Human Structure and Function II

Anatomy of the Digestive system - Oral cavity, tongue and teeth

Captain Assoc Prof. Dr Farid Bin Che Ghazali,
Health campus , Universiti Sains Malaysia.
Semester II 2011 / 2012
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Digestive System: Mouth, Pharynx, Digestive Tube

Plus: Salivary Glands, Pancreas, Liver Hollow Passage: Mouth to Anus = Digestive Tract Regional Specializations Modifications correlate to functions Functional component = lining (Mucous Membrane)

ORAL CAVITY Vestibule Boundaries Anteriorly and laterally - lips and cheeks Posteriorly and medially - teeth and gums Contents Termination of the parotid duct Oral cavity proper Boundaries Anteriorly and laterally - teeth and gums . Superiorly - hard palate inferiorly - tongue and sublingual structures Posteriorly - palatoglossal and palatopharyngeal arches Contents Teeth and gums ,Tongue Sublingual structures Frenulum of the tongue,Submandibular ducts & Sublingual folds Palatine tonsils

MOUTH & PHARYNX

Mucosa Stratified squamous epithelium (not cornified) Basement membrane = basal attachment Lamina Propria vascular papillae

Lymphocytic infiltration pharynx

Lamina muscularis mucosae absent

Repaced by elastic network (pharynx)

Submucosa
Lax layer where present Attaches: mucosa to muscles & bone Absent on hard palate (part), gums, dorsum of tongue

Glands
Compound tubulo-alveolar

Regional
Serous, Mucous, mixed Sero-mucous Location: submucosa
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Superficial tissues attached: deep lying skeletal muscle or bone Blood vessels, lymphatics, nerves:
coarse plexuses submucosa

LIP
Outer surface: skin (thin, cornified) Hair follicles, sebaceous glands, sweat glands Inner surface: typical mucous membrane Submucosa: present, not well defined

Stratified squamous epithelium (thicker than epidermis)

Central Core: Skeletal muscle Orbicularis oris; Mimetic muscles Labial glands rounded groups; Sero-mucous (mucous dominant); submucosal
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Transition Zone at margin

Thick epithelium: much eleidin Vascular papillae tall, indent epithelium Blood capillaries show through epithelium Glands: absent (drying of lips)

A, Stratified nonkeratinized;

squamous B, Lamina

epithelium, propria; C, 9

Seromucous salivary gland

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CHEEK Lip plan continued laterally Mucosa short papillae; abundant elastic fibers; no glands Lamina propria bound to muscle layer (at intervals) Submucosa: looser, fat-containing Mixed (largely mucous) glands invade muscle (M. buccinator)

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GUM
Mucosa attached to alveolar bone Epithelium moves inward at margin

Gingival Sulcus (~2 mm.)

Bottom of groove epithelium attached to tooth

Zone of attachment shifts with age

Epithelium resembles labial mucosa Lamina Propria: dense, fibrous tissue Binds gum to cementum & alveolar bone Gum line: papillae very tall, vascular Zone attachment: no papillae Mast cells
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TEETH
Tooth = modified soft papilla, hard covering

Hard exposed surface (enamel) ectodermal

Concealed portion (dentin) mesodermal Unique organ first set replaced by permanent set

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Ground preparation

Demineralised preparation

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Tooth
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Tooth Structure
Free Crown 1 to 3 Roots Crown Root junction = Neck At gum margin

Root in alveolus
Periodontal membrane

joins root & alveolar wall

Pulp Chamber Crown into root
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Tooth wall 3 specialized substances:

1) Dentine borders pulp Collagenous mesh Calcified ground substance Harder than bone (72% inorganic)

Uncalcified areas (crown) = interglobular spaces

Adjacent to cementum = Granular layer of Tomes Dentinal canaliculi radially striate

1 3 dia.; to 4 mm. long

Lined with Dentinal Sheath of Neumann 17

Dentine, continued
Dentinal Fiber of Tomes (in canaliculus) = specialized osteoblast = odontoblast Calcification obliterates Incremental Lines of Owen & of Ebner Layered deposits

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2) Enamel over crown

Hardest tissue 97% inorganic salts Calcium phosphate = 90% Structural unit = Enamel Prism Enclosed by Enamel Sheath

