ANATOMY OF THE ORAL CAVITY

LECTURE NOTE
BY
DR CHARLES O. AYARA
LEARNING OBJECTIVES/ OUTCOME
• At the end of the this lecture you should be able
to do the following:
• 1. Define the extent of the oral cavity.
• 2. Describe the boundaries of the oral cavity in
relation to the nasal cavity, pharynx & larynx.
• 3. Identify the contents of the oral cavity & their
functions.
• 4. Explain some clinic features/ importance of the
oral cavity.
 OUTLINE
• INTRODUCTION
• ORAL CAVITY:
• TONGUE
• TEETH
• HARD & SOFT PALATE
• PHARYNX
MEDIAN SECTION OF HEAD & NECK
 INTRODUCTION
• The oral cavity is inferior to the nasal cavities.
• It has a roof & floor & lateral walls, open onto
the face through the oral fissure, and is
continuous with the cavity of the pharynx at
the oropharyngeal isthmus.
SKELETAL FRAMEWORK OF THE ORAL CAVITY

• The skeletal framework is made up of the

following bones:
• -the paired maxillae, palatine & temporal bones;
• -the unpaired mandible, sphenoid & hyoid
bones.
• -In addition the cartilaginous parts of the
pharyngo-tympanic tubes on the inferior aspect
of the base of the skull.
 ORAL CAVITY
• BOUNDARIES
• Roof- consists of the hard (anterior 2/3rd) & soft palate
(posterior 1/3rd).
• Floor- is formed mainly of the soft tissues which include a
muscular diaphragm- the mylohyoid muscle & the tongue.
• Content- the tongue forms the main content of the oral
cavity proper.
• The Lateral walls (cheeks)- are muscular & merge
anteriorly with the lips surrounding the oral fissure
(anterior opening of the oral cavity).
 ORAL CAVITY…
• The posterior aperture- of the oral cavity
communicates with the oropharynx, which is
the oral part of the pharynx.
• The oral cavity is separated into 2 regions by
the upper & lower dental arches consisting of
teeth & alveolar bone that support them.
 ORAL CAVITY…
• CONSISTS OF 2 PARTS
• -ORAL VESTIBULE: is the horse-shoe shaped outer
part of the oral cavity between the dental arches & the
deep surfaces of the cheek & lips. The oral fissure
opens into it & can be closed by muscle of facial
expression & by movement of the lower jaw.

