Hard palate (Palatum durum)
The hard palate is arched, with its convexity facing upward. A median raphe runs along the center, where the mucous membrane is tightly fused with the periosteum. Closer to the posterior regions, this fixation becomes less strong.
Blood supply and sensation are provided via two main pathways:
- Anterior part: through the incisive foramen (foramen incisivum) from the canal of the same name, the nasopalatine vessels and nerve (a., v. et n. nasopalatini) emerge onto the palate. This nerve branches off from the second division of the trigeminal nerve.
- Posterior part: through the greater and lesser palatine foramina, major neurovascular bundles penetrate — the greater and lesser palatine arteries, veins, and nerves (aa., vv. et nn. palatini majores et minores).
Soft palate (Palatum molle) and fauces
The soft palate is a direct posterior continuation of the hard palate. Externally, it represents an irregular quadrilateral, from the center of which hangs the uvula (uvula). The soft palate forms the upper boundary of the fauces.
Boundaries of the fauces:
- Inferiorly — the dorsum of the tongue (dorsum linguae).
- Laterally — the palatoglossal arches.
Muscular apparatus includes symmetrically arranged muscles:
- Anteriorly and inferiorly (in the respective arches): palatoglossus muscle (m. palatoglossus).
- Posteriorly and inferiorly: palatopharyngeus muscle (m. palatopharyngeus).
- Laterally: levator veli palatini muscle (m. levator veli palatini) and tensor veli palatini muscle (m. tensor veli palatini).
- In the center: uvular muscle (m. uvulae).
Palatine tonsil (Tonsilla palatina)
Located in the tonsillar fossa, wedged between the anterior (palatoglossal) and posterior (palatopharyngeal) arches. It is separated from the lateral wall of the pharynx by a layer of loose connective tissue. From the oral cavity side, the tonsil is covered by a mucous membrane that deeply penetrates the tissues, forming crypts. The adventitia of the organ is firmly fused with the connective tissue capsule.
Together with the lingual, pharyngeal, and tubal tonsils, it forms the protective lymphoepithelial ring of Pirogov-Waldeyer.
Venous blood from the organ collects into venous plexuses on the outer surface and drains into the facial vein or directly into the internal jugular vein.
Innervation and lymphatic drainage
Sensation of the mucous membrane and palatine glands (gll. palatinae) is provided by the maxillary nerve (n. maxillaris). Its fibers pass through the pterygopalatine ganglion (ganglion pterygopalatinum) and descend further as the middle and posterior palatine nerves (nn. palatini medius et posterior). Nerve trunks approach the palatine tonsil from the outer side from the glossopharyngeal (CN IX), vagus (CN X), and lingual nerves.
Motor innervation of the soft palate has an important exception: the tensor veli palatini muscle (m. tensor veli palatini) receives signals from the mandibular nerve (n. mandibularis — the third division of the trigeminal nerve). All other muscles of the soft palate are innervated by branches from the pharyngeal plexus (plexus pharyngeus).
Lymph from the tissues of the hard and soft palate, as well as from the tonsils, penetrates through the pharyngeal wall (at the level of the tonsil or auditory tube) and drains into the retropharyngeal and deep cervical lymph nodes.
Briefly: answers to topical questions
Which major vessels give rise to the arteries supplying the hard and soft palate?
The arteries supplying the hard and soft palate mainly branch off from the maxillary artery. The descending palatine artery enters the greater palatine canal and divides into the greater palatine artery, supplying the hard palate, and the lesser palatine arteries, supplying the soft palate and palatine tonsil. The blood supply to the palatine tonsil is also carried out by branches of the ascending pharyngeal artery and the ascending palatine artery, which is a branch of the facial artery.
Which nerves participate in the formation of the pharyngeal plexus (plexus pharyngeus)?
Methodological texts contain only fragmentary information about the innervation of the muscles of the soft palate and pharynx. It is indicated that all other muscles of the soft palate, except for the tensor veli palatini, are innervated from the pharyngeal plexus (plexus pharyngeus), however, the complete list of nerves forming this plexus is not provided in the given sources.
Which branches arise from the pterygopalatine ganglion for the sensory innervation of the palatal mucosa?
The greater palatine nerve, lesser palatine nerves, and nasopalatine nerve through the incisive foramen arise from the pterygopalatine ganglion for the sensory innervation of the palatal mucosa. These branches provide sensory innervation to the hard and soft palate.
- Greater palatine nerve (n. palatinus major) — runs to the hard palate.
- Lesser palatine nerves (nn. palatini minores) — run to the soft palate and uvula.
- Nasopalatine nerve (n. nasopalatinus) — runs to the mucous membrane of the anterior hard palate.
To easily remember the innervation of the soft palate muscles: absolutely all muscles are controlled by the pharyngeal plexus, except for one — the tensor veli palatini muscle (m. tensor veli palatini), which is controlled by the mandibular nerve (third division of the trigeminal).
Class and exam questions
What passes through the incisive foramen in the anterior palate?
The incisive canal opens onto the palate through the incisive foramen, transmitting the nasopalatine artery, vein, and nerve (a., v. et n. nasopalatini).
What bounds the tonsillar fossa anteriorly and posteriorly?
Anteriorly, it is bounded by the palatoglossal arch (containing the muscle of the same name), and posteriorly by the palatopharyngeal arch.
Where does venous blood drainage from the palatine tonsils occur?
Blood collects in plexuses on the outer surface of the tonsil and drains into the facial vein or directly into the internal jugular vein.
What else to study on this topic
- Topographic relationships of the palate with adjacent structures (masseter, buccinator muscles, and superior pharyngeal constrictor).
- Structure of the pterygopalatine ganglion and detailed course of the maxillary nerve branches.
- Anatomy of the pharyngeal plexus (plexus pharyngeus).
- Localization and composition of Waldeyer's lymphoepithelial ring.
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