Prism = separate cell

Entends: dentine to surface

Diameter = 3 6
12 million prisms / molar Cross banded, beaded (surface) Transverse: hexagonal (humans appear semicircular); bundled
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3) Cementum over root

Thin layer Invests denine of root

Bone cells in lacunae; typical bone matrix

Lamellation: inconstant; irregular

Vessels absent
Old age: Haversian systems

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Dental Pulp (nerve of tooth not really a nerve Fills pulp cavity Soft, gelatinous

Cells: fusiform; stellate like mesenchymal cells

Reticular fibers in ground substance

Odontoblasts line cavity

cell processes enter dentinal canaliculus the Dentinal Fibers of Tomes Also: nerves & blood vessels

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Periodontal Membrane
= periosteum (between alveolar bone & root Merges with gum; supports gum

Neck region: forms dentinal ligament

Dense, coarse collagenous fibers; Fibroblasts; Osteoblasts NO ELASTIC FIBERS Sharpeys fibers: membrane to alveolar bone; membrane to cementum = Suspensory Ligament of Teeth

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Prof. Madya Dr. Farid Che Ghazali

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TONGUE Mouth/Pharynx Mobile organ

Structural: mass of skeletal muscle with mucous membrane covering

Median sulcus over deep lingual septum V separates anterior third from posterior two thirds

angle forward
foramen caecum (apex) Body (oral); Root (pharyngeal) Lingual papillae dorsal surface
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Lingual tonsils dorsum

The Mucosa: Stratified Squamous Epth. Tightly bound

Lamina Propria compact, unites with muscle Vertical projections with epithelium = lingual papillae
4 types lingual papillae: Filiform, Fungiform, Vallate, Foliate
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Filiform Papillae
= plush of tongue Parallel rows

Primary columnar elevation of lamina propria

5 30 tall secondary papillae

Epithelium over papillae end in tapered points

Cat of Nine Tails Hard & scaly (not cornified)

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Fungiform Papillae Knob-like Scattered, single, among filiform papillae

Larger & fewer than filiform papillae

Narrow stalk, rounded top

Size: 1.8 mm. high; 1 mm. wide

C.T. core; secondary papillae 1 to several taste buds Modified fungiform papillae: conical (3 mm. high) - few

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Vallate Papillae
V-shaped row; V separates tongue body & root 7 to 11 papillae

Largest papillae: 0.5 to 1.5 mm. high; 1 to 3 mm. wide

Top below surface of tongue

Trench around periphery

Inverted cone shape
General surface of tongue

C.T. core; secondary papillae

~200 taste buds lateral surface; trench wall ~50 29

Number of taste buds highly variable

Von Ebners Glands (serous) may project into muscle

Tongue surface

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Foliate Papillae
Parallel folds; lateral margin tongue Body-root junction

Regress in adult rudimentary

Infants: 4 to 8; each side tongue

Taste buds middle region

Von Ebners glands open into bottom of trench Rabbits: highly developed

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Taste Buds Taste buds are most numerous in the fungiform, circumvallate and foliate papillae. In addition, taste buds are found in the palate, palatoglossal and palatopharyngeal arches and in the pharynx and larynx. In histological sections they appear as ovoid lightly stained bodies, which extend perpendicular from the basement membrane to a little opening formed in the epithelium, the taste pore. The elongated cells that form the taste bud can functionally be divided into three groups: sensory cells, supporting (or sustentacular) cells, and basal cells. Sensory cells extend microvilli into the taste pore. These microvilli contain the receptors for the different basic taste modalities (sweet, salty, bitter and acid). Basal cells regenerate the two other cell types. (Cell turnover is quite high, and it is thought that the cells of the taste buds are replaced (on average) every 10th day).

