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Palate: Anatomy

The palate is the structure that forms the roof of the mouth and floor of the nasal cavity Nasal cavity The proximal portion of the respiratory passages on either side of the nasal septum. Nasal cavities, extending from the nares to the nasopharynx, are lined with ciliated nasal mucosa. Nose and Nasal Cavity: Anatomy. This structure is divided into soft and hard palates. The palate is formed between weeks 7 and 10 of gestation, and deformities of this structure ( cleft palate Cleft palate Congenital fissure of the soft and/or hard palate, due to faulty fusion. Cleft Lip and Cleft Palate) are usually relevant because of its role in feeding, especially in infants.

Last updated: Sep 26, 2022

Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Embryology

The embryology of the palate is complex, with a critical stepwise process to midline fusion. Interruption of this process can result in cleft disorders. 

  • Process:
    • Medial nasal prominences Medial nasal prominences Development of the Nervous System and Face fuse and descend.
    • Primary palate moves posteriorly.
    • Palatine shelves fuse with each other and with the nasal septum Nasal septum The partition separating the two nasal cavities in the midplane. It is formed by the septal nasal cartilage, parts of skull bones, and membranous parts. Nose and Nasal Cavity: Anatomy.
    • Secondary palate is formed.
    • Primary palate fuses with the secondary palate.
    • Point of fusion is marked by the incisive foramen.
    • Hard palate is formed.
    • Soft palate and uvula Uvula A fleshy extension at the back of the soft palate that hangs above the opening of the throat. Peritonsillar Abscess extend off the posterior side of the secondary palates.
  • Fusion occurs from anterior to posterior.
Formation of the palate

Formation of the palate

Image by Lecturio.

Gross Anatomy

The palate is divided into the hard palate and soft palate. The hard palate is located anterior to the soft palate, and each receives blood supply from branches of the external carotid artery External carotid artery Branch of the common carotid artery which supplies the exterior of the head, the face, and the greater part of the neck. Carotid Arterial System: Anatomy and nerve supply via the palatine and nasopalatine nerves. 

Location and relations between the hard and soft palate

Location and relations between the hard and soft palate

Image: “Line art drawing of palate” by Pearson Scott Foresman. License: Public Domain

Structure

Hard palate (anterior):

  • Formed anteriorly by the 2 palatine processes of the maxilla Maxilla One of a pair of irregularly shaped bones that form the upper jaw. A maxillary bone provides tooth sockets for the superior teeth, forms part of the orbit, and contains the maxillary sinus. Skull: Anatomy
  • Formed posteriorly by the horizontal plates of the palatine bones
  • Foramina:
    • Incisive fossa
    • A pair of greater palatine foramina
    • A pair of lesser palatine foramina
Inferior view of the hard palate

Inferior view of the hard palate, showcasing the 2 palatine processes of the maxilla Maxilla One of a pair of irregularly shaped bones that form the upper jaw. A maxillary bone provides tooth sockets for the superior teeth, forms part of the orbit, and contains the maxillary sinus. Skull: Anatomy and the horizontal plate of the palatine bones

Image by Lecturio.

Soft palate (posterior):

  • Soft and movable
  • Contains the tensor veli palatini muscle posteriorly
Table: Muscles of the soft palate
Muscle Origin Insertion Nerve supply Function
Musculus uvulae Posterior nasal spine Spine The human spine, or vertebral column, is the most important anatomical and functional axis of the human body. It consists of 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae and is limited cranially by the skull and caudally by the sacrum. Vertebral Column: Anatomy Musculus uvulae of the opposite side Pharyngeal branch of vagus nerve Vagus nerve The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). Pharynx: Anatomy Pulls uvula Uvula A fleshy extension at the back of the soft palate that hangs above the opening of the throat. Peritonsillar Abscess forward
Tensor veli palatini Cartilaginous part of the auditory tube Palatine aponeurosis Muscular branch of the mandibular nerve Mandibular nerve A branch of the trigeminal (5th cranial) nerve. The mandibular nerve carries motor fibers to the muscles of mastication and sensory fibers to the teeth and gingivae, the face in the region of the mandible, and parts of the dura. Jaw and Temporomandibular Joint: Anatomy Tenses the soft palate
Levator veli palatini Cartilaginous portion of the eustachian tube Eustachian tube A narrow passageway that connects the upper part of the throat to the tympanic cavity. Ear: Anatomy Palatine aponeurosis Pharyngeal branch of vagus nerve Vagus nerve The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). Pharynx: Anatomy Elevates soft palate
Palatopharyngeus Palatine aponeurosis and hard palate Upper border of the thyroid Thyroid The thyroid gland is one of the largest endocrine glands in the human body. The thyroid gland is a highly vascular, brownish-red gland located in the visceral compartment of the anterior region of the neck. Thyroid Gland: Anatomy cartilage Cartilage Cartilage is a type of connective tissue derived from embryonic mesenchyme that is responsible for structural support, resilience, and the smoothness of physical actions. Perichondrium (connective tissue membrane surrounding cartilage) compensates for the absence of vasculature in cartilage by providing nutrition and support. Cartilage: Histology Elevates larynx Larynx The larynx, also commonly called the voice box, is a cylindrical space located in the neck at the level of the C3-C6 vertebrae. The major structures forming the framework of the larynx are the thyroid cartilage, cricoid cartilage, and epiglottis. The larynx serves to produce sound (phonation), conducts air to the trachea, and prevents large molecules from reaching the lungs. Larynx: Anatomy and the pharynx Pharynx The pharynx is a component of the digestive system that lies posterior to the nasal cavity, oral cavity, and larynx. The pharynx can be divided into the oropharynx, nasopharynx, and laryngopharynx. Pharyngeal muscles play an integral role in vital processes such as breathing, swallowing, and speaking. Pharynx: Anatomy
Palatoglossus Palatine aponeurosis Lateral aspect of the tongue Tongue The tongue, on the other hand, is a complex muscular structure that permits tasting and facilitates the process of mastication and communication. The blood supply of the tongue originates from the external carotid artery, and the innervation is through cranial nerves. Lips and Tongue: Anatomy Elevates posterior part of the tongue Tongue The tongue, on the other hand, is a complex muscular structure that permits tasting and facilitates the process of mastication and communication. The blood supply of the tongue originates from the external carotid artery, and the innervation is through cranial nerves. Lips and Tongue: Anatomy
Muscles that comprise the soft palate

Muscles that comprise the soft palate:
This image is of the coronal Coronal Computed Tomography (CT) plane viewed in an anteroposterior orientation Orientation Awareness of oneself in relation to time, place and person. Psychiatric Assessment.

Image by Lecturio.

Neurovasculature

Blood supply:

  • Greater palatine artery: supplies the area anterior to the greater palatine fossa
  • Lesser palatine artery: supplies the area posterior to the greater palatine fossa
  • Ascending palatine artery
  • Palatine branches of the ascending pharyngeal artery.

Innervation:

  • Hard palate: greater palatine and nasopalatine nerves
  • Soft palate: lesser palatine nerve
Blood supply and innervation of the palate

Blood supply and innervation of the palate

Image by Lecturio.

Related videos

Microscopic Anatomy

The microscopic anatomy of the palate consists primarily of squamous epithelial tissue, although the hard palate also contains osseous components. 

The palate contains:

  • Mucus-secreting glands: moisten the oral cavity
  • Masticatory mucosa: stratified squamous epithelium Epithelium The epithelium is a complex of specialized cellular organizations arranged into sheets and lining cavities and covering the surfaces of the body. The cells exhibit polarity, having an apical and a basal pole. Structures important for the epithelial integrity and function involve the basement membrane, the semipermeable sheet on which the cells rest, and interdigitations, as well as cellular junctions. Surface Epithelium: Histology

Clinical Relevance

  • Cleft palate Cleft palate Congenital fissure of the soft and/or hard palate, due to faulty fusion. Cleft Lip and Cleft Palate: results from lack of fusion of the palatal shelves. Cleft palate Cleft palate Congenital fissure of the soft and/or hard palate, due to faulty fusion. Cleft Lip and Cleft Palate can be isolated to either the soft or the hard palate, or it can affect both palates at the same time. Cleft palate Cleft palate Congenital fissure of the soft and/or hard palate, due to faulty fusion. Cleft Lip and Cleft Palate can result in feeding problems that may be severe. The treatment is usually surgical.
  • Streptococcal infection: Streptococcal pharyngitis Streptococcal Pharyngitis Rheumatic Fever often presents with palatal petechiae Petechiae Primary Skin Lesions, where pinpoint red areas can be seen on the soft palate. Patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship with streptococcal pharyngitis Streptococcal Pharyngitis Rheumatic Fever will also likely have fever Fever Fever is defined as a measured body temperature of at least 38°C (100.4°F). Fever is caused by circulating endogenous and/or exogenous pyrogens that increase levels of prostaglandin E2 in the hypothalamus. Fever is commonly associated with chills, rigors, sweating, and flushing of the skin. Fever, sore throat Sore throat Pharyngitis is an inflammation of the back of the throat (pharynx). Pharyngitis is usually caused by an upper respiratory tract infection, which is viral in most cases. It typically results in a sore throat and fever. Other symptoms may include a runny nose, cough, headache, and hoarseness. Pharyngitis, and cervical lymphadenopathy Lymphadenopathy Lymphadenopathy is lymph node enlargement (> 1 cm) and is benign and self-limited in most patients. Etiologies include malignancy, infection, and autoimmune disorders, as well as iatrogenic causes such as the use of certain medications. Generalized lymphadenopathy often indicates underlying systemic disease. Lymphadenopathy. Treatment is with antibiotics.

References

  1. Tolarová, M.M., Cervenka, J. (1998). Classification and birth prevalence of orofacial clefts. Am J Med Genet 75:126–137. https://pubmed.ncbi.nlm.nih.gov/9450872/ 
  2. Mai, C.T., Cassell, C.H., Meyer, R.E., et al. (2014). Birth defects data from population-based birth defects surveillance programs in the United States, 2007 to 2011: highlighting orofacial clefts. Birth Defects Res A Clin Mol Teratol 100:895–904. https://pubmed.ncbi.nlm.nih.gov/25399767/ 
  3. Shkoukani, M.A., Chen, M., Vong, A. (2013). Cleft lip—a comprehensive review. Front Pediatr 1:53. https://pubmed.ncbi.nlm.nih.gov/24400297/ 

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