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Anatomy - NEETMDS- courses
NEET MDS Lessons
Anatomy

3 basic functions
o    protection of respiratory tract during swallowing food/air pathways cross.
    epiglottis provides protection
o    control intra-thoracic pressure (in coughing) -    close off airway to build pressure then rapidly open to release stuff
o    production of sound (in speaking, singing, laughing)

Important structures

o    hyoid bone
o    thyroid cartilage
o    arytenoids cartilage: vocal and muscle process
    sits on slope on posterior side of cricoid - spin and slide
o    cricoid cartilage: signet ring
o    thyroepiglottic ligament

Membranes and ligaments

o    membrane: general; ligament: thickening of membrane
o    folds: free edges of membranes or ligaments
o    names: tell you where located

Important membranes:
    quandrangular/vestibular membrane—from epiglottis to arytenoids
•    inferior edge: false vocal fold
    thyrohyoid membrane
    conus elasticus = cricothyroid = cricovocal
•    superior/medial edge = vocal fold
•    vocal ligaments: true folds, top of cricothyroid membrane

Endochondral ossification

  • A cartilage model exists
  • Through intramembraneous ossification in the perichondrium a collar of bone forms around the middle part of the cartilage model
  • The perichondrium change to a periostium
  • The bone collar cuts off the nutrient and oxygen supply to the chondrocytes in the cartilage model
  • The chondrocytes then increase in size and resorb the surrounding cartilage matrix until only thin vertical septae of matrix are left over
  • These thin plates then calcify after which the chondrocytes die
  • The osteoclasts make holes in the bone collar through which blood vessels can now enter the cavities left behind by the chondrocytes
  • With the blood vessels osteoprogenitor cells enter the tissue
  • They position themselves on the calcified cartilage septae, change into osteoblasts and start to deposit bone to form trabeculae
  • In the mean time the periosteum is depositing bone on the outside of the bone collar making it thicker and thicker
  • The trabeculae,consisting of a core of calcified cartilage with bone deposited on top of it, are eventually resorbed by osteoclasts to form the marrow cavity
  • The area where this happens is the primary ossification centre and lies in what is called the diaphysis (shaft)
  • This process spreads in two directions towards the two ends of the bone the epiphysis
  • In the two ends (heads) of the bone a similar process takes place
  • A secondary ossification centre develops from where ossification spreads radially
  • Here no bone collar forms
  • The outer layer of the original cartilage remains behind to form the articulating cartilage
  • Between the primary and the secondary ossification centers two epiphyseal cartilage plates remain
  • This is where the bone grows in length
  • From the epiphyseal cartilage plate towards the diaphysis a number of zones can be identified:

 Resting zone of cartilage

 Hyaline cartilage

 Proliferation zone

 Chondrocytes divide to form columns of cells that mature.

Hypertrophic cartilage zone

 Chondrocytes become larger, accumulate glycogen, resorb the surrounding matrix so that only thin septae of cartilage remain 

Calcification and degeneration zone

The thin septae of cartilage become calcified.

The calsified septae cut off the nutrient supply to the chondrocytes so subsequently they die.

Ossification zone.

Osteoclasts make openings in the bone collar through which blood vessels then invade the spaces left vacant by the chondrocytes that died.

Osteoprogenitor cells come in with the blood and position themselves on the calcified cartilage

septae, change into osteoblasts and start to deposit bone.

 When osteoblasts become trapped in bone they change to osteocytes.

Growth and remodeling of bone

Long bones become longer because of growth at the epiphyseal plates

They become wider because of bone formed by the periosteum

The marrow cavity becomes bigger because of resorbtion by the osteoclasts

Fracture repair

When bone is fractured a blood clot forms

 Macrophages then remove the clot, remaining osteocytes and damaged bone matrix

The periosteum and endosteum produce osteoprogenitor cells that form a cellular tissue in the fracture area

 Intramembranous and endochondral ossification then take place in this area forming trabeculae.

Trabeculae connect the two ends of the broken bone to form a callus

Remodelling then takes place to restore the bone as it was

Joints

The capsule of a joint seals off the articular cavity,  

The capsule has two layers

 fibrous (outer)

synovial (inner)

The synovial layer is lined by squamous or cuboidal epithelial cells,  Under this layer is a layer of loose or dense CT, The lining cells consists of two types:

- A cells

- B cells

They secrete the synovial fluid

They are different stages of the same cell, They are also phagocytic., The articular cartilage has fibres that run perpendicular to the bone and then turn to run parallel to the surface

 

CARTILAGE

There are 3 types:

Hyaline cartilage
Elastic cartilage
Fibrocartilage

Matrix is made up by: Hyaluronic acid

Proteoglycans

 

- In cartilage the protein core of the proteoglycan molecule binds through a linking protein to hyaluronic acid to form a proteoglycan aggregate which binds to the fibres

- In the matrix there are spaces, lacunae in which one to three of the cells of cartilage, chondrocytes, are found

- The matrix around the lacuna is the territorial matrix

- Type II collagen fibrils are embedded in the matrix

- The type of fiber depends on the type of cartilage

- Cartilage is surrounded by perichondrium which is a dense CT

- Apositional growth takes place in the perichondrium

- The fibroblasts of the perichondrium change to elliptic chondroblasts which later change to round chondrocytes

- Interstitial growth takes place around the lacunae

- Nutrients diffuse through the matrix to get to the chondrocytes   this limits the thickness of cartilage

Hyaline cartilage

Found: Rib cartilage,  articulating surfaces,  nose,  larynx, trachea, embryonic skeleton, Articulating cartilage has no perichondrium

 Bluish-white and translucent

Contains type II collagen that is not visible

 

Elastic cartilage

Found:  external auditory canal,  epiglottis

Similar to hyaline except that it contains many elastic fibres ,Yellow in colour,  Can be continuous with hyaline

Fibrocartilage

Found: Intervertebral disk, symphysis pubis

Always associated with dense CT,  Many collagen fibres in the matrix, No perichondrium

- Chondrocytes tend to lie in rows, Can withstand strong forces

Skull bones

 

  • 26 bones: 22 bones + hyoid (small bone in neck for swallowing) + 3 auditory ossicles (middle ear: incus, malleus, stapes)
  • 21 bones: tightly connected; mandible is freely mobile at temperomandibular joint (synovial)
  • connective-tissue interface b/w bones = suture
  • bones – mandible = cranium
  • cranium
    • neurocranium: covers brain anteriorly, laterally and posteriorly
    • brain supported by bones of basicranium
      • also contributes to interorbital region; b/w eyes and superior to nasal passages
    • viscerocranium/splanchnocranium: bones of face
  • sutures
    • coronal: separates frontal from parietals
    • sagittal: separates two parietal bones
    • lambdoidal: separates parietal form occipital
    • squamosal: b/w temporal and parietal; overlapping sutures
    • At birth: 2 frontal bones which eventually fuse; metopic suture disappears

Cranial Cavities: 5 major cavities

            Endocranial, left and right orbits, nasal cavities, oral cavity, middle ear cavities

Endocranial cavity

  • contains brain, meninges, cerebrospinal fluid, brain’s vascular supply and most proximal portion of cranial nerves
  • enclosed by neurocranium and basicranium
  • basicranium: foramina for neurovascular bundles
  • foramen magnum: spinal cord exit
  • floor of endocranial cavity divide into fossae
    • anterior: frontal lobes of brain
    • middle: pair temporal lobes
    • posterior: cerebellum and brainstem

The Lateral Wall of the Orbit

  • This wall is thick, particularly its posterior part, which separates the orbit from the middle cranial fossa.
  • The lateral wall is formed by the frontal process of the zygomatic bone and the greater wing of the sphenoid bone.
  • Anteriorly, the lateral wall lies between the orbit and the temporal fossa.
  • The lateral wall is partially separated from the roof by the superior orbital fissure.

- The forehead is formed by the smooth, broad, convex plate of bone called the frontal squama.
- In foetal skulls, the halves of the frontal squama are divided by a metopic suture.
- In most people, the halves of the frontal bone begin to fuse during infancy and the suture between is usually not visible after 6 years of age.
- The frontal bone forms the thin roof of the orbits (eye sockets).
- Just superior to and parallel with each supraorbital margin is a bony ridge, the superciliary arch, which overlies the frontal sinus. This arch is more pronounced in males.
- Between these arches there is a gently, rounded, medial elevation called the gabella; this term derives from the Latin word glabellus meaning smooth and hairless. In most people, the skin over the gabella is hairless.
-The slight prominences of the forehead on each side, superior to the superciliary arches, are called frontal eminences (tubers).
- The supraorbital foramen (occasionally a notch), which transmits the supraorbital vessels and nerve is located in the medial part of the supraorbital margin.
- The frontal bone articulates with the two parietal bones at the coronal suture.
-It also articulates with the nasal bones at the frontonasal suture. At the point where this suture crosses the internasal suture in the medial plane, there is an anthropological landmark called the nasion . The depression is located at the root of the nose, where it joins the cranium.
- The frontal bone also articulates with the zygomatic, lacrimal, ethmoid, and sphenoid bones.
In about 8% of adult skulls, a remnant of the inferior part of the metopic (interfrontal) suture is visible. It may be mistaken in radiographs for a fracture line by inexperienced observers.
- The superciliary arches are relatively sharp ridges of bone and a blow to them may lacerate the skin and cause bleeding.
- Bruising of the skin over a superciliary arch causes tissue fluid and blood to accumulate in the surrounding connective tissue, which gravitates into the upper eyelid and around the eye. This results in swelling and a "black eye".
- Compression of the supraorbital nerve as it emerges from its foramen causes considerable pain, a fact that may be used by anaesthesiologists and anaesthetists to determine the depth of anaesthesia and by physicians attempting to arouse a moribund patient.

 

The Submandibular Glands

  • Each of these U-shaped salivary glands is about the size of a thumb and lies along the body of the mandible.
  • It is partly superior and partly inferior to the posterior 1/2 of the base of the mandible.
  • It is partly superficial and partly deep to the mylohyoid muscle.
  • The submandibular duct arises from the portion of the gland that lies between the mylohyoid and hyoglossus muscle.
  • The duct passes deep and then superficial to the lingual nerve.
  • It opens by one to three orifices on a small sublingual papilla beside the lingual frenulum.
  • The submandibular gland is supplied by parasympathetic, secretomotor fibres from the submandibular ganglion (preganglionic fibres from the chorda tympani via the lingual nerve).

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