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Prof. Madya Dr. Farid Che Ghazali

Lingual Glands Several sets: Anterior; Glands of Von Ebner; Mucous Glands of the Root Anterior Glands: under apex of tongue mixed sero-mucous glands

several ducts/gland group

Glands of Von Ebner: near vallate & foliate papillae

purely serous
4 to 38 ducts (vallate trenches) Mucous Glands of Root lymphoid area into body purely mucous ducts into pits lingual tonsils
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Muscle
halved incompletely (fibrous lingual septum) Skeletal muscle 2 groups

Intrinsic group: M. lingualis, confined to tongue

Extrisic group: arise outside tongue; insert into tongue hyoglossus, genioglossus, styloglossus, palatoglossus, chondroglossus

Fibers in bundles: all directions, common direction in bundle

Fibers: in loose, fatty areolar C.T. Insertion: perimysial C.T.
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Blood Vessels:
plexus in lamina propria capillaries into papillae Lymphatics: drain papillae plexus in lamina propria

Nerve Fibers:
Efferent nerve fibers: muscle, glands, blood vessels

Sensory nerve fibers: end freely, general sensibilities; taste buds (= gustatory)

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Palate
Roof of mouth 2 sides: oral, nasal Oral side: oral type mucosa Nasal side: respiratory mucosa

Uvula (conical) at end

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Hard Palate

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Hard Palate:
Oral Side: Stratified squamous epithelium tall papillae densely fibrous lamina propria Submucosa: except at raphe

Anterior 1/3 fatty

Posterior 2/3 pure mucous glands

Middle layer: maxillary & palate bones

Nasal Side: Pseudostratified columnar epithelium, ciliated Mixed sero-mucous glands deep elastic fibers
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Soft Palate:
Continuation of hard palate Oral side similar to hard palate

lamina propria infiltrated with lymphocytes

Dense layer elastic fibers between mucosa-submucosa

Middle layer: skeletal muscle

Nasal side similar to hard palate exception: near free margin: stratified squamous epithelium

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Pharynx
Flattened, conical chamber Superior & Inferior regions Superior = respiratory naso-pharynx Nasal mucosa

Inferior = oro-pharynx (behind palatine arches); laryngo-pharynx

Tonsilar ring at beginning

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Epithelium:
naso-pharynx: pseudostratified columnar, ciliated; specialized goblet cells

Changes at lower levels to: stratified columnar then stratified squamous

oro- & laryngo-pharynx: soft, stratified squamous Lamina Propria:

naso-pharynx basement membrane distinct

C.T. papillae Oro- & laryngo-pharynx: scattered, solitary lymph nodules deepest layers: thick elastic layer
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Submucosa: Well developed: naso-pharynx (laterally); near esophagus Other regions: elastic layer against muscle Small mucous glands regions of stratified epithelium Musclularis: 2 layer (skeletal muscle) Inner longitudinal; outer oblique/circular

Adventitia:
thin, fibrous (most regions)

other regions: muscles attached to bones of skull

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Pharyngotympanic tube Auditory tube Eustachian tube

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Oropharynx
Digestive function Anterior: anterior tonsillar pillar Posterior: superior constrictor Superior: soft palate Inferior: base of tongue, superior epiglottis Laterally: palatoglossal and palatopharyngeal arches

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Epiglottis
This is a slightly curved, leafshaped structure, the stalk of the epiglottis is attached to the deep aspect of the laryngeal prominence. This cartilage overhangs the ventricle of the larynx. The epiglottis is connected to the: Tongue by the median and lateral glossoepiglottic folds. Arytenoids cartilages by the aryepiglottic and false vocal folds.
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Palatine Tonsil

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Lingual Tonsil
Several lymphoid follicles, which represent a portion of the lingual tonsil, are present. They protrude slightly above the surface of the posterior tongue. Variable distribution extending to epiglottis or the palatine tonsil.

Lymphatic nodules at arrows

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Pharyngeal Tonsil
Respiratory epithelium

Pharyngeal tonsils resemble those of the palate but with ciliated, pseudostratified epithelium rather than stratified squamous epithelium lining the surface and crypts.

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A, Condylar head; B, Tubercle of temporal bone; C, Articular fossa; D, Articular disk; E, Upper synovial cavity; F, Lower synovial cavity; G, Lateral pterygoid muscle; H, Upper portion of posterior disk and capsule; I, Lower portion of posterior disk and capsule

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Important notes

The Pharyngeal walls made up of mucosa, submucosa, pharyngobasilar fascia, constrictor m., buccopharyngeal fascia Lateral walls made up of ant. and post. tonsillar pillars, tonsillar fossa with the palatine tonsil, lateral phayngeal wall Soft palate made up of palatine aponeurosis, tensor and levator veli palatini, uvular m, palatoglossus, palatopharyngeus