Mouth to oesophagus

Dr Paula Vickerton
 Lecture objectives

To be able to identify the major anatomical features of the mouth

To understand the motor nervous supply to the muscles of

mastication, facial expression, soft palate, tongue, pharynx and
oesophagus.

To understand the sensory nerve supply to the face, teeth, tongue

and pharynx.
 Cranial Nerves
1. Olfactory
2. Optic
3. Oculomotor
4. Trochlear
5. Trigeminal
6. Abducent
7. Facial
8. Vestibulocochlear
9. Glossopharyngeal
10.Vagus
11.Accessory
12.Hypoglossal
Oral cavity

Pharynx

Oesophagus
 The Mouth 1.
Lips-control entry
and exit to the
2. mouth
Teeth (moved by
muscles of
mastication)-
break down food
mechanically

3.
5.
Salivary glands-
Soft palate-elevates
chemically digest
to prevent food
food
passing into nasal
cavity

6. 4.
Tonsils- Tongue-moves
immunological food to the back
defence of the mouth
 Skeleton

Head
Coronoid
process
Neck

Ramus

Maxilla
Body

Mandibular
Angle foramen

Mandible

Mental foramen
 Skeleton
Hyoid

Styloid
process

Stylohyoid
ligament

Hyoid
Thyroid
cartilage
 Lips
Temporal
The lips contain muscle fibres from orbicularis oris, a sphincter
muscle which encircles the mouth.
This is one of the muscles of facial expression, and is innervated
by the facial nerve. Buccinator is also a muscle of facial
expression which makes up the cheek.
Zygomatic

Buccal

Mandibular Cervical
Orbicularis oris

Buccinator
 Lips
The lips contain muscle fibres from orbicularis oris, a sphincter
muscle which encircles the mouth.
This is one of the muscles of facial expression, and is innervated
by the facial nerve. Buccinator is also a muscle of facial
expression which makes up the cheek.

Orbicularis oris
 Trigeminal nerve
The trigeminal nerve provides the sensory innervation
for the entire face. It has 3 divisions; ophthalmic, Ophthalmic
maxillary and mandibular. V1

Maxillary
V2

Mandibular
V3
 Teeth
The upper teeth are embedded in the maxillary bones,
and the lower teeth are embedded within the
mandibular bone. They are innervated by the maxillary
and mandibular branches of the trigeminal nerve
respectively.
Ophthalmic
Trigeminal nerve

Maxillary Inferior alveolar

Superior
nerve
alveolar
nerve Mandibular
foramen

Mandibular Lingual
Mental foramen
 Teeth
Canines Incisors Canines

Premolars Premolars
(2 cusps)

Molars Molars
(3 cusps)

The permanent dentition consists of, 4

incisors, 2 canines, 4 premolars and 6
molars in both jaws.
 Muscles of Mastication
The muscles of mastication are a group of muscles, all innervated
by the Mandibular branch of the Trigeminal nerve. They
collectively move the mandible with respect to the facial
skeleton.

Temporalis

Masseter
Lateral Pterygoid Medial Pterygoid
 Muscles of Mastication
The muscles of mastication are a group of muscles, all innervated
by the Mandibular branch of the Trigeminal nerve. They
collectively move the mandible with respect to the facial
skeleton.

Lateral Medial Lateral

pterygoid pterygoid pterygoid
plate plates plate

Lateral Pterygoid Medial Pterygoid

Muscles of Mastication
Temporalis
Elevation and
retraction of the jaw.

Protrusion
Retraction

Masseter
Elevation and
protrusion Elevation
Depression
Muscles of Mastication
Lateral Pterygoid
Depression and
protrusion

Protrusion
Retraction

Medial Pterygoid
Elevation and protrusion Elevation
Depression
Salivary glands
There are 3 paired salivary glands; the Parotid gland,
the Submandibular gland and the Sublingual gland.
The Parotid gland, is innervated by the
Glossopharyngeal nerve and drains via the parotid
duct and enters the mouth at the level of the upper 2nd
molar.
The sublingual and submandibular glands are
innervated by the Facial nerve and drain in to the
mouth either side of the frenulum of the tongue.
 Salivary glands
There are 3 paired salivary glands; the Parotid gland,
the Submandibular gland and the Sublingual gland.
The Parotid gland, is innervated by the
Glossopharyngeal nerve and drains via the parotid
duct and enters the mouth at the level of the upper 2nd
molar.
The sublingual and submandibular glands are
innervated by the Facial nerve and drain in to the
mouth either side of the frenulum of the tongue.