• -ORAL CAVITY PROPER: is the space enclosed by the

dental arches (upper & lower) OR the (maxillary &
mandibular alveolar arches & the teeth they bear).
 ORAL CAVITY…
• The upper and lower dental arches of the oral
cavity can be separated by elevating or
depressing the lower jaw (mandible) at the
temporomandibular joint (TMJ).
• The oropharyngeal isthmus at the back of the
oral cavity proper can be opened or closed by
the surrounding soft tissues, which include the
soft palate & tongue.
 ORAL CAVITY…
• Oral Cavity
• The oral cavity consists of two parts: the oral vestibule and the oral cavity proper
(Fig. 7.44). It is in the oral cavity that food and drinks are tasted and savored and
where mastication and lingual manipulation of food occur. The oral vestibule is the
slit-like space between the teeth and buccal gingiva and the lips and cheeks. The
vestibule communicates with the exterior through the mouth. The size of the oral
fissure (the oral opening; L. rima oris) is controlled by the circumoral muscles, such
as the orbicularis oris (the sphincter of the oral fissure), the buccinator, risorius,
and depressors and elevators of the lips (dilators of the fissure). The oral cavity
proper is the space between the upper and the lower dental arches or arcades
(maxillary and mandibular alveolar arches and the teeth they bear). It is limited
laterally and anteriorly by the maxillary and mandibular alveolar arches housing the
teeth. The roof of the oral cavity is formed by the palate. Posteriorly, the oral cavity
communicates with the oropharynx (oral part of the pharynx). When the mouth is
closed and at rest, the oral cavity is fully occupied by the tongue.
MEDIAN SECTION OF HEAD & NECK
 FUNCTIONS OF THE ORAL CAVITY
• 1. It is the inlet of the digestive system involved
with the initial processing of food, which is aided
by secretions from salivary glands. (ingestion of
food & preparation for digestion) + chewing of
food by the teeth to manageable bolus.
• 2. It manipulates sounds produced by the larynx to
produce speech.
• 3. Used for breathing because it opens into the
pharynx which is a common pathway for food & air.
FUNCTIONS OF THE ORAL CAVITY…
• 4. The oral cavity can be used by physicians to
access the lower airway, & dentists use
“rubber dams” to prevent debris such as tooth
fragments from passing through the
oropharyngeal isthmus & pharynx into either
the oesophagus or the lower airway.
• 5. It is involved in the initiation of voluntary
swallowing.
INNERVATION OF THE ORAL CAVITY
• Multiple nerves innervate the oral cavity as
follows:
• General sensory- is carried by branches of
Trigeminal nerve (V) as follows:
• -upper part of OC + palate +upper teeth; are
innervated by branches of Maxillary N (V2).
• -lower part of OC + lower teeth & oral part of the
tongue; are innervated by the branches of the
Mandibular nerve (V3).
- Taste (special afferent (SA) ) from oral part or anterior
2/3rd of the tongue is carried by branches of facial N
(VII).
- Parasympathetic fibres to the glands with the oral
cavity are also carried by branches of facial nerve (VII).
- Sympathetic fibres in the oral cavity ultimately come
from the spinal cord level T1, synapse in the superior
cervical ganglion & are eventually distributed to the
oral cavity alon branches of the Trigeminal nerve (V) or
directly along blood vessels.
 TONGUE
• LATIN- LINGUA; GREEK- GLOSSA.
• A MOBILE MUSCULAR ORGAN COVERED WITH
MUCOUS MEMBRANE
• PARTLY IN ORAL CAVITY & OROPHARYNX.
• FUNCTIONS: ARTICULATION, SWALLOWING,
MASTICATION, TASTE & ORAL CLEANSING
• DEFINTION: Latin-Lingua; Greek- Glossa
• The tongue is a muscular structure that forms part
of the floor of the oral cavity & of the anterior wall
of the oropharynx.
• DESCRIPTIVE PARTS:
• Shape: triangular
• Parts: root, body & a blunt apex anteriorly behind
the incisor teeth.
• The root is attached to the mandible & hyoid bone.
 PARTS OF TONGUE…

• SURFACES: it has 2 surfaces: DORSUM “TOP”

surface & an INFERIOR “UNDERSIDE” surface.
• DORSUM HAS V-SHAPED GROOVE, THE
TERMINAL SULCUS WHICH DIVIDES THE
TONGUE TRANSVERSELY INTO PRESULCAL
ANTERIOR PART & POSTSULCAL POSTERIOR
PART
TONGUE
TONGUE
• ANTERIOR PART IS DIVIDED INTO LEFT & RIGHT halves
BY THE MIDDLE GROOVE or median sagittal septum of
connective tissue.
• THE MUCOSA OF THE ANTERIOR PART HAS A ROUGH
TEXTURE BECAUSE OF NUMEROUS SMALL LINGUAL
PAPILLAE;
• -VALLATE PAPILLAE;
• FOLIATE PAPILLAE;
• FILIFORM PAPILLAE;
• FUNGIFORM PAPILLAE.
• THE MUCOSA OF THE POSTERIOR PART OF
THE TONGUE IS THICK & FREELY MOBILE, HAS
NO LINGUAL PAPILLAE BUT HAS LYMPH
NODULES (LINGUAL TONSIL).
• INFERIOR SURFACE: COVERED WITH THIN
TRANSPARENT MUCOUS MEMBRANE
CONNECTED TO FLOOR OF MOUTH BY
MIDLINE FOLD- FRENULUM OF THE TONGUE.
 MUSCLES OF THE TONGUE
• The bulk of the tongue is composed essentially
of mass of muscles covered by mucosa & it is
completely divided into left & right halves by the
median sagittal septum of connective tissue.
• It is a highly mobile organ.
• This means that all the muscles of the tongue
are paired.
• These are intrinsic & extrinsic lingual muscles.
MUSCLES OF THE TONGUE…
 MUSCLES OF THE TONGUE

• -EXTRINSIC MUSCLES are:

