firm irregular ridges of tissue radiating from the incisive papilla and raphe

palatine rugae

soft palate

yellower, looser and softer posterior part of the palate

uvula

hangs down from the posterior margin of the soft palate

midline ridge of tissue that runs the full length of the palate from the incisive papilla to the uvula

median palatine raphe

pterygomandibular fold

extends from the junction of hard and soft palates down to the mandible, just posterior to the most distal mandibular tooth, and stretches when the mouth is opened wider

visually inspect the soft palate

have the patient tilt the head back slightly and extend the tongue

• Use a mouth mirror to intensify the light source.

• e mouth mirror is gently placed with the mirror side down on the middle of the tongue and the patient asked to say “ah.” As this is done, the uvula is visually inspected as well as the visible parts of the pharynx.

• Then the hard palate is compressed with the first or second finger of one hand, avoiding circular compression as well as palpation of the soft palate to prevent initiating the gag reflex

palatal torus

less than common variation, similar to the mandibular tori in presentation and etiology

base of tongue

posterior one-third of the tongue is the pharyngeal part

body of the tongue

anterior two-thirds of the tongue is the oral part

apex of the tongue.

tip of the tongue

dorsal surface of the tongue has a midline depression

median lingual sulcus

small, elevated structures of specialized mucosa which are associated with taste buds

lingual papillae

filiform lingual papillae

slender threadlike whitish lingual papillae, which give the doral surface its velvety texure

fungiform lingual papillae

reddish small mushroom shaped dots on the dorsal surface of the tongue

inverted v-shaped groove that separates the base from the body of the tongue

sulcus terminalis

circumvallate lingual papillae

10 to 14 larger mushroom-shaped lingual papillae with taste buds

foramen cecum

Where the sulcus terminalis points backward toward the throat or pharynx is a small, pitlike depression

lingual tonsil

posteriorly on the dorsal surface of the base of the tongue is an irregular mass of tissue

foliate lingual papillae

lateral surface of the tongue has vertical ridges

ventral surface of the tongue has

large visible blood vessels, the deep lingual veins, which pass close to the surface

is the plica fimbriata with fringelike projections

Lateral to each deep lingual vein

tongue examined

• assess the dorsal and lateral surfaces of the tongue, have the patient slightly extend the tongue.

• Then wrap a gauze square around the anterior one-third of the tongue in order to obtain a firm grasp. Digitally palpate the dorsal surface.

• Turn the tongue slightly on its side to visually inspect its base and lateral borders. Bidigitally palpate the lateral surfaces of the tongue.

• To assess the ventral surface, have the patient lift the tongue to visually inspect and digitally palpate the ventral surface.

enlarged lingual tonsil

• The lingual tonsils are rounded masses of lymphatic tissue that cover the posterior region of the tongue located on the dorsal surface at the base of the tongue.

• The cause of enlargement (lymphadenopathy) of the lingual tonsils is most likely a chronic, low-grade infection of the tonsil.

• It can be asymptomatic, but can be associated with vague symptoms, including sore throat, dysphagia, snoring, obstructive sleep apnea; a nonproductive chronic cough caused by irritation of the pharynx by the lingual tonsils may occur.

floor of the mouth

located in the oral cavity proper, inferior to the ventral surface of the tongue.

lingual frenum

anterior midline fold of tissue between the ventral surface of the tongue and the floor of the mouth.

sublingual fold

ridge of tissue on each side of the floor of the mouth

sublingual caruncle

small papilla at the anterior end of each sublingual fold contains openings of the submandibular duct and sublingual duct

floor of the mouth examined

• Use the mouth mirror to facilitate lighting and direct observation while the patient lifts the tongue to the palate, to visually inspect the mucosa of the floor of the mouth and check the lingual frenum

• Bimanually palpate the sublingual area by placing an index finger intraorally behind each mandibular canine and the index finger of the opposite hand extraorally under the chin, compressing the tissue between the fingers.

pharynx

deeper structure of the throat

a muscular tube that has both respiratory and digestive system functions.

division of the pharynx that is superior to the level of the soft palate which is continuous with the nasal cavity

nasopharynx

division that is between the soft palate and the opening of the larynx, which is the oral part of the pharynx

oropharynx

more inferior division of the pharynx, close to the laryngeal opening

laryngopharynx

oropharynx examined

• The mouth mirror is gently placed with the mirror side down on the middle of the tongue and the patient asked to say “ah.”

• As this is done, the oropharynx is visually inspected when the soft palate and hard palate are examined

• Compress hard palate with first or second finger of one hand. Avoid circular compression on the soft palate to prevent initiating the gag reflex.