surgical anatomy of palate. by dr. amit t. suryawanshi, oral surgeon, pune
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Surgical Anatomy of Palate
Dr. Amit T. SuryawanshiOral and Maxillofacial Surgeon
Pune, India
Contact details :Email ID - amitsuryawanshi999@gmail.com
Mobile No - 9405622455
Contents - • Introduction- • Development of palate.• Hard Palate• Soft Palate
Hard Palate - - Boundaries - Anatomical structures
Soft palate - - Borders and Surfaces
- Contents - Movements and Functions
• Studying surgical anatomy of palate helps Oral surgeons to have complete knowledge while performing surgeries of the palate.
Which include , 1. Cleft palate surgery 2. Squamous cell carcinoma of palate3. Adenoid cystic carcinoma of palate.4. Surgical removal of Torus palatinus
Introduction -
• Palate forms the roof of the Oral cavity.
• It is the partition between nasal and oral cavities.
• The palate is divided into two parts,
• 1. Hard palate, • 2.Soft palate or velum.
Introduction -
Development of Face
• Palate develops from 3 parts.A. Two Palatal processesB. Frontonasal process.
• From each maxillary process, a plate like shelf grows medially . This is called as a Palatal Process.
Development of palate
• Palate is formed by the fusion of these 3 parts-
1.Each palatal process fuses with posterior margin of primitive palate(premaxilla).
2. Two palatal processes fuse with each other in the midline .Their fusion begins anteriorly and proceeds posteriorly.
Development of palate
3. The medial edges of the palatal processes fuse with the free lower edge of the nasal septum, thus separating two nasal cavities, from each other and from the mouth.
4. At later stage mesoderm in the palate undergoes intramembranous ossification to form hard palate.
Development of palate
5. However, ossification does not extend to the most posterior portion hence it remains as the Soft palate.
6. Part of the palate developed from frontonasal process is Primary palate.
7. Part of palate developed from Palatal processes is Secondary palate.
Development of palate
• Elevation of the palatine shelves occurs when tongue descends , which allows their meeting in the midline and fusion.
•Its anterior 2/3rd is formed by Palatine processes of Maxilla .
•Posterior 1/3rd is formed by Horizontal plates of Palatine bone.
HARD PALATE-
• The hard palate is covered by a mucous membrane which is attached to the periosteum.
• Deep to the membrane, there are mucus-secreting palatine glands.
• The anterior mucous membrane has 3-4 transverse palatine folds called as Rugae.
Rugae
Boundaries of Hard palate
Antero-lateral margins – Continuous with alveolar arches and gingiva .Posterior margins - Gives attachment to Soft Palate.Superior Surface - Forms the floor of nasal cavity.Inferior Surface – Forms the roof of the oral cavity.
Anatomical structures of Hard palate
Median palatine suture
• The incisive foramen - The opening of the incisive canal.
Neurovasculature - -The Nasopalatine nerve -The terminal branch of the Sphenopalatine artery
• Greater palatine foramen -One opening of the palatine canal.
Neurovasculature - -The Greater palatine nerve and vessels.
Anatomical structures of Hard palate
• Lesser palatine foramen -Another opening of the palatine canal.
Neurovasculature - -The Lesser palatine nerve and vessels.
Anatomical structures of Hard palate
Lymphatics – They drain mostly to Upper deep cervical lymph
nodes and partly to Retropharyngeal lymph nodes .
Anatomical structures of Hard palate
Soft Palate
• It is a movable, muscular fold suspended from the posterior border of hard Palate.
• It separates the Nasopharynx from the Oropharynx.
• It is covered with a mucous membrane.• Its free posterior border has a conical
projection in the midline called Uvula.• It has no bony framework.
Soft Palate
• Soft Palate has 2 surfaces-
1. Anterior Surface. 2. Posterior Surface.
• It has 2 borders – 1. Superior Border. 2. Inferior Border.
Contents of Soft Palate
• Palatine aponeurosis • Muscles• Lymphoid tissues• Glands.
Palatine aponeurosis
• It is a fibrous sheet attached to the posterior border of the hard palate.
• It is a extended tendon of Tensor veli palatini and forms the fibrous basis of the palate.
Spine of Sphenoid bone
Soft palate
Uvula
Musculus Uvulae
Palatine aponeurosis Pterygoid
hamulus
Tensor veli palatini
• Near median plane, the aponeurosis splits to enclose the musculus uvulae.
Palatine aponeurosis
Muscles of Soft Palate
1. Tensor veli palatini.2. Levator veli palatini.3. Musculus uvulae.4. Palatoglossus.5. Palatopharyngeus.
Tensor veli palatini
Origin – 1. Spine of the
sphenoid,2. Lateral side of
auditory tube.3. Scaphoid fossa.
