HYPOGLOSSAL AREA

From Big Medical Encyclopedia

HYPOGLOSSAL AREA (regio sublingualis) — the area located between an inner surface of a body of the mandible and a lower surface of language within its front third. It is more correct to call P. the lake hypoglossal space as it does not come to a body surface (tsvetn. fig. 1 and 2). The lower bound of P. of the lake is the maxillary and hypoglossal muscle (m. mylohyoideus).

Anatomy

Hypoglossal area, hypoglossal gland, submaxillary area, submaxillary gland. Fig. 1. Topography of submaxillary and hypoglossal areas (the right half of a mandible is removed, skin and muscles are delayed). Fig. 2. Topography of hypoglossal area (language is lifted, a part of his mucous membrane is removed). Fig. 3. Topography of submaxillary area (the hypodermic muscle of a neck and a superficial plate of a cervical fascia are removed): 1 — language, 2 — a peredneyazychny sialaden, 3 — a deep artery of language, 4 — a submandibular channel, 5 — hypoglossal gland, 6 — the mandible (is partially removed), 7 — a maxillary and hypoglossal muscle, 8 — a mental hypoglossal muscle, 9 — submandibular gland, 10 — a facial artery, 11 — a facial vein, 12 — podjyazychno - a lingual muscle, 13 — a submaxillary lymph node, 14 — an upper root of a cervical loop, 15 — a breast - klyuchichno - a mastoidal muscle, 16 — a zanizhnechelyustny vein, 17 — an internal jugular vein, 18 — an internal carotid artery, 19 — an outside carotid artery, 20 — deep cervical lymph nodes, 21 — a hypoglossal nerve, 22 — a back abdomen of a biventral muscle, 23 — a shilopodjyazychny muscle, 24 — a parotid gland, 25 — a masseter, 26 — a deep vein of language, 27 \the branch of a mandible (is partially removed) with U-2014\, 28 — a lingual nerve, 29 — hypoglossal nipples, 30 — a hypoglossal fold, 31 — a bridle of language, 32 — a front abdomen biventral - muscles, 33 — a hypodermic muscle of a neck, 34 — a superficial plate of a cervical fascia, 35 — the basis of a mandible, 36 — a regional branch of a mandible of a facial nerve.

The item of the lake has the horseshoe form, its front department in the form of the triangular field is located under a tip of language, narrower posterolateral departments stretch to the basis of nebnoyazychny handles (areus palatoglossus).

The hypoglossal area is covered with a mucous membrane, the bridle of language (frenulum linguae) going on a lower surface of language is allocated for a cut. On the parties of a bridle of a knaruzha and from top to bottom fringed folds (plicae fimbriatae) fall. Hypoglossal folds (plicae sublinguales) formed by a mucous membrane and the subject hypoglossal glands adjoin to the lower end of a bridle of language (gll. sublinguales).

On the medial end of each hypoglossal fold directly the basis of a bridle of language has a small conic eminence — a hypoglossal nipple (caruncula sublingualis), on Krom a pinhole open a submaxillary channel (a submandibular channel, T.; ductus submandibularis) and big hypoglossal channel (ductus sublingualis major). On other extent of hypoglossal folds several openings small channels of hypoglossal gland (ductus sublinguales minores) open.

Posterolateral departments of P. of the lake behind hypoglossal folds, so-called maxillary and lingual fillets, represent the ladyeobrazny deepenings along big molars which are coming to an end at the basis of palatoglossal handles.

The number of the anatomic educations which are located in P. with the lake includes hypoglossal glands with channels, channels of submaxillary glands, vessels, nerves and the muscles going to language. All educations of P. of the lake are surrounded with well developed friable cellulose.

Hypoglossal glands (see. Hypoglossal gland ) are located in front department of P. of the lake directly under a mucous membrane. The bottom of glands lies on a maxillary and hypoglossal muscle. A side outside part of gland adjoin to an inner surface of a body of the mandible, the rear edge — with submaxillary glands (see. Submaxillary gland ). Channels of hypoglossal glands can fall into canals of the submaxillary glands which are also passing under hypoglossal folds or to open on a surface of folds independently.

In P. the lake located three pairs of muscles: genioglossal (m. genioglossus), geniohypoid (m. geniohyoideus) and hypoglossal and lingual (m. hyoglossus), between to-rymi are formed kletchatochny spaces.

Blood of the lake comes to P. from a branch of a lingual artery (a. lingualis) — a hypoglossal artery (a. sublingualis) which is located between hypoglossal gland and a podborodochnoyazychny muscle. The hypoglossal vein (v. sublingualis) is located under a mucous membrane of a lower surface of language, through to-ruyu it is well visible. The hypoglossal vein joins a lingual vein (v. lingualis), edges falls into an internal jugular vein (at. jugularis int.).

Limf, P.'s vessels of the lake are continuation limf, vessels of language and fall in submaxillary (Submandibular limf, nodes, T.; nodi lymphatici submandibulares) and submental limf, nodes (nodi lymphatici submentales).

P.'s innervation of the lake is carried out by generally lingual nerve (n. lingualis) which gives a branch — a hypoglossal nerve (n. sublingualis) — to a mucous membrane of P. of the lake. The secretory innervation of hypoglossal gland is carried out by a drum string (chorda tympani) and branches of sympathetic nerves from an upper cervical node (gangl, cervicale superius).

Pathology

In P. of the lake easily there are inflammatory processes, and in posterolateral departments (maxillary and lingual fillets) they tend to distribution on the neighboring areas on kletchatochny spaces on the course of a channel of submaxillary gland and along vessels.

Treatment operational. At cuts in these departments of an occasion of suppurative processes it is necessary to consider a saturation their anatomic educations.

In front department of P. of the lake shortening of a bridle most often meets language (see), demanding an operative measure — sections of the basis of a bridle (more radical intervention — movement of counter triangular rags). Also ranula (cyst) resulting from obstruction of output channels of hypoglossal glands, and also formation of salivary stones are observed (see. Sialolithiasis ).

The mucous membrane and other tissues P. of the island can be surprised at tuberculosis (see. Tuberculosis extra pulmonary ), actinomycosis (see) and other diseases, including development of tumors is possible.

During processing of teeth at prosthetics the lingual artery or its branches is sometimes injured. Attempts to stop bleeding through a section in P. of the lake because of a large amount of friable cellulose are not always successful. In these cases it is reasonable to make bandaging of vessels on an extent (see. Bandaging of blood vessels ).



Bibliography: Anthropotomy, under the editorship of S. S. Mikhaylov, with * 82, M., 1973; Evdokimov And, And. and Melik - the Pasha - e in N. Sh. Topographical anatomy of an oral cavity, M. — JI., 1930; Zolotareva T. In, and Axes G. N. Surgical anatomy of the head, M., 1968; Zolotko Yu. A. Atlas of a topographical ayatomiya of the person, p.1, page 112, M., 1964; Kasatkin S. N. Anatomy of sialadens, Stalingrad, 1948; G. K Korning. Topographical anatomy, the lane with it., M. — L., 1936.


V. I. Zausayev; L. L. Kolesnikov (An.).

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