• - genioglossus,
• -hypoglossus,
• -styloglossus &
• -palatoglossus
• INTRINSIC MUSCLES are:
• -superior & inferior longitudinal,
• - transverse & vertical muscles are confined to the tongue.
 FUNCTIONS OF THE MUSCLE OF THE
TONGUE
• Extrinsic muscles: origin is from structures
outside the tongue & insert into the tongue:
they protrude & retract and depress & elevate.
• Intrinsic muscles: origin & insertion are within
the tongue: they alter shape of the tongue by:
• -lengthening & shortening it;
• -curling & uncurling its apex and
• -flattening & rounding its surface.
 FUNCTIONS OF THE MUSCLE OF THE
TONGUE…
• Working together in pairs or one side at a
time, the intrinsic muscles contribute to
precision movements of the tongue required
for speech, eating & swallowing.
MUSCLES OF THE TONGUE
 INNERVATION OF TONGUE
• MOTOR INNERVATION: ALL muscles of the tongue are
innervated by THE HYPOGLOSSAL NERVE CN XII
EXCEPT PALATOGLOSSUS which is innervated by the
PHARYNGEAL PLEXUS OF THE VAGUS NERVE (X).
• GENERAL SENSATION (TOUCH & TEMPERATURE):
• -ANTERIOR 2/3RD –SUPPLIED BY LINGUAL N. a BRANCH
OF CN V3
• -POSTERIOR 1/3RD + VALLATE PAPILLAE- LINGUAL
BRANCH OF GLOSSOPHARYNGEAL N (CN IX) ; general &
special sensation.
• FOUR BASIC TASTE SENSATIONS:
• SWEETNESS –APEX
• SALTINESS- LATERAL MARGINS
• SOURNESS & BITTERNESS- POSTERIOR PART
OF THE TONGUE.
• ??? UMAMI (savoury taste) for broth
 VASCULATURE OF TONGUE
• BRANCHES FROM LINGUAL ARTERY WHICH
ARISES FROM EXTERNAL CAROTID ARTERY.
• VEINS OF THE TONGUE ARE THE:
• -dorsal lingual veins
• -deep lingual veins
• -sublingual vein
BLOOD SUPPLY OF THE TONGUE
 CLINICAL FEATURES OF THE TONGUE
• 1. persistent thyroglossal duct: in some people a
thyroglossal duct persists and connects the foramen
caecum on the tongue with the thyroid gland in the
neck.
• 2. Injury to the Hypoglossal nerve (XII) on one side
results in the weakness or paralysis of the muscles
on that side which is demonstrated by the tip or
apex of the tongue pointing to the side of the injury,
when the patient is asked to “stick your tongue out”.
 TEETH
• TEETH ARE SET IN THE TOOTH SOCKETS.
• FUNCTIONS: CUTTING, CHEWING & ASSIST IN
ARTICULATION.
• TWO TYPES OF TEETH:
• DECIDUOUS (PRIMARY) – CHILDREN; 20
• PERMANENT (SECONDARY) – ADULT; 32
 TEETH…
• In the adult there are 16 permanent teeth in
each jaw. Consists on each side from the
median plane, of : 2 incisors, 1 canine,
2premolar & 3 molars.
• The complete milk dentition consists of 10
teeth in each jaw- on each side 2 incisors, 1
canine & 2 molars.
Adult upper & lower permanent teeth
Deciduous (baby) teeth
Section of teeth: A. an incisor tooth B. a
molar tooth
 HARD & SOFT PALATE
• THE PALATE SEPARATES THE NASAL & ORAL CAVITIES &
COMPRISES:
• THE HARD PALATE- vault shaped, made up of palatine
plate of maxilla & horizontal plate of palatine bone; it
is bounded by the alveolar margin anteriorly &
laterally & merges posteriorly with:
• THE SOFT PALATE- hanging as a curtain btw the naso-
& oropharynx; centrally it bears the uvula on its free
posterior edge; laterally it blends into the anterior and
posterior pillars of the fauces (throat).
 HARD & SOFT PALATE…
• SENSORY SUPPLY- largely from the maxillary
division of CN V & fibers of IX supply the most
posterior part.
• MOTOR INNERVATION: of palatine muscles is
from XI transmitted by the vagus fibers in the
pharyngeal plexus.
 PHARYNX
• Definition: The pharynx is a musculofascial (fibromuscular) tube or
half cylinder that links the oral & nasal cavities in the head to the
oesophagus & laynx in the neck.
• Extent: extends from base of skull to the oesophagus at level of C6
vertebra. It is about 12 cm in length.
• It is incomplete anteriorly & acts as a common entrance to the
respiratory & alimentary tracts.
• From above downwards, made of 3 portions based on the anterior
relations:
• Nasopharynx
• Oropharynx
• laryngopharynx
MEDIAN SECTION OF HEAD & NECK
 NASOPHARYNX
• Lies behind the nasal cavity & above the soft
palate, it cuts off from the rest of the pharynx
during swallowing to prevent regurgitation of
food through the nose.
• Contents:
• 1. nasopharyngeal tonsil (adenoids)- collection
of lymphoid tissues. Forms continuous lymphoid
ring with the palatine tonsil & lymphoid nodules
on the dorsum of the tongue (Waldeyer’s ring).
 NASOPHARYNX…
• 2. the orifice of the pharyngotympanic or
auditory tube (Eustachian canal) lies on the side-
wall of the nasopharynx level with the floor of
the nose.
• CLINICAL FEATURES
• 1. inspected indirectly via posterior rhinoscopy
or direct rhinoscopy.
• 2. nasopharyngeal tonsils (adenoids) are
prominent in children, atrophy after puberty
 NASOPHARYNX…
• 3. auditory canal –pathway of sepsis from
pharynx to middle ear; thus otitis media
frequently complicate throat infections.
 OROPHARYNX
• Definition: Part of the pharynx that lies behind the
mouth & tongue. Its anterior boundaries are the
anterior pillars of the fauces (throat).