Spine of Sphenoid bone
Soft palate
Uvula
Musculus Uvulae
Palatine aponeurosis Pterygoid
hamulus
Tensor veli palatini
Palatopharyngeus
Tensor veli palatini
Levator veli palatini
Musculus Uvulae
Posterior wall of pharynx
Auditory tube
Scaphoid fossa
Insertion- 1. Palatine
aponeurosis 2. Horizontal
part of palatine bone.
Tensor veli palatini
Spine of Sphenoid bone
Soft palate
Uvula
Musculus Uvulae
Palatine aponeurosis Pterygoid
hamulus
Tensor veli palatini
• Nerve supply – Nerve to medial pterygoid.
Tensor veli palatini.
Action –1. It tenses the soft palate
and assists the levator veli palatini in elevating the palate to prevent entry of food into the nasopharynx during swallowing.
Action –
2. It equalises air pressure between the tympanic cavity and the outside air during swallowing or yawning.
Levator Veli Palatini
• Origin- 1. Undersurface
of petrous part of temporal bone
2. Medial surface of cartilage of auditory tube.
Spine of Sphenoid bone
Soft palate
Uvula
Musculus Uvulae
Palatine aponeurosis Pterygoid
hamulus
Levator veli palatini
Palatopharyngeus
Tensor veli palatini
Levator veli palatini
Musculus Uvulae
Posterior wall of pharynx
Auditory tube
• Insertion- Upper
surface of the palatine aponeurosis.
Levator Veli Palatini
Spine of Sphenoid bone
Soft palate
Uvula
Musculus Uvulae
Palatine aponeurosis Pterygoid
hamulus
Levator veli palatini
• Nerve supply- -Pharyngeal plexus
• Action- -Assists the Tensor veli palatini in
elevating the palate to occlude and prevent entry of food into the nasopharynx during swallowing.
Levator Veli Palatini
Palatoglossus
• Origin- From the undersurface of
palatine aponeursis, where it is continuous with the muscle of opposite side.
• Insertion- It passes in front of tonsil
and it is inserted into the side of the tongue.
• Nerve supply- -Cranial part of accessory nerve via
pharyngeal plexus.
• Action- -Pulls the root of the tongue upward &
backward. Both muscles contracting together cause the palatoglossal arches to approach the midline, thus opening between the oropharynx & oral cavity is narrowed.
Palatoglossus
Palatopharyngeus• Origin –1. Posterior
border of hard palate
2. Palatine
aponeurosis
Palatopharyngeus
Palatine aponeurosis
Posterior border of hard palate
Palatopharyngeus
Palatopharyngeus
• Insertion – It is inserted to the posterior border of
lamina of thyroid cartilage .
Palatopharyngeus
• Nerve supply- - Cranial part of accessory nerve via
pharyngeal plexus.
• Action – Pulls the wall of pharynx upwards.
Palatopharyngeus
Musculus Uvulae
• Origin – 1. Posterior border
of hard palate 2. Palatine
aponeurosis
• Insertion – Mucous
membrane of the Uvula.
Palatine aponeurosis
Posterior border of hard palate
• Nerve supply- -Pharyngeal plexus
• Action – Pulls up the Uvula.
Musculus Uvulae
Muscles of soft palate
• Blood supply – All the muscles of soft palate are supplied by
lesser palatine artery.
Faucial pillars of mouth
Passavant’s Ridge
• Some of the upper fibers of the palatopharyngeus pass circularly deep to the mucous membrane of the pharynx, and constitute Passavant’s muscle internal to the superior constrictor.
• which on contraction raises a ridge (Passavant’s ridge) on the posterior wall of the nasopharynx .
• When the soft palate is elevated, it comes in contact with the ridge and two of them together close the pharyngeal isthmus (between the nasopharynx and oropharynx).
Movements & Functions of Soft palate-
• Palate control two gates – 1. Pharyngeal isthmus 2. Oropharyngeal isthmus
• It closes gates or regulate their size according to requirements. Through these movements ,the soft palate plays an important role in chewing, swallowing, speech, coughing, sneezing, etc.
• It isolates mouth from oropharynx during chewing so that breathing is unaffected.
• In second stage of swallowing, it separates oropharynx from nasopharynx.
• It modifies quality of voice.• During sneezing, it divides blast of air and
directs through nasal & oral cavities.• During coughing, it directs air & sputum into
mouth & not into the nose.
Movements & Functions of Soft palate-
References -
• Grey's anatomy• Atlas of anatomy • Snell –Textbook of Anatomy• Sicher • Internet
Thank You
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