Opening of
sublingual duct

Frenulum of the
Opening of
tongue
submandibular duct
Tongue
The tongue is composed two groups of skeletal muscles;
intrinsic muscles and extrinsic muscles. The skeletal muscles
are covered by mucous membrane and receive their motor
nerve supply from the hypoglossal nerve.
 Tongue
Foramen caecum

Lingual tonsil

Posterior

Vallate
papillae
Anterior

Special sensory (taste) General sensory

Anterior 2/3 Chordae tympani Lingual nerve (V3)
Posterior 1/3 Glossopharyngeal Glossopharyngeal
 Tongue
Lingual nerve (Mandibular nerve) Chordae tympani (Facial nerve)

Glossopharyngeal

Hypoglossal

Special sensory (taste) General sensory

Anterior 2/3 Chordae tympani Lingual nerve (V3)
Posterior 1/3 Glossopharyngeal Glossopharyngeal
 Soft Palate
Hard palate Soft palate
The hard palate is
composed of the maxilla
and palatine bones,
posterior to this is the soft
palate, this is composed of
muscles covered by mucous
membrane.

The soft palate elevates

during swallowing to
prevent food entering the
nasal cavity.

The muscles of the soft

palate are innervated by
the Vagus nerve.
 Soft Palate
Palatoglossal arch (contains
palatoglossal muscle)
Palatopharyngeal arch
(contains palatopharyngeal
muscle)
Palatine tonsil
Uvula
The hard palate is
composed of the maxilla
and palatine bones,
posterior to this is the soft
palate, this is composed of
muscles covered by mucous
membrane.
The soft palate elevates
during swallowing to
prevent food entering the
nasal cavity.
The muscles of the soft
palate are innervated by
the Vagus nerve.
 Tonsils
Lingual tonsil
The palatine tonsils are
collections of lymphoid tissue
on each side of the oropharynx,
between the palatine arches.

Palatine
tonsil
 The Mouth 1.
Lips-control entry
and exit to the Facial
2. mouth nerve
Teeth (moved by
Mandibular
muscles of
branch of
mastication)-
trigeminal
break down food
nerve
mechanically

3.
5.
Salivary glands-
Soft palate-elevates
Vagus nerve to prevent food chemically Facial and
digest food Glossopharyngeal
passing into nasal
nerves
cavity

6. 4.
Tonsils- Tongue-moves
immunological food to the back
of the mouth Hypoglossal
defence nerve
Pharynx

Oral cavity

Pharynx

Oesophagus
 Pharynx
Nasopharynx

Oropharynx

Laryngopharynx

Sensory innervation of the pharynx is from the

Glossopharyngeal nerve.
 Pharynx

Superior constrictor Stylopharyngeus

All constrict the walls
of the pharynx Elevates the pharynx
Middle constrictor
during swallowing during swallowing
and are innervated and is innervated by
Inferior constrictor by the Vagus nerve the Glossopharyngeal
nerve
Superior oesophageal
sphincter
 Pharynx
Pharyngeal tonsil (adenoids)

Opening of the
Eustachian tube
Salpingopharyngeal fold

Soft Lingual
palate tonsil
Palatine
tonsil
 Pharynx
The gag reflex is a response to touching
the posterior pharyngeal wall
(Glossopharyngeal nerve) and involves a
brisk and brief elevation of the soft palate
and contraction of pharyngeal muscles
(Vagus nerve).
Deglutition
Oesophagus

Oral cavity

Pharynx

Oesophagus
 Oesophagus
Composed of skeletal muscle (superior 1/3), and smooth
muscle (inferior 1/3)
The middle 1/3 of the oesophagus is a mixture of skeletal and
smooth muscle
Vagus nerve
The end