• Extent: Extends from the uvula of soft palate above to

the tip of epiglottis below.

• Contents: Most important contents- palatine tonsils; a

collection of lymphoid tissue covered by squamous
epithelium
 LARYNGOPHARYNX
• Definition: The part of the pharynx that lies
behind the larynx.
• Extent: Extends from level of tip of epiglottis
to the termination of the pharynx in the
oesophagus at level of C6 vertebra.
 STRUCTURE OF THE PHARYNX
• Made up of mucosa, submucosa, muscle &
loose areolar sheath.
• mucosa: ciliated columnar epithelium in
nasopharynx but elsewhere it is stratified &
squamous.
• submucosa: thick & fibrous layer form capsule
of tonsil. (pharyngobasilar fascia).
• Muscle layer:
 STRUCTURE OF THE PHARYNX…
• There are 3 pharyngeal constrictor muscles (superior,
middle & inferior) arranged like flower pots placed
one inside the other but are open in front at the
entries of the nasal, oral, & laryngeal cavities.
• Each muscle is attached anteriorly to the side-wall of
these cavities & fan out to insert into the median
raphe along the posterior aspect of the pharynx,
extending from base of skull to the oesophagus.
• The muscles are covered by buccopharyngeal fascia
(areolar sheet)
• BLOOD SUPPLY OF PHARYNX
• Arterial supply- mainly from superior thyroid &
ascending pharyngeal branches of eternal
carotid.
• Venous drainage is via pharyngeal venous plexus
into the internal jugular vein.
• NERVE SUPPLY: sensory & motor- pharyngeal
branches of CN IX & X.
• Maxillary division of CN V supply nasopharynx.
 CLINICAL FEATURES
• 1. cleft lip: a birth defect usually of upper lip,
occurs in 1 of 1000 births; 60-80 % affected
infants are males.
• 2. gingivitis due to poor oral hygiene >>
periodontitis >> dento-alveolar abscess.
• 3. dental caries, pulpitis & tooth abscesses.
• 4. supernumerary teeth (hyperdontia): extra
teeth in addition to the normal
 CLINICAL FEATURES…
• 5. cleft palate +/- cleft lip occurs in 1 of 2500
birth; more common in females than males.
• 6. gag reflex: caused by touching posterior
part of the pharynx supplied by CN IX & X.
results in muscular contraction of each side of
the pharynx
CONCLUSION
THANK YOU FOR YOUR
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