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Anatomy

  • The tongue is divided into halves by a medial fibrous lingual septum that lies deep to the medial groove.
  • In each half of the tongue there are four extrinsic and four intrinsic muscles.
  • The lingual muscles are all supplied by the hypoglossal nerve (CN XII).
  • The only exception is palatoglossus, which is supplied by the pharyngeal branch of the vagus nerve, via the pharyngeal plexus.

The Medial Wall of the Orbit 

  • This wall is paper-thin and is formed by the orbital lamina or lamina papyracea of the ethmoid bone, along with contributions from the frontal, lacrimal, and sphenoid bones (L. papyraceus, "made of papyrus" or parchment paper).
  • There is a vertical lacrimal groove in the medial wall, which is formed anteriorly by the maxilla and posteriorly by the lacrimal bone.
  • It forms a fossa for the lacrimal sac and the adjacent part of the nasolacrimal duct.
  • Along the suture between the ethmoid and frontal bones are two small foramina; the anterior and posterior ethmoidal foramina.
  • These transmit nerves and vessels of the same name.

The Nasal Mucosa

  • Mucosa lines the entire nasal cavities except for the vestibule of the nose.
  • The nasal mucosa is firmly bound to the periosteum and perichondrium of the supporting structures of the nose.
  • It is continuous with the adjoining cavities to which the nasal cavity communicates (e.g., the nasopharynx and paranasal sinuses).
  • The inferior 2/3 of the nasal mucosa is called the respiratory area and air passing over this is warmed and moistened before it passes into the lungs.
  • The superior 1/3 is called the olfactory area.

The Olfactory Area of Nasal Mucosa

  • This area contains the peripheral organ of smell.
  • Sniffing draws air into this area
  • Olfactory receptor cells (from the olfactory nerve, CN I, are located in the mucosa of this area in the nose.

Nerves to the Respiratory Area of Nasal Mucosa

  • The inferior 2/3 of the nasal mucosa are supplied chiefly by the trigeminal nerve (CN V).
  • The mucous membrane of the nasal septum is supplied chiefly by the nasopalatine nerve, a branch of the maxillary nerve (CN V2).
  • Its anterior portion is supplied by the anterior ethmoidal nerve (a branch of the nasociliary nerve) which is derived from the ophthalmic nerve (CN V1).
  • The lateral walls of the nasal cavity are supplied by branches of the maxillary nerve (CN V2); the greater palatine nerve, and the anterior ethmoidal nerve.

Arteries of the Nasal Mucosa

  • The blood supply of the mucosa of the nasal septum is derived mainly from the maxillary artery.
  • The sphenopalatine artery, a branch of the maxillary, supplies most of the blood of the nasal mucosa.
  • It enters by the sphenopalatine foramen and sends branches to the posterior regions of the lateral wall and to the nasal septum.
  • The greater palatine artery, also a branch of the maxillary, passes through the incisive foramen to supply the nasal septum.
  • The anterior and posterior ethmoidal arteries, branches of the ophthalmic artery, supply the anterosuperior part of the mucosa of the lateral wall of the nasal cavity and nasal septum.
  • Three branches of the facial artery (superior labial, ascending palatine, and lateral nasal) also supply the anterior parts of the nasal mucosa.

Veins of the Nasal Mucosa

  • The veins of the nasal mucosa form a venous network of plexus in the connective tissue of the nasal mucosa.
  • Some of the veins open into the sphenopalatine vein and drain to the pterygoid plexus.
  • Others join the facial and infraorbital veins.
  • Some empty into the ophthalmic veins and drain into the cavernous sinus.

The Middle Ear

 

  • This part of the ear is in a narrow cavity in the petrous part of the temporal bone.
  • It contains air, three auditory ossicles, a nerve and two small muscles.
  • The middle ear is separated from the external acoustic meatus by the tympanic membrane.
  • This cavity includes the tympanic cavity proper, the space directly internal to the tympanic membrane, and the epitympanic recess, the space superior to it.
  • The middle ear is connected anteriorly with the nasopharynx by the auditory tube.
  • Posterosuperiorly, the tympanic cavity connects with the mastoid cells through the aditus ad antrum (mastoid antrum).
  • The tympanic cavity is lined with mucous membrane that is continuous with the mucous membrane of the auditory tube, mastoid cells, and aditus ad antrum.

Contents of the Tympanic Cavity or Middle Ear

  • This cavity contains the auditory ossicles (malleus, incus and stapes); the stapedius and tensor tympani muscles; the chorda tympani nerve (a branch of the facial nerve, CN VII); and the tympanic plexus of nerves.

The Lateral Pterygoid Muscle

  • This is a short, thick muscle that has two heads or origin.
  • It is a conical muscle with its apex pointing posteriorly.
  • Origin: superior head—infratemporal surface and infratemporal crest of the greater wing of the sphenoid bone, inferior head—lateral surface of lateral pterygoid plate.
  • Insertion: neck of mandible, articular disc, and capsule of temporomandibular joint.
  • Innervation: mandibular nerve via lateral pterygoid nerve from anterior trunk, which enters it deep surface.
  • Acting together, these muscles protrude the mandible and depress the chin.
  • Acting alone and alternately, they produce side-to-side movements of the mandible.

  • Bones begin to form during the eighth week of embryomic life in the fibrous membranes (intramembranous ossification) and hyaline cartilage (endochondral ossification)

  •  Provides a rigid support system
  • Protects delicate structures (e. g., the protection provided by the bones of the vertebral column to the spinal cord)
  • Bones supply calcium to the blood; are involved In the formation of blood cells (hemopoiesis)
  • Bones serve as the basis of attachment of muscles; form levers in the joint areas, aIlowing movement

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