The Auditory Ossicles

The Malleus

• Its superior part, the head, lies in the epitympanic recess.
• The head articulates with the incus.

• The neck, lies against the flaccid part of the tympanic membrane.
• The chorda tympani nerve crosses the medial surface of the neck of the malleus.

• The handle of the malleus (L. hammer) is embedded in the tympanic membrane and moves with it.
• The tendon of the tensor tympani muscle inserts into the handle.

The Incus

• Its large body lies in the epitympanic recess where it articulates with the head of the malleus.
• The long process of the incus (L. an anvil) articulates with the stapes.
• The short process is connected by a ligament to the posterior wall of the tympanic cavity.

The Stapes

• The base (footplate) of the stapes (L. a stirrup), the smallest ossicle, fits into the fenestra vestibuli or oval window on the medial wall of the tympanic cavity.

Functions of the Auditory Ossicles

• The auditory ossicles increase the force but decrease the amplitude of the vibrations transmitted from the tympanic membrane.

​​​​​​​The Tongue

• The tongue (L. lingua; G. glossa) is a highly mobile muscular organ that can vary greatly in shape.
• It consists of three parts, a root, body, and tip.
• The tongue is concerned with mastication, taste, deglutition (swallowing), articulation (speech), and oral cleansing.
• Its main functions are squeezing food into the pharynx when swallowing, and forming words during speech.

Muscles Around the Eyelids

• The function of the eyelid (L. palpebrae) is to protect the eye from injury and excessive light. It also keeps the cornea moist.

The Orbicularis Oculi Muscle

• This is the sphincter muscle of the eye.
• Its fibres sweep in concentric circles around the orbital margin and eyelids.
• It narrows the eye and helps the flow of tears from the lacrimal sac.

• This muscle has 3 parts: (1) a thick orbital part for closing the eyes to protect then from light and dust; (2) a thin palpebral part for closing the eyelids lightly to keep the cornea from drying; and (3) a lacrimal part for drawing the eyelids and lacrimal punta medially.

• When all three parts of the orbicularis oculi contract, the eyes are firmly closed and the adjacent skin becomes wrinkled.
• The zygomatic branch of the facial nerve (CN VII) supplies it.

The Levator Palpebrae Superioris Muscle

• This muscle raises the upper eyelid to open the palpebral fissure.
• It is supplied by the oculomotor nerve (CN III).

The Orbital Margin

• The frontal, maxillary and zygomatic bones contribute equally to the formation of the orbital margin.

• The supraorbital margin is composed entirely of the frontal bone.
• At the junction of its medial and middle thirds is the supraorbital foramen (sometimes a notch), which transmits the supraorbital nerves and vessels.

• The lateral orbital margin is formed almost entirely of the frontal process of the zygomatic bone.

• The infraorbital margin is formed by the zygomatic bone laterally and the maxilla medially.

• The medial orbital margin is formed superiorly by the frontal bone and inferiorly by the lacrimal crest of the frontal process of the maxilla.
• This margin is distinct in its inferior half only.

• 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.

Muscles of the Soft Palate

The Levator Veli Palatini (Levator Palati)

• Superior attachment: cartilage of the auditory tube and petrous part of temporal bone.
• Inferior attachment: palatine aponeurosis.
• Innervation: pharyngeal branch of vagus via pharyngeal plexus.

• This cylindrical muscle runs inferoanteriorly, spreading out in the soft palate, where it attaches to the superior surface of the palatine aponeurosis.

• It elevates the soft palate, drawing it superiorly and posteriorly.
• It also opens the auditory tube to equalise air pressure in the middle ear and pharynx.

The Tensor Veli Palatini (Tensor Palati)

• Superior attachment: scaphoid fossa of medial pterygoid plate, spine of sphenoid bone, and cartilage of auditory tube.
• Inferior attachment: palatine aponeurosis.
• Innervation: medial pterygoid nerve (a branch of the mandibular nerve).

• This thin, triangular muscle passes inferiorly, and hooks around the hamulus of the medial pterygoid plate.
• It then inserts into the palatine aponeurosis.

• This muscle tenses the soft palate by using the hamulus as a pulley.
• It also pulls the membranous portion of the auditory tube open to equalise air pressure of the middle ear and pharynx.

The Palatoglossus Muscle

• Superior attachment: palatine aponeurosis.
• Inferior attachment: side of tongue.
• Innervation: cranial part of accessory nerve (CN XI) through the pharyngeal branch of vagus (CN X) via the pharyngeal plexus.

• This muscle, covered by mucous membrane, forms the palatoglossal arch.

• The palatoglossus elevates the posterior part of the tongue and draws the soft palate inferiorly onto the tongue.

• Superior attachment: hard palatThe Palatopharyngeus Musclee and palatine aponeurosis.
• Inferior attachment: lateral wall of pharynx.
• Innervation: cranial part of accessory nerve (CN XI) through the pharyngeal branch of vagus (CN X) via the pharyngeal plexus.

• This thin, flat muscle is covered with mucous membrane to form the palatopharyngeal arch.
• It passes posteroinferiorly in this arch.

• This muscle tenses the soft palate and pulls the walls of the pharynx superiorly, anteriorly and medially during swallowing.

The Musculus Uvulae

• Superior attachment: posterior nasal spine and palatine aponeurosis.
• Inferior attachment: mucosa of uvula.
• Innervation: cranial part of accessory through the pharyngeal branch of vagus, via the pharyngeal plexus.

• It passes posteriorly on each side of the median plane and inserts into the mucosa of the uvula.
• When the muscle contracts, it shortens the uvula and pulls it